Connectivity between ethical sensitivity and empathy ability of nursing students at the initial stage of internship:...

This study utilized network analysis methods to examine the connection nodes and network correlation characteristics between the ethical sensitivity and empathy skills of nursing students at the beginning of their internship. The interaction mechanism between these two constructs was clarified, thereby providing empirical support for the cultivation of humanistic literacy in clinical nursing education.

A cross-sectional survey design was adopted from August to September 2025, employing cluster sampling to select 355 nursing students in the early stages of their clinical internship from a tertiary hospital in Zibo City. The Jefferson Scale of Empathy for Healthcare Providers (JSE-HP) and the Nursing Student Ethical Sensitivity Questionnaire (ESQ-NS) were administered to assess the participants. Network analysis was then conducted to construct symptom networks and identify core and bridge symptoms.

The ethical sensitivity score for nursing students at the outset of their internship was 39 (interquartile range: 36, 42), while the average score for empathy ability was 98.19 ± 14.82. Network analysis revealed that items A5, A6, A7, and A13 (representing Items 5, 6, 7, and 13 of the ethical sensitivity scale) and items B1, B6, and B11 (representing Items 1, 6, and 11 of the empathy scale) serve as key bridge connection nodes. These nodes establish a core network path characterized by "emotional perception-ethical decision-making-action implementation."

Nursing students at the commencement of their internship demonstrate a medium level of ethical sensitivity, while their empathy ability is relatively high. The identified bridge connection nodes play a pivotal role in maintaining the network linkage between ethical sensitivity and empathy skills. Clinical teaching should emphasize ethical dilemmas related to these bridge connections through scenario-based instruction, thereby enhancing the integration of both competencies. This approach will support the development of professional rationality and humanistic care as essential components of nursing students' career literacy.