# Translation, psychometric assessment, and adaptation of the state empathy scale among healthcare students

## TL;DR

This study translated and validated the State Empathy Scale for Norwegian healthcare students, showing it is a reliable tool for measuring empathy in this group.

## Contribution

The study provides a validated Norwegian version of the State Empathy Scale tailored for healthcare education.

## Key findings

- The Norwegian version of the State Empathy Scale demonstrated good face, content, and structural validity.
- The adapted scale showed strong convergent and discriminant validity and internal consistency.
- Three items were removed, resulting in a nine-item version suitable for healthcare students.

## Abstract

Understanding patients’ experiences, opinions, and feelings is essential for health professionals to assess patients’ real needs and provide optimal treatment. Teaching and assessing healthcare students’ empathy is challenging in an educational context. The English measurement instrument State Empathy Scale, based on the theory of empathy, measures state empathy during message processing and was found to be suitable for measuring state empathy among healthcare students.

This study aimed to translate and adapt the State Empathy Scale into Norwegian and assess its psychometric properties among healthcare students. The study was conducted among healthcare students at the Norwegian University of Science and Technology (NTNU). Participants consisted of 189 students from various healthcare study programs who took part in a VR 360° video learning design conducted during Trauma Week.

The translation process followed international guidelines and included independent forward translation, synthesis, back-translation, and expert committee review. Minor adaptations were made to tailor the scale to the healthcare education context. The revised version was field-tested among healthcare students and assessed using exploratory and confirmatory factor analysis.

Small adjustments to a healthcare student context were made, and the measurement instrument demonstrated good face/content validity. The Norwegian version of the State Empathy Scale’s structural validity was evaluated. It supported a three-factor structure similar to the original English instrument but with three removed items. The measurement instrument demonstrated good convergent and discriminant validity and internal consistency.

The translated, adapted, and validated State Empathy Scale 9 - Norwegian version (SES9-No) is reliable and valid for assessing empathy among Norwegian healthcare students. This tool can facilitate the development and evaluation of empathy training programs, ultimately enhancing the quality of patient care.

The online version contains supplementary material available at 10.1186/s12909-026-08645-6.