Construction and Validation of Educational Video Addressing Empathy

Empathy is a phenomenon that goes beyond the psychological aspects of human beings and has come to be understood as a multidimensional skill. This work is an experience report of a process of construction and validation of an educational video that addresses the importance of Empathy as a fundamental element in the quality of interpersonal relationships. Methodological study developed in two stages: construction and validation of educational video. The construction of the educational product adopted CTM3 Method which advocates the making of educational products considering three stages, namely: (C) Conception of the educational product; (T) Theoretical framework; and (M3) Methodological framework, which is based on three theories: Transactional Analysis, Multisensory Exploration, and Neurolinguistic Programming. The structuring of the aforementioned educational product took place between the months of May and June 2019. The product was validated by expert judges in a special session. The video is under a Creative Commons License and made available on the EDUCAPES Platform. The content consisted of scenes, images, music, narration in Portuguese and subtitles available in English and Portuguese in two different versions, which can meet elements of the proposed method. Through this product, it is possible to reflect and decide for empathetic attitudes, stimulating attitudes that will surely be able to positively intervene in social life.


Introduction
Empathy is a phenomenon that goes beyond the psychological aspects of the human being and is related to several mechanisms of the central nervous system, especially with neuronal activities (Tassinari & Durange, 2014). For Pavarino, Prette and Prette (2005), the definition of the word empathy originated with the German philosopher Robert Vischer, in 1873, with the German term einfuhlung, which means "feeling into". Vischer had addressed this term in his treatise on the psychology and perception of aesthetics and understood that empathy would be the clear way for a person to perceive him or herself involved in the work of art, maintaining this view of empathy in aesthetics until around 1897.
Based on the definition of the Greek term empatheia (entering the feeling), the German psychologist Titchener, in 1909, created the term empathy as a version of einfuhlung and established that this definition of empathy could be a form of inner imitation or mental effort of an individual for the other, that is, the perception of what it is like to enter the other's feeling could be both perceived and felt, by the effort of the mind (Silvares, 2000).
Empathy then came to be understood as a multidimensional skill, making it possible to perceive and understand someone's feeling, according to that person's perspective, this skill being fundamental for professionalism in the healthcare area (Stepien & Baernstein, 2006). Falcone, Gil and Ferreira (2007) considered it important to emphasize that the function of empathy would encompass the individual's affective, behavioral and cognitive aspects. The affective component is manifested by feelings of sympathy, compassion for the other and a genuine concern for their well-being. The behavioral component translates into transmitting explicit recognition of what was understood, without personal judgment, giving the other person the feeling of having been truly understood and welcomed. In this perspective, embracement is elaborated and emphasized as a behavioral embodiment of empathy, which is a social skill that favors a good relationship. Empathy becomes a basic presupposition to provide embracement.
In the study of the psyche and human behavior, the humanist approach theorists were pioneers in recognizing the importance of empathy in interpersonal relationships, and according to Rodrigues and Silva (2011), scholars of the cognitive-behavioral approach began to study empathy, characterizing it as a social skill, thus amenable to learning.
Considered the creator of the cognitive-behavioral therapy's theory, psychiatrist Aaron Beck points to the importance of professional empathy, as an essential element for a better possibility for the patient to adhere to treatment (Beck, Rush, Shaw, & Emery, 1982). Therefore, the use of social skills such as manifesting empathetic behavior, in interpersonal relationships, can increase the chances of success in communications and learning this early on since academic life is relevant in preparation for future application in professional practice.
Social skills, according to Del Prette and Del Prette (2011), bring together behavioral components (verbal of form, verbal of content and non-verbal), cognitive-affective mediators (skills and feelings involved in decoding the interpersonal demands of the situation, in the decision on performance required in this situation and in the elaboration and self-monitoring of this performance) and physiological (sensory processes and regulation or autonomic control).
Social skills, for Magalhães and Murta (2003), can be developed naturally throughout the life cycle and in different contexts. These skills are acquired throughout life, through a learning process. Since childhood, human beings observe and copy the behaviors of parents, teachers and people in their environment, consequently, taking and replicating them through the different stages of human development and manifesting these behavior patterns in different situations both in their personal and professional lives.
One of the ways to convey and disseminate concepts of this important skill (empathy), according to Moraes (2008), would be through videos, which is an element of communication and information and has respectability in the space of public opinion through the notion of competence. Likewise, Moran (1995) attests that the videos provide a greater awareness of the individual in relation to the outside world, as they touch the senses, and manage to go far beyond the conscious, touching us in a profound way.
Also, according to Moran (1994) this process must be improved, as knowledge cannot be reductionist, it needs a coordinated action of all five senses, sight, hearing, smell, taste, and touch.
Learning actions need to be rethought, in this sense, new technologies have a decisive role because with the advent of the internet, the possibilities of access to learning environments are multiple (Wyszomirska, Quintas-Mendes, Souto, Soares, & Simão, 2021).
Technology is a great ally in improving education, and in particular the use of cell phones as they help to disseminate educational materials, contributing to new forms of teaching. In particular, videos are the most popular audiovisual resources due to their low cost and ease of access by most (Soares, 2019).
The development and use of educational products that help in health promotion is essencial. Educational videos draw attention for their ability to attract attention and it is essential that professionals and health services make use of this resource (Carvalho Filho, Warren, Medeiros, Melo, Wyszomirska, & Santos, 2000).
The videos are seen as didactic and technological resources, through their interactivity they can, with profound richness, disseminate knowledge and contribute to the formation of a critical conscience and can promote behavior change (Paula, Razera, Buetti, Lenza, & Snobe, 2014).
The technical validation of products is extremely important, as it assesses the relationship between form and content, attesting to the achievement of the proposed objectives, also declaring the material's capacity to produce what it has proposed, taking into account the target audience (Ruiz, Motta, Bruno, Demonte, & Tufró, 2014).
In order for them to be effective in what they propose, educational materials must be evaluated and validated, which guarantees their representativeness and the adequacy of their content, and may eliminate unnecessary elements to the target audience (Leite, Áfio, Carvalho, Silva, Almeida, & Pagliuca, 2018).
In view of human subjectivity, it is important to include elements in educational products that address this subjectivity, seeking the totality of the individual in their way of thinking, acting and feeling.
Rossini (2019) highlights the importance of understanding the structure of personality in the characterization of human relationships, which leads to a greater understanding of the individual, paying attention to a greater understanding of how communications are established between them.
Eric Berne, creator of the Transactional Analysis theory, states that the way individuals apprehend information is captured through Ego States. Which he defines as: "a coherent system of feelings, or as a set of coherent patterns of behavior" (Berne, 1977: p. 25). This structure is composed of 3 categories, Parent Ego State, Adult Ego State and Child Ego State.
The Parent Ego State is one that resembles that of parental figures, configuring itself as norms, prejudices and models of conduct. The Adult Ego State, on the other hand, configures itself as an objective assessment of reality, objectively analyzing each situation, without prejudice. The Child Ego State represents early childhood residues, it is represented by joy, pleasure and play (Berne, 1977).
Just as individuals have in their personality structure the three ego states, they also have five senses, which are fundamental in the perception of the world. Fujisawa (2006) reports how the communication industry has greatly explored vision, highlighting the importance of using the five senses as a way of accessing individuals.
The five senses are the channels through which information is captured, although vision and hearing are the most used. Lindstrom (2011) states that when communication is able to access the five senses, there is a greater receptive potential, and even though 80% of established impressions are non-verbal.
Hence the importance of using all possible elements in an educational product to enhance what we want to communicate.
Another potentiating element in communication are the anchors, which according to O' Connor and Seymour (1995) are any element that gives access to an emotional state, or to a memory.
Anchors leverage the initial message, reinforcing it. Every time the individual makes contact with the anchor, he will be consciously or unconsciously returning to the original message.
As stated by Santos, Teixeira and Warren (2019), one of the ways to communicate effectively with individuals in its entirety facilitating learning is the insertion in educational products of mechanisms that refer to the Ego States, five senses and with the reinforcement of anchors. The present work is an experience report of a process of construction and validation of an educational video that addresses the importance of Empathy as a fundamental element in the quality of interpersonal relationships, we present reflections and the method on the structuring of an educational product in video format about the Empathy theme.

Methodology
Methodological study developed in two phases: construction and validation of educational video. The construction of the educational product adopted CTM3 Method (Santos & Warren, 2020) and the validation of the product was carried out through the evaluation of judges in especial session.
The educational product was prepared by the main author of this study, a clinical psychologist and a student of the Professional Master's Degree Program in Health Teaching and Technology at UNCISAL while attending the Educational Resources course, whose learning objectives are to provide students with the theoretical basis for the development of educational products that meet a demand from society and guide the process of evaluating and validating the products.
Phase 1 The product Conception (C) was the initial moment when the planning, theme establishment, as well as the type of desired product (video, manual, blog, game, application), format and elements that will be inserted took place. As this is a creative moment, planning is a fundamental factor as well as knowledge of the target audience.
Theorical framework (T)-It is the moment that highlights the idea of the product and supports the information on the theme defined in the conception and which will be shown in the video. Therefore, theoretical reference research should always be carried out on recognized and impactful platforms, such as: LILACS, MEDLINE, SciELO, Google Scholar, VHL, Capes Platform. For the reference of this study, they were consulted both to obtain data on the type of product (video) as well as on the topic addressed (empathy) in these platforms, demonstrating its importance and applicability and justifying its elaboration.
Next, as recommended by the CTM3 Method, the Methodological framework (M3) was the insertion of elements of Transactional Analysis, which can evoke the 3 ego states (Parent, Adult and Child) (Berne, 1977), Multisensory exploration, with the insertion of elements that can awaken in the target audience the five senses:sight, smell, taste, hearing and kinesthetic (Lindstrom, 2011). Neurolinguistic programming was also used with the use of anchors, which according to O'Connor and Seymour (1995) is any element that gives access to an emotional state, or to a memory.
Phase 2-Educational Product Validation The technical validation of a product is extremely important, as it assesses the relationship between form and content, attesting to the achievement of the proposed objectives, considering the target audience (Ruiz, Motta, Bruno, Demonte, & Tufró, 2014).
The Professional Master's Degree Program in Health Teaching and Technology at UNCISAL regularly promotes validation sessions of the educational technologies presented, which consist in assessing the clarity and understanding of items, appearance, and motivation, that is, the product's ability to make an impact, motivation and/or interest. At the time of the validation session, between three and five ad hoc evaluators are invited, who must have a master's degree as a minimum requirement, but preferably with a PhD in the areas of Health or Education with expertise in Education and Communication.
For the validation process, the authors make an oral presentation of the product, questioning by the evaluators, with filling in the evaluation instrument with the following elements: Social relevance of the theme; Creativity; Audiovisual or visual quality; Easy, comprehensive language with logical sequence; Applicability; The educational goals are noticeable; It is based on a theoretical and methodological framework; Adequacy to the target audience and scope; Learning potential; Content and form arouse interest, and finally, issuing a conclusive opinion: Validated, Validated after corrections and Not Validated. The product presented here was considered validated, with no change suggestions. This video was submitted for validation purposes at the 1st Exhibition of Educational Products at UNCISAL, in November 2019.

Results and Discussion
According to Hojat et al. (2009)  The video is under a Creative Commons License and available on the EDUCAPES Platform through the link http://educapes.capes.gov.br/handle/capes/560448, which is freely accessible, having been filed on December 5, 2019.
The construction of the video followed the steps of the CTM3 Method 16 , detailed in Table 1. The content consisted of scenes, figures, music with narration in Portuguese and subtitles available in English and Portuguese in two different versions, which can meet all the elements of the proposed Method, as through these elements the three Ego states can be evoked (Parent, Adult and Child) Multisensory (Vision, Smell, Hearing, Gustatory and Synesthetic) and the anchors, opting to insert two visual anchors (hero figure and flower) and another synesthetic one, music. It is noteworthy that in the construction phase of the video, all elements described in methods were inserted, acting as facilitating elements of communication with the target audience-the three ego states, the five senses and the anchors-, which became essential for the approach through the elements to have been broad and therefore assertive, promoting the inclusion of all. Scenes that denote care, attention and expressions with normative content were added to the educational material and that reflect precepts, principles and models of conduct that must be adopted by users of the educational product. Example: 1) Scene of a man helping a lady with a wheelchair; 2) Scenes of a man helping a woman to cross the street; 3) Young woman talking to boy and giving a handkerchief to wipe tears; 4) Child helping another by pushing a wheelchair; 5) Friend visiting each other; 6) Phrase "In empathy, you care, welcome, help and can even save a life"; 7) Scene of a lady talking to a teenager; 8) Scene of a woman visiting another in bed.

Adult Ego
Scenes that evoke thought were added to the educational material, as well as expressions with informative and/or explanatory content. Example: 1) Concepts about empathy; 2) Quotation from the theoretical framework; 3) The steps to being empathic; 4) Teacher teaching student; 5) In the narration when it says: "You call and report". Added scenes that evoke joy, play and fun, as well as phrases evocative of this ego state. 1) Children talking; 2) Children playing with airplanes and rollerblades; 3) Group of adults laughing and talking; 4) Women tidying Christmas tree; 5) Child giving apple to teacher; 6) Final scene with 3 children smiling.

Anchor
In the work, 3 anchors were added: 1) The hero figure at the beginning and end of the video 2) Background music: "Imagine" by John Lennon, which also mobilizes the sensory and auditory 3) The figure of the daisy flower held and protected by human hands Multisensory Vision Images and scenes were inserted in different spaces, in different ways and with individuals from different age groups, evoking in different audiences the feeling of empathy. Subtitles in Portuguese and English were also included in different videos.

Hearing
Portuguese narration was introduced by the main author as well as the song "Imagine" by John Lennon, which will also serve as an auditory anchor.

Smell
The scene of a steaming cup of coffee and the procedural phrase "enjoying the taste and aroma".
gustatory It was inserted through scenes and words: 1) The scene of a child offering an apple to the teacher.
2) The scene of a cup of coffee.

Synesthetic
Elements that evoke the kinesthetic were introduced, such as: 1) The song "Imagine" by John Lennon.
It is noteworthy that so far the video has had 18,989 downloads, having been viewed in the following countries: Brazil, United States, Ireland, Italy, Spain, Portugal, Czech Republic, Romania, France and Holland.

Conclusion
The material was prepared based on the CTM3 Method, which presented itself as a facilitating element in this process, as it contributed to giving shape and structure to the product, providing the ways, techniques and tools that enabled the development of the product, enhancing the use of the video to communicate the need for an empathetic attitude, which is fundamental in academic work.
Through this video, it is possible to reflect and decide for empathetic attitudes, stimulating attitudes that will surely be able to positively intervene in social life. It is applied to different environments, from family, work or even in work relations and academia.
It is expected that, based on this report, empathy as a social skill becomes a reality in people's lives, being understood as something that can be learned and an essential component for the quality of relationships, consequently for the quality of life.