Emotions in Nursing Education: How the TRI‑COM Model Could Make a Difference?

Emotional competence is essential for future nurses, yet university programs often overlook it. Italian researchers tested the TRI‑COM model, based on tripartite emotion theories, to explore how students handle feelings.\n\nThe study involved 233 nursing students from several universities, average age 24, with almost all participants female. They completed two questionnaires: the Toronto Alexithymia Scale (TAS‑20), measuring difficulty recognizing and describing emotions, and the Jefferson Scale of Empathy for Health Profession Students (JSE‑HPS), assessing the ability to put oneself in others' shoes.\n\nResults show the average TAS‑20 score is near the clinical cut‑off, indicating a tendency to rationalize emotions. The “externally oriented thinking” subscale is highest, suggesting many students focus on objective facts rather than feelings. Conversely, the empathy score is solid, especially in perspective‑taking, with a significant gender gap favoring females.\n\nNo major differences appear across study years, but age slightly reduces alexithymic traits. Overall, students display emotional detachment, possibly as a coping strategy in stressful contexts. The TRI‑COM model provides a conceptual lens to embed emotional skills into curricula, though further research is needed to translate it into practice.

The TRI‑COM model rests on three theoretical dimensions of emotion: cognitive, physiological, and behavioral. The cognitive component involves evaluating and interpreting emotional stimuli; the physiological side includes autonomic responses (heart rate, hormones); the behavioral aspect refers to facial expressions and gestures. Applying this framework in nursing education means designing learning activities that simultaneously stimulate all three facets. For instance, clinical simulations with mannequins that record vital signs can let students feel the physiological stress response, while guided debriefings foster cognitive reflection on how they managed empathy.\n\nMethodologically, the study used the TAS‑20, which distinguishes three factors: difficulty identifying feelings (DIF), difficulty describing feelings (DDF), and externally oriented thinking (EOT). A high EOT score, as observed, is typical of individuals who prefer an analytical approach, down‑playing subjective experience. The JSE‑HPS, on the other hand, separates perspective‑taking ability from compassionate care. The gap between these sub‑scores suggests that while students are adept at understanding others' viewpoints, they may struggle to translate that understanding into emotionally caring actions.\n\nNegative correlations between age and TAS‑20 scores indicate that, as students progress, they tend to improve emotional awareness, possibly due to increasing clinical exposure. However, the lack of significant differences across academic years suggests the current curriculum does not systematically address alexithymia. Embedding TRI‑COM with modules on mindfulness, role‑play, and video feedback could fill this gap, fostering a more humane and resilient nursing education.