Effects of an embodied micro-film intervention on ethical sensitivity, compassion, and ethical decision-making in...

Bridging the "knowing-doing gap" remains a central challenge in nursing ethics education. Traditional didactic methods often position students as disembodied observers, limiting the transformation of ethical knowledge into practical competence.

To address the "knowing-doing gap" in ethics education, this study aimed to develop and evaluate an innovative micro-film intervention, guided by embodied cognition theory, and to assess its impact on key components of nursing ethical competence.

A mixed methods study employing a two-arm cluster-assigned quasi-experimental design with an embedded qualitative component.

A nursing school at a medical university in China.

A total of 282 third-year undergraduate nursing students were cluster-randomised into an experimental group (n = 142) and a control group (n = 140).

A 16-week embodied micro-film intervention was administered to the experimental group, and traditional lecture-based instruction was delivered to the control group. Validated instruments, including the Ethical Sensitivity Questionnaire for Nursing Students, the Compassionate Love for Humanity Scale, and the Judgments about Nursing Decisions questionnaire, were administered at baseline and post-intervention. Qualitative data were collected from reflective journals submitted by the experimental group. Data were analysed using SPSS version 26.0, with paired and independent t-tests and mixed-design ANOVA for quantitative directed content analysis for qualitative responses.

Compared with the control group, the experimental group demonstrated significantly greater improvements in ethical sensitivity (t = 8.741, p < .001, d = 1.04), compassionate tendency (t = 4.663, p < .001, d = 0.56), and overall ethical decision-making ability (t = 6.634, p < .001, d = 0.79). In addition, a significant reduction in the knowing doing gap of the JAND was observed only in the experimental group (p < .05). Qualitative findings revealed four interrelated mechanisms underpinning these changes: transforming abstract ethical principles into embodied understanding, cultivating empathy through simulated lived experience, strengthening ethical decision-making in contextualized dilemmas, and showing preliminary potential in narrowing the knowing-doing gap through bodily rehearsal and anticipatory reflection.

An embodied micro-film-based pedagogy represents an effective and theory-informed innovation in nursing ethics education. By integrating bodily engagement, situated interaction, and reflective learning, this approach facilitates the internalisation and enactment of ethical competence, offering a promising strategy for narrowing the knowing-doing gap in undergraduate nursing education.