Caring is a cornerstone of nursing.  But how do we teach it?  

First, I strongly believe that modeling these behaviors is an essential first step in teaching caring and empathy.  We can start by abandoning the feared nursing instructor persona and showing empathy and kindness to students. 

Next, I think it is important to distinguish between empathy and sympathy. Sympathy is feeling the same emotions as another. We cannot make students “feel” a certain way. But empathy is seeking to understand how another is feeling. And this a skill that can be taught. But like any skill, it needs to be practiced. In the spirit of active learning, the brain that does the work does the learning.  The creation of an empathy map can help students to develop this skill.

Here is how to quickly and easily implement this activity.

The first step is to decide on a patient persona.  I use this exercise when we discuss COPD.  Begin by finding a picture of a patient.  Then build a bit of a story around them.

Below is the example that I use


Next, draw a simple grid on a whiteboard or using the document camera.

Example of an Empathy Map

Finally, begin filling in the boxes.  You can use prompting questions to help students come up with ideas.

SAYS Quadrant

  • Think of things this patient may directly say to you when you enter the room or ask how they are.
  • This patient may say “I can’t breathe” or “Is my oxygen on?”  Think of these as direct quotes that the patient would actually say.

THINKS Quadrant

  • This involves getting into the patient’s inner voice.  What are they saying to themselves but not out loud?  What would they be reluctant to share because they are self-conscious, afraid or being polite?
  • This patient may say “I’m afraid of dying” or “I just want to get out of here.”  

DOES Quadrant

  • This asks the student to think of what the patient physically does.  What do they do when you leave the room?  What do they do once they are discharged?
  • This patient may leave and smoke a cigarette.  They may cry about their hopeless situation.

FEELS Quadrant

  • This aims to understand how the patient is feeling.  What are they worried about?  What are they excited about?  How do they feel about their hospital experience?
  • This patient may be worried about moving to assisted living and not having anyone to care for his dog.  They may want to go home more than anything but can’t stand in the kitchen long enough to cook a meal. 

Work to develop a deeper understanding of the patient’s choices

Once the chart is finished, try to ask more questions to gain a deeper understanding.  In this scenario, students may view the patient’s smoking as soon as they leave as an insult or that they don’t really care about their health.  But challenging them to see smoking as a comfortable behavior, when they have been in a highly uncomfortable situation.  Is it possible that they can be concerned about their health and still need the comfort of something familiar?  Encourage students to explore this the next time they encounter a patient who is non-compliant.  

Empathy and caring can be taught

Empathy can be modeled and taught.  This activity will take about 15 minutes and seamlessly blend your course content for the day with the art of caring.

Where does this activity work best?

Any classroom or clinical experience can benefit from discussing empathy and caring behaviors.

Ideas for Variations

This activity can be easily translated to online live or asynchronous classrooms.  For asynchronous online classes, you could set up this activity as a discussion board (written or video) and have students respond to their peer’s ideas.  

In clinical, you could add this empathy map to clinical paperwork of complete it as part of a post conference activity.

Just like any skill, caring and empathy can be practiced and mastered by nursing students.

I have always loved the art of nursing. It can be the perfect blend of clinical knowledge and compassionate bedside presence. But we need to give our students the opportunity to practice this. Just like we do for IV starts and lung sounds. Look for opportunities to ask students these questions and allow them time for reflection to understand how a patient is feeling.

Did you know we have a community?

Head over to the ACTIVE LEARNING STRATEGIES FOR NURSE EDUCATORS Facebook group for more ideas and inspiration!

Martha Johnson is the charge nurse over at BreakoutRN

Martha Johnson MSN, RN, CEN

Charge nurse over at BreakoutRN with a focus on helping other nursing educators transition from lecture to active learning.  She believes it does not have to be hard or overwhelming, just take it one activity at a time 💜

Looking for more inspiration and active learning techniques?

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