Narrative Education Combined With Experiential Teaching in the Development of Empathic Competence of Undergraduate Nursing Students: Pre-Test Post-Test Design

Empathy is a fundamental quality that nursing staff should possess, but the empathy ability of nursing students in China is currently at an intermediate level and requires improvement. This study aimed to explore teaching methods for nursing humanistic education, that can improve the empathy ability of nursing students and cultivate high-quality nursing talents. This study employed narrative education and experiential teaching methods to develop empathic competence in teaching pediatric nursing courses. The empathic ability of nursing students was measured using the JSPE-NS scale before and after teaching and was analyzed to refine the teaching reflection theme words. After teaching, nursing students scored higher on the total empathy scale, perspective-taking dimension, and emotional care dimension than before teaching, with statistically significant differences (p < 0.05). Five themes were extracted from the teaching reflection, including emotional empathy, pediatric nursing skills, gratitude to parents, reverence for life, and course experience. The results show that the combination of narrative education and experiential teaching methods applied to pediatric nursing courses effectively improved nursing students’ empathy, strengthened their identification with the nursing profession, and promoted the teaching reform of humanistic education in nursing courses. The combination of narrative education and experiential teaching methods can improve the empathic ability of nursing students. This approach is suitable for integrating humanistic education into nursing professional courses and provides a feasible idea for developing humanistic qualities in nurses.


Background
Empathy is a core quality of nursing that refers to the ability to perceive, understand, and express care and comfort for patients (Levett-Jones et al., 2019).Nursing emphasizes respect for people and building trusting relationships with patients and their families (Morgan & Yoder, 2012).Nurses with stronger empathy can better understand the patient's point of view, communicate effectively with patients, and establish a good nursingpatient relationship (Yi et al., 2021).However, low empathy ability or empathy fatigue can negatively impact the caregiver-patient relationship and the quality of life of caregivers (Ruiz-Ferna´ndez et al., 2020).Since nursing students are the reserve army of the nursing workforce, their empathy ability determines the quality of future clinical care and the quality of the patient-nurse relationship (Ireland, 2022).Narrative education's core is to share stories, stimulate emotions, and provoke analysis and reflection among nursing students.This approach aims to develop their empathy and humanistic care ability and achieve the purpose of education through telling stories and experiences (Nash-Patel et al., 2023).Experiential teaching is a student-centered method that allows students to actively participate and immerse themselves in teaching activities through personal experiences and feelings.This approach aims to develop students' emotions, active learning, and critical thinking skills (Bresolin et al., 2022).
According to studies conducted by Wang et al. (2022) and J. Zhang et al. (2022), nursing students in China possess an intermediate level of empathy and require improvement.However, the current approach to nursing humanistic education, primarily based on Watson care theory and curriculum teaching, is insufficient and needs enhancement (Yip, 2023), Moreover, the effectiveness of humanistic education needs to be improved, and a formal empathy curriculum is lacking (Y.Zhang et al., 2021;Zhu et al., 2021).While research has shown that empathy for nursing staff can be acquired through education, and narrative education can enable nursing students to improve their empathy through hands-on experiences or simulations (Ma˚rtensson et al., 2021;Petty, 2017).Most studies have focused on narrative education courses rather than integrating narrative education methods into existing curricula, which may increase the academic burden on students and waste faculty resources (C.-D.Huang et al., 2021;Petty, 2017;Xue et al., 2023).Therefore, it is necessary to integrate humanistic education into the nursing curriculum to cultivate high-quality empathic nursing talents and improve nursing students' empathic ability.Pediatric nursing is a critical course in the nursing profession.Due to the rapid changes in the condition of pediatric patients, their limited comprehension skills (Davies et al., 2023), and their low level of cooperation, meeting the needs of children and families with only therapeutic care can be challenging.Hospitalization experience affects children and causes psychological burdens to their parents (Tsui et al., 2023).Pediatric nurses with strong empathic skills can reassure patients and provide better care during the nursing process.However, limited studies use narrative education methods for pediatric nursing teaching in China.To address this gap and respond to the trend of educational change, this study uses narrative education combined with experiential teaching methods to explore their effectiveness in improving the empathy, emotional experience, and professional identity of nursing undergraduates, taking pediatric nursing as an example.

Study Design
This study used a pretest-posttest control group design to evaluate the effectiveness of experiential teaching in pediatric nursing for undergraduate nursing students.Pediatric nursing was uniformly taught using the seventh edition of the textbook Pediatric Nursing, edited by Yan Cui, with a course of 3.5 credits and a total of 72 hours.The knowledge of pediatric nursing includes the contents of child age staging, growth and development, child health care, nutrition and feeding, newborn care, care of children with common pediatric diseases, and nursing operation techniques.

Participants and Environment
From March 2022 to July 2022, using cluster sampling method, 59 full-time undergraduate nursing students in their early years were selected as the study subjects from a higher education institution in Hunan Province.Before data collection and recruitment, this study was approved by the Research Ethics Review Board of XiangYa Nursing School, Central South University (No. 2019054), and participants were provided with a detailed explanation of the study.
The inclusion criteria were students with a certain level of reading and comprehension ability, who were informed and agreed to participate in this study and had access to internet equipment.Exclusion criteria were students with mental-psychological abnormalities or those who had been suspended or dropped out of school for various reasons.

Assumptions
The hypothesis proposed in this study posited that undergraduate nursing students who receive narrative education and experiential teaching methods in a pediatric nursing course would exhibit an increased ability to empathize and enhance their professional identity with the nursing profession.

Instructional Intervention Design
Narrative Education Design.The researcher developed a carefully designed the narrative education process for this study.Initially, the course teacher meticulously selected, organized, and summarized experiences and stories from various sources such as the Internet, teaching, clinical work, and real life.These materials were mapped and integrated into the Pediatric Nursing course, focusing on enhancing empathy.The teacher arranged and narrated the course content according to the student's learning and teaching objectives.Before the course began, teachers conducted narrative education-related training and training, trained the language art of telling experiences and stories, and controlled the quality and quantity of the content conveyed.The teachers also arranged experiences and stories of corresponding topics in each chapter, using pictures and videos to share empathic experiences and stories in multiple forms during the narrative lectures to guide nursing students to feel the preciousness of life, the power of empathy, and the warmth of human care.Finally, the nursing students were encouraged to participate and share their experiences actively, and weekly free discussion sessions were arranged to record their stories and feelings using the TronClass software (Wisdom Garden, China) and the ''Happy Child Care'' public platform created by themselves.
(1) A library of narrative education materials was established by collecting experiences and stories from various sources such as the Internet, teaching, clinical work, and real life.The course instructors carefully screened, organized, and summarized the materials according to the teaching objectives and content, mapping the empathy of the materials into the Pediatric Nursing course and arranging them with specific course content.(2) Narrator Preparation: Before the course, the teachers received training related to narrative education in order to develop language and artistic skills for sharing experiences and stories.
They controlled the quality and quantity of the content conveyed during the narration and guided the material according to students' learning and teaching objectives.(3) Narrative teaching: Teachers arranged experiences and stories of corresponding topics in theory, practice, or clinical practice classes.Using multimedia forms such as images and videos, they shared empathic experiences and stories during the narrative teaching to guide nursing students to feel the preciousness of life, the power of empathy, and the warmth of human caring.Nursing students were encouraged to participate actively and share their own experiences, with weekly free discussion sessions arranged for 1 to 2 hours using the Tronclass software and the ''Happy Child Care'' public platform created by the researchers to document their stories and feelings.During teaching, attention was paid to modeling a positive attitude, leading by example, and implicitly influencing nursing students.
Experiential Instructional Design.The researcher has designed experiential teaching, including intelligent simulation baby care activities, situational simulation and role-playing activities, and clinical practice experience.The intelligent simulation baby (Real care baby 3; Realityworks Co., U.S.A.) is currently the most advanced baby simulator in the world and is introduced and used as a unique learning aid (de Anda, 2006).This smart baby has four random events: rocking, diaper changing, burping, and breastfeeding/bottle feeding, occurring at different intervals depending on the difficulty pattern.Nursing students need to meet the needs of the simulated baby to relieve the model from crying.If the baby is subjected to violent treatment or improper care, the smart baby will cry, and points will be deducted accordingly in the system report.The smart baby is wirelessly programmed to track and report caregiver behavior, including caregiving events, mishandling behavior, body surface temperature perception, time in the car seat, and clothing changes.To develop empathetic experiences and independent problem-solving behaviors, the nursing students had to care for the intelligent simulation infants as if they were real infants for 2 days.The intelligent infant simulation simulated the needs and behaviors of the infant, and there were corresponding induction and scores for getting the proper care.Regarding situational simulation and role-playing activities, nursing students in small groups chose more typical clinical cases to design and interpret situational cases before the end of the course.Nursing students were encouraged to analyze patients' possible psychological reactions and explore solutions to problems from the perspective of empathy.As for clinical practice experience, eight clinical teaching practice experience courses were conducted based on the basic knowledge and theory of child growth and development in pediatric nursing, child nutrition and feeding, child health care, common diseases and care of newborns and children, in multiple locations such as neonatal units, NICUs, pediatric wards, and kindergartens.The nursing students practiced empathy based on real nursing situations combined with narrative education materials.They needed to communicate with the children or their families in small groups according to the actual situation of the children, not only focusing on the condition but also requiring the nursing students to pay attention to the communication style and tone of voice, which need to reflect empathy.

Teaching Reflection.
(1) Narrative Education Reflection: After the narrative story was explained, students were organized to discuss and communicate, highlighting and guiding the value perspectives of transpersonal thinking, empathy, and emotional care in the experience and story.(2) Reflection on Smart Baby Care: For Smart Baby Care, nursing students were required to write a care diary within 1 week after the baby care experience, based on their personal experience and reflection.In the diary, they described the care process, their emotions and experience, and the changes brought to them.(3) Situation simulation and role-play reflection: After each group's role-play, nursing students conducted open discussions and spoke for selfevaluation and other evaluations, reflecting on themselves and learning from others, and summarizing and inspiring empathic care and psychological care.

Outcome Measurement
To evaluate the effectiveness of narrative education combined with experiential teaching, undergraduate nursing students' perspective-taking, emotional care, and transpersonal thinking regarding empathic competence were assessed.Thematic words were refined for teaching reflection content.
Jefferson Student Nursing Version of Empathy Scale (JSPE-NS) Measurements.The Jefferson Scale of Physician Empathy-Nursing Students was developed by Qiu Zhijun, a Chinese scholar, in 2010 to measure the level of empathy among nursing students (Qiu et al., 2011).It comprises 20 items, including ten reverse-scored items, and is categorized into three dimensions: perspective taking (10 items), emotional care (8 items), and transpersonal thinking (2 items).Responses were rated on a 7-point Likert scale, with scores ranging from 1 to 7, indicating ''strongly disagree'' to ''strongly agree.''The scale's total score ranged from 20 to 140, with higher scores reflecting greater empathic ability.The scale demonstrated good reliability and validity, as indicated by its total Cronbach's alpha coefficient of .836and half-reliability of .830.Thus, it can serve as a reliable measurement tool for assessing the empathic ability of nursing students in China.

Refinement of Theme Words for Teaching Reflection
Content.The content of teaching reflections from the narrative teaching, intelligent infant care diary, contextual simulation, and role-play sessions were collected, and the Colaizzi seven-step analysis method was used (Wirihana et al., 2018).The data were analyzed, while the NVivo 12 software (QSR, Australia) was used for data management.The researcher carefully read and understood the original materials submitted by the nursing students and marked sentences with value and meaning.The data were simplified, the statements were refined, and the subject words were extracted and recorded until no new subject words appeared.Based on coding, materials with the same or similar meaning were fused and grouped into one category for analysis.

Sample Size
Drawing upon previous randomized controlled trials (Yang et al., 2018) and qualitative studies (Adamson et al., 2018) that examined the educational effectiveness of narrative education for nursing students, a mean difference of 3.47 (standard deviation =1.13 points) in empathy scores was observed.The appropriate sample size was calculated using the Gpower software, setting up a paired samples t-test with parameters a = 0.05 and 1 2 b = 0.95 (Faul et al., 2007).The total sample size required was 26 students assuming a 10% dropout rate midway through the course.Given ethical considerations and interference reduction, we recruited all 60 nursing students from the same grade at one school as participants.Participation was voluntary, and enrollment was limited.

Data Collection Procedures
Basic information was collected from participants before the experiment, including gender, age, personality traits, family residence, father's/mother's occupation, reasons for choosing the nursing profession, preference for the nursing profession, and employment intentions to measure baseline comparability and empathic abilities.Empathic abilities were measured at the end of the intervention, and data on teaching reflections from narrative teaching, intelligent infant care diary, contextual simulation, and role-play sessions were also collected.

Statistical Analysis
Statistical analysis was performed using SPSS 26.0 software with normally distributed measures described as mean 6 standard deviation: ( X 6 s), and skewed measures described as median (interquartile range): M (IQR).A paired data t-test was conducted, with a test level of a = 0.05, and p \ 0.05 was considered statistically significant.
Teaching reflection data were anonymized and numerically labeled.The Colaizzi seven-step analysis method was used to analyze the data, and the Nvivo12 software was used for data management, designing a classification outline, coding the data, categorizing, describing, and interpreting them.

Ethical Considerations
This study received approval from the Research Ethics Review Board of *Xiangya School of Nursing, Central South University (No. 2019054) and was conducted following the Declaration of Helsinki.Participants were provided with a detailed explanation of the study and informed that they would not receive any academic or monetary rewards for their participation.All participants completed an informed consent form.

Participant Sample and Characteristics
As shown in Figure 1, 60 students participated in the study, but one student did not participate in the precourse empathy measure for personal reasons.However, this student attended the remaining courses for ethical considerations, and his data was not included in the analysis.The other 59 students attended all the courses and completed the pre-and post-course empathy measures.In addition, 20 students were selected for analysis of their teaching reflections.
All 59 questionnaires distributed were returned, resulting in a 100% response rate.The mean age of the participants was 21.25 6 0.893 years, with 47 (79.9%) females and 12 (20.3%)males.Further details on participant characteristics are presented in Table 1.

Main Results
The study used paired t-tests to compare nursing students' Jefferson Empathy Scale scores before and after the intervention.The results showed that nursing students' total empathy scale scores, perspective-taking dimension, and emotional care dimension scores after teaching were higher than before, and the difference was statistically significant (p \ 0.05).However, there was no statistically significant difference in the scores of transpersonal thinking dimensions before and after teaching.Further details are shown in Table 2.

Analysis of the Content of Teaching Reflection
This study collected the participants' narrative and experiential teaching reflections and analyzed them thematically.A total of 20 reflections were extracted and categorized into five themes: emotional empathy, pediatric nursing skills, gratitude to parents, reverence for life, and course experience.The reflections reflected the gains of nursing students in empathic abilities such as perspective-taking dimension, emotional care, and transpersonal thinking.

Sense of Responsibility:
(1) N1: ''To bring a baby into the world and leave him or her to face the elements, one must shoulder the weight of a great responsibility to provide a haven from the wind and rain.''(2) N4: ''This answers my grandmother's doubts and reflects my inner sense of responsibility towards motherhood.''(3) N12: ''Through my experiences, I have come to understand the multifaceted nature of motherhood and the immense responsibility it entails, from moments of novelty and playfulness to times of dissatisfaction and complaints, and ultimately to the deep sense of responsibility that accompanies it.''Satisfaction: (1) N2: ''The reward for my efforts as a mother is when I hear my baby's cries turn into laughter.''(2) N4: ''When I hear my baby's tender laughter or light snoring after an operation, it brings me immense satisfaction, a unique feeling that only a mother can experience, and a special gift that is only bestowed upon those who have embraced motherhood.'' (3) N20: ''Although raising a child can be challenging, the joy it brings is far greater than any hardship.This joy stems not from physical comfort but from the spiritual satisfaction that comes from the sense of responsibility and emotional connection to one's child.It is a joy that cannot be bought.''Compassion: (1) N9: ''We should strive to show more compassion towards these mothers, allowing them to rightfully hold their babies and do what they need to do, and should also exhibit greater patience with all babies.''(2) N6: ''Although I had observed my mother and sister care for my sibling, it wasn't until I became a mother myself that I gained a deeper appreciation for the exhaustion and hard work that comes with motherhood.''Balancing Myself: (1) N1: ''Many new mothers experience similar anxieties, worrying about their babies and work.This tension and anxiety can lead to postpartum depression, a condition that we, as caregivers, should be vigilant of.''(2) N10: ''Through my experiences, I have learned the importance of balancing my responsibilities as a mother with my other obligations and not allowing myself to be consumed by the demands of motherhood.''Reflection: (1) N12: ''I have come to realize the importance of self-reflection, particularly concerning my impatience and lack of patience and how it affects my relationship with my child.''(2) N19: ''Exploring the relationship between feeding and the infant's work and rest patterns, and understanding how to feed scientifically, is a long journey that we, as students of Xiangya School of Nursing, must undertake.We need to consider ways to alleviate people's fear of childcare and find solutions to the challenges faced by new parents.''Humanistic Care: (1) N17: ''Through conscious and unconscious actions, nurses convey their care and concern for the child, striving to create a comfortable, peaceful, and safe medical environment that facilitates the child's early recovery.''(2) N20: ''In life, we should prioritize developing a caring and compassionate nature, as these qualities are essential to becoming a nurturing and empathetic nurse.''Pediatric Nursing Skills.
Proper Care: (1) N5: ''I developed my baby-raising skills from scratch, starting from being slightly frazzled on the first day, then slowly calming down, until finally, on the third day, I reached a state of perfection through practice.''(2) N6: ''It taught me how to quickly take the right measures in response to a crying baby.I also realized how challenging it can be to care for a little human without any issues!''(3) N10: ''Initially, I was overwhelmed, but with time and practice, I could quickly determine from the baby's cries whether they were hungry or needed a diaper change.''New Understanding: (1) N5: ''The experience gave me a new perspective on baby care, emphasizing the importance of patience, kind words, comforting embrace, and gentle touch.''(2) N10: ''Through continuous learning and adaptation, I gained valuable experience caring for my baby and became more proficient in my role.''Gratitude to Parents.Compassionate Parenting: (1) N1: ''Through my experience with the little ones, I gained a newfound appreciation for the difficulties of raising children.As the saying goes, ''Raising a child is the only way to understand parents'' grace truly.''(2) N2: ''My immersive experience in pediatrics gave me a greater understanding of the hard work and dedication required to raise a child, particularly as a mother.''(3) N14: ''Taking care of my own needs while tending to my baby's needs can be exhausting, and it has given me a greater appreciation for the sacrifices and hard work of mothers.''(4) N16: ''I aspire to be a good son and a competent father in the future.'' Love and Care: (1) N4: ''A mother and her child share an unparalleled special bond.''(2) N7: ''As a parent, dedicating oneself to raising a child and watching them grow into a mature adult is both a joy and a source of anxiety.''Empathy: (1) N9: ''Through caring for my child, I have gained a greater understanding of the challenges my mother faced in raising me.''(2) N20: ''I am beginning to appreciate the immense difficulty of raising a child, and I am in awe of my mother's care, attention, and patience in raising me.'' Reverence for Life.
Attention and Love: (1) N2: ''Raising a healthy, happy child requires an immense amount of attention, love, time and energy.''(2) N7: ''Observing the baby's face closely, sketching their little body wrapped in blankets, and admiring their cuteness is a truly special experience.''(3) N8: ''Children are highly intuitive and sensitive beings, and their hearts can sense when they are loved and cared for.Conversely, if they sense neglect, they will express their dissatisfaction through crying and other behaviors.''Protective Desire: (1) N4: ''I am grateful that he approached me, allowing me to experience the unique pride of motherhood and inspire my unlimited potential.''(2) N9: ''A mother's love endures even when their child is rowdy, exhausted, and angry.However, despite all this, a mother will feel very protective and worthy when looking at their little one.They will slowly adapt to the situation and find happiness every day.''

Course Experience.
Experiences and Challenges: (1) N6: ''This simplified simulation left me physically and emotionally exhausted.Facing a live baby would be even more challenging.'' (2) N18: ''This simulation only scratches the surface of the challenges of becoming a mother or a qualified pediatric nurse.We still have a lot to learn and improve upon in the future.''

Discussion
Narrative Education Combined With Experiential Teaching Methods Can Effectively Improve the Empathy of Nursing Students The empathic ability of nursing students is the power to put themselves in the perspective of patients and their families in clinical work, experience their inner feelings and emotional needs, provide emotional support and psychological care, and help patients and their families navigate psychological distress and cooperate with treatment (MacKinnon et al., 2015).The study's results showed that nursing students' total empathy, perspective-taking, and emotional care dimension scores after implementing the teaching method were higher than before the teaching (p \ .05).Yamashita and Petty (2022) also suggest that narrative education can enhance nursing students' awareness of emotional experiences and that strong emotional messages from parents enhance their awareness, understanding, and insight into their emotional experiences (Petty et al., 2020).It might be related to the implementation strategy of narrative education combined with experiential teaching.
Narrative education enables nursing students to learn and vicariously experience emotions from the perspective of the characters in stories and experiences by narrating and sharing patient, life, and classical stories and experiences in the classroom.It leads to psychological empathy and transpersonal awareness, which helps nursing students empathize better with patients and their families (El Hussein & Cuncannon, 2022).Additionally, nursing students create their case situations and act out characters in various pediatric cases to better understand the patients' and their families' psychological activities and emotions.They also go into real-life scenarios in the hospital and kindergarten pediatric department to practice, observe, learn, and develop the ability to communicate effectively, extract ideas, and feel emotions (Chen et al., 2015).Experiential teaching methods promote the absorption and improvement of nursing students' empathy and sympathy skills through practice and first-hand experience.Finally, reflective journaling based on the student's personal experiences and reflections enhances the emotional experience of the story or experience.The feelings are internalized into the concept of empathy through the behavioral reflections of the caregiving baby (Dhaliwal et al., 2018).The reflections on the caregiver's behavior internalize the feelings into the concept of empathy.Although the pre-and post-course comparisons of empathy dimension scores were not statistically significant, analysis of the nursing students' reflective diaries showed they gained new insights and the ability to think differently after the teaching.They appreciated the greatness of their parents and became more grateful for their parents and revered life.

Narrative Education Combined With Experiential
Teaching Methods Can Strengthen Nursing Students' Sense of Identity in the Nursing Profession In the general data, nursing students did not have a strong inclination toward nursing or a desire to work in nursing after graduation.Only half of the nursing students displayed a positive attitude.However, the results of the reflective diary theme analysis suggest that the reflective aspect of narrative education can improve nursing students' skills in basic nursing operations with children, enhance their professionalism in understanding the psychology and emotions of children and their families, promote the exploration of scientific care, and aid in the implementation of recovery methods for children.Arrogante et al.'s (2022) findings in geriatric nursing indicated that simulation could improve empathy and attitudes toward patients, leading to a better quality of care.In summary, narrative education is a continuous teaching method that combines learning with practice and experience with reflection.The impact of narrative education is not limited to the resonate emotionally with students of the teacher in telling stories or experiences, the values and professional outlook embedded and conveyed in the story or experience, but also the experience of nursing students in practice, independent thinking and creation, introspection, and internalization in the reflective journal.These aspects enable nursing students to have greater empathy for patients, deeper understanding of their profession, and stronger professional awareness (Buescher & McGugan, 2022).The content of narrative education is not limited to textbook knowledge, and the teaching method developed around the core of sharing stories broadens the learning horizon of nursing students.
Telling stories-listening stories-writing stories can help nursing students share and listen better from the perspective of narrative education, better experience from the perspective of patients and their families, feel the gains brought by nursing work, better appreciate the value of the nursing profession, and promote nursing students' professionalism Spirituality (Y.-K.Huang et al., 2021;Milota et al., 2019).Experiential teaching methods, such as contextual simulation, caregiving for smart babies, and clinical practice, are active learning methods for nursing students to acquire professional skills and knowledge.Observation and experiencing real nursing work situations can help students consider problems from the patient's perspective, leading to more direct interpersonal interaction and teamwork.Reflective discussions and messages aid nursing students in revisiting and recreating the gains and feelings of narrative and experiential teaching, deepening their emotional sublimation and internalization of the ability to empathize.It helps nursing students improve their emotional perception, enhance the humanistic quality of nursing, and promote their recognition of the nursing profession (Foppa et al., 2021).

Improvement and Insight of Narrative Education Combined With Experiential Teaching Methods
Narrative education combined with experiential teaching emphasizes person-centered nursing teaching and learning that is scientifically and effectively co-applied.Experiential teaching is a cyclical process involving four components: concrete knowledge learning, reflective observation, dialectical thinking, and hands-on practice (Konstantinidis et al., 2021).Integrating narrative education and experiential teaching can be better applied in nursing teaching, enhancing nursing students' professional skills and empathy in the natural nursing environment, utilizing innovative teaching methods and resources, and enriching the classroom.The combination of narrative education and experiential teaching methods represents an improvement over the single approach to humanistic education currently in place and results from teaching reform (Adams-Becker et al., 2017).This study focused on pediatric nursing and explored the effect of combining humanistic education with nursing courses to achieve better results in the short term.However, implementing this teaching method requires exploring a standardized model, that considers the best conditions for implementing the program and prioritizes educational goals (Daryazadeh et al., 2020).

Limitations of This Study
This study has several limitations that must be acknowledged.First, the participants in this study were recruited from a single university and may not be representative of all nursing students.Second, the study employed a pretest-posttest controlled experiment design without a parallel control group, which may limit the generalizability of the findings.Third, the study did not compare the participants with nursing students from other institutions, and the sample size was small.Finally, using an intelligent simulation infant in this study was specialized, not all institutions could access this equipment.

Conclusion
In conclusion, this study demonstrated that integrating narrative education and experiential teaching methods in pediatric nursing courses could increase engagement, improve empathy and humanistic care skills, and strengthen professional identity among nursing students.This approach represents a promising strategy for integrating humanistic education into nursing professional courses.However, given the small sample size of this study, further research with larger and more diverse samples is needed.Future studies may also explore the long-term effects of this approach, such as the humanistic care skills of nursing students after entering clinical practice.Additionally, while this study focused on pediatric nursing, future research can incorporate the unique characteristics of other nursing disciplines to develop and refine teaching strategies and promote the training of nursing professionals.

Figure 1 .
Figure 1.Flow diagram of the participants of this study.

Table 2 .
Comparison of Jefferson Nursing Student Empathy Scale Scores Before and After Teaching (Scores, X 6 s). *p\0.05.