Undergraduate nursing students empathy before clinical internship: a video recording-based analysis

In view of the limitations of traditional empathy measurement methodssuch as self-report questionnairesdue to social desirability bias and insufficient capture of dynamic processes, this study adopted an objective, video-based analysis approach to explore the behavioral characteristics of nursing students clinical empathy. Twenty-six undergraduate nursing students with no internship experience participated. Their interactions in six standardized simulated scenarios were video-recorded, followed by facial expression analysis and text analysis. NVivo 22.0 was used for linguistic emotion coding, combined with independent dual-coder behavioral coding (Kappa = 0.87). The results identified three core behavioral indicators of empathy in nursing students: nonverbal expressions of care, emotional synchrony, and collaborative problem-solving. Female students outperformed male students in nonverbal expressions of care and emotional synchrony, whereas male students showed stronger performance in collaborative problem-solving behaviors. In summary, this study is the first to systematically apply video analysis to assess nursing students empathy, providing a quantifiable behavioral observation tool for nursing education. It is therefore recommended that video feedback be incorporated into empathy training courses.