Exploring empathy revitalization in nursing education: A game-based study

Empathy is fundamental to nursing practice, yet sustaining empathic engagement remains a pedagogical challenge in demanding clinical environments. This study introduces a novel game-based intervention designed to facilitate emotional expression and reflection through guided interaction.

This study evaluated an empathy-focused board game, specifically developed by the authors, as a pedagogical strategy. We explored participants' meaning-making during scenario-based play and examined the perceived value of this approach in supporting clinical practice. Finally, we considered the implications for nursing education and professional development.

A qualitative study using interpretative phenomenological analysis (IPA) was conducted. Purposeful sampling recruited 82 registered nurses from five hospitals in northern and central Taiwan (aged 21-41 years). Learning sessions included free writing, role play, and guided discussion. Audio-recorded dialogue and written reflections were analyzed iteratively to identify patterns of meaning.

Findings were organized into the Empathy Competence Cycle in Nursing, comprising depletion and revitalization phases. The depletion phase included three interrelated themes: (1) compassion fatigue exhausting empathy; (2) perceived medical hierarchy shaping empathic expression; and (3) emotional burden arising from societal and professional role expectations. The revitalization phase comprised three processes: facilitating emotional expression, promoting reflection, and fostering empathic re-engagement.

Empathy was experienced as a fluctuating, context-dependent relational capacity. The board game provided a novel, non-evaluative "third space" for emotional articulation and peer reflection, which participants linked to sustaining empathic engagement in challenging clinical contexts. Integrating structured reflective game-based learning into nursing education and professional development could support nurses' ongoing empathic practice and well-being.