Background Rapid population aging has intensified the complexity of gerontological nursing care, highlighting the need for educational approaches that foster empathy and reduce ageist attitudes among nursing students. Narrative medicine has been proposed as a humanistic pedagogy to enhance perspective-taking; however, its integration within structured instructional models in nursing education remains underexplored. Objective: This study aimed to describe within-cohort changes in empathy and ageist attitudes among undergraduate nursing students following participation in a narrative-medicine module structured using the BOPPPS instructional framework, and to examine the association between these two constructs. Methods A quasi-experimental, one-group pretest–post test design was employed in a compulsory undergraduate nursing course. A total of 120 nursing students participated. Empathy was measured using the Jefferson Scale of Empathy–Health Professions Student version, and ageism was assessed using the Chinese version of the Fraboni Scale of Ageism. Paired-samples t tests were used to examine pre–post changes, and correlation and exploratory regression analyses were conducted to summarize associations between empathy and ageism. Results Mean empathy scores increased from pre-test to post-test (mean difference = 0.45, 95% CI [0.33, 0.57]; t = 7.18, p < 0.001), while mean ageism scores decreased (mean difference = − 0.40, 95% CI [− 0.53, − 0.27]; t = − 6.02, p < 0.001), reflecting small-to-moderate effect sizes. Post-intervention empathy was moderately and negatively associated with ageism (r = − 0.42, p < 0.001). Exploratory regression analysis indicated that empathy accounted for a modest proportion of variance in ageist attitudes (B = − 0.34, p < 0.001). Conclusions These findings describe modest within-cohort changes and associations observed following a narrative-based instructional module delivered within a structured teaching framework. Given the one-group pre–post design and the compulsory course context, results should be interpreted cautiously due to predictable threats to internal validity, including testing and maturation effects. The proposed CARE-AGE framework is therefore presented as an evidence-informed conceptual curriculum model rather than a validated intervention. The study contributes descriptive insight into how theory-guided narrative pedagogy may be situated within gerontological nursing education.

A BOPPPS-structured narrative medicine intervention to enhance empathy and reduce ageism among undergraduate nursing students

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2026年4月9日

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Shuai Li

摘要

Background

Rapid population aging has intensified the complexity of gerontological nursing care, highlighting the need for educational approaches that foster empathy and reduce ageist attitudes among nursing students. Narrative medicine has been proposed as a humanistic pedagogy to enhance perspective-taking; however, its integration within structured instructional models in nursing education remains underexplored. Objective: This study aimed to describe within-cohort changes in empathy and ageist attitudes among undergraduate nursing students following participation in a narrative-medicine module structured using the BOPPPS instructional framework, and to examine the association between these two constructs.

Methods

A quasi-experimental, one-group pretest–post test design was employed in a compulsory undergraduate nursing course. A total of 120 nursing students participated. Empathy was measured using the Jefferson Scale of Empathy–Health Professions Student version, and ageism was assessed using the Chinese version of the Fraboni Scale of Ageism. Paired-samples t tests were used to examine pre–post changes, and correlation and exploratory regression analyses were conducted to summarize associations between empathy and ageism.

Results

Mean empathy scores increased from pre-test to post-test (mean difference = 0.45, 95% CI [0.33, 0.57]; t = 7.18, p < 0.001), while mean ageism scores decreased (mean difference = − 0.40, 95% CI [− 0.53, − 0.27]; t = − 6.02, p < 0.001), reflecting small-to-moderate effect sizes. Post-intervention empathy was moderately and negatively associated with ageism (r = − 0.42, p < 0.001). Exploratory regression analysis indicated that empathy accounted for a modest proportion of variance in ageist attitudes (B = − 0.34, p < 0.001).

Conclusions

These findings describe modest within-cohort changes and associations observed following a narrative-based instructional module delivered within a structured teaching framework. Given the one-group pre–post design and the compulsory course context, results should be interpreted cautiously due to predictable threats to internal validity, including testing and maturation effects. The proposed CARE-AGE framework is therefore presented as an evidence-informed conceptual curriculum model rather than a validated intervention. The study contributes descriptive insight into how theory-guided narrative pedagogy may be situated within gerontological nursing education.