Education and Ethics In Nursing ISSN: 2322-5300

Analyzing the effect of reflective notes on the empathy of nursing students in oncology internship: a mixed study

https://doi.org/10.22034/ethic.2025.2063270.1179
Volume 14, 3-4
October 2025
Pages 40-50
Education and Ethics In Nursing ISSN: 2322-5300

Document Type : Original Article

Authors

Elaheh Ashori 1
Maryam Bagheri 1
Nayereh Naseri 2
Akram Mohammadi Pelarti 3

1 Nursing and Midwifery Care Research Center, Department of Medical Surgical Nursing, School of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran

2 Islamic azad university, najafabad branch, medical surgical nursing, Isfahan, Iran

3 Isfahan University of Medical Sciences, Klishad Hospital, Isfahan, Iran

Abstract
Introduction: Empathy is a vital component of the nurse–patient relationship and a cognitive attribute that facilitates understanding of patients’ experiences, concerns, and perspectives. Its development is essential in nursing education. While supportive interventions, student preparedness, communication skills, and well-designed educational strategies contribute to improved attitudes and experiences among nursing students in cancer care settings, many still find caring for cancer patients undergoing complex treatments to be challenging. Therefore, this study aimed to explore the impact of a reflective intervention on the empathy levels of nursing students during oncology internships.
Method and Materils: This single-group pre-test/post-test study utilized qualitative content analysis to examine the perspectives of nursing students through reflective writing. A total of 65 fifth- and seventh-semester nursing students were recruited via convenience sampling from Isfahan University of Medical Sciences and Najafabad Azad University during the second academic semester of 2019–2020. The students completed the Persian version of the Jefferson Scale of Empathy for Nursing Students before and after the intervention. Their written reflections were analyzed using the conventional content analysis method described by Graneheim and Lundman (2004).
Results: The findings revealed no statistically significant difference in empathy scores before and after the oncology internship (P > 0.05). Content analysis of barriers identified three main categories—environmental influences, ineffective resilience, and emotional empathy—with eight subcategories.
Conclusion: This study suggests that the complexities of clinical education and the interaction with cancer patients require structured support programs for nursing students during oncology internships. It also recommends that psychological dimensions and personal characteristics of students be considered in designing interventions that foster cognitive empathy and self-awareness throughout clinical education.
 

Keywords

Clinical education
Oncology ward
Nursing students
Empathy
Subjects
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