Developing Disability Awareness, Attitude, and Empathy in Nursing Students

NCT07609238 | Not Yet Recruiting

• 1 other identifier: KA26/105
• Study Type: interventional
• Target: 66
• Locations: 0 countries
• Sites: N/A

Brief Summary

Abstract Individuals with disabilities frequently face barriers to accessing healthcare services due to physical, social, economic, and policy-related factors. As essential members of the healthcare workforce, nurses play a critical role in addressing these inequities. Previous studies focusing on disability awareness, attitudes, and empathy highlight the need for high-quality research employing mixed-method, simulation-based interventions aimed at enhancing awareness and empathy, fostering positive attitudes, and supporting learning outcomes. However, the existing literature lacks studies that simultaneously compare different simulation methods and comprehensively evaluate awareness, attitudes, and empathy using a multidimensional approach. This study aims to examine the effectiveness of simulation-based interventions-standardized patient encounters and virtual reality training-in improving nursing students' awareness, strengthening positive attitudes, and increasing sensitivity in the delivery of healthcare services to individuals with disabilities. The findings are expected to support the integration and expansion of disability-focused simulation practices in nursing curricula and contribute to the development of evidence-based nursing education programs. Keywords: nursing students; disability; attitude; simulation; virtual reality

Conditions

Simulation Training; Students, Nursing; Attitude; Empathy Skills; Disabled People; Awareness and Knowledge Level

Keywords

simulation training; nursing students; attitude; empathy; disabled people; awareness

Outcome Measures

Primary Outcomes (3)

• Disability Awareness Program (DAP) scale

  The primary outcome is the change in total score on the Disability Awareness Program (DAP) Scale, a 15 item self reported questionnaire designed to assess awareness related to disability. The DAP Scale evaluates three predefined domains: (1) Awareness of Basic Human Rights (5 items), (2) Awareness of Disability based on the ICF framework (6 items), and (3) Awareness of Diversity (4 items). Items are rated on a 5 point Likert scale. Reverse scoring is applied to items Q1-Q5, and weighted scoring is applied to items Q5, Q10, Q11, Q14, and Q15, according to the predefined scoring algorithm. The total score ranges from 0 to 100, with higher scores indicating greater disability awareness As part of this study, a validity and reliability study of the Turkish version of the original English scale will be conducted among first- and second-year undergraduate students enrolled in the Department of Nursing at Başkent University, in order to ensure its suitability for use in the target population

  Change from baseline in disability awareness scores measured immediately after the interventions and at 6 weeks post-intervention.

• The Multidimensional Attitudes Toward Persons with Disabilities Scale

  The Multidimensional Attitudes Toward Persons with Disabilities Scale (MATPDS) was developed by Findler, Vilchinsky, and Werner in 2007. The scale provides a multidimensional assessment of adults' attitudes toward persons with disabilities across cognitive, affective, and behavioral domains. The Turkish validity and reliability study of the scale was conducted among university students by Yelpaze and Türküm in 2018, and the scale was reported to be suitable for use in the Turkish population. The scale consists of three subscales: Cognition, Affect, and Behavior. The scale is scored using a 5 point Likert format ranging from 1 = Not at all to 5 = Very much. In the Affect subscale, 11 items (items 1, 2, 3, 4, 5, 9, 10, 11, 12, 14, and 15), and in the Behavior subscale, 6 items (items 1, 2, 3, 4, 5, and 6) are reverse coded. Subscale scores as well as a total scale score can be calculated. Higher scores indicate more positive attitudes toward persons with disabilities.

  Change from baseline in disability attitude scores measured immediately after the interventions and at 6 weeks post intervention.

• Multidimensional Empathy Scale

  The Multidimensional Empathy Scale (MES) is a valid and reliable 30-item instrument developed by Mayer and Caruso (1998) to provide a multidimensional emotional assessment of individuals' empathic abilities. The Turkish validity and reliability study of the original scale was conducted among university students by Turan et al. (2020), and the Turkish version was accepted as a valid and reliable tool for assessing empathy levels among nursing students. The scale consists of six dimensions: Personal Distress (8 items), Positive Sharing (5 items), Sensitive Crying (3 items), Emotional Attention (4 items), Feeling for Others (4 items), and Emotional Contagion (2 items). The 30-item scale is rated on a 5-point Likert scale ranging from 1 = Strongly disagree to 5 = Strongly agree. The total score ranges from 30 to 150, with higher total scores indicating higher levels of multidimensional empathic ability.

  Change from baseline in disability empathy scores measured immediately after the interventions and at 6 weeks post intervention.

Study Arms (3)

Standard Training Group

EXPERIMENTAL

Primary and secondary outcome data will be collected from participants in the control group at three time points. Baseline measurements (pre-test) will be obtained prior to the initiation of the study. Following the five-week standard Disability Awareness Training period, an interim assessment (mid-test) will be conducted to evaluate short-term changes in outcomes. Follow-up assessments (post-test) will be administered six weeks after the interim assessment to assess the longer-term effects of the training on participants' awareness, attitudes, and empathy toward individuals with disabilities.

Behavioral: Disability Awareness Education

Standard Patient Group

EXPERIMENTAL

Outcome data for participants assigned to Intervention Group 1 will be collected at three predefined time points. Baseline assessments (pre-test) will be completed prior to the intervention. During the same academic week, participants will receive the Standardized Patient Intervention in conjunction with the Disability Awareness Training, with scheduling coordinated according to the course module and participants' availability. Immediately following the completion of the Standardized Patient procedure and the subsequent debriefing session, an interim assessment (mid-test) will be administered to evaluate short-term effects of the intervention. Follow-up assessments (post-test) will be conducted six weeks after the interim assessment to assess the longer-term impact on participants' awareness, attitudes, and empathy toward individuals with disabilities.

Behavioral: Disability Awareness Education; Behavioral: Standart Patient Group

Virtual Reality Group

EXPERIMENTAL

Outcome data for participants assigned to Intervention Group 2 will be collected at three predefined time points. Baseline assessments (pre-test) will be completed prior to the intervention. During the same academic week, participants will receive the Virtual Reality Intervention in conjunction with the Disability Awareness Training, with scheduling coordinated according to the course module and participants' availability. Immediately after completion of the Virtual Reality procedure and the subsequent debriefing session, an interim assessment (mid-test) will be administered to evaluate short-term intervention effects. Follow-up assessments (post-test) will be conducted six weeks after the interim assessment to assess the longer-term impact of the intervention on participants' awareness, attitudes, and empathy toward individuals with disabilities.

Behavioral: Disability Awareness Education; Behavioral: Virtual Reality Group

Interventions

Disability Awareness Education BEHAVIORAL

Participants will receive Disability Awareness Training delivered through face-to-face instruction. The training will cover core topics including the concept of disability, physical, social, and attitudinal barriers experienced by individuals with disabilities, challenges related to accessing healthcare services, and the roles and responsibilities of healthcare professionals in providing inclusive and equitable care. The intervention will be delivered using standardized educational content, and no additional simulation-based or technology-assisted interventions will be included.

Standard Patient Group; Standard Training Group; Virtual Reality Group

Virtual Reality Group BEHAVIORAL

Participants assigned to the Virtual Reality Intervention group will receive a Virtual Reality-based simulation intervention following the Disability Awareness Training. The Virtual Reality intervention will provide computer-generated experience designed to simulate situations encountered by individuals with disabilities, with the aim of enhancing participants' understanding, awareness, and empathy. The simulated scenarios will focus on challenges related to daily living, interaction with the environment, and access to healthcare services. The intervention will be delivered using standardized virtual reality content during the same academic term as the Disability Awareness Training and will be followed by a structured debriefing session facilitated by the researcher. No additional interventions will be applied to this group.

Virtual Reality Group

Standart Patient Group BEHAVIORAL

Participants assigned to the Standardized Patient Intervention group will receive Disability Awareness Training, followed by a Standardized Patient-based simulation intervention. During the simulation, participants will provide care to a trained standardized patient portraying an individual with a disability, in accordance with the procedures and objectives outlined in the predefined scenarios. The simulation will be conducted using standardized scenarios during the same academic term as the Disability Awareness Training and will be followed by a structured debriefing session facilitated by the researcher. No additional interventions will be applied to this group.

Standard Patient Group

Eligibility Criteria

• Age: 18 Years+
• Sex: all
• Healthy Volunteers: Yes
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• Must be a 3rd or 4th-year student in the Department of Nursing at Başkent University.
• Must be willing to participate in the study.

You may not qualify if:

• Any kind of disability.
• A visually-related problem

Sponsors & Collaborators

• Baskent University: lead

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• Sakellariou D, Rotarou ES. Access to healthcare for men and women with disabilities in the UK: secondary analysis of cross-sectional data. BMJ Open. 2017 Sep 11;7(8):e016614. doi: 10.1136/bmjopen-2017-016614.

  PMID: 28893735 BACKGROUND

• Popplewell NT, Rechel BP, Abel GA. How do adults with physical disability experience primary care? A nationwide cross-sectional survey of access among patients in England. BMJ Open. 2014 Aug 8;4(8):e004714. doi: 10.1136/bmjopen-2013-004714.

  PMID: 25107434 BACKGROUND

Related Links

• WHO World Report on Disability 2011
• Disability and health fact sheet

MeSH Terms

Conditions

Behavior

Study Officials

• Ziyafet Ugurlu, Proff.Dr.

  Baskent University

  STUDY DIRECTOR

• Emine Koc, Phd student

  Baskent University

  PRINCIPAL INVESTIGATOR

Central Study Contacts

Emine Koc, Phd Student

CONTACT

+90 0507 995 51 52; eminesatilmis@baskent.edu.tr

Ziyafet Ugurlu, Proff.Dr.

CONTACT

zhanoglu@baskent.edu.tr

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: SINGLE
• Who Masked: OUTCOMES ASSESSOR
• Masking Details: As the researcher will be conducting the study, they will not be blinded. Randomisation of participants in the study will be carried out by a statistician to ensure blinding. To ensure blinding in the statistical analysis of the study, the statistical analysis will be performed by a different statistician.
• Purpose: SUPPORTIVE CARE
• Intervention Model: FACTORIAL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Research Assistant

Model Details: This study was designed as a single-blind, randomised controlled trial with a control group, employing a pre-test, mid-test, and post-test design, to evaluate the effectiveness of simulation-based programmes developed to enhance nursing students' awareness, attitudes, and empathy toward individuals with disabilities.

Study Record Dates

• First Submitted: April 19, 2026
• First Posted: May 27, 2026
• Study Start (Estimated): September 15, 2026
• Primary Completion (Estimated): November 1, 2026
• Study Completion (Estimated): June 1, 2027
• Last Updated: June 3, 2026

Record last verified: 2026-05

Data Sharing

• IPD Sharing: Will not share