The effect of role play-based education on nursing students’ stigmatizing attitudes, empathy levels, and communication skills toward the care of individuals with substance use disorder
Year: 2026
Type: article
Study design: Clinical Trial
Abstract: Background Stigmatizing attitudes toward individuals with substance use disorder (SUD) remain common among healthcare professionals and students and may negatively affect care quality, therapeutic relationships, and treatment access. Nursing students may demonstrate stigma, limited empathy, and insufficient communication skills in SUD care contexts. Active learning approaches such as role play have been suggested to improve affective and communication-related competencies; however, experimental studies simultaneously targeting stigma, empathy, and communication skills in SUD contexts remain limited. Purpose This study aimed to examine the effect of role play–based education on nursing students’ stigmatizing attitudes toward individuals with SUD, empathy levels, and communication skills. Materials and methods A quasi-experimental pretest–posttest control group design was conducted during the 2025–2026 academic year with 76 nursing students (experimental n = 38; control n = 38) at a faculty of health sciences in Türkiye. The experimental group received a structured four-session role play–based SUD education program, while the control group continued with the standard curriculum. Data were collected using the Toronto Empathy Questionnaire (TEQ), Communication Skills Inventory (CSI), and Attitudes Toward Mental Illness Scale—Substance Related Subscale (ATMI-SRS). Linear mixed models were used as the primary analysis, supported by ANCOVA and mixed ANOVA. The Bonferroni-adjusted significance level was set at α = 0.017. Results Significant time × group interactions were found for all outcomes. The experimental group showed greater reductions in stigmatizing attitudes than controls ( β = −5.61, p < 0.001), with a 57% reduction versus 15% in controls. Empathy increased significantly ( β = 11.92, p < 0.001), and communication skills improved significantly ( β = 20.06, p < 0.001). Effects were stronger among students with higher baseline stigma levels. Conclusion Role play–based education appears effective in reducing stigma and improving empathy and communication skills toward individuals with SUD among nursing students. Despite quasi-experimental design limitations, findings support integrating structured role play into nursing curricula. Further randomized controlled studies with larger samples and long-term follow-up are recommended.
Source: Frontiers in Public Health
Institutions: Hakkari University, Gaziantep University, Mustafa Kemal University
Language: English
Subfield: Epidemiology
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $3,801
OpenAlex ID: W7222945432