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Updated: Aug 24, 2026

Using Visual and Narrative Methods to Achieve Fair Process in Clinical Care
14:32

Using Visual and Narrative Methods to Achieve Fair Process in Clinical Care

Published on: February 16, 2011

Visualized Standardized Narrative Communication Training for Empathy and Reflective Practice Among Outpatient Nurses:

Keyu Chen1, Haiyan Wang2, Qiuying Peng1

  • 1Outpatient Department, Beijing Anzhen Nanchong Hospital of Capital Medical University & Nanchong Central Hospital.

Journal of Visualized Experiments : Jove
|August 22, 2026
PubMed

Outpatient nurses frequently work under substantial time constraints and high emotional demands, making consistent empathic and reflective communication difficult. This nonrandomized controlled pre-post study evaluated whether a visualized, standardized narrative nursing communication technique (SNNCT) was associated with improvements in empathy, reflective practice, communication performance, and patient communication experience among outpatient nurses. Sixty-eight outpatient nurses at a tertiary hospital in Nanchong, Sichuan, China, were assigned nonrandomly to the intervention group (n = 38) or the control group (n = 30). The intervention combined standardized narrative communication training with visual workflow tools, including flowcharts, and structured reflective debriefing. Outcomes included nurse-reported empathy, reflective practice, communication self-efficacy, patient-centered values, patient-reported communication experience, implementation fidelity, and observer-rated communication quality. Mixed-effects models and mediation analyses evaluated intervention effects. Compared with the control group, nurses receiving SNNCT showed greater improvements in empathy, reflective practice, communication self-efficacy, reflective competence, implementation fidelity, observer-rated communication quality, and patient-reported communication experience. Mediation analyses indicated that improvements in empathy and reflective practice partially explained improvements in patient communication experience. These findings suggest that visualized, standardized narrative communication training may strengthen humanistic communication and support high-quality outpatient nursing care in busy clinical settings.

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