The DOI matches its Crossref record; 41 of the 41 references it cites were found in a registry or an index.
Narrative medicine as a teaching strategy for nursing students to developing professionalism, empathy and humanistic caring ability: a randomized controlled trial
Open accessAbstract
Background: Narrative medicine has become a solution to cultivate medical students’ ability of empathy and humanistic care. However, the role of narrative medicine is lacking in the study of professionalism. The aim of this study was to analyze the effects of narrative medical theory learning and narrative writing on professionalism, empathy and humanistic care ability of nursing students. Methods: This cluster randomized controlled trial was conducted between June 2021 and June 2022 in two universities in Jiangsu, China. The participants of this study were 85 nursing students who were randomly divided into the intervention group ( n = 43) or the control group ( n = 42). Participants in the intervention group were trained in narrative medical theory learning and narrative writing based on a Web-based platform, while those in the control group were not. Self-report questionnaires of professionalism, empathy and humanistic care ability were used before and after intervention. Results: The results showed that the professionalism score of the intervention group was (68.7 ± 6.8 vs. 64.5 ± 7.5; P = 0.005), empathy (99.4 ± 15.7 vs. 92.2 ± 14.6; P = 0.014) and humanistic care ability (127.6 ± 20.0 vs. 113.3 ± 18.8; P = 0.004) were better than the control group. Conclusion: The results of this quantitative study suggest that narrative medical theory education and narrative writing based on the network platform can promote the development of professionalism, empathy and humanistic care ability of nursing undergraduates.
Overview
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Integrity signals
Registry
Cites
Statistics
Figures
Verification
Claims the paper makes
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
The source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
In the citing paper
“These studies indicate that the long-term stability of teaching outcomes and the efficiency of translating knowledge comprehension into clinical decision-making capabilities remain critical challenges to be addressed [11–21].”
From Exploring the integration of AI and national quality courses in China: a study on teaching practices in nursing smart education (2025) · cites this paper as [12]
Experimental — accuracy not yet measured
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
The self-check needs the paper’s full text.
Citations
Cites
Consort 2010 statement: extension to cluster randomised trials
Campbell, M. K., Piaggio, G., Elbourne, D. R., Altman, D. G., & for the CONSORT Group (2012) · BMJ · doi:10.1136/bmj.e5661 · Cited by 3,510
Charon, R. (2001) · JAMA · doi:10.1001/jama.286.15.1897 · Cited by 2,351
The Devil is in the Third Year: A Longitudinal Study of Erosion of Empathy in Medical School
Hojat, M., Vergare, M. J., Maxwell, K., Brainard, G. C., Herrine, S. K., Isenberg, G. A., Veloski, J. J., & Gonnella, J. S. (2009) · Academic Medicine · doi:10.1097/acm.0b013e3181b17e55 · Cited by 1,673 · cited 1×
“showed that the level of empathy did not change during the first 2 years of medical education, however, at the end of the third year, medical students showed a significant decline in empathy and this decline persisted until graduation, notably, the weakening of empathy occurred when the course was directed towards pat…”
BackgroundProfessionalization and Bureaucratization
Hall, R. H. (1968) · American Sociological Review · doi:10.2307/2092242 · Cited by 1,265
The Effects of Physician Empathy on Patient Satisfaction and Compliance
Kim, S. S., Kaplowitz, S., & Johnston, M. V. (2004) · Evaluation & the Health Professions · doi:10.1177/0163278704267037 · Cited by 1,063 · cited 1×
“There is growing evidence that improved empathy during clinical practice increases patient adherence to treatment and patient satisfaction and builds positive relationships between nurses and patients, leading to more effective treatment outcomes [25, 26].”
BackgroundEffectiveness of empathy in general practice: a systematic review
Derksen, F., Bensing, J., & Lagro-Janssen, A. (2013) · British Journal of General Practice · doi:10.3399/bjgp13x660814 · Cited by 1,034 · cited 1×
“Empathy is a multidimensional concept that includes emotional, cognitive, moral, behavioral and relational dimensions [21].”
BackgroundNursing: human science and human care. A theory of nursing.
Watson, J. (1988) · PubMed · Cited by 895
Narrative medicine as a medical education tool: A systematic review
Milota, M., van Thiel, G. J. M. W., & van Delden, J. J. M. (2019) · Medical Teacher · doi:10.1080/0142159x.2019.1584274 · Cited by 337 · cited 4×
“To help healthcare professionals truly understand patients from different perspectives and experience their inner feelings in future clinical practice, so as to improve the level of humanistic literacy [2].”
BackgroundInfluentialLiu, W., Zhao, S., Shi, L., Zhang, Z., Liu, X., Li, L., Duan, X., Li, G., Lou, F., Jia, X., et al. (2018) · BMJ Open · doi:10.1136/bmjopen-2017-019525 · Cited by 334 · cited 1×
“However, in the clinical environment, nursing students are faced with the high turnover rate of nurses, negative doctor-patient relationship, frequent workplace violence and other situations [16, 17], leading to cognitive deviation of nursing profession [18], which is not conducive to the cultivation of their professi…”
BackgroundThe Empathy Enigma: An Empirical Study of Decline in Empathy Among Undergraduate Nursing Students
Ward, J., Cody, J. W., Schaal, M., & Hojat, M. (2012) · Journal of Professional Nursing · doi:10.1016/j.profnurs.2011.10.007 · Cited by 321 · cited 1×
“found the greatest decline in empathy levels among those students with the most clinical exposure and those with healthcare work experience [12].”
BackgroundNarrative medicine as a means of training medical students toward residency competencies
Arntfield, S., Slesar, K., Dickson, J., & Charon, R. (2013) · Patient Education and Counseling · doi:10.1016/j.pec.2013.01.014 · Cited by 265
Watson, J. (2007) · Texto & Contexto - Enfermagem · doi:10.1590/s0104-07072007000100016 · Cited by 219
Reliability and Validity of the Jefferson Scale of Empathy in Undergraduate Nursing Students
Ward, J., Schaal, M., Sullivan, J., Bowen, M. E., Erdmann, J. B., & Hojat, M. (2009) · Journal of Nursing Measurement · doi:10.1891/1061-3749.17.1.73 · Cited by 186 · cited 1×
“[37], is divided into three dimensions of perspective taking, compassionate care, and standing in patient’s shoes, with 20 items.”
BackgroundReflective writing and its impact on empathy in medical education: systematic review
Chen, I., & Forbes, C. M. (2014) · Journal of Educational Evaluation for Health Professions · doi:10.3352/jeehp.2014.11.20 · Cited by 164 · cited 1×
“On the other hand, writing may be an important way to enhance empathy and by recording the patient’s story, students have more perspective to contact the patient’s emotions and gain a deeper understanding and appreciation of the patient as a way to achieve empathy [49].”
BackgroundRemein, C. D., Childs, E., Pasco, J. C., Trinquart, L., Flynn, D., Wingerter, S., Bhasin, R. M., Demers, L., & Benjamin, E. J. (2020) · BMJ Open · doi:10.1136/bmjopen-2019-031568 · Cited by 156 · cited 2×
“On the other hand, narrative writing in the form of storytelling can develop writing skills for personal and professional development [3].”
BackgroundMiller, E. C., Balmer, D. F., Hermann, N., Graham, G., & Charon, R. (2013) · Academic Medicine · doi:10.1097/acm.0000000000000098 · Cited by 145 · cited 1×
“Previous qualitative research has suggested that narrative medicine has been found to positively influence the development of professional identity and professional literacy [42, 43].”
BackgroundThe influence of role models in undergraduate nurse education
Jack, K., Hamshire, C., & Chambers, A. (2017) · Journal of Clinical Nursing · doi:10.1111/jocn.13822 · Cited by 133 · cited 1×
“In addition, the role of a role model or mentor influences the development of students’ professionalism [45].”
BackgroundMoreno‐Poyato, A. R., Rodríguez‐Nogueira, Ó., & MiRTCIME.CAT working group (2020) · Journal of Psychiatric and Mental Health Nursing · doi:10.1111/jpm.12675 · Cited by 113 · cited 1×
“There is growing evidence that improved empathy during clinical practice increases patient adherence to treatment and patient satisfaction and builds positive relationships between nurses and patients, leading to more effective treatment outcomes [25, 26].”
BackgroundProfessionalism: the major factor influencing job satisfaction among Korean and Chinese nurses
Hwang, J., Lou, F., Han, S. S., Cao, F., Kim, W. O., & Li, P. (2009) · International Nursing Review · doi:10.1111/j.1466-7657.2009.00710.x · Cited by 111 · cited 1×
“It has been reported that professionalism level can affect nurses’ job satisfaction and retention intention [19, 20].”
BackgroundImpact of a narrative medicine programme on healthcare providers’ empathy scores over time
Chen, P.-J., Huang, C., & Yeh, S. (2017) · BMC Medical Education · doi:10.1186/s12909-017-0952-x · Cited by 105 · cited 1×
“Previous studies have shown [9, 48] that medical professionals’ participation in narrative medicine programs leads to increased self-reported empathy scores.”
ResultPatient Perceptions of Clinician’s Empathy
Hojat, M., DeSantis, J., & Gonnella, J. S. (2017) · Journal of Patient Experience · doi:10.1177/2374373517699273 · Cited by 103
Promoting Reflection on Professionalism
Baernstein, A., & Fryer-Edwards, K. A. (2003) · Academic Medicine · doi:10.1097/00001888-200307000-00018 · Cited by 99
Roff, S. (2015) · Medical Teacher · doi:10.3109/0142159x.2015.1009022 · Cited by 90 · cited 1×
“found that medical students’ empathy did not decline over time [24].”
BackgroundHumanistic Nursing Theory: application to hospice and palliative care
Wu, H., & Volker, D. L. (2011) · Journal of Advanced Nursing · doi:10.1111/j.1365-2648.2011.05770.x · Cited by 73 · cited 1×
“Nurses with high humanistic care ability can help reduce patients’ suffering related to disease, establish a good relationship with patients and their families, and better understand the meaning of their work [13].”
BackgroundThe role of mediation in solving medical disputes in China
Wang, M., Liu, G. G., Zhao, H., Butt, T., Yang, M., & Cui, Y. (2020) · BMC Health Services Research · doi:10.1186/s12913-020-5044-7 · Cited by 63 · cited 1×
“However, in the clinical environment, nursing students are faced with the high turnover rate of nurses, negative doctor-patient relationship, frequent workplace violence and other situations [16, 17], leading to cognitive deviation of nursing profession [18], which is not conducive to the cultivation of their professi…”
BackgroundYao, X., Shao, J., Wang, L., Zhang, J., Zhang, C., & Lin, Y. (2020) · International Journal of Mental Health Nursing · doi:10.1111/inm.12770 · Cited by 63 · cited 1×
“On the other hand, high levels of empathy can reduce stress and burnout [27, 28] and improve the quality of professional life [29].”
BackgroundDaryazadeh, S., Adibi, P., Yamani, N., & Mollabashi, R. (2020) · Journal of Educational Evaluation for Health Professions · doi:10.3352/jeehp.2020.17.3 · Cited by 61
Huang, C., Jenq, C., Liao, K., Lii, S.-C., Huang, C.-H., & Wang, T. (2021) · BMC Medical Education · doi:10.1186/s12909-021-02823-4 · Cited by 52 · cited 3×
“Previous qualitative research has suggested that narrative medicine has been found to positively influence the development of professional identity and professional literacy [42, 43].”
BackgroundReflective student narratives: honing professionalism and empathy
Dhaliwal, U., Singh, S., & Singh, N. (2017) · Indian Journal of Medical Ethics · doi:10.20529/ijme.2017.069 · Cited by 42
Beck, C. T. (1992) · Nurse Educator · doi:10.1097/00006223-199211000-00013 · Cited by 41 · cited 1×
“Therefore, it is extremely important to cultivate nursing students to provide humanistic care behavior and caring ability for patients, and it is also the important responsibility and moral mission of teachers [32, 33].”
BackgroundHui, Z., Dai, X., & Wang, X. (2019) · Nursing Open · doi:10.1002/nop2.404 · Cited by 30 · cited 1×
“On the other hand, high levels of empathy can reduce stress and burnout [27, 28] and improve the quality of professional life [29].”
BackgroundLi, C., Yang, J., Li, M., & Wang, W. (2020) · Nursing Open · doi:10.1002/nop2.584 · Cited by 29 · cited 1×
“On the other hand, high levels of empathy can reduce stress and burnout [27, 28] and improve the quality of professional life [29].”
BackgroundA Novel Narrative Medicine Approach to DEI Training for Medical School Faculty
Holdren, S., Iwai, Y., Lenze, N. R., Weil, A., & Randolph, A. (2022) · Teaching and Learning in Medicine · doi:10.1080/10401334.2022.2067165 · Cited by 29 · cited 1×
“At the same time, narrative medical education has been applied to the teacher population to provide a unique space for reflection on their growth [5].”
BackgroundApplication and Evaluation of a Caring Code in Clinical Nursing Education
Lee‐Hsieh, J., Kuo, C., & Tseng, H. F. (2005) · Journal of Nursing Education · doi:10.3928/01484834-20050401-07 · Cited by 28 · cited 1×
“Therefore, it is extremely important to cultivate nursing students to provide humanistic care behavior and caring ability for patients, and it is also the important responsibility and moral mission of teachers [32, 33].”
BackgroundSimulation education: A primer for professionalism
Duphily, N. H. (2014) · Teaching and learning in nursing · doi:10.1016/j.teln.2014.03.003 · Cited by 24 · cited 1×
“Professionalism refers to the value orientation and standards of practicing nurse which reflects work attitude and concepts of nursing [15].”
BackgroundMeasures of empathy and the capacity for self-reflection in dental and medical students
Paloniemi, E., Mikkola, I., Vatjus, R., Jokelainen, J. J., Timonen, M., & Hagnäs, M. P. (2021) · BMC Medical Education · doi:10.1186/s12909-021-02549-3 · Cited by 23 · cited 1×
“Research has shown that empathy can be taught and trained through education and reflection [30].”
BackgroundLessons in Stories: Why Narrative Medicine Has a Role in Pediatric Palliative Care Training
Lanocha, N. (2021) · Children · doi:10.3390/children8050321 · Cited by 20 · cited 1×
“This may promote positive empathy among clinical staff by exploring literature [47].”
BackgroundMustika, R., & Soemantri, D. (2020) · Malaysian Journal of Medical Sciences · doi:10.21315/mjms2020.27.3.12 · Cited by 15 · cited 1×
“believe that role models play an important role in the cultivation of humanism [52].”
BackgroundLorenz, F. J., Darok, M. C., Ho, L., Holstrom-Mercader, M. S., Freiberg, A. S., & Dellasega, C. A. (2021) · Journal of Cancer Education · doi:10.1007/s13187-021-02029-8 · Cited by 12
Nursing Student's Clinical Learning Experiences and the Barriers Faced
Santa, D., Mahadalkar, P., & Bera, L. P. (2016) · International Journal of Nursing Education · doi:10.5958/0974-9357.2016.00070.2 · Cited by 5
Factors Influencing Retention Intention of Nurses at Long-Term Care Hospitals in Korea
Shin, S. Y., & Kim, J. H. (2021) · Journal of Gerontological Nursing · doi:10.3928/00989134-20210908-07 · Cited by 5
Research works printed but not linked: 11
- Yang NX, Li XY, Yan H, et al. Influence of narrative medical education on empathy ability and academic achievement of clinical medical students: a randomized controlled trial. Chinese J Clin Psychol. 2018;26(03):557–560+556.
- Shi HR, Zhou X, Shan BF, et al. The practice and effects of narrative nursing course for nursing undergraduates. Chinese J Nurs Educ. 2021;18(06):510–4.
- Wang YB, Wu SL, Wang L. Discussion on the application of narrative medicine in nursing psychology teaching. Med Philos. 2021;42(01):44–7.
- Li W, Li CJ, Chen BB, et al. Exploration and practice of narrative medicine education on promoting medical Students’Empathy ability. Chinese Health Ser Manage. 2022;39(09):678–83.
- Shan YW, Wu KL, Sun YN, et al. Application of moral education online teaching of surgical nursing science based on the medical narrative concept in undergraduate nursing teaching. Chin Nurs Res. 2021;35(23):4260–4.
- LZ, MX. Current situation investigation and countermeasures of medical students' professional identity. Xuexiao Dangjian Yu Sixiang Jiaoyu. 2016;21:72–4.
- ZQ. Study on the empathy status for higher vocational nursing students in Hunan Province: Sun Yat-sen University; 2010.
- YH. An empirical study on evaluation of humanistic Cadng ability of nursing undergraduates: Fujian Medical University; 2007.
- Fisher LD, Dixon DO, Herson J, et al. Intention to treatment in clinical trials. In: Issues in pharmaceutical drug development. New York: Statistical; 1989. p. 331–50.
- Hua QQ, Dai XY, Yi XH, et al. Cultivating path of medical Students' humanistic care ability from the perspective of narrative medicine. Med Philos. 2022;43(13):68–72.
- SL, ZD, ZL, et al. The mediating effect of emotional intelligence on perceived organizational care climate and humanistic care of undergraduate nursing students. J Nurs. 2021;28(11):46–50.
Cited by
Sorted by citations
Zhang, X., Pang, H.-F., & Duan, Z. (2023) · BMC Medical Education · doi:10.1186/s12909-023-04932-8 · Cited by 51
Özdemir, C., & Kaplan, A. (2024) · Journal of Clinical Nursing · doi:10.1111/jocn.16992 · Cited by 25
Yang, Y., & Wang, C. (2024) · Frontiers in Psychology · doi:10.3389/fpsyg.2023.1339194 · Cited by 22
A survey of ethical sensitivity among nursing students and its influencing factors
Juan, H., Chen, X., Khoshnood, K., Luo, E., Muramatsu, T., & Yang, M. H. (2024) · Nursing Ethics · doi:10.1177/09697330231225399 · Cited by 21
“21 Nurses can alleviate patients ’ pain and avoid harm if they face ethical issues from the perspective of humanistic care.”
Schwartzkopf, C. T., Alves, R. T., Lopes, P. C., Braux, J., Capucho, F., & Ribeiro, C. (2025) · BMC Medical Education · doi:10.1186/s12909-025-07038-5 · Cited by 20
“Twenty [26, 27, 29, 36–39, 41, 42, 44, 46, 48, 50, 51, 53, 57, 61–64] studies used the JSE, three [49, 52, 54] studies used the and the JSPPPE and two studies used the CARE [37, 38] questionnaire.”
Metadata
- Authors
- Xue, M., Sun, H., Xue, J., Zhou, J., Qu, J., Ji, S., Bu, Y., & Liu, Y.
- Affiliations
- Yangzhou University (CN)
- Corresponding author
- Liu, Yongbing
- Venue
- BMC Medical Education
- Published
- 2023-01-18
- Volume
- 23
- Issue
- 1
- Pages
- 38-38
- ISSN
- 1472-6920 (ISSN-L)
- PMC
- PMC9850682
- OpenAlex
- W4317361252
- Cited by
- 119
- References
- 41
- Citations by year
- 2026: 44 · 2025: 42 · 2024: 24 · 2023: 9
- FWCI
- 24.13
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Locations
- BMC Medical Education (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Funders
- the Jiangsu Graduate Research and Innovation Program (KYCX21_3298)
- the 2020 Medical Education Research Project of the Medical Education Branch of the Chinese Medical Association and Medical Education Professional Committee of the Chinese Society of Higher Education (20A0576)
- the Interdisciplinary Research Project of Chinese Language and Literature Special Zone of Yangzhou University (yzuxk202019)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Empathy and Medical Education
- Social Sciences › Education › Innovations in Medical Education
- Health Sciences › Nursing › Leadership and Management › Healthcare Education and Workforce Issues
- Keywords
- narrative medicine, nursing students, professionalism, empathy, humanistic caring, narrative writing, online learning platforms, nursing education, undergraduate nursing education
- MeSH terms
- Professionalism, Narrative Medicine, Empathy, Humans, Students, Nursing, Narration
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review

