Doctoral Dissertations

Date of Award


Degree Type


Degree Name

Doctor of Philosophy



Major Professor

Martha R. Alligood

Committee Members

Mary Lue Jolly, Tricia McClam, Johnie Mozingo, Gerald Ubbens


This study explored the relationship between baccalaureate nursing students' perception of empathy and stress experienced in student-instructor interactions. A midrange Theory of Optimal Student System Stability derived from Neuman's Systems Model was tested. A descriptive cross-section correlational design was used to test the hypothesis; The higher the levels of empathy baccalaureate nursing students perceive when interacting with clinical instructors, the less stressful students perceive the interaction to be. A convenience sample of 132, selected from two national League for Nursing accredited baccalaureate nursing programs, volunteered to complete the Perception of Empathy Inventory (PEI) and the Nursing Clinical Experience Subscale (NCES) along with a demographic data form. The scores of the PEI and NCES were correlated using Pearson's product-moment correlational coefficient. The hypothesis was not supported. Further examination of the instruments to determine their performance was done. Factor analysis revealed that four of the 24 items on the NCES specifically measured stress in student-instructor interactions. Use of the NCES scores was limited to these four items and the hypothesis was retested. The results supported the hypothesis and midrange Theory of Optimal Student System Stability.

Conclusions were from theoretical and methodological perspectives. The findings of this study support the use of empathy by clinical instructors during interactions with students to decrease students' perceived stress. The Theory of Optimal Student System Stability requires further testing using an instrument to measure stress specifically in the student-instructor interaction.

From a methods perspective, questions were raised regarding the instruments used and sample selection. Recommendations for further research were included.

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