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Relationship Between the Problem-Solving Skills and Empathy Skills of Operating Room Nurses

AY, Fatma 1* ; POLAT, Şehrinaz; KASHIMI, Tennur

1 PhD, RN, Assistant Professor, Faculty of Health Sciences, Department of Midwifery, Istanbul University-Cerrahpaşa, Turkey

2 PhD, RN, Directorate of Nursing Services, Hospital of Faculty of Medicine, Istanbul University, Turkey

3 MS, RN, Director, Operating Room, Hospital of Faculty of Medicine, Istanbul University, Turkey.

Accepted for publication: January 21, 2019

*Address correspondence to: Fatma AY, No.25, Dr. Tevfik Saglam Street, Dr. Zuhuratbaba District, Bakirkoy, Istanbul 34147, Turkey. Tel: +90 212 4141500 ext. 40140; Fax: +90 212 4141515; E-mail: [email protected]

The authors declare no conflicts of interest.

Cite this article as: Ay, F., Polat, Ş., & Kashimi, T. (2019). Relationship between the problem-solving skills and empathy skills of operating room nurses. The Journal of Nursing Research , 28 (2), e75. https://doi.org/10.1097/jnr.0000000000000357

This is an open access article distributed under the Creative Commons Attribution License 4.0 (CCBY) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Background

The use of empathy in problem solving and communication is a focus of nursing practice and is of great significance in raising the quality of patient care.

Purpose

The purposes of this study are to investigate the relationship between problem solving and empathy among operating room nurses and to explore the factors that relate to these two competencies.

Methods

This is a cross-sectional, descriptive study. Study data were gathered using a personal information form, the Interpersonal Problem Solving Inventory, and the Basic Empathy Scale ( N = 80). Descriptive and comparative statistics were employed to evaluate the study data.

Results

Age, marital status, and career length were not found to affect the subscale scores of cognitive empathy ( p > .05). A negative correlation was found between the subscale scores for “diffidence” and “cognitive empathy.” Moreover, the emotional empathy scores of the graduate nurses were higher than those of the master's/doctorate degree nurses to a degree that approached significance ( p = .078). Furthermore, emotional empathy levels were found to decrease as the scores for insistent/persistent approach, lack of self-confidence, and educational level increased ( p < .05). The descriptive characteristics of the participating nurses were found not to affect their problem-solving skills.

Conclusions/Implications for Practice

Problem solving is a focus of nursing practice and of great importance for raising the quality of patient care. Constructive problem-solving skills affect cognitive empathy skills. Educational level and career length were found to relate negatively and level of self-confidence was found to relate positively with level of cognitive empathy. Finally, lower empathy scores were associated with difficult working conditions in operating rooms, intense stress, and high levels of potential stress-driven conflicts between workers in work settings.

Introduction

Healthcare institutions are where individuals seek remedies to their health problems. These institutions face problems, which relate to both employees and care recipients. These problems may occur spontaneously and require immediate solution. Moreover, these problems require that the preferred remedies be adapted to address the unique nature of both organizational circumstances and individual requirements. Therefore, it is important that nurses, who are a major component of the healthcare system, have problem-solving skills.

Operating rooms are complex, high-risk environments with intense levels of stress that require rapid judgment making and fast implementation of appropriate decisions to increase patients' chances of survival ( Kanan, 2011 ; Jeon, Lakanmaa, Meretoja, & Leino-Kilpi, 2017 ). Furthermore, aseptic principles may never be compromised, and a high level of coordination and cooperation among team members should be maintained in these areas ( Kanan, 2011 ; Sandelin & Gustafsson, 2015 ). The members of a surgical team may vary in the operating room ( Sandelin & Gustafsson, 2015 ; Sonoda, Onozuka, & Hagihara, 2018 ). Under these difficult conditions, time management and workload are important stress factors for nurses ( Happell et al., 2013 ; Suresh, Matthews, & Coyne, 2013 ). At the same time, operating room nurses are legally responsible for the nature and quality of the healthcare service received by patients before, during, and after their surgical intervention ( Kanan, 2011 ). The American Nurses Association defines a nurse as “the healthcare professional establishing, coordinating and administering the care while applying the nursing process in an aim to meet the identified physiological, psychological, sociocultural and spiritual needs of patients who are potentially at the risk of jeopardized protective reflexes or self-care ability because of surgery or invasive intervention” ( Association of periOperative Registered Nurses, 2015 ).

Problem solving is the most critical aspect of the nursing practice. The fact that nursing requires mental and abstract skills, such as identifying individual needs and finding appropriate remedies, was first stated in 1960s. In 1960s, the nursing theorists Abdellah, Orem, and Levin emphasized the mental aspect of nursing. They argued that the most critical requirement of nurses in the clinical field is the ability to decide on and plan the right action and that nursing care should be founded on a sound knowledge base ( Taşci, 2005 ).

The World Health Organization has stated that “taking measures and applying a problem-solving approach to provide appropriate care is one of the compulsory competencies of nurses” ( Taşci, 2005 ). Thus, enhancing the problem-solving skills of nurses is of great importance in raising the quality of patient care ( Taylor, 2000 ; Yu & Kirk, 2008 ). On the other hand, Bagnal (1981) argued that people with problem-solving skills need to be equipped with personal traits including innovation, clear manifestation of preferences and decisions, having a sense of responsibility, flexible thinking, courage and adventurousness, ability to show distinct ideas, self-confidence, a broad area of interest, acting rationally and objectively, creativity, productivity, and critical perspective (as cited in Çam & Tümkaya, 2008 ).

To provide the best surgical care to a patient, team members must work together effectively ( Sonoda et al., 2018 ). One of the most important factors affecting the quality of healthcare service delivery is effective communication between healthcare professionals and healthcare recipients, with empathy forming the basis for effective communication.

Because of the intrinsic nature of the nursing profession, nurses should have empathy skills. Thus, empathy is the essence of the nursing profession ( Fields et al., 2004 ; Vioulac, Aubree, Massy, & Untas, 2016 ). A review of resources in the literature on problem solving reveals that gathering problem-related data is the first major step toward determining the root causes of a problem. In this respect, empathy is an important skill that helps properly identify a problem. On the basis of the definition of empathy, sensing another person's feelings and thoughts and placing oneself in his or her position or feeling from within his or her frame of reference should work to improve one's problem-solving skills, particularly those skills related to social problem solving ( Taşci, 2005 ; Topçu, Baker, & Aydin, 2010 ; Vioulac et al., 2016 ). It is possible to explain empathic content emotionally as well as cognitively. Emotional empathy (EE) means feeling the emotions of another person and providing the most appropriate response based on his or her emotional state. This is very important in patient–nurse communications. Cognitive empathy (CE) is the ability to recognize the feelings of another without experiencing those feelings yourself ( de Kemp, Overbeek, de Wied, Engels, & Scholte, 2007 ).

Gender, age, level of education, marital status, years of work, duration working at current institution, and problem-solving situations have been shown in the literature not to affect the problem-solving or empathy skills of nurses ( Abaan & Altintoprak, 2005 ; Kelleci & Gölbaşi, 2004 ; Yu & Kirk, 2008 ). Empathy is especially critical to the quality of nursing care and is an essential component of any form of caring relationship. The findings in the literature regarding empathy among nurses are inconsistent ( Yu & Kirk, 2008 ), and no findings in the literature address the relationship between problem-solving skills and empathy skills in operating room nurses.

Today, the healthcare system demands that nurses use their professional knowledge to handle patient problems and needs in flexible and creative ways. Problem solving is a primary focus of the nursing practice and is of great importance to raising the quality of patient care ( Kelleci & Gölbaşi, 2004 ; Yu & Kirk, 2008 ). Enhancing the problem-solving and empathy skills of nurses may be expected to facilitate their identification of the sources of problems encountered during the delivery of healthcare services and their resolution of these problems.

The purposes of this study are to investigate the relationship between problem solving and empathy in operating room nurses and to explore the factors related to these two competencies.

Study Model and Hypotheses

This study is a cross-sectional and descriptive study. The three hypotheses regarding the relationships between the independent variables are as follows:

H1: Sociodemographic characteristics affect problem-solving skills.
H2: Sociodemographic characteristics affect level of empathy.
H3: Problem-solving skills are positively and significantly correlated with empathy.

Study Population and Sample

The study was conducted during the period of May–June 2015 at three hospitals affiliated with Istanbul University. The study population consisted of 121 nurses who were currently working in the operating rooms of these hospitals. The study sample consisted of the 80 nurses who volunteered to participate and answered all of the questions on the inventory.

Data Collection Tool

Study data were gathered using a personal information form, the Interpersonal Problem Solving Inventory (IPSI), and the Basic Empathy Scale.

Personal information form

This questionnaire, created by the researchers, is composed of 10 questions on the age, gender, educational background, organization and department, position, and organizational and professional functions of the respondent.

Interpersonal problem solving inventory

The IPSI, developed and validated by Çam and Tümkaya (2008) , was used in this study. The Cronbach's α internal consistency coefficients of the IPSI subscales were previously evaluated at between .67 and .91. The IPSI includes 50 items, all of which are scored on a 5-point Likert scale, with 1 = strictly inappropriate and 5 = fully appropriate . The lack of self-confidence (LSC) subscale assesses lack of confidence in problem solving. The constructive problem solving (CPS) subscale assesses emotions, thoughts, and behaviors that contribute to the effective and constructive solution of interpersonal problems. The negative approach to the problem subscale assesses intensely the negative emotions and thoughts such as helplessness, pessimism, and disappointment that are experienced when an interpersonal problem is encountered. The abstaining from responsibility subscale assesses failure to take responsibility for solving the problem. The persistent approach (PA) subscale assesses self-assertive/persistent thoughts and behaviors in solving problems encountered in interpersonal relationships. A high score on a subscale indicates a high interpersonal-problem-solving capability for that subscale category ( Çam & Tümkaya, 2008 ). A high score on the negative approach to the problem subscale indicates a higher likelihood of experiencing intense negative feelings and thoughts such as helplessness, pessimism, and sadness when encountering a problem. A high score on CPS indicates that the respondent will show more of the emotions, thoughts, and behaviors that contribute to the problem in an effective and constructive way. A low level of self-confidence indicates that the respondent will exhibit low self-confidence toward effectively resolving a problem. A high score on the abstaining from responsibility subscale indicates a high inclination to assume responsibility to resolve a problem ( Table 1 ). The high level of insistent approach indicates that the participant is more willing to solve problems ( Çam & Tümkaya, 2008 ). In this study, the Cronbach's α reliability coefficients were .901, .899, .763, .679, and .810, respectively.

Basic empathy skill scale

The Basic Empathy Skill Scale was developed by Jolliffe and Farrington (2006) and validated by Topçu et al. (2010) in Turkish. It is a 5-Likert scale (1 = s trictly disagree and 5 = strictly agree ) consisting of 20 items, of which nine measure CE and 11 measure EE. The Cronbach's α coefficients that were calculated for the reliability study range between .76 and .80. The lowest possible scores are 9 and 45 and the highest possible scores are 11 and 55 for the CE and EE subscales, respectively. A high score on the CE subscale indicates that the CE level is high, and a high score on the EE subscale indicates that the EE level is high ( Topçu et al., 2010 ). The two subscales of the Basic Empathy Skill Scale have been found to be highly reliable. The Cronbach's α reliability coefficients in this study were .782 for the CE subscale and .649 for the EE subscale.

Data Collection

The study was conducted between May and June 2015 at three hospitals affiliated with Istanbul University. The researcher explained the study to those nurses who agreed to participate. The questionnaire form was distributed to the participants, the purpose of the investigation was clarified, and permission to use participant data was obtained. The participants completed the questionnaire on their own, and the completed questionnaires were collected afterward. The time required to complete the questionnaire was 15–20 minutes in total.

Evaluation of Data

Number Cruncher Statistical System 2007 (Kaysville, UT, USA) software was used to perform statistical analysis. To compare the quantitative data, in addition to using descriptive statistical methods (mean, standard deviation, median, frequency, ratio, minimum, maximum), the Student t test was used to compare the parameters with the regular distribution in the two groups and the Mann–Whitney U test was used to compare the parameters without normal distribution in the two groups. In addition, a one-way analysis of variance test was used to compare three or more groups with normal distribution, and a Kruskal–Wallis test was used to compare three or more groups without normal distribution. Pearson's correlation analysis and Spearman's correlation analysis were used to evaluate the relationships among the parameters. Finally, linear regression analysis was employed to evaluate multivariate data. Significance was determined by a p value of < .05.

Ethical Considerations

Ethical conformity approval was obtained from the Non-Interventional Clinical Research Ethics Board at Istanbul Medipol University (108400987-165, issued on March 30, 2015). Written consent was obtained from the administrations of the participating hospitals. Furthermore, the informed consent of nurses who volunteered to participate was obtained. Permission to use the abovementioned scales that were used in this study as data collection tools was obtained via e-mail from their original authors.

Eighty nurses (97.5% female, n = 78; 2.5% male, n = 2) were enrolled as participants. The age of participants ranged between 24 and 64 (mean = 37.56 ± 8.12) years, mean years of professional nursing experience was 15.84 ± 8.30, and mean years working in the current hospital was 13.19 ± 8.23. Other descriptive characteristics for the participants are provided in Table 2 .

A comparison of scale subdimension scores revealed a negative and statistically significant correlation at a level of 22.3%. Statistical significance was reached only between the LSC subscale and the CE subscale ( r = −.223, p = .047; Table 3 ). Thus, a higher LSC score was associated with a lower CE score.

Comparisons between participants' descriptive characteristics and subdimension scores on the problem-solving skill scale revealed no significant differences. Thus, demographic characteristics such as age, educational background, and career length were found to have no influence on problem-solving skills ( p > .05; Table 4 ).

Age, marital status, and professional career length were not found to affect the CE and EE subscale scores, with no statistically significant correlations found between the two subscales ( p > .05; Table 4 ). However, the EE scores of undergraduate nurses were found to be higher than those of postgraduate nurses, at a level that approached statistical significance ( p = .078). In addition, the average CE scores of nurses who had worked for 1–10 and 11–20 years were higher than those of nurses who had worked for 21 years or more, at a level that approached statistical significance ( p = .066).

A statistically significant difference was found between mean years working in the current hospital and educational background, respectively, and CE scores ( p = .027 and p = .013; Table 4 ). On the basis of paired comparison analysis, the CE scores of participants with 1–10 years of working experience at their current hospital were higher than those with ≥ 21 years of working experience at their current hospital ( p = .027). Also on the basis of paired comparison analysis, the CE score of participants educated to the undergraduate level was found to be higher at a statistically significant level than those educated to the master's/doctorate degree level ( p = .013).

The comparison of problem-solving skill scores by descriptive characteristics revealed no statistically significant difference between subscale scores and the variables of age, marital status, length of professional and organizational career, or educational background ( p > .05). Thus, the descriptive characteristics of the participants did not affect their problem-solving skills.

Regression Analysis of Risk Factors Affecting Cognitive and Empathy Skills

Variables found after univariate analysis to have significance levels of p < .01 were subsequently modeled and evaluated. A regression analysis was conducted to determine the effect on CE skills of educational level, duration of institutional work, CPS level, and self-insecurity level. The explanatory power of this model was 29.9% ( R 2 = .299), and the model was significant ( p < .001). As a result of the analysis, CPS ( p = .006), educational status of graduate ( p < .001), and working for the current hospital for a period of more than 20 years ( p = .004) were found to have a significant and positive influence on the CE score.

A 1-unit increase in the CPS score was found to increase CE skills by 0.139 points (β = 0.139, 95% CI [0.041, 0.237], p < .01). For education, graduate education was found to decrease the CE score by 4.520 points (β = −4.520, 95% CI [−6.986, −2.054], p < .001). For duration working for the current hospital, working for the same institution for a period exceeding 20 years was found to decrease the CE score by 3.429 points (β = −3.429, 95% CI [−5.756, −1.102], p < .05). In addition, a 1-unit increase in the LSC score was found to decrease the CE score by 0.114 points, which did not achieve statistical significance (β = 0.114, 95% CI [−0.325, 0.096], p > .05).

Regression analysis was used to evaluate the effects of education, PA, and LSC on the risk factors affecting EE. As a result of this evaluation, the explanatory power of the model was determined as 15.3% ( R 2 = .153), which was significant despite the low level ( F = 3.388, p = .001). The effects of PA ( p = .021) and educational status ( p = .015) on the EE score were shown through analysis to be statistically significant ( Table 5 ). A 1-unit increase in PA score was found to increase the EE score by 0.323 points (β = 0.323, 95% CI [0.049, 0.596], p < .05). For education, having a graduate education was found to decrease the EE score by 3.989 points (β = −3.989, 95% CI [−7.193, −0.786], p < .05). Moreover, the LSC score was found to be 0.119 points lower than the EE score. However, this result was not statistically significant (β = −0.193, 95% CI [−0.467, 0.080], p > .05). Dummy variables were used in the regression analysis of sociodemographic characteristics (educational status and years working for the current hospital).

This study found that age, marital status, educational background, years of professional working experience, and years working for the current hospital did not affect the problem-solving skills of the participants. In the literature, the findings of several studies indicate that characteristics such as age, educational background, department of service, and career length do not affect the problem-solving skills of nurses ( Abaan & Altintoprak, 2005 ; Kelleci & Gölbaşi, 2004 ; Yu & Kirk, 2008 ), whereas other studies indicate that these variables do affect these skills ( Ançel, 2006 ; Watt-Watson, Garfinkel, Gallop, Stevens, & Streiner, 2000 ; Yu & Kirk, 2008 ). However, beyond these characteristics, some studies have reported a positive correlation between the problem-solving skills of nurses and their educational level, with this correlation mediated by the physical conditions of the workplace, good relationships with colleagues, and educational background ( Yildiz & Güven, 2009 ). These findings suggest that factors affecting the empathy and problem-solving skills of nurses working in operating rooms differ from known and expected factors.

Operating room nurses deliver dynamic nursing care that requires attention and close observation because of the fast turnover of patients. In addition to the problem-solving skills that they use during the patient care process, these nurses must use or operate a myriad of lifesaving technological devices and equipment ( AbuAlRub, 2004 ; Özgür, Yildirim, & Aktaş, 2008 ). The circumstances in which nurses employ their problem-solving skills are generally near-death critical conditions and emergencies. Furthermore, operating rooms are more isolated than other areas of the hospital, which affects nurses who work in operating rooms and intensive care units ( AbuAlRub, 2004 ; Özgür et al., 2008 ).

Communication is a critical factor that affects the delivery of healthcare services. Communication does not only take place between a service recipient and a provider. To establish a teamwork philosophy between employees, it is essential to build effective communication ( Sandelin & Gustafsson, 2015 ). Empathic communication helps enhance the problem-solving skills of nurses as they work to learn about individual experiences ( Kumcağiz, Yilmaz, Çelik, & Avci, 2011 ). Studies in the literature have found that nurses who are satisfied with their relationships with colleagues, physicians, and supervisors have a high level of problem-solving skills ( Abaan & Altintoprak, 2005 ; Kumcağiz et al., 2011 ) and that higher problem-solving skills are associated with a higher level of individual achievement ( Abaan & Altintoprak, 2005 ; Chan, 2001 ). Another finding of this study is that CPS increases the cognitive emphatic level. This may be attributed to constructive problem-solving skills increasing CE, as these skills are associated with feelings, thoughts, and behaviors that contribute to problem resolution.

A review of the literature on empathy and communication skills revealed, as expected, that these skills increased with level of education ( Kumcağiz et al., 2011 ; Vioulac et al., 2016 ). However, a number of studies have reported no significant correlation between age, marital status, and professional working experience and empathy skills or communication abilities in nurses ( Kumcağiz et al., 2011 ; Yu & Kirk, 2008 ).

EE is assumed to be a more intuitive reaction to emotions. Factors that affect EE are nurses working with small patient groups, frequent contact with patient groups, and long periods spent accompanying or being in close contact with patient groups ( Vioulac et al., 2016 ). Studies in the literature have reported no correlation between the empathy skills of nurses and demographic characteristics ( Vioulac et al., 2016 ). This study supports this finding, with the empathy skills of operating room nurses found to be close to the peak value of the scale.

Studies in the literature reveal a positive correlation between empathy and career length ( Watt-Watson et al., 2000 ; Yu & Kirk, 2008 ) as well as a correlation between increased professional experience and lower empathy ( Yu & Kirk, 2008 ). This study found an association between longer periods working for the same hospital and higher levels of education with lower empathy scores. This may be attributed to the difficult working conditions in operating rooms, intense stress, and high level of potential stress-driven conflicts between employees in work settings.

Stress is a major factor that affects the empathy skills and relationship-building abilities of nurses ( Vioulac et al., 2016 ). Nurses are exposed to a wide variety of stressors such as quality of the service, duration of shifts, workload, time pressures, and limited decision-making authority ( Patrick & Lavery, 2007 ; Shimizutani et al., 2008 ; Vioulac et al., 2016 ). In particular, environments evoking a sense of death (e.g., operating rooms) is another factor known to elevate perceived stress ( Ashker, Penprase, & Salman, 2012 ). High stress may lead to negative consequences such as reduced problem-solving abilities ( Zhao, Lei, He, Gu, & Li, 2015 ). Both having a long nursing career and working in stressful environments such as operating rooms may negatively affect empathy and problem-solving skills. However, this study revealed that working for a long period at the current hospital had no influence on problem-solving skills. The low reliability of the scales means that the variance may be high in other samples that are drawn from the same main sample, with the resultant data thus not reflecting the truth.

Low reliability coefficients reduce the significance and value of the results obtained by increasing the standard error of the data ( Şencan, 2005 ). The Cronbach's α of the EE scale used in the study was between .60 and .80 and is highly trustworthy. However, the Cronbach's α value is close to .60 (i.e., .649). This result may elicit suspicion in regression analysis estimates that are done to determine the variables that affect EE. In the correlation analysis, a statistically significant weak correlation was found only between the LSC subdimension and CE. However, the fact that the subscales of empathy and problem-solving skills are significantly related to the regression models may also be related to the reliability levels of the scales.

According to the results of the regression analysis, all of the variables remaining in Model A affected level of low for the CE ( R 2 = .299). Having constructive problem-solving skills ( p = .006), having a high level of education ( p < .001), and working for the current hospital for over 20 years ( p = .004) were found to be significantly related to CE.

Other variables were found to have no significant effect. According to the results of the regression analysis, all of the remaining variables in Model B accounted for a relatively low portion of the EE ( R 2 = .153). When the t test results for the significance of the regression coefficients were examined, it was determined that PA ( p = .021) and educational status ( p = .015) were significant predictors of EE. Other variables had no significant effect ( Table 5 ). The increase in the level of education of nurses may have increased their cognitive and emotional development. Thus, working in the same hospital for over 20 years was found to increase the levels of CE and EE. This result may be because of greater professional experience and regular experience handling numerous, different problems. In addition, the low explanatory power of the models may also be because of the fact that many other arguments that may affect empathy were not modeled. When constant values are fixed and the value of the independent variables entering the regression formula is zero, constant value is the estimated value of the dependent variable. According to findings of this study, sociodemographic characteristics and problem-solving abilities did not affect empathy level, although the CE value was 31.707 and the EE value was 37.024. Repeating this research in larger and different nurse groups may be useful to verify these research results.

Conclusions

The following results were derived from this study: First, constructive problem-solving skills affect CE skills. EE is adversely affected by the PA and LSC. Second, no correlation was found between the demographic characteristics of nurses and their problem-solving skills. Third, as level of education increases, cognitive and emotional levels of empathy decrease.

Duration of time spent working at one's current healthcare institution and educational level were both found to correlate negatively with the CE score. The higher the educational level and PA and the lower the self-confidence of the participants, the lower their EE levels. Finally, higher constructive problem-solving scores were associated with higher CE skills.

Limitations

The major limitation of the study is that it was conducted in the affiliated hospitals of one healthcare organization. The study data were obtained from operating room nurses who currently worked in these hospitals and who volunteered to participate. The conditions of nurses who did not participate in the study cannot be ascertained. A second important limitation is that the data reflect the subjective perceptions and statements of the participants. A third important limitation is that participant characteristics such as trust in management, trust in the institution, burnout, and communication skills were not assessed. For this reason, the effects of these variables on problem-solving and empathy skills remain unknown.

Author Contributions

Study conception and design: SP

Data collection: TK

Data analysis and interpretation: FA, SP

Drafting of the article: FA

Critical revision of the article: FA

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operating room; critical thinking; surgery; cognitive; emotional

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Relationship Between the Problem-Solving Skills and Empathy Skills of Operating Room Nurses

Affiliations.

1 PhD, RN, Assistant Professor, Faculty of Health Sciences, Department of Midwifery, Istanbul University-Cerrahpaşa, Turkey.
2 PhD, RN, Directorate of Nursing Services, Hospital of Faculty of Medicine, Istanbul University, Turkey.
3 MS, RN, Director, Operating Room, Hospital of Faculty of Medicine, Istanbul University, Turkey.
PMID: 31856024
DOI: 10.1097/jnr.0000000000000357

Background: The use of empathy in problem solving and communication is a focus of nursing practice and is of great significance in raising the quality of patient care.

Purpose: The purposes of this study are to investigate the relationship between problem solving and empathy among operating room nurses and to explore the factors that relate to these two competencies.

Methods: This is a cross-sectional, descriptive study. Study data were gathered using a personal information form, the Interpersonal Problem Solving Inventory, and the Basic Empathy Scale (N = 80). Descriptive and comparative statistics were employed to evaluate the study data.

Results: Age, marital status, and career length were not found to affect the subscale scores of cognitive empathy (p > .05). A negative correlation was found between the subscale scores for "diffidence" and "cognitive empathy." Moreover, the emotional empathy scores of the graduate nurses were higher than those of the master's/doctorate degree nurses to a degree that approached significance (p = .078). Furthermore, emotional empathy levels were found to decrease as the scores for insistent/persistent approach, lack of self-confidence, and educational level increased (p < .05). The descriptive characteristics of the participating nurses were found not to affect their problem-solving skills.

Conclusions/implications for practice: Problem solving is a focus of nursing practice and of great importance for raising the quality of patient care. Constructive problem-solving skills affect cognitive empathy skills. Educational level and career length were found to relate negatively and level of self-confidence was found to relate positively with level of cognitive empathy. Finally, lower empathy scores were associated with difficult working conditions in operating rooms, intense stress, and high levels of potential stress-driven conflicts between workers in work settings.

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Empathy is becoming a central component to classroom instruction and rising to the top of many school's curriculum, as well as a timely topic of discussion within the corporate world. It's a simple action with broad reach. We understand it as the ability to truly understand and share the feelings of others. What brings this to focus for me is just how powerful empathy is when it expands beyond personal relationships and gets ushered to the forefront of problem solving in education, business and politics.

Empathy can be a fundamental force in problem solving because, once employed, it enables individuals to better see and at least appreciate all sides of an issue. Think of approaching a "problem" as a detective or scientist might, by first thoroughly collecting and dissecting all of the elements of an issue, such as the timing, location, motivation, and the individuals involved. This more thoughtful "step back" empowers individuals to become more versed and in a better, more stable, position to ask thoughtful questions that may then lead to the generation of an actionable and successful solution.

Teaching thoughtful questioning, or the practice of applying empathy to problem solving, serves students well. It should be liberally applied in and outside of the classroom because asking more thoughtful questions helps deepen an individual's thinking in a way that enables them to understand complex issues more quickly and proficiently, it affords the chance for true understanding.

When integrating thoughtful questioning inside the classroom, teachers help lay the foundation of a child's critical-thinking ability. Creating curriculum that fosters curiosity and teaches children how to ask meaningful questions is a best practice that bears nurturing. For example, teachers can encourage students to ask "how" and "why" questions instead of "do" and "have" questions, as well as use interpersonal communication skills (both verbal and nonverbal) when engaging in conversations in the classroom, such as focusing on eye contact and appropriate body language. These are valuable, foundational skills toward becoming better problem solvers.

With those tools in their belts, students can ask thoughtful questions to fully immerse themselves in a subject before suggesting a solution. After a student truly understands and relates to an issue, they can begin to identify ways to bring about change.

These concepts also apply to the bigger world. Professionals and corporate leaders are beginning to prioritize empathy to solve tough business problems as well. When I attended Microsoft's Alumni event, " Reunion with a Purpose ," empathy was a large theme at the conference and motivated the topic of my last blog post, " Teaching Empathy Leads to More Inspired Leaders ."

Applying empathy and then asking thoughtful questions in a professional setting can help businesses identify and overcome internal company roadblocks, as well as the obstacles facing their clients and customers.

In taking a step back and viewing a problem from all angles (past, current, and potential future), enterprises can then start making realistic plans to create a better future for the company, partners, customers, and the greater community.

One organization putting this methodology into practice is Seattle-based Unloop . Unloop helps individuals who have been in prison re-enter and succeed in careers in technology. Although the non-profit has a great mission, its inception is what first caught my eye and truly embodies strategic and empathetic problem solving. Unloop was founded to put an end to recidivism. In order to do this, they researched the main reasons for individuals re-enter the prison system and found that access to a living wage job made individuals three times less likely to return to prison. With awareness of this data, and with the growing number of technology-based jobs available, Unloop saw an opportunity to connect individuals with software development careers – where success is not solely dependent on a college degree or formal work experience – giving birth to the organization. Unloop's ability to ask questions and problem-solve has allowed them to provide meaningful solutions and positively impact individuals and their families.

Empathy transcends all industries. In order to successfully integrate thoughtful questioning, we must invest in the proper leadership training. It is important that companies and schools provide their leaders with the resources needed to instill the future generation of employees and students with the ability to effectively problem solve.

When I was an employee at Microsoft I was introduced to the idea of "precision questioning." Similar to thoughtful questioning, precision questioning is the ability to ask the right questions in order to solve a complex problem. This type of learning (and teaching) is so transformational and has remained one of my best tools for success and a practice that I shared with the senior leadership team at St. Thomas School to help us be more focused, make better decisions and tackle more complex issues.

Through founding the Center of Leadership and Innovation at St. Thomas School, I hope to continue providing teachers and students with the expertise needed to be empathetic and thoughtful problem solvers. Applying empathy not only helps raise intentional thinkers that can ask tough questions, it also empowers individuals to think creatively and deliver meaningful impact to the world around them.

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Empathy in problem solving , for projects and relationships.

Understanding other people, by thinking with empathy, is almost always essential for skillful design thinking, for solving problems. You use design thinking (with empathy) for almost everything in life , so empathy can help you achieve a wide variety of objectives, in design projects and in relationships as described in an overview of using empathy in Design-Thinking Process by asking empathy questions — "What do THEY want?" and "What do I want?" and, combining these, "What do WE want?" — while you're trying to achieve win-win results.

In the following sections about empathy, later we'll explore the similarities between Empathy (to understand others) & Metacognition (to understand self) and will examine the Empathy-Ecology of a Classroom .

But we'll begin by asking...

What is empathy?

It's useful to think about — and think with, * and cultivate in yourself & others — different kinds of empathy : Cognitive Empathy by cognitively understanding the feeling-and-thinking and behaviors of another person; Emotional Empathy (aka Affective Empathy ) by feeling what another person feels; Compassionate Empathy (aka Compassion or Empathic Concern or Compassionate Concern ) is a desire for the well-being of another person.

For most purposes, including education, it seems more useful to think about 2 kinds of empathy (Cognitive & Emotional) instead of 3, and to focus on the Cognitive Empathy that I think is more learn-able and generally is more beneficially useful for problem solving, for making things better. * Why 2, not 3? Instead of Compassionate Empathy, I prefer the term Empathic Concern because it places attention on the compassionate Concern (the Compassion ) that is produced by Cognitive Empathy (perhaps combined with Emotional Empathy ) and is motivated by Kindness . / * There is wide variation in the terms used, and their definitions; a comprehensive Literature Review about Empathy Training includes a recognition that "there are as many researchers acknowledging discrepancies in the use of the term, as there are inconsistent definitions." many definitions of empathy(s)

also - How wide is the scope of "others"? In addition to other humans, we also can have empathy for animals — such as a monkey or dolphin, dog or cat, parrot or lizard — although the accuracy of our empathy is limited by significant differences between us and them in our experiences of thinking & feeling, and our difficulties in communicating with them.

* Do we "think with" empathy? Both kinds of empathy, cognitive and emotional, are important. But this is a website about thinking that is productive for problem solving, so I'll be saying more about Cognitive Empathy, which is the ability to understand what another person is thinking-and-feeling.

Developing and Using a Growth Mindset for

Improving emotional-and-social intelligence.

As part of a whole-person education for ideas-and-skills & more a teacher can help students learn how to more effectively use both kinds of empathy, by improving their Cognitive Empathies and Emotional Empathies, and their skills in being aware (cognitively and emotionally) of the thinking & feeling of others in a wide variety of life-situations, and also (with metacognitive self-empathy ) of themselves. These essential components of Emotional Intelligence* are closely related to Social Intelligence. Students can improve all of their multiple intelligences (including emotional-and-social) when they develop-and-use a growth mindset by believing that their abilities are not fixed at the current levels, instead each ability can become better, can be “grown” when they invest intelligent effort to improve this kind of ability.

* Psychology Today describes Emotional Intelligence as "the ability to identify and manage one’s own emotions, as well as the emotions of others. Emotional intelligence is generally said to include at least three skills: emotional awareness, or the ability to identify and name one's own emotions [by using self-empathy, and by using empathy to "identify and name" another person's emotions]; the ability to harness those emotions and apply them to tasks like thinking and [to "make things better" in ways that include improved relationships] problem solving; and the ability to manage emotions, which includes both regulating one's own emotions when necessary, and helping others to do the same." { em phasis and [comments] added by me}

Two closely related abilities – Social Intelligence and Emotional Intelligence – are combined in educational programs * to improve the Social-Emotional Learning (SEL) that is briefly defined by ca sel .org — "social and emotional learning (SEL) is the process through which children and adults understand and manage emotions, set and achieve positive goals, feel and show empathy for others, establish and maintain positive relationships, and make responsible decisions" — in the introduction for What is SEL? { * and people improve these skills informally by learning from their life-experiences }

As part of a school's Social-Emotional Learning to improve Social Intelligence and Emotional Intelligence , teachers can help students improve their Cognitive Empathy & Emotional Empathy and their Empathic Concern and Compassionate Action.

Compassion in Action: A process that produces compassionate action occurs in a sequence: cognitive empathy and/or emotional empathy, plus kindness, may produce empathic concern for a person, which may produce a desire to help them, and then action to help them. / The whole process can occur quickly, as with emergency action, or during a long period of time. Or action may not occur at all, if the sequence is broken at any point.

Compassion in Design: A process of design may lead to Compassionate Action if, for any area of life, * Empathic Concern is a motivating-and-guiding factor when you Define a Problem by Choosing an Objective and Defining Goal-Criteria. { * compassionate action can be motivated by empathic concern in traditional design projects and in relationships }

Is empathy always useful? In most design projects – even when you are not motivated mainly by compassion – it's very useful to think with empathy . { why do I say "most" projects, instead of “all”? } And self-empathy , to understand yourself, is useful when your objective is a personal decision or a personal thinking strategy . {more about empathy and self-empathy }

Human-Centered Design: Because "empathy is the foundation of a human-centered design process," d.school (of Stanford) emphasizes the importance of a mode for Empathy by including it (when you search for "empath") in 19 of its 47 pages. And one of their mindsets for design-thinking is to Focus on Human Values. { Empathy in Design Thinking with d.school and DEEPdt} { designing with empathy and self-empathy }

Accuracy in Empathy

Do you have an accurate understanding of people? If you are surprised by a behavior — because your Observations (of how a person responds, in what they do or say) don't match your Predictions (your expectations) — something is wrong with your empathetic understanding of the way other people are thinking & feeling, of how they will respond in this situation. Why?

When you do a Reality Check by comparing Predictions with Observations, a mis-match can occur due to...

your inadequate Observations in the past, or your incorrect interpretations of these Observations when you constructed an explanatory Theory/Model (used to make Predictions ) for this aspect of human feeling/thinking-and-behaving, in one of the areas (re: psychology, sociology, economics, marketing, politics,...) studied by Social Sciences. Or maybe the other person(s) responded in an unusual way, not consistent with their previous feeling & thinking & actions.

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Empathy in design projects.

In all phases of a traditional Design Project — especially in Modes 1A and 1B when you Choose an Objective and Define Desired Goal-Properties for a product (or activity, strategy, theory) — it's important to think with empathy. This is important for your Solution-Users and for those (you and maybe others) who are Solution-Designers.

Empathy for Solution-Users: You learn about the thinking-and-behavior of potential users of a product by getting observations — old (already known by yourself or others) or new (from your own new studies) from customer interviews, focus groups, market surveys,... — that help you understand, with better insights into “how will they use the product? what do they need? and want?” Ask users for feedback (positive & negative), for constructive criticism and suggestions. By creatively imagining what it's like to “be a user and think like a user” from their perspective, make predictions. * Also try to “think like a buyer” or (in another aspect of the project) to “think like a seller.” These information-gathering activities will help you supplement your internal egocentric thinking with externally-oriented empathetic thinking for all stake - holders in a project, for everyone who will be involved in (or affected by) the project in any way, who will design, make, market, distribute, sell, buy, use, or service the product, or be involved or affected in other ways.

* Predictive Empathy: Usually you'll try to "think like a buyer/user" in their future, which may differ from their thinking in the present. For example, Helen Walters describes the "approach to customer research [of Steve Jobs, who said] ‘It isn't the consumers' job to know what they want.’ Jobs is comfortable hanging out in the world of the unknown, and this confidence allows him to take risks and make intuitive bets" by using empathy-based predictions of what buyers/users will want later, even if they don't yet want it now.

Relevant Empathy: You can never fully understand another person. Usually your main goal is relevant empathy, by trying to understand what is most important for a particular situation. If you're designing a product, for example, you'll want to understand the thinking & feeling, the needing and wanting, of people who would use (or might buy) the product, in the context of their using the product and/or b uying it. And for a relationship-situation, usually you focus on understanding what is most relevant in the context of that situation.

Empathy for Solution-Designers: During a design project you'll want to develop empathy for solution-users (those you are serving), as described above . And when you're co-designing as part of a group, you'll want to develop empathy for the other solution-designers in your team, to make your process of cooperative problem-solving more enjoyable and productive. If members of a group improve their use of “collaborative empathy” this will improve their interactions, and will help them develop a cooperative community for creative collaboration . This can occur in many contexts, including schools where better educational teamwork (by everyone involved in education ) will make the process more enjoyable for teachers, and more effective for students by increasing positives (in learning, performing, enjoying ) and decreasing negatives (like jealous attitudes & bullying behaviors). { building empathy-ecology in a classroom }

Traditional and Relational: Empathy is useful whenever you want to solve a problem by “making it better” with a traditional design project ( above ) — when you use empathy to produce a better solution (for your solution-users ) and a better process (if you're working in a team of solution-producers ) — and/or a relational design project (below) when your objective is to improve an interpersonal relationship.

Empathy in relationships .

An Important Objective: Originally I defined four general categories for problem-solving objectives – for when we decide to design a better product, strategy, activity, and/or theory. Later I added relationships because our most important problems (our opportunities to make things better ) usually involve people, so improved relationships are among the most important objectives we can choose to improve. How? An essential foundation is developing...

Empathy and Self-Empathy to improve Two Understandings: You can build a solid foundation for improving your relationships by improving two kinds of understandings (external and internal) with externally-oriented empathetic skills – to develop empathy (overall and also situation-specific relevant empathy ) based on external observations, trying to understand what others are feeling & thinking – and internally-oriented metacognitive skills (to develop self-empathy based on internal observations, trying to understand what you are feeling & thinking). The practical value of these life-skills is a reason to define...

Educational Goals for Relationship Skills: We can aim for whole-person education that will help students improve personally useful ideas & skills and more in their whole lives as whole people. Our educational goals should include the important life-skill of building better relationships, with empathy & kindness and in other ways. A very useful general strategy — for educating students (and yourself) in all of the multiple intelligences, including social-emotional intelligences — is to develop & consistently use a growth mindset .

Kindness plus Empathy: When you want to be kind — and you combine your kindness with empathy — this will help you...

Choose a Win-Win Goal: In many common life-situations, when you are trying to "make things better" your two understandings (external for others, and internal for self) are combined when you ask — while you are defining your goals — “what do they want?” (using empathy to understand others ) and (using self-empathy to understand yourself ) “what do I want?” and (if you choose to define your goal as an optimal win-win result ) “what do we want?” / You also make choices when you...

Define the Scope of Your Win-Win Goals: How broadly do you define "they" when you're trying to achieve win-win results? If you want to decrease the unfortunate tendency of positive teamwork to become negative tribalism, one strategy is for you (and those you influence) to increase your...

Understanding and Respect: One of the many ways we can improve relationships is to develop better teamwork . But one strategy for developing strong relationships among insiders (within a team) — by promoting hostile “us against them” attitudes toward outsiders (not in the team) — can convert positive teamwork into negative tribalism. { I'm calling it negative tribalism because tribe-like strong loyalties produce some positive effects and some negative effects. } One kind of educational activity that can help reduce the negative aspects of tribalism is examined in a page describing how my favorite high school teacher, by using informative debates in his civics class, helped us develop Accurate Understandings and Respectful Attitudes . How? After he helped us carefully-and-diligently study an issue, so our understandings of different position-perspectives were more accurate and thorough, usually we recognized that even when we have justifiable reasons to prefer one position, * people on other sides of an issue may also have justifiable reasons, both intellectual and ethical, for believing as they do, so we learned respectful attitudes. { * yes, he wanted us to find "justifiable reasons" because his educational goal was not a logically-fuzzy postmodern relativism , instead he promoted a logically appropriate humility with confidence that is not too little and not too much.} When this kind of educational process is done well, it can produce a foundation of empathetic understanding that is useful for producing authentic understanding & respect, that helps us be more kind in our feeling & thinking & actions.

Empathy without Kindness: This can be a bad combination, when it allows the use of empathetic thinking as a tool for manipulating others in harmful ways.

Empathy plus Kindness: This is a good combination, when empathy (a useful skill) is accompanied by kindness (an essential aspect of good character). Thinking with empathy is beneficial for other people when it's combined with kindness-and-caring in feeling & thinking & actions, when an attitude of caring for others (in feeling & thinking) leads to caring for others (in actions), with actions motivated by kindness, by genuinely caring for other people.

Kindness in Thinking-and-Actions: More people will have better lives... if more of us are more often motivated by kindness, with goals of trying to “make things better” for other people, wanting to affect their lives in ways that are beneficial for them, that make life better for them; and if our empathy-based compassionate concerns were more often actualized with kindness in our actions.

A Wonderful Life produces Beneficial Effects: A creative illustration of helping others is my favorite movie, It's a Wonderful Life. I like it partly for its artistry (in plot, dialogue, acting, directing, photography) but mainly for the message: each of us affects other people – as dramatized in the end-of-movie comparison of lives with & without George Bailey – and our own life is better when we affect others in ways that make their lives better, and help them achieve worthy goals in life. We can help others enjoy what they do, and (when they “pass it on”) do more actions that benefit others, and more fully develop their whole-person potentials.

Helping Others achieve Their Goals: For understanding how we can be more beneficial — by helping another person "enjoy..." and "more fully develop their whole-person potentials" so they are becoming a better version of themself, growing into the kind of “ideal person” they want to be, or they should be — a useful perspective is the Michelangelo Phenomenon; this concept was developed by social psychologists, with Caryl Rusbult ( my wonderful sister ) being a main developer. As described in a review article by Rusbult, Finkel, & Kumashiro: "close partners sculpt one another's selves, shaping one another's skills and traits [analogous to Michelangelo's Actions while shaping a piece of stone so it becomes a beautiful work of art] and promoting versus inhibiting one another's goal pursuits... of attaining his or her ideal-self goals" in the "dreams and aspirations, or the constellation of skills, traits, and resources that an individual ideally wishes to acquire." When lovingly influential Michelangelo Actions are done well, the beneficial effects usually are lovingly appreciated, as we see in "Love" by Roy Croft: "I love you, not only for what you have made of yourself, but for what you are making of me." Or in the language of education, when feedback-actions help another person improve, this is formative feedback that helps them “form themselves” into a better person. Of course, a beneficial shaping influence — a teaching influence that helps them develop a growth mindset about improving their skills with social-emotional intelligences and relational empathy — can come from a "close partner" and also others, including friends and family, counselors, fellow students & team members & co-workers, and teachers & coaches & supervisors.

Golden Rule with Empathy: For building mutually beneficial relationships, one useful principle-for-life is a Golden Rule with Empathy that combines kindness with empathy, by treating others in ways THEY want to be treated, which may differ from what you would want. * Treating others this way will be beneficial for them, and also for you (especially in the long run), in a wide variety of situations. / * But it doesn't really "differ from what you would want," if we look more deeply. Why? You want others to empathetically understand you, and then treat you the way you want to be treated. Other people also want this, so you should Seek First to Understand (with Habit 5 in The 7 Habits of Highly Effective People ) and then use a Golden Rule , e.g. "Do for others what you want them to do for you" by treating them the way THEY want to be treated.

Empathy for Society: I.O.U. – This paragraph might be written before mid-2023, with ideas from John Rawls: imagine you are part of a group in Original Position (before you're born) that is designing a society with the goal of making life optimal for all, and you are self-interested in "all" because – with a Veil of Ignorance – you don't know “who you will be” when you are born, re: your multiple intelligences, looks, race, health, wealth, status, location,... ; in reality we cannot be “ignorant of our situation” now, during life as it really is, but we can use empathy + kindness/compassion in our thinking about society. {for more, an article by Richard Beck, Empathy, the Veil of Ignorance, and Justice }

Clever and Kind: Abraham Heschel, sharing an insightful observation based on self-empathy, wisely said "When I was young, I admired clever people. Now that I am old, I admire kind people." Teachers can help students, while they are still young, appreciate the value of being truly clever (with skills in creative-and-critical productive thinking to solve problems to make things better) and also kind.

Empathy and Metacognition

These related ways of thinking – helping you understand others , and understand yourself – are very useful in all areas of life, including education. This section — first in Goals & Perspectives, then in RESULTS and PROCESS , and Using Empathetic Feedback in a Classroom — will examine ideas & strategies that can help a teacher and students develop better empathy-ecology in their classroom .

Goals & Perspectives

Empathy and Metacognition have similar goals (to understand thinking & feeling) but different orientation-perspectives, re: external and internal.

• With empathy you try to understand the thinking & feeling of others, who are external to you. { two empathies and a result : cognitive empathy (used "to understand" thinking & feeling) plus emotional empathy (to feel) can produce empathic concern. } • With metacognition ( self-empathy ) you try to understand your own internal thinking (& feeling). { In its basic definition, with metacognition you "think about your thinking. " But in practice, thinking and feeling are related, often with strong mutual influences. Therefore, typically it's useful to “think about your thinking AND feeling . ” }

External & Internal, for You and Others:

everyone – you and others – thinks with externally-oriented empathy, to understand the thinking & feeling of other people; everyone – you and others – thinks with internally-oriented metacognition, to understand your own thinking & feeling.

The external & internal understandings constructed by you are summarized in the 1st & 2nd rows-of-cells in this table.

The 3rd & 4th cell-rows describe the external & internal understandings constructed by another person .

	and )
by you, for ANOTHER PERSON, is	external understanding of , of
by you, for YOURSELF, aka is	internal understanding of , of
by another person, for YOU, is	understanding of , of
by another person, for THEMSELF, is	understanding of , of

Metacognition and Self-Empathy: These terms have the same meaning, in this page. More generally, when these terms are used by others, typically with metacognition the emphasis is more heavily on thinking, and with self-empathy it's on feeling (but also thinking).

other terms: a metacognitive understanding is aka personal metacognitive knowledge that is one aspect of a person's overall general-and-personal metacognitive knowledge . By analogy, empathetic understanding also can be called empathetic knowledge, although the term metacognitive knowledge is used much more often.

RESULTS — Perspectives and Understandings

By comparing understandings of YOU in the 2nd & 3rd cell-rows, or of THEM in the 1st & 4th rows, you can see how understandings ( of YOU , or of THEM ) depend on point-of-view perspectives (on whether the constructing is done by you , or by them ).

two pov-perspectives on YOU, in rows 2 & 3: You use internal metacognition (self-empathy) to construct your understanding of YOUR thinking & feeling. And another person uses external empathy to construct their understanding of YOUR thinking & feeling. It can be interesting to compare these two understandings, asking “How do I view me? How do they view me?” and “What are the similarities? and differences?” and “Why do the differences occur?” and “Which understanding is more accurate ? and in what ways?”

three pov-perspectives on ANOTHER PERSON, in rows 1 & 4 & _: You also can make comparisons and ask questions (about similarities & differences, and accuracy), re: understandings of ANOTHER PERSON – “How do I view THEM ? How does this person view THEMSELF ? And, not shown in the table, how do other people view THEM ?”

When we compare empathy (to understand others) with metacognition (to understand self), we see many similarities and analogous relationships in the PROCESS used (below) and (above) the RESULT produced .

PROCESS — constructing Empathy & Metacognition

Now we'll shift attention from RESULTS to PROCESS.

We construct our understandings (of others & self) in a social context, so it's useful to distinguish between...

Understanding and Feedback: We construct (i.e. we develop) feedback in a two-step process. First we use empathy or metacognition to construct understanding that we use, after evaluative filtering, to provide feedback for others, with communication. { Understanding and Feedback, Part 2 }

You construct your external EMPATHY (it's your understanding of ANOTHER PERSON ) when you internally interpret all of the evidence you find. You can use three kinds of evidence: your observations of the person ; feedback about the person from other people; feedback about self from the person.

You construct your internal SELF-EMPATHY (to get your understanding of YOURSELF ) when you internally interpret all of the evidence you find. You can use two kinds of evidence: your observations of yourself ; and feedback about you from others.

{an option: If the table below is too wide for easy reading in your browser window, you can temporarily view this page in a new full-width window . }

The first 4 rows in the tables above (for RESULTS) and below (for PROCESS) are matched, re: who is trying to understand WHO . Below,

The 1st and 2nd rows summarize-and-organize the processes you use to construct your understandings of ANOTHER and YOURSELF . The 3rd and 4th rows describe how, using the same processes, another person constructs their other-understanding of YOU , and their self-understanding of THEMSELF . The 5th row shows how they construct their other-understanding of ANOTHER PERSON, of someone who isn't YOU or THEM, and thus is a THIRD PERSON .


, trying to , is	, using found-evidence that is empathetic of-person , empathetic about-person , metacognitive about-person ,	about ]
, trying to , is	, using found-evidence that is metacognitive of-self , empathetic about-you ,	of ]
, trying to , is	, using found-evidence that is empathetic of-you , metacognitive about-yourself , empathetic about-you ,	about ]
, trying to , is	, using found-evidence that is metacognitive of-self , empathetic about-them that can include about-them ,	of ]
, trying to , is	, using found-evidence that is empathetic of-third , metacognitive about-third , empathetic about-third that can include about-third ,	about a ]

Did you notice that the 3rd & 5th rows are analogous but with one difference? (what is it? the 5th-row process can include one extra evidence that is "feedback-about-third from you")

Understanding and Feedback — These are related, but different. They occur in sequence:

1. First you use empathy and observations-of-performance, trying to get accurate understandings of another person(s), and of their performance(s). 2. Then if you want to provide helpful feedback, * you will wisely filter your understandings by not saying everything you are thinking, but only what will be helpful. You do this by deciding, for each person or group, what to say (and not say), when and how, or whether to say nothing. The goal is to be helpful by providing formative feedback with an intention, and hopefully a result, of being kind and beneficial . / * Unfortunately, sometimes (if a person doesn't want to be kind-and-beneficial) the feedback is intended to be un-helpful. 1-during-2: An empathetic understanding (developed in Step 1) is used (in Step 2) during the process of filtering, when you're deciding the details (the what/when/how-and-whether) of providing feedback that will be helpful.

MORE - Other useful strategies for providing helpful feedback are in two places: Developing a Creative (and critical) Community by trying to minimize any "harshness" in feedback-providing and feedback-receiving; Evaluation is Argumentation that in a group requires "the social skills of communication" when you combine Evaluative Thinking with a Persuasion Strategy and Communication Skills, along with productive Attitudes while Arguing.

Using Empathetic Feedback in a Classroom

The three * s — above in the table-for-process and below in descriptions of each * — are three kinds of "feedback... from you ." Imagine that you are a teacher , and two of your students are Sue (" a person ", aka " them ") and John (" a third person ", aka " third ").

How will you use these 3 kinds of empathy-based feedbacks? If you're an effective teacher, then (in cell-Rows 4, 5, and 3)...

* You want to provide feedback that will help Sue construct a better self-understanding of HERSELF . (This is her SELF-EMPATHY, aka her METACOGNITION, in Row 4.) / a new term: Sue's own internal METACOGNITION (by "thinking about Sue's thinking) is being supplemented by your feedback-to-her about her, which is aka external metacognition because it's the "thinking about Sue's thinking" that is externally supplied by you, as an empathetic observer. * You want to provide feedback that will help Sue (and other students) construct a better other-understanding of JOHN . (This is her EMPATHY for A THIRD PERSON in Row 5.) / You can provide feedback-to-others about all of your students, individually and collectively, to influence each student's other-understandings of their fellow students, and attitudes toward them. * You want to provide feedback that will help Sue construct a better other-understanding of YOU . (This is her EMPATHY for YOU in Row 3.)

With a particular feedback, you want to help a student understand themself (Row 4), or another student (Row 5), or you (Row 3).

Building an Ecology of Empathy in a Classroom

All of these * -feedbacks are one part of the complex personal interactions (simplistically symbolized in the diagram) that occur in every classroom. In this context, "better self-understanding" and "better other-understanding" will help all of you — Teacher , Student (like Sue or John), and students (in the whole class, or in smaller groups) — develop a better ecology of empathy in your classroom.

In the interactions-diagram, arrows indicate a variety of interactions, including communications that are verbal (with * -feedbacks and in other ways) and non-verbal:

two arrows point away from the Teacher (you) who can communicate with only one Student (like Sue) or with two or more students . two arrows point away from the Student (Sue) who can communicate with you , or with one or more other students . two arrows point away from students (John & others) who can communicate with you , or with any other Student (s). {note: A complex diagram that is more-complete would show more kinds of interactions between students, as individuals and in groups.}

A skilled teacher will provide guidance for students in how to " wisely filter " their communications (using feedback and in other ways) with the teacher and each other, so their interactions will be helpful. A wise evaluating-and-filtering should be based on a foundation of healthy interpersonal motivations, with each student wanting to be kind, wanting to affect others in beneficial ways.

Shared Goals and Individual Goals: In ideal educational teamwork the teacher and all students will have shared educational goals of “greatest good for the greatest number” with optimal learning-performing-enjoying for everyone in the classroom. But each student also will have their own personal goals that include wanting to improve their interpersonal relationships and personal education .

Habit 5 of Highly Effective People is "Seek first to understand, then to be understood. " As a teacher, you can use this habit/principle in (at least) two ways:

When you provide feedback , in Step 1 you try to understand Sue, as a foundation for Step 2 when you help her understand your view of her and what she is doing and how she can improve. {your feedback is one aspect of stimulating and guiding students} In the third * -feedback you try to understand Sue, so (with your * -feedback about yourself) you can help her understand you .

Building Empathy-Ecology for a Classroom

I.O.U. - Below are some ideas that eventually, maybe by mid-2019, will be developed more fully.

a humble disclaimer: This section is just ideas, and most of the ideas (maybe all of them) aren't really new. I'm just describing some goals of skilled teachers, and some strategies they already are using to effectively pursue their goals.

Important foundational ideas, essential for this section, are in other parts of the website:

• empathy-ecology performs a valuable function in a system of strategies for teaching by helping a teacher provide formative feedback that will help students improve their performing-enjoying-learning and their system of self-perceptions and...

more generally, will help guide our goal-directed designing of coordinated curriculum & instruction .

• definitions for empathy(s) & metacognition and their Process (of construction) & Result (in understanding) and their uses (by teacher & students) in developing a classroom ecology . / [[here are ideas that will be developed later: motivational teamwork for cooperation-collaboration in education, at all levels, including Teaching Strategies for students (re: how they influence the learning of other students, directly with peer teaching, and indirectly/unofficially); being motivated, as on a sports team, to establish an education-culture for better learning/performing/enjoying; a HMW for students, in activity where they ask "How Might We" design our own ideal culture/environment for optimal learning, to pursue a “greatest good for the greatest number of students” and for the teacher.]]

strategies for thinking (in a wide variety of contexts ) by learning from experience , and...

related strategies for teaching .

based on their understanding of personal motivation teachers can use motivational persuasion to help students recognize that school experiences (when they're well designed) can help them learn for life so they will want to adopt a problem-solving approach (to "make it better" in their life) for their own personal education . When students are personally motivated to learn, it will be much easier for teachers & students to build educational teamwork in a classroom and a school.

Educational Ecologies (in Educational Ecosystems) occur at many levels, in large-scale systems — in a nation, state, district, school, department — and , on a smaller scale,

in a classroom with its ecosystem of interactions between each Student and other students and the Teacher , as shown simplistically in this diagram, to produce 6 kinds of formative feedback — from one person (or group ) to another — based on empathetic understandings of what others are feeling & thinking in their hearts & minds. Each person also tries to understand, with metacognitive self-empathy, their own feeling & thinking, their own life-goals and life-strategies, for what they want (in their goals ) and how to get it (with their strategies ). { a process of developing classroom ecology should be based on a foundation of kind attitudes and compassionate intentions to be benefically helpful}

Ideally, the shared goal when building empathy-ecology in a classroom will be improving the total school experience to produce an optimal performing-enjoying-learning overall, with “greatest good for the greatest number” but also respect for all individuals. For each student, and the teacher(s), the shared mutual objective is to build educational teamwork that will be helpful in achieving individual goals, and group goals. All can work together in creative collaboration to construct a classroom community with a learning-friendly atmosphere, so students can learn in the ways they want to learn and are able to learn.

I.O.U. reminder - Soon, maybe in mid-2023, these ideas (and related ideas) "will be developed more fully," including my exploration of what others are doing — in principle and in applications — with different aspects of educational ecology.

Is empathy always needed?

This section responds to a question: Is thinking-with-empathy useful in ALL design projects?

A high quality of thinking with empathy (so your understanding is relevant, accurate, and deep) is extremely important for defining and solving most problems. But not all problems, because empathy is not very important (or at least it's different) for problem-solving objectives in two categories, when your problem either (1) involves mainly you, or (2) does not directly involve any people, when...

1) ...when you want to “make life better” by achieving an objective that is mainly for your own benefit, not for other people, * and you do most of the problem solving (or all of it) by yourself. This focus-on-self occurs for some personal decisions and for many of your thinking strategies . To do each of these well, you need to know yourself, with self-empathy for your own thinking & feeling . You can use the benefits of different perspectives by supplementing your own understanding (from internal self-observation & self-empathy by yourself) with other understandings (from external observations & empathy by other people). { perspectives - internal & external, metacognition & empathy }

* Even when a problem-solving project does not "directly involve people" (as in 2a below) or "...other people" (in 1 above), usually some people will be affected in some way, so typically we are describing an objective that requires less empathy, rather than no empathy.

2a) ...when the objective is mostly technical, so it does not directly involve people. This can occur because a wide variety of objectives (for designing a better object, activity, or strategy in General Design) require a wide variety of empathy, with less needed for a few objectives (those in 2a) than for most objectives. { IOU - Later, maybe in May, some of these variations-in-empathy will be examined in an appendix, as outlined in the final paragraph of this page.

2b) ...when your functional responsibility in a problem-solving process is to solve a purely technical problem, in a sub-project within the overall project. For example, you might be asked to design a new piece of equipment (or to repair it) after the technical goal-specifications already have been clearly defined by others in a part of the design project ( Defining a Problem ) that usually requires empathy. }

2c) ...when your objective in Science-Design is an explanatory theory about NON-HUMAN aspects of nature (as in chemistry, physics, or astronomy), not about HUMAN nature (as in psychology, sociology, political science, economics, marketing,...). { If you ask “is science-design authentic design?”, we can discuss the pros & cons of using definitions (for problem, design, design thinking,...) that are broad or narrow. }

Empathy for Collaboration: During any design project (including 1, 2a, 2b, 2c), if you're working collaboratively it's important to have empathy for your colleagues, so you can understand ( intellectually and emotionally ) what they are thinking & feeling, to help all of you work together more effectively and enjoyably.

I.O.U. - The ideas below are in gray text because they need to be developed and revised:

In this website, the importance of empathy is emphasized (as in mc-em.htm#empathy - ws.htm#dpmo1ab - ws.htm#dpmo2aem - ws.htm#mcts ) but some other models-for-process (like d.school and DEEPdt) emphasize it more strongly, as described here .

The fact that creative thinking is necessary to imagine projects requiring "no empathy (or very little)" shows that empathy is essential (or at least is extremely useful) for understanding-and-improving almost all problem-situations. — especially for "design projects" (which include almost everything we do in life) that are worthwhile.

maybe responses will be indicated by text-highlighting the objectives where empathy is extremely important and very important and not as important.

for a problem that only you can solve, analogous to solo mountain climbing when you are “on your own” so you must do everything by yourself.

A larger project is making a detailed appendix (maybe in May) by asking, for many objectives (across a wide range of objectives ), "How useful is thinking with empathy when you define a problem (by learning about a problem-situation, defining an objective, defining goals for a solution) and solve the problem (by designing a solution that satisfactorily achieves your goals)?"

If you want to discuss any of these ideas, you can contact me, <craigru178-att-yahoo-daut-caum> ; Craig Rusbult, Ph.D. - my life on a road less traveled

Copyright © 1978-2023 by craig rusbult. all rights reserved., this page is designed to be in the left frame, so put it there ., options: here are three other useful links, sitemap (in left frame ) - home (in right frame ) - open this frame in a new full-width window (i.o.u. - until this link is available, right-click frame and choose "open frame in new window - and useful information is in tips for using this website ..

Breadcrumbs

Design thinking: problem-solving rooted in empathy.

Danielle Piccinini Black, academic lead for Johns Hopkins Executive Education’s Design Thinking for Innovation, discusses the benefits of utilizing design thinking as an empathy-centered approach to problem-solving.

At Johns Hopkins Carey Business School, we believe in a better business world through advanced education.

While volunteering with the Peace Corps in South Africa, Johns Hopkins Executive Education adjunct faculty member Danielle Piccinini Black (MBA/MPH ’16) experienced the complex challenges of creating effective and desirable solutions for global health initiatives.

Her time in South Africa inspired her to pursue an MPH/MBA dual degree from Johns Hopkins, confident that comprehensive public health and business skillsets would help create a niche for herself in the public health sector.

Today, Piccinini Black is the academic lead for Design Thinking for Innovation within Johns Hopkins Carey Business School’s Executive Education program. She also serves as an adjunct faculty member for design thinking courses at Carey, as well as the design innovation lead at Johns Hopkins Center for Communication Programs.

Her initial exposure to design thinking came during her time as an MBA student at Carey Business School. Now, an empathy-centered approach to problem-solving through design thinking is the basis of her career in both business and public health.

Post-graduation, Piccinini Black was hired at the Johns Hopkins Center for Communication Programs. Using her background in public health, she was brought onto a project to reinvigorate a commercial market for bed nets for malaria prevention in Ghana.

“This project was a great opportunity to apply the skills I gained in the design thinking course to a ‘real world’ project. I pitched the idea of using design thinking to design new bed nets for commercial sale and it stuck. That project was really the catalyst for my career,” she said.

Design thinking is a creative problem-solving process that’s rooted in empathy. By leveraging creativity, individuals can ultimately design and achieve novel solutions to complex problems and compete in today’s dynamic market.

“It’s a process to help create solutions that will actually meet the needs, desires, and constraints of its end users,” she said.

Piccinini Black leverages this human-centered mindset in the way she approaches and designs her design thinking research, workshops, and classes.

“I approach all my courses and design thinking work in an empathetic way. The design of my research processes and teaching approaches are rooted in a deep understanding of the participants, users, and key stakeholders,” she said. “I never conduct two processes or teach two courses the exact same way. It’s important to tailor each in order to respond to the realities of those involved.”

Breaking old habits

Piccinini Black says the pandemic created a space where organizations were forced to break out of old habits and become more creative in their approaches to problem-solving.

Looking for creative and effective approaches to problem-solving, working professionals from various industries are enrolling in Carey Business School’s Executive Education design thinking courses to help build their skillsets with hopes of bringing new, innovative solutions to their organizations. This approach to problem-solving can be leveraged for a variety of problems in different industries.

“Individuals want to revolutionize their problem-solving skills. Working professionals of all career levels participate in design thinking courses to better understand how to tackle business challenges and develop a more expansive human-centered mindset,” she said. “It is intended for individuals of different disciplines and backgrounds to learn how to solve complex problems in a more effective and strategic way.”

Piccinini Black explained that design thinking gives organizations a mechanism for engaging end users and key stakeholders at the beginning of and throughout the problem-solving process. And by doing so, it reduces risk and failure of not meeting the needs of stakeholders.

“Individuals leverage empathy, research, ideation, and iteration to devise novel, human-centered solutions. We collaborate with companies and organizations to bring ‘real world’ challenges to our courses, so participants learn design thinking through experiential learning,” she said.

“Working professionals of all career levels participate in design thinking courses to better understand how to tackle business challenges and develop a more expansive human-centered mindset.” Danielle Piccinini Black

A promising future for design thinking

Piccinini Black has seen greater emphasis on design thinking approaches to problem-solving since the pandemic, giving her hope for the future of innovation and empathy-focused problem-solving and solutions.

“We have a global shared experience from the pandemic, which I believe has made people more empathetic. Design thinking is empathy-centric, and the process seems to resonate with people more now than ever. Because our world is ever-changing, as a society we recognize that we must challenge routines and solve problems while fostering an empathetic mindset,” she said.

While it may be challenging to apply design thinking effectively without study and practice, Piccinini Black says adopting a human-centered mindset is something individuals can do right away.

“Simply approach your work and problem-solving with empathy for a comprehensive understanding of those you are working with and designing for. The easiest way to do that is to simply engage in conversation from the beginning. Learn directly from them,” she said.

Those who are interested in building their knowledge and skills in design thinking, Piccinini Black says to explore the Johns Hopkins Executive Education certificate in Design Thinking for Innovation.

“Knowing design thinking is one thing. But knowing how to do design thinking effectively and having the confidence to implement it in your work and lives outside of the classroom is another. Earning a certificate will get you there.”

Executive Education

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Introduction to Design Thinking
Executive Certificate in Design Thinking for Innovation
Design Thinking Practicum

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DOI: 10.1097/jnr.0000000000000357
Corpus ID: 209427303

Relationship Between the Problem-Solving Skills and Empathy Skills of Operating Room Nurses.

Fatma Ay , Şehrinaz Polat , Tennur Kashimi
Published in Journal of Nursing Research 17 December 2019

12 Citations

Empathy and type d personality as the correlates of level of social skills of primary healthcare nurses, empathy and mobile phone dependence in nursing: a cross-sectional study in a public hospital of the island of crete, greece, the influencing factors of clinical nurses’ problem solving dilemma: a qualitative study, effect of applying design thinking-based team project teaching method in nursing clinical practice education, basic empathy scale: a systematic review and reliability generalization meta-analysis.

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Factors influencing the complex problem-solving skills in reflective learning: results from partial least square structural equation modeling and fuzzy set qualitative comparative analysis

Intellectual humility in the health and well-being context: implications for promoting positive client relationships, client receptivity, and unbiased information gathering, temel eğitim kurumlarında alınan güvenlik önlemlerinin okul kazalarına etkisinin i̇ncelenmesi, hemşi̇relerde problem çözme beceri̇si̇ i̇le covi̇d-19 korkusu arasindaki̇ i̇li̇şki̇ni̇n i̇ncelenmesi̇, knowing well, being well: well-being born of understanding: editor’s desk: it’s critical to cultivate intellectual humility, 30 references, research on burnout level of nurses and their problem solvi̇ng skills, developing empathy in nurses: an inservice training program., comparisons of nurses and physicians on an operational measure of empathy, nurses' perceptions of their problem-solving ability..

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Problem solving is the enemy of empathy

It’s actually very common, even “normal”, in human conversations to jump to solutions. But this is the enemy of authentic human exchanges.

Water colour graphic representation of microbial cells in red and blue and green and yellow and orange.

Listening is hard work. And listening to someone’s pain is even harder.

Humans are good at avoiding pain. And we have a variety of defence reactions designed to block the experience of having pain. And that includes the pain caused by proximity to someone else’s pain.

This poses a problem for empathy . Empathy connects us to others’ pain. Problem solving is one of the most common blocks, and it can be hard to notice because most of the time problem solving is a pro social behaviour. Problem solving is an emotional intelligence skill.

In coaching we resist the impulse to offer solutions to the challenges our clients talk about. This is no small feat actually. It takes practice and more practice.

It’s actually very common, even “normal”, in human conversations to jump to solutions. But this is the enemy of authentic human exchanges. So stop it. Seriously, stop it.

Our desire to problem solve might come from empathy , but it doesn’t express empathy . We struggle to see someone we love and care about in pain. It hurts us. That hurt flows from empathy.

And it’s uncomfortable. So we try to put it in the closet. Our brain reacts impulsively: go away pain .

“Sooo… you just want me to listen to your story of heartbreak and control my impulse to mucky muck and look smart and fix things?”

But in order to express empathy, we need to do something else. And this something else takes practice. It’s a little like walking into fire. It takes training. You have to overcome your fear of discomfort.

Even after coaching for as long as I have, it’s extraordinary how often the impulse to problem solve comes up. It’s ongoing. And I have to continue to cultivate my awareness and my capacity to resist the gravitational force of trying to fix people’s challenges.

When I offer a solution, it immediately makes me feel better. But when someone else offers a solution to me, I often feel like they’re shutting down the conversation. Problem solving is a an exit. Problem solving can act as a signal to the person exploring a situation, that the exploration is (or should be) over. And in some cases this invitation to exit is not an invitation. It’s a tacit judgement of someone’s interest in exploring the terrain of their experience.

Solutions we offer are rarely as good as what someone comes up with themselves. This is because folks know the nuance and subtleties of their context. Or they want to know it. This is why in coaching we cultivate the practice of asking questions. We try to create a space within which people can explore the terrain of their contexts and emotions and when they’re ready they can construct their own map and path.

Even in the instance that a coach, or mentor, or friend, does know better than a colleague, this doesn’t necessarily predicate problem solving. Doing so prematurely can rob them of the chance to explore and articulate their experience and effectively journey through a map of their own creation.

In many contexts, especially in our work lives, problem solving is what’s called for. This is why it’s so important to avoid doing it in the situations where problem solving is best set aside.

Get EQ-i 2.0 / EQ 360 Certified Online

Emotional intelligence competencies are critical skills that are highly correlated with performance and wellbeing. Get certified to assess and develop emotional intelligence.

Rebecca Cory is an EQ coach. She has an MA in Adult Education from the University of Victoria. In addition to her work as an EQ coach with EITC, she is the Program Coordinator for University 101, a UVic initiative to make knowledge more accessible. She has worked in community engagement, facilitation, and curriculum development for over fifteen years.

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Relationship Between the Problem-Solving Skills and Empathy Skills of Operating Room Nurses

2019, Journal of Nursing Research

Related Papers

şermin metin , Şule Kavak

This study aiming to determine whether there is a relationship between social skills and problem solving skills of students in Primary Education Department of the Faculty of Education and reveal the differences between departments is a descriptive study done with the relational screening model. A total of 246 prospective teachers who were studying in the first and fourth grade in the departments of PreSchool Education and Classroom Education in the Department of Basic Education of Abant İzzet Baysal University Education Faculty were included In the study group, in the 2016-2017 academic year. The Social Skill Inventory (SOBE) developed by Aydoğan and Özyürek (2016) and the Problem Solving Inventory (PÇE) developed by Heppner and Peterson (1982) were used to collect the data. In the analysis of the data obtained, t test, unidirectional variance analysis (ANOVA), Kruskal Wallis H test, and Pearson Correlation Coefficient were used for number, percentage, unrelated samples. As a result of the research, it was found that there was a positive and meaningful relationship between the students' social skills proficiency and problem solving skill perceptions, that the age of the students caused a significant difference in the social skill levels of the students, and that the pre-primary education students, the female students, the fourth grade students and the students with high academic averages had higher level of social skills and more adequate problem solving perception.

Client – centered Nursing Care Journal

Background: Today’s nursing graduates value ability to creatively solve problems and make decisions, as these skills assist them with recognizing and evaluating situations that require prompt attention. This study aimed to determine and compare nursing student’s perceived levels of own problem solving skills in various years of their 4-year program. Methods: This is a cross-sectional study. All undergaraduate nursing students (350) included in this study. A total of 322 undergraduate nursing students participated in this study. The study setting was Nursing School of Iran University of Medical Sciences, Tehran, Iran. The problem solving inventory (PSI), a widely used measure to assess one’s perceived ability, was used for data collection. Low scores indicated the strong judgment ability and high scores a weak judgment ability. Students involved in the study signed the informed consent forms. Results: Findings showed that the mean score of total problem solving skill was 89.52±21.58. The mean score of this skill in fourth year students (84.18±27.47) was less than other students i.e. the fourth year (senior) students judged their own problem solving abilities stronger than other students. Conclusion: Educating should help students reach the high levels of problem solving skills by allowing them to acquire and practice these abilities in the field. Nursing students with advanced problem solving skills are essential for this changing society.

Revista Romaneasca pentru Educatie Multidimensionala

Iryna Zharkova , Marija Czepil

Belgin Bal İncebacak

A problem is a situation, in which a person tries to find a solution and does not exactly know how but still tries to solve it. One of the important elements of problem solving skills that individuals should have is to choose the appropriate strategy in the solution of the problems, which is important in terms of achieving success in solving problems. The research question of the study is " what are the levels of sixth and seventh grade students' problem solving skills? " The aim of this study was to investigate the problem solving and problem-solving strategies levels of secondary school students. The study was carried out through method with a total of 72 students from the two provinces in the Black Sea region of Turkey selected by random in the second term of the 2014-2015 academic year. In this qualitative research for the case study, content analysis was applied. The study group consists of 50 students in Samsun province and 22 students in Sinop province in the Blacksea region, 35 of the students are females, whereas 37 of them are male students. Turkish by the researchers, were used as the data collection tools. The problems applied were evaluated according to Polya's stage of problem solving. The problems were evaluated according to stages such as understanding the problem, choosing a strategy, applying the chosen strategy, and evaluating the solution. While examining students' problem solving papers, it was observed that they were more successful at solving problems, with which they came across before or are similar to the ones they had solved. It was observed that majority of the students had difficulty in solving non-routine problems. It is believed that this results from the fact that mostly routine problems are discussed and solved in the curricula.

IJAR Indexing

Problem solving has a special importance in the study of mathematics. The primary goal of mathematics teaching and learning is to develop the ability to solve a wide variety of complex mathematics problems. A problem is an obstruction of some sort to the attainment of an objective, a sort of difficulty which does not enable the individual to reach a goal easily. The present study aims to find out the relationship between problem solving ability and achievement in mathematics of higher secondary students. Fifty five, higher secondary students were randomly selected as sample. Survey method was adopted for the study. The data was collected using a test on problem solving ability (PSA). The t-test, chi-square test and pearson?s product moment correlation were applied to test the hypotheses. Interpretation were drawn based on the findings. Problem solving ability of the higher secondary students was found to be an average and there was a high positive correlation between problem solving ability and achievement in mathematics.

International Journal of Eurasia Social Sciences

Elifcan Cesur

Problem solving is one of the important skills, which enables individuals to adapt to life and is associated with skills like theory of mind, empathy and self-regulation, in their life. Problem solving is an improvable skill and should be supported as from early childhood years. The purpose of this study is to determine how children generate solutions to problems and how they feel in such cases. As long as children are good problem solvers, they will find effective solutions to all kinds of problems. In the study, the qualitative model and the case design were used. The data of study were obtained from the children attending a kindergarten in the city center of Kırklareli in the school year of 2016-2017. Eleven children who were selected on a volunteer basis were included in the study where content analysis was carried out. Among the children who participated in the study, six were girls and five were boys. During the application, a puppet and five problem statuses were used. The data collected as a result of one-to-one applications with the children were examined with content analysis method. As a result of the study, it was observed that the children were able to generate effective solutions including the use of empathy and self-regulation skills to the problem statuses; however, they had difficulty in naming their emotions in relation to problem statuses. The results of the study suggest that primarily parents and educators should emphasize emotions more and encourage children to think about their emotions. Additionally, qualitative studies with larger sample groups concerning theory of mind, problem solving, empathy and self-regulation skills can help to understand the development process of these skills better.

Aysel Köksal Akyol , Vuslat OĞUZ

In this research, it is aimed to determine whether problem solving skills of 60-72-month-old children attending a nursery school change as regards gender, birth order, the duration of nursery school attendance and the number of children in the family. The sample of 204 children consisting of 60-72 month-old children attending a nursery school are interviewed. Data is collected by means of the Personal Information Form and the Problem Solving Skills Scale (PSSS). The Mann-Whitney U test and the Kruskal Wallis test are used for the statistical analysis. According to the results, it is obtained that gender, birth order, the duration of nursery school attendance and the number of children in the family do not significantly affect the problem solving skills of children (p>.05).

Shanlax International Journal of Arts, Science and Humanities

Lilu Ram Jakhar

Problem solving is one of the basic requirement for the adjustment and social well-being for an individual. The present study was conducted to ascertain whether there exists difference in the problem solving ability of the students studying at the secondary stage on the basis of the gender. The results of the study showed that the mean score on the problem solving ability test of the boys was 10.14 whereas the mean score on the problem solving ability test of girls was found to be 10.40. The difference in the mean scores of the problem solving ability was determined by applying t- test and was found to be 0.26. This indicate that the there is no significant difference in the problem solving ability of the students on the basis of gender at secondary level.

Journal of Education and Health Promotion

sara shahbazi

BACKGROUND: Nursing students are generally trained to acquire the knowledge, skills, and approaches required for solving problems and contradictions in life and at work. In fact, problem-solving skills are the core of effective nursing activities. Therefore, the aim of this study is to evaluate the effectiveness of problem-solving training on the promotion of emotional intelligence in nursing students. MATERIALS AND METHODS: This interventional case–control study used a pretest-posttest design. All senior nursing students (n = 43) attending the seventh semester of their undergraduate studies at Hazrat Fatemeh School of Nursing and Midwifery of Shiraz University of Medical Sciences were recruited in the present study. The participants were randomly allocated to either the intervention group (n = 20) or the control group (n = 23). The collected data were analyzed with SPSS software version 16. RESULTS: While the mean standardized scores of Emotional Quotient Inventory of the two group...

Educational research and reviews

Veysel Temel

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Why Empathy Is the Golden Rule of Couples Communication

Here’s why feedback, reassurance, and problem-solving work best after empathy..

Posted December 6, 2017

The Importance of Empathy
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It would seem like common sense that you have to first emotionally connect with your partner if they’re to hear you the way you want to be heard. Yet if you’re like most people, you respond to them differently — especially if they’re voicing frustration — either by immediately offering them words of reassurance or consolation; or what you imagine is good practical advice or constructive criticism; or (especially if you're a male) initiating a process of problem-solving, endeavoring to help them fix what’s wrong. If so, you’re likely surprised and maybe irritated when your supposedly positive reaction doesn’t have the effect you intended.

As I emphatically tell the individuals and couples I work with, “Empathy first!” It’s a maxim I suggest they commit to memory before verbally engaging with their partner. If there’s a single internal catchphrase that almost guarantees that a dialogue will begin favorably — regardless of the topic — I’ve learned from over 35,000 hours of hands-on clinical experience that this simple “ self-talk ” slogan works best. (It’s also optimal with children — as in, “connection before correction.”)

Not that starting out with heartfelt words of understanding and compassion will always work. There are times when nothing can. But particularly in troubling or thorny situations where the startup is likely to determine the outcome, there’s no safer way to open a discussion than seeking to genuinely “participate” in your partner’s state of mind. This is most effectively accomplished through accurately identifying with their feelings, whether they’ve been overtly stated or implied by language, facial expression, and tone of voice. However, the reason that vicariously entering into your partner’s subjective reality can sometimes be quite challenging is that in any individual instance, their reactions may be quite dissimilar from your own.

In an earlier post, I wrote that feeling understood was in some ways more important than feeling loved. So when your partner experiences that you’re sincerely making an effort to grasp where they’re coming from, the odds that they'll be more receptive to where you’re coming from are greatly enhanced. And when you can’t discern their subjective reality, offering empathy needs to be done tentatively, as in, “The expression on your face right now makes me think that what I said struck you the wrong way. Did it make you feel hurt (or angry, sad, confused, misunderstood, etc.? What are you feeling now?”

It can hardly be overemphasized that this powerful prelude to talking about challenging subjects doesn’t relate just to altering the course of a conflict. It’s also ideal in situations where your sole objective is to console your partner when they’re confiding in you a deeply felt inadequacy or failure that’s distressing them.

Let’s say in interviewing for a position your partner coveted, they accidentally put their foot in their mouth. And now, certain that they blew it, they can’t stop beating themselves up. If you start out by saying, “Well, don’t forget, there have been times when you did really well in an interview,” they’re probably not going to experience much comfort. They’re more likely to feel you’re not in sync with them, and are maybe even invalidating them. For you’re doing nothing to emotionally identify the nature, or extent, of their disturbance, and by doing so, "joining" them. What they need is for you to recognize their discouraged, disconcerted feelings.

Imagine if instead you were to have said something like, “I can only imagine how terrible you must feel right now. It has to be awful to have all these second thoughts about how you could have presented yourself better or said something differently. I know how much getting that position meant to you.” Only then might you add, “All I can say is that in the past, you’ve shared times when you did really well in an interview. Maybe, when you’re ready, we can look at what went wrong this time, so we can get a better sense of how you might prepare in the future. I know I’ve messed up while being interviewed when I got so nervous I couldn’t think straight, or didn’t get myself properly 'psyched' for it.”

Note how much more thoughtful and “involved” this alternative, more elaborate response sounds, and how it communicates more connection, caring, and concern. If you immediately responded by taking a stance of glib reassurance, or made problem-solving suggestions, or — worst of all — critically sat in judgment on your partner’ performance, these admittedly more common responses would have done little, if anything, to help heal the psychological wound your partner may still be experiencing.

Here’s another example:

Say your partner confesses, “It really makes me disgusted with myself that I’m so bad at saying what I mean. So many times, my words just don’t come out the way I want them to.” And in return, you respond, “Well, yeah, but look at how good you are at fixing problems on the computer that make me crazy!” Is that really the best thing you could say to help them feel caringly understood?

What if you said, “Yeah, that ‘s got to be really frustrating — when you know what you want to say, but what comes out just doesn’t fit what was in your head. And then I can’t help but reply to you as though you said something else. And you end up feeling really frustrated with yourself, ’cause it hits you that what you said wasn’t what you meant...Is that how it feels to you?”

Is it not obvious that first “meeting” your partner where they are lays the emotional groundwork for any comforting message you might wish to convey? And that anything reassuring you might say will register more deeply once you’ve vicariously reflected their upset back to them — effectively “uniting” yourself with them?

In a sense, this is what a loving companionship is all about, what’s absolutely essential to creating the relationship you desire. And it’s largely absent any criticism or evaluation. Sure, if you’re skilled at it, there may be all kinds of constructive comments or feedback you can provide that your partner will appreciate. But in most instances, it’s not that productive, and may even be harmful, to start out with them. Unquestionably, there’s a time for suggestions and solutions. But in general, what needs to come first is making your mate feel heard , making them feel you truly “get” where they’re coming from — both what they’re thinking and how they’re feeling.

All the same, as effectively as an initial empathic response to your partner usually works, it’s not easy to do — especially when your buttons have been pushed. Then, either you’re not at all inclined to respond this way, or you simply haven’t developed the communication expertise to do so. If what I’ve described was easy to do, a lot more people would do it. But few of us truly have the awareness or the emotional strength and resilience to respond this way. Given human nature, it just doesn’t come naturally.

So, if you’re to develop this invaluable communication skill, and attitude, expect it to take substantial practice and self-discipline, until it becomes a habit. For a while, you may have to pause and take a deep breath to free yourself of what you’re “programmed” to do. But if you’re willing to make the effort, you may be amazed at how your relationship can transform, how much closer you can feel toward each other, and how much more intimate your union can become.

Leon F. Seltzer, Ph.D. , is the author of Paradoxical Strategies in Psychotherapy and The Vision of Melville and Conrad . He holds doctorates in English and Psychology. As of mid-July 2024, Dr. Seltzer has published some 590 posts, which have received over 54 million views.

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Relationship Between the Problem-Solving Skills and Empathy
The three hypotheses regarding the relationships between the independent variables are as follows: H1: Sociodemographic characteristics affect problem-solving skills. H2: Sociodemographic characteristics affect level of empathy. H3: Problem-solving skills are positively and significantly correlated with empathy.
The role of empathy in problem construction and creative problem solving
The problem construction process has been shown to be influenced by cognition as well as the environment. Other research has suggested a relationship between creativity and empathy, although the underlying mechanism has not been examined. Empathy has been related to increased novelty and quality of problem solutions.
Relationship Between the Problem-Solving Skills and Empathy ...
Background: The use of empathy in problem solving and communication is a focus of nursing practice and is of great significance in raising the quality of patient care. Purpose: The purposes of this study are to investigate the relationship between problem solving and empathy among operating room nurses and to explore the factors that relate to these two competencies.
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The role of empathy in problem construction and creative problem solving
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Design thinking is a creative problem-solving process that's rooted in empathy. By leveraging creativity, individuals can ultimately design and achieve novel solutions to complex problems and compete in today's dynamic market. "It's a process to help create solutions that will actually meet the needs, desires, and constraints of its end ...
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THE BASICS. The Importance of Empathy. Conflict is a fact of life and occurs for a variety of reasons, such as differing perspectives, priorities or solutions to a problem. Many believe that ...
Relationship Between the Problem-Solving Skills and Empathy Skills of
The use of empathy in problem solving and communication is a focus of nursing practice and is of great significance in raising the quality of patient care. Purpose The purposes of this study are to investigate the relationship between problem solving and empathy among operating room nurses and to explore the factors that relate to these two ...
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tolerate interpersonal differences. Developing empathy and problem solving skills in primary school children will enable them to grow as more dynamic and more powerful individuals. In this context, the aim of the study is to e xamine whether there is a relationship between empathy tendency skills and problem solving skills of primary school ...
(PDF) Relationship Between the Problem-Solving Skills and Empathy
Background: The use of empathy in problem solving and communication is a focus of nursing practice and is of great significance in raising the quality of patient care. Purpose: The purposes of ...
Relationship Between the Problem-Solving Skills and Empathy Skills of
Investigation of the relationship between problem solving and empathy among operating room nurses finds lower empathy scores were associated with difficult working conditions in operating rooms, intense stress, and high levels of potential stress-driven conflicts between workers in work settings. BACKGROUND The use of empathy in problem solving and communication is a focus of nursing practice ...
How Empathy Can Boost Your Problem-Solving Skills
Here are some ways to develop and practice empathy in your problem-solving process: Ask thoughtful questions : Asking thoughtful questions is a great way to show empathy and learn more about others.
PDF Relationship Between the Problem-Solving Skills and Empathy Skills of
ings in theliteratureaddressthe relationship between problem- solving skills and empathy skills in operating room nurses. Today, the healthcare system demands that nurses use
Problem solving is the enemy of empathy
Empathy connects us to others' pain. Problem solving is one of the most common blocks, and it can be hard to notice because most of the time problem solving is a pro social behaviour. Problem solving is an emotional intelligence skill. This comic is really great. In coaching we resist the impulse to offer solutions to the challenges our ...
(PDF) Relationship Between the Problem-Solving Skills and Empathy
A problem is a situation, in which a person tries to find a solution and does not exactly know how but still tries to solve it. One of the important elements of problem solving skills that individuals should have is to choose the appropriate strategy in the solution of the problems, which is important in terms of achieving success in solving problems.
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This study found male and female nursing students to generally exhibit equal levels of empathy and problem-solving skills. Female nursing students had higher emotional intelligence than males. Gender differences were also established in the relationships between empathy, emotional intelligence, and problem-solving ability in nursing students. 4.1.
Why Empathy Is the Golden Rule of Couples Communication
The Importance of Empathy. It would seem like common sense that you have to first emotionally connect with your partner if they're to hear you the way you want to be heard. Yet if you're like ...
Horoscope for the week of 9th September, 2024, weekly horoscope
Add structure and activate empathy, Cancer! ... and problem-solving. Thursday's Mercury-Mars sextile wants you to lead your friends to a new vision of what's possible, so don't be afraid to ...

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Relationship Between the Problem-Solving Skills and Empathy Skills of Operating Room Nurses

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