CCE Theses and Dissertations

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Date of Award


Document Type

Dissertation - NSU Access Only

Degree Name

Doctor of Philosophy in Computing Technology in Education (DCTE)


Graduate School of Computer and Information Sciences


Stephen Terrell

Committee Member

Laurie P. Dringus

Committee Member

Martha M Snyder


affective development, empathy, Krathwohl's taxonomy, medical professionalism, narrative


Medical educators, clinical trainers, and professional organizations that have responded to the need to humanize medicine have not explored prospects for affective development in distance education. In this dissertation, the author explored narrative as an affective learning technique. Medical fiction, lay exposition, autobiography and other written forms of patient narratives, as well as multimedia presentations, movies, music, song, and visual arts were explored and analyzed for use in teaching medical professionalism to online health science students. A collection of narratives and learning activities for teaching medical professionalism in an online class were presented.

Finally, a comparison study evaluated the use of narrative medicine to foster professional development in an online class. The use of narrative to introduce professionalism and help online students internalize the humanistic values of empathy and compassion was grounded in affective theories of moral development. Quantitative evaluation of medical professionalism was performed using the Jefferson Scale of Physician Empathy (JSPE), a psychometrically sound instrument designed to measure empathy in the context of patient care. Comparisons of mean changes in empathy suggest that the treatment group experienced significant changes in total empathy, reflected by increased scores in all elements of the JSPE. These results were validated by a qualitative review of student discussion posts, course evaluations, and instructor feedback.

The goal was to explore affective development and the educational value that narrative brings to teaching medical professionalism in the online class. The study helped to clarify the role of narrative in transformative learning. The implication is that online students can benefit from exposure to narrative. The relationship between narrative and medical professionalism may have applications for educational theory, medical and allied health practice, public policy, and future research.

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