This randomized controlled trial examined the effects of using an aging simulation suit on empathy levels among healthcare professionals working in long-term care facilities. A total of 82 participants from four nursing homes in Madrid and Asturias were randomly assigned to an experimental group or a control group. The experimental group received a theoretical session on aging and empathy, followed by an immersive experience using the GERT aging simulation suit, which replicates age-related physical and sensory limitations. The control group attended only the theoretical session.

Empathy was assessed before and after the intervention using the Interpersonal Reactivity Index (IRI) and the Jefferson Scale of Empathy - Health Professions version (JSPE-HPS). Results showed significant improvements in the JSPE-HPS total score and in its Perspective Taking and Compassionate Care dimensions in the experimental group, indicating that the immersive experience enhanced both cognitive and affective components of clinical empathy. No significant changes were observed in the IRI scores.

These findings suggest that experiential learning through aging simulation can effectively strengthen empathy in active healthcare professionals, promoting more person-centered and compassionate care for older adults in long-term care settings.

Aging is accompanied by physiological, structural, and psychosocial changes that affect mobility, sensory functions, and interaction with the environment. Healthcare professionals working in long-term care facilities play a crucial role in supporting the physical, emotional, and social well-being of older adults. Empathy, understood as the ability to understand and share another person's feelings, is a key component of effective therapeutic relationships and person-centered care.

Traditional empathy training for healthcare providers often relies on lectures, role-playing, or observation of patient interactions. However, there is limited evidence regarding the impact of immersive simulation-based methods on empathy among active healthcare professionals. The use of aging simulation suits, which reproduce the physical and sensory limitations of older adults, has emerged as an innovative educational tool to promote understanding of the aging experience and improve empathic attitudes toward older persons.

This randomized controlled trial was designed to evaluate the effect of an aging simulation suit (GERT, Niederstotzingen, Germany) on levels of clinical empathy among healthcare professionals working in long-term care facilities. Participants were randomly assigned to one of two groups:

Experimental Group: Received a theoretical educational session on aging, functional limitations, and the role of empathy in care, followed by a practical session using the aging simulation suit. During the simulation, participants performed daily living tasks (e.g., walking, climbing stairs, dressing, interacting with others) while experiencing the physical restrictions associated with advanced age.

Control Group: Received only the theoretical session on aging and empathy without the immersive simulation experience.

Empathy was assessed pre- and post-intervention using two validated instruments:

Interpersonal Reactivity Index (IRI) - measures cognitive and emotional dimensions of general empathy.

Jefferson Scale of Empathy - Health Professions version (JSPE-HPS) - evaluates empathy specifically in clinical contexts.

Data analysis was conducted using repeated-measures ANOVA to assess within- and between-group differences over time.

Main findings: The experimental group showed significant increases in total JSPE-HPS scores and in the subscales Perspective Taking and Compassionate Care, whereas the control group showed no significant changes. No significant differences were observed in IRI scores. These results indicate that immersive experiential learning through the use of an aging simulation suit can enhance both cognitive and affective aspects of empathy in healthcare professionals.

The study was approved by the Ethics Committee of Universidad Rey Juan Carlos and conducted in accordance with the Declaration of Helsinki and ICH Good Clinical Practice guidelines.

This research supports the integration of simulation-based empathy training in continuing professional education for healthcare workers in long-term care, promoting more compassionate, person-centered care for the aging population.

Inclusion Criteria:

• Healthcare professional (nurse, nursing assistant, occupational therapist, physiotherapist, physician, psychologist, or social worker).
• Currently working in a long-term care or nursing home facility with direct contact with residents.
• Willing to participate voluntarily during working hours.
• Signed written informed consent.

Exclusion Criteria:

• Failure to provide written informed consent.
• No direct patient contact with older adults.
• Any physical or cognitive limitation that would prevent safe participation in the aging simulation experience.

Individual participant data (IPD) will not be shared because the dataset includes information from a small group of healthcare professionals that could potentially allow identification of participants. Only aggregated and anonymized summary results will be published in scientific journals and conference presentations.

Due to the nature of the educational intervention, neither participants nor investigators were blinded to group assignment