Developing Disability Awareness, Attitude, and Empathy in Nursing Students (Disability)

May 21, 2026 updated by: EMINE KOC, Baskent University

A Randomized Controlled Trial Comparing Training Programs Designed to Improve Awareness, Attitudes, and Empathy Toward Individuals With Disabilities in Nursing Students

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

Study Overview

Status

Not yet recruiting

Conditions

Intervention / Treatment

Detailed Description

This study aims to evaluate the effectiveness of simulation-based interventions designed to improve nursing students' awareness, attitudes, and empathy toward individuals with disabilities. The study will be conducted using a pre-test, mid-test, and post-test design within a double-blind, randomized controlled framework that includes a control group. A total of 60 third- and fourth-year students from the Nursing Department of Başkent University Faculty of Health Sciences will be enrolled. Participants will be assigned to three groups (20 students per group) using stratified block randomization.

Data will be collected using the Student Information Form, the Disability Awareness Scale, the Multidimensional Attitudes Toward Persons with Disabilities Scale, and the Multidimensional Empathy Scale.

The intervention will begin with Standard Disability Education delivered online via the Zoom platform to both the experimental and control groups in separate sessions. Subsequently, in accordance with schedules arranged by the researcher and students' course availability, Experimental Group 1 will receive a Standardized Patient Simulation, while Experimental Group 2 will participate in a Virtual Reality Simulation. Statistical analyses appropriate to the study design will be performed, and the level of statistical significance will be set at p = 0.05.

Study Type

Interventional

Enrollment (Estimated)

66

Phase

  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Contact

Study Contact Backup

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

  • Adult
  • Older Adult

Accepts Healthy Volunteers

Yes

Description

Inclusion Criteria:

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

Exclusion Criteria:

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

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Supportive Care
  • Allocation: Randomized
  • Interventional Model: Factorial Assignment
  • Masking: Single

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Experimental: Standard Training Group
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
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.
Experimental: Standard Patient Group
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
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.
Behavioral: Standart Patient Group
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.
Experimental: Virtual Reality Group
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
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.
Behavioral: Virtual Reality Group
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.

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Disability Awareness Program (DAP) scale
Time Frame: Change from baseline in disability awareness scores measured immediately after the interventions and at 6 weeks post-intervention.
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
Time Frame: Change from baseline in disability attitude scores measured immediately after the interventions and at 6 weeks post intervention.
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
Time Frame: Change from baseline in disability empathy scores measured immediately after the interventions and at 6 weeks post intervention.
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.

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Baskent University

Investigators

  • Study Director: Ziyafet Ugurlu, Proff.Dr., Baskent University
  • Principal Investigator: Emine Koc, Phd student, Baskent University

Publications and helpful links

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

General Publications

Helpful Links

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Estimated)

September 15, 2026

Primary Completion (Estimated)

November 1, 2026

Study Completion (Estimated)

June 1, 2027

Study Registration Dates

First Submitted

April 19, 2026

First Submitted That Met QC Criteria

May 21, 2026

First Posted (Actual)

May 27, 2026

Study Record Updates

Last Update Posted (Actual)

May 27, 2026

Last Update Submitted That Met QC Criteria

May 21, 2026

Last Verified

May 1, 2026

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

  • KA26/105

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

NO

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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