Cultural empathy in physiotherapy students: a pre-test post-test study utilising virtual simulation

Abstract

Objectives: To investigate how a virtual cultural simulation experience and guided reflection influenced physiotherapy students' intrapersonal and interpersonal cultural empathy, and to explore students' satisfaction with the learning experience.

Design: Three research arms within a single cohort: 1) pre-test post-test investigation of intrapersonal cultural empathy; 2) quasi-experimental investigation of interpersonal cultural empathy; 3) post-test measurement of satisfaction.

Setting: An Australian university.

Participants: Bachelor and Master physiotherapy students, response rate 98% (162/165).

Interventions: A self-directed online virtual simulation in which the student assumed the role of a patient who has been hospitalised in a developing country. Students were then guided to reflect on the experience via online questions.

Main outcome measures: The primary measure was the Comprehensive State Empathy Scale (CSES) of intrapersonal cultural empathy. Secondary measures were the Theory of Planned Behaviour:Cultural Competence Questionnaire (TPB:CCQ) of interpersonal cultural empathy; and the Satisfaction with Cultural Simulation Experience Scale (SCSES).

Results: Intrapersonal cultural empathy improved after the virtual simulation, shown in overall CSES scores [pre-test: 95 (81-109) vs post-test: 106 (89-117); median difference 11; P=<0.001]. For the TPB:CCQ, the post-simulation ('intervention') group demonstrated greater 'Perceived Behavioural Control' interpersonal empathy compared to the presimulation ('control') group [4.41 (0.54) vs 4.59 (0.53); mean difference=0.19; 95% confidence interval=0.01 to 0.36; P=0.020]. Satisfaction with the experience was high (mean SCSES score=40/56 (71%)).

Conclusions: A virtual cultural simulation experience and guided reflection led to significant increases in students' intrapersonal cultural empathy, with some influence on interpersonal cultural empathy. Students were highly satisfied with this learning experience.

Keywords: Cultural competence; Cultural empathy; Physiotherapy students; Virtual simulation.