# Effects of Arts-Based Pedagogy on Competence Development in Nursing: A Critical Systematic Review

## TL;DR

This paper reviews how using arts in nursing education affects students' skills, finding that only creative drama has strong evidence of improving empathy.

## Contribution

The study identifies creative drama as the only evidence-based arts-based method in nursing education.

## Key findings

- Creative drama is the only arts-based approach with strong evidence of enhancing empathy in nursing students.
- Most arts-based pedagogy studies lack methodological rigor, limiting evidence on competence development.
- There is a need for better tools to measure the impact of arts-based methods in nursing education.

## Abstract

The integration of arts-based methods into nursing education is a topic of growing interest in nursing practice. While there is an emerging body of research on this subject, evidence on competence development remains vague, largely due to methodological weaknesses. The purpose of this review is to evaluate the effectiveness of arts-based pedagogy in nursing, specifically in terms of students’ changes in knowledge, skills, and attitudes. It explores which arts-based approaches to nursing education qualify as evidence-based practice in terms of nursing competence. A systematic critical review of research on arts-based pedagogy in nursing was conducted, identifying 43 relevant studies. These studies were assessed for methodological quality based on the CEC Standards for evidence-based practice, and 13 high-quality comparative studies representing a variety of arts-based approaches were selected. Creative drama was identified as the only evidence-based practice in the field, positively affecting empathy. The findings highlight a research gap in nursing education and emphasize the need for measurement and appraisal tools suitable for the peculiarities of arts-based pedagogy.