Visualized Standardized Narrative Communication Training for Empathy and Reflective Practice Among Outpatient Nurses: A Nonrandomized Controlled Study.

Abstract

Outpatient nurses frequently work under substantial time constraints and high emotional demands, making consistent empathic and reflective communication difficult. This nonrandomized controlled pre-post study evaluated whether a visualized, standardized narrative nursing communication technique (SNNCT) was associated with improvements in empathy, reflective practice, communication performance, and patient communication experience among outpatient nurses. Sixty-eight outpatient nurses at a tertiary hospital in Nanchong, Sichuan, China, were assigned nonrandomly to the intervention group (n = 38) or the control group (n = 30). The intervention combined standardized narrative communication training with visual workflow tools, including flowcharts, and structured reflective debriefing. Outcomes included nurse-reported empathy, reflective practice, communication self-efficacy, patient-centered values, patient-reported communication experience, implementation fidelity, and observer-rated communication quality. Mixed-effects models and mediation analyses evaluated intervention effects. Compared with the control group, nurses receiving SNNCT showed greater improvements in empathy, reflective practice, communication self-efficacy, reflective competence, implementation fidelity, observer-rated communication quality, and patient-reported communication experience. Mediation analyses indicated that improvements in empathy and reflective practice partially explained improvements in patient communication experience. These findings suggest that visualized, standardized narrative communication training may strengthen humanistic communication and support high-quality outpatient nursing care in busy clinical settings.