MOOCs and Empathy as core tools for preparing professionals in charge of sexual abuse prevention

Headnote

Abstract: This study presents an interdisciplinary experience between the fields of Information and Communication Technologies for Education and Psychology, by ways of a MOOC aimed at preventing sexual abuse of children and adolescents. The study builds on previous research and validates both, the influence of empathy on professionals in the field of prevention, and how it can be improved by means of adequate training. The objectives were reached thanks to an online training program carried out in several cohorts for six years. The role of dispositional empathy was evaluated with personal interviews, focus groups, participant observation and specifically designed polls. The results were statistically correlated and contrasted considering how social events may influence the perception of participants. The results validate not only the methodology, but also the importance of training on empathy for the professionals in the area.

Keywords: empathy; sexual abuse prevention; MOOC; online education; professional training.

1.Introduction

Sexual abuse of children and adolescents has captured the attention of media and society at all levels; globally and regionally (Cook et al., 2017; Dupret, 2012). This is an increasingly alarming problem, given some of the current complex generalized situations like domestic violence, carelessness in professional training and the diffuse ethical boundaries of society.

The key to prevent this problem is empathy, that can be considered as the ability to understand and share the feelings of others, within the sphere of interpersonal communication (Decety, 2010; Sepp & Embree, 2010). Moreover, previous studies (Man-Ging et al., 2015) highlighted not only the relevance of empathy, but also the prospect of improving or increasing it, for example by ways of specialized training (EgasReyes et al., 2018).

The main tool used in this work is an online training platform which underwent a complex adaptation process over time, as reported in (Egas-Reyes, Ordóñez-Camacho, BarahonaCruz, et al., 2019). This platform serves not only for the transmission of knowledge, but also to allow those participants dealing with situations of abuse and violence, to share their work experiences. Considering the sensitivity of the topic discussed in this course, there are additional face-to-face meetings with qualified tutors who support the participants.

Our objectives in this study were twofold. First, to report how, thanks to a blend of qualitative and quantitative methods, this interdisciplinary experience between Information and Communication Technologies for Education (ICTE) and Psychology was conceived, resulting in a MOOC aimed at preventing sexual abuse of children and adolescents. Second, this work validates both, the influence of empathy and the ability to improve it by means of adequate training. Finally, the results show the importance of blending virtual and face-to-face formative work, thus allowing for close support of the participants.

1.1. Background and related work

In 2012 the "Center for Child Protection" (McElwee, 2015) was opened in Munich. This institute was primarily dedicated to the prevention of sexual abuse of children and adolescents through research and online education. In 2015 it was decided to transfer this operation to the Gregorian University of Rome (UNIGRE) also for the purpose of increasing the internationalization of the online courses offered. The institute is currently partnered with 7 countries and offers the course in 4 languages. During the first 3 years more than 1000 students attended and graduated from the offered MOOCs.

The present work is based on this initiative because Ecuador is one of the countries associated to this project through the Pontifical Catholic University of Ecuador (PUCE). Since 2016, PUCE, together with UNIGRE, has proposed the "Online Training Program for the Prevention of Sexual Abuse of girls, boys and young people", aimed at professionals and people who are working in the field of social education.

Compared to face-to-face classes, the pedagogical approaches applied in MOOCs can improve learning outcomes, specifically in cases related to sexuality education, where instructors have stated that students in online courses have achieved at least equal, if not better, results than students in face-to-face courses (Goldman, 2016).

In the project for the Prevention of Sexual Abuse, a MOOC was applied as an innovative technological tool, which turned out to be an important complement to the face-to-face meeting. Furthermore, considering that the complexity of the courses' content is the prevention of sexual abuse of minors, the easy and personal access to the MOOC from various locations and times, made the taking on of this training challenge more feasible.

The proposed MOOC goes beyond training on sexual abuse prevention. It addresses empathy, as stated in the introduction, as a human capacity to feel compassion, that is not a rigid element but can be learned. Despite the difficulty of reaching a consensus on its definition (Nowak, 2011), we can consider empathy as a cognitive, affective and dispositional process that relates to the emotional state of another person (Chung, 2014; Lietz et al., 2011).

Some works on empathy (Carich et al., 2003) study how it provides the ability to express compassion for victims of violent acts, while other investigators present studies in samples of sexual offenders (García et al., 2008; Hanson et al., 2010) where it was observed that the violators treated, showed higher values of empathy than both the untreated rapists and the non-sexual offenders.

Other researchers noted a deficit in the dispositional empathy of high-risk parents, regarding child physical abuse. These parents showed less feelings of warmth, compassion and concern for others, but instead, more feelings of anxiety and discomfort as a result of witnessing another person's negative experience (Heugten & Wilson, 2017; Perez-Albeniz & de Paul, 2003).

There are many studies on sexual abuse of children that analyze risk factors and conditions that have led to hiding problems (Nurcombe, 2016; Sinanan, 2011). The quality of child and youth care for people at risk of being sexually abused is a public health affair which must be addressed in a professional manner, resulting in medium and long-term prevention goals. We must not leave out of sight the fact that, as confirmed by Echeburúa, Corral, and Amor (2002); Soler, Barreto, and González (2005), and Perepletchikova and Kaufman (2010), there exists a strong relationship between traumatic experiences and emotional and behavioral sequelae in the medium and long term.

2.Methodology

This work has a prominent interdisciplinary nature, combining ICTE, and Psychology, while searching for a technological transition which would favor a better methodological approach and an improved course coverage, thanks to the participation of trained online tutors.

The investigation followed a blended approach: quantitative and qualitative research. Since this mixed approach was proposed, a mixed-method design (DEXPLIS sequential explanatory model) was applied, which involved the initial work from a quantitative approach (collection of data through online questionnaires for subsequent analysis) moving forward to a second phase through a qualitative phase (using observation, focus groups and individual interviews) (Hernández Sampieri, 2018).

Data gathering from the participants was performed at different stages of the course using online surveys, interviews with the tutors and forum analysis. Indicators generated from this data allowed us to determine the degree of commitment, satisfaction index and dropout rate, among others.

Where empathy was concerned, the quantitative logic was used and the basic tool applied for research was the Davis scale (Davis, 2018). The questionnaire contains 28 items which are distributed in 4 subscales: Perspective (PT), Fantasy (FS), Empathic Concern (EC) and Personal Discomfort (PD), with seven sub-themes each. An important element of this instrument is that it measures both: the cognitive aspect and the emotional reaction of the individual. In the questionnaire the test subject must answer questions related to thoughts and feelings which arise in different situations. PT and FS subscales refer to the cognitive area, while EC and PD subscales to the emotional area (Man-Ging et al., 2015). Figure 1 shows these subscales.

The sample for the study was determined by the number of participants in each training course. The description of each group: cohort, type of participants, data gathering stage, and number or participants, can be found in Table 1.

As far as quantitative process is concerned, the reliability of the original test and the samples obtained were verified through the Pearson coefficient, as well as with the methodology of the exploratory and confirmatory factor analysis. The data of the different groups and samplings (see Table 1) were compared in each of the Davis subscales. Significant differences were sought through t-tests, using the statistical software R, version 3.15, and the stats package, version 3.5.1 (R Core Team, 2018). Only significant differences were considered (95% confidence; p <0.05).

The data gathering and analysis orientation was not purely quantitative, but to a greater extent also qualitative, mainly through work with focus groups and in situ observation during face-to-face meetings. Qualitatively, the methods applied were participant observation (PO), focus groups (FG) and individual interviews (II), in each one of those the anonymity was respected. PO allowed to gather general impressions on the training: about the participants' expectations and how they change as the course progresses.

FGs were used to discuss on how the participants perceive the online course (friendliness, ergonomics, intuitiveness), and on the contents of the different units; these groups were formed at random with about 40% of those participants attending face-to-face meetings. Finally, about 15% of the participants were invited to Ils for an in-depth discussion on topics of interest highlighted by the previous methods. Data analysis was organized on two stages: transcription and categorization. FG and II meetings were fully transcribed and for PO a diary of notes was used. Categorization was based on the transcripts and the observation journals.

The qualitative analysis of information was carried out by systematizing the data through main and secondary categories (focus groups), and discourse analysis (individual interviews). By the end of the analysis, in 2018, a division into two large groups was carried out along with a total of 7 meetings where participants were observed; 4 focus groups with 47 participants, and 6 interviews were organized.

Next, in Section 3, we attempt to answer the question: what aspects of empathy improve after the application of the sexual abuse prevention program? The analysis was based on the use of the Davis scale to assess the impact of the course on Dispositional Empathy.

3.Results and discussion

For the remainder of this section, data will be presented and compared as depicted in Table 1, by cohort (2013, 2016, 2017), group (1 to 5) and sampling (T1 and T2). Only significant differences between means will be presented (with a 95% confidence).

When comparing the results between the first and the second samplings, some significant differences, according to the Dispositional Empathy criteria, are observed by cohort. Table 2 presents the relevant scales. We can see that in 2016, in FS, there was a significant decrease of 0.3 points, indicating that at the end of the course the participants shifted from a rather theoretical point of view to a more human-centered approach.

In 2017, for EC, there is also a significant reduction of 0.54 points between samplings. This could be interpreted as the participants changing their feelings of warmth regarding people involved in the problem. Participants' perspective could have changed with respect to their own limits and how they supported the victims when the course began.

Table 3 presents relevant differences between groups at the time of enrollment (sampling T1). Group 3 presents a PT value 0.45 points higher than Group 1. This could be related with an increased presence in media, at the time, of sexual abuse cases; it also points out, for Group 3, a more defined perspective in relation to the theoretical and accompaniment aspects regarding these cases. Group 4 has higher values than Group 1 on PT (+0.54) and EC (+0.38), showing that those participants taking the course later, presented a more defined theoretical perspective and greater concern regarding their personal approach to the subject. Group 4 also received a lot of media influence. Group 2 is lower than Group 3 in EC (-0.27) and at the same time higher in FS (+0.34). Group 2 therefore, mostly composed of university professors, had greater interest in the theoretical approach to the subject, learning from experiences where there are not personal involvement; there is a clear relation with lower scores in EC, since it shows they are interested in the subject, but with a personal distance from it.

Some relevant differences between groups also exist in the post-test (sampling T2), after the course; they are reported in Table 4. Group 3 has a PT score 0.45 higher than Group 1, showing that after the course they had greater interest in the psychological accompaniment and a better definition on how to approach the subject in practical terms. On the EC scale, Group 5 shows lower values than Group 3 (-1.07) and Group 4 (-0.77), suggesting that at the end of the course, although Group 5 did not neglect the empathic aspect, they dealt with the subject with greater objectivity, leaving aside a purely personal perspective. It is worth noticing that the participants of Group 5 lived in Cuenca, where many cases were being reported by the media, during that period, regarding children sexual abuse involving a well-known cleric. Participants were closely affected, with an undeniable influence on the reported outcomes.

It can be inferred, then, that at the end of the course, participants have a greater perspective on how they can intervene and what type of accompaniment can be provided. There is a bigger sensibilization and empathy regarding those persons directly involved in situations of sexual abuse, and it is important to notice that this sensibilization is not only an emotional personal issue; it is embedded with important theoretical aspects that guarantee objectivity when supporting the victims. Also, participants who started the course with a greater theoretical background, achieved greater awareness and sensibilization towards those individuals personally involved in the problem.

Media has proven to be a source of great influence, especially with respect to the PT, FS and EC scales. Cohorts following the course during peaks of cases reported by the media, have shown different perspectives and are sensitive to the problem in a rather personal way.

Semi-structured interviews were a valuable source of information allowing us to better understand how the participants felt about the subject. In general terms they feel more sensitive to the problem and they are more aware of the specific signals of sexual abuse a person can show. Regarding empathy, they believe they can accompany the victims with a more human-centered approach. Finally, the participants considered that the contents of the course allowed them to open their points of view regarding aggressors, understanding that they also need some type of specialized work and support.

The results confirm the initial research question: the training program shows an improvement on the empathy levels in the participants. These observations are consistent with the stability of the Davis scale that measures dispositional empathy in its cognitive (PT, FS) and emotional (EC, PD) aspects (Perez-Albeniz & de Paul, 2004).

With respect to the online course and the tutors, mainly regarding Psychology and Education, the articulation of the face-to-face and the virtual aspects strengthens the educational processes. It is shown then, that learning is not merely a phenomenon of repetition or transmission of content but rather a process of human interaction where the articulation between the psychic, the affective and the contents is sine qua non. How the spiritual and the psychological articulate, manifests in the problem itself: sexual abuse and how participants and tutors handled this issue. Tutors supporting and accompanying participants (whether virtually or face-to-face) in affectional or emotional difficulties due to certain module contents. The Information and Communication Technologies, thanks to the virtual technological platforms, overlaps the rest of the fields, since the MOOC platform becomes not only a tool to host contents and modules, but also a means to communicate between tutors-participants on issues of support and accompaniment.

Finally, it is worth highlighting the importance of previous studies (Egas-Reyes et al., 2018; Egas-Reyes, Ordóñez-Camacho, Grijalva-Vásquez, et al., 2019; Man-Ging et al., 2015) which laid out the person-centered methodological foundations, that gave rise to the technological evolution. It was this technological transition of the platform that led to training the tutors, improving empathy in the participants and searching for an innovative response regarding the problem of sexual abuse prevention.

4.Conclusions and recommendations

This work allowed us to deduce some ideas related to the use of MOOCs, from different aspects: their relevance in delicate contexts, the place of tutors and the coexistence of the virtual and the face-to-face. Delivering a virtual course that deals with sexual abuse in children and adolescents, required not only to ensure the relevance and accuracy of the formal contents to be transmitted, but also having capable tutors accompanying the participants, for a close and sustained monitoring. The accompaniment of tutors also involved the inclusion of a virtual-face-to-face learning dynamic that gave positive results, lowering the participants dropout rate.

Media played an important role, showing influence on the general public with respect to their vision and position against sexual abuse. However, at the end of the course, participants can have a broader approach to the difficulties of victims and aggressors, in addition to being closer to the reality presented in the media. It would be important to further investigate the place and impact of the media on the population with respect to this problem.

It is interesting to note how empathy surrounds several fields. Initially (Man-Ging et al., 2015), the approach was aimed at the concept of empathy directly related with the participants. Then, in a second moment the impact of the media and its influence on the reaction of both the participants and the tutors was evidenced (Egas-Reyes et al., 2018). Finally, with the MOOC, we realized the importance of having friendly and assertive platforms that give confidence and security to both participants and tutors, achieving an impact on empathy and on the learning process. Empathy, therefore, surrounds people (participants-tutors), ICTs (platforms) and media (press, internet, radio), as a main element to consider in processes of sexual abuse prevention in children and adolescents.

It has been shown, thanks to the various methods and instruments used, that there is a great need to discuss the problem, to train and to have clear action criteria in the presence or suspicion of sexual abuse. The training program has contributed to the development of sensibilization on the participants regarding how they handle the cases, not only with a professional criterion but with a human perspective. The media have contributed to make cases of sexual abuse public, in a society that has not yet discussed the issue; this allowed a greater interest in addressing these problems. This course is a response from the academy to this endeavor.

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