Abstract
Description
Historically, compassionate care has been briefly introduced in nursing education, without a sustained focus throughout nursing programs. Compassionate care models define the essential qualities needed to deliver meaningful care. Many of the traditional compassionate care models rely on high-level concepts that can be difficult to operationalize in academia. Further, current compassionate care models are typically limited to specific settings and are taught separately from other parts of the nursing curriculum. To address these concerns, a single purpose nursing college created and implemented the iCare Compassionately Model, which emphasizes both measurable behaviors and concepts related to compassion. As a result of this model, compassionate care is being integrated into the curriculum of every course in every program across the college. This article serves as an introduction to the iCare Compassionately Model and includes an overview of its theoretical underpinnings as well as a discussion of the curriculum integration efforts.
Keywords: compassionate care, nursing education, delivery of healthcare, empathy, nursing students, clinical competence, respect, attitudes of health personnel
Background and Problem
The continued worldwide rise in patients reporting they do not feel cared for by their nurses emphasizes the need to integrate compassionate care into nursing education.1,2 Compassionate care requires a genuine, authentic approach to patient care that recognizes the significance emotions have on the patient experience.1,3 When nurses include a focus on patient suffering and actively seek to form a connection with their patients, they are demonstrating compassionate care.1–3 Further, research supports that patients who report feeling cared for by their nurses have improved outcomes.1,4 Additionally, nurses who demonstrate self-compassion and compassionate care to each other are more likely to remain in the nursing profession.5
Despite its well-supported importance, the concept of compassionate care is minimally integrated into nursing education. Most models of compassionate care have been created for clinical settings, often for specific populations, resulting in a lack of clear applicability to nursing education. Further, educators face challenges in teaching compassionate care, such as a lack of a clear definition, the absence of well-defined pedagogical strategies, and the tendency for programs to prioritize clinical skill development.6,7 For nurses to reach proficient levels in demonstrating compassionate care towards patients and themselves, faculty need the content and strategies to effectively teach the concepts throughout the student nurse journey.6,8–13
The Innovative Solution: The iCare Compassionately Model
Drawing from psychological, sociological, and nursing theories, the iCare Compassionately model was intentionally designed to reflect the college’s values. The iCare (inclusivity, character, accountability, respect, excellence) Compassionately model includes operationalized definitions to allow for actionable and measurable content in the educational context. Research supports that when faculty and staff role-model compassion for students, students show increased compassion in their learning.6,7,10 As such, the model was also developed to enhance and expand the organizational culture.
The theoretical foundations of the iCare Compassionately model include nursing, psychological, and sociological perspectives. Watson’s Theory of Human Caring,14 and Leininger’s Transcultural Nursing Theory,15 support the model’s commitment to respect, inclusivity, excellence, and compassion, while Dempsey’s Compassionate Connected Care framework,1 offers practical strategies for reducing suffering in both academic and clinical contexts. Rogers’ Person-Centered Theory,16 contributes principles of empathy and respect, and Bandura’s Social Learning Theory,17 reinforces the importance of role modeling, which is central to faculty and staff training. Tajfel and Turner’s Social Identity Theory,18 provides insight into how social categorization and bias form, guiding educational approaches that foster inclusivity and cultural humility.
Curriculum Integration and Teaching Strategies
Using the iCare Compassionately model as a framework, compassionate care was thoughtfully integrated into the curricula of pre-licensure and post-licensure nursing programs. A subject-matter expert identified opportunities to align existing course outcomes and content with the iCare Compassionately model’s principles. Content and evaluation methods were developed in a collaborative effort between the subject-matter expert, faculty course leads, and instructional design team members. Teaching strategies for the compassionate care content were provided in a faculty toolkit. Content was integrated into both didactic and clinical courses. Table 1 provides an overview of the model definitions, curriculum content, and instructional and evaluation strategies.
Table 1.
Model Definitions, Curriculum Content, and Instructional and Evaluation Strategies of Compassionate Care Content
| Model concept and definition | Curriculum content examples of approaches | Instructional and evaluation strategies examples |
|---|---|---|
| Inclusivity: accepting oneself or others with an open-minded, positive attitude free from judgment or criticism | Inclusive language; implicit bias; microaggressions; health equity; social determinants; cultural humility/competence | Integrate social considerations into care planning; culturally responsive assignments; reflective bias assessment; promote health/self-compassion practices |
| Character: modeling integrity by demonstrating ethical behaviors toward oneself and others. | Ethical challenges; academic integrity; moral distress | Link nursing’s trustworthiness to academic integrity; simulate ethical dilemmas with resource identification; case scenarios on ethics, moral distress, and just culture |
| Accountability: ownership of one’s knowledge, abilities, actions, and behaviors. | Timeliness; responsibility for errors; seeking help; active team contribution | Group projects; visual mapping of accountability factors; connect deadlines to timeliness in patient care |
| Respect: the intentional act of showing consideration for another person’s interests and well-being. | Nurse–patient relationship; patient dignity; incivility; interprofessional communication; self-respect | Role-play/simulation of respectful interactions; teach self-advocacy strategies |
| Excellence: an individual’s ability to utilize knowledge, skills, and attitudes to demonstrate high-quality, compassionate, and authentic care to all persons. | Patient safety; advocacy; positive outcomes; evidence-based practice; accreditation standards | Apply compassionate care to EBP; link compassion to safety/outcomes; advocacy role-play |
| Compassionately: the mental skill used for recognizing feelings and emotions of self and others, and the ability to respond authentically. | Observable compassionate behaviors; patient connection strategies; emotional intelligence; self-compassion; therapeutic communication | Faculty role-modeling; evaluate therapeutic, compassionate responses in clinical evaluations; include in concept mapping |
Abbreviation: EBP = evidence-based practice
Future Implications
Multiple pathways for future research stem from the creation of the iCare Compassionately model. Continued evaluations of student performance on assignments, test questions, and in clinical practice will provide data to assess the effectiveness of the curriculum integration. Opportunities for future cohort studies include patient satisfaction surveys, nurse satisfaction evaluations, and intent to remain in practice assessments. Faculty perspectives about teaching compassionate care to nursing students are underrepresented in the current literature.6 Adding faculty insights and experiences could strengthen the evidence supporting the integration of compassionate care in nursing education and other patient-facing disciplines.
Conclusion
Integrating compassionate care into nursing education may ultimately improve patient outcomes and decrease nurse burnout. An emphasis on compassionate care in conjunction with clinical competence will aid nurses in recognizing the significance of providing competent and compassionate care to patients. Educators must expand the focus of nursing education from clinical competence to a more comprehensive approach to patient care, which includes the criticality of compassion. Intentionally teaching patient-facing healthcare professionals about the essential role of self-compassion may ultimately improve the health of the nursing workforce.19 The iCare Compassionately offers a comprehensive framework to address the missing need.
Funding Statement
This research was supported (in whole or in part) by HCA Healthcare and/or an HCA Healthcare-affiliated entity
Footnotes
Conflicts of Interest: The author declares she has no conflicts of interest.
Dr Brodie is an employee of Galen College of Nursing, an organization affiliated with the journal’s publisher.
This research was supported (in whole or in part) by HCA Healthcare and/or an HCA Healthcare-affiliated entity. The views expressed in this publication represent those of the author(s) and do not necessarily represent the official views of HCA Healthcare or any of its affiliated entities.
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