The purpose of this study was to understand the effect of empathy in the project team on the outcome of the integrated design process of infrastructure projects. Despite years of experience, many infrastructure projects are still underperforming. Within the project lifecycle, the integrated design process has an important role in this. Empathy could be an important tool to improve the outcomes of the integrated design process through communication. This study represents one of the first steps towards a better understanding of this competency as an important tool for project success through the use of serious research gaming. The serious game Patchwork was designed and played for data collection. The research showed that empathy positively influences the degree to which people understand each other's information expectations and the communicative hindrance experienced due to logistical, interpersonal, or accessibility barriers. This is particularly determined by the cognitive side of empathy. In addition, this study shows that sufficient effective communication is necessary for solid project outcomes. Communication seems to serve as a prerequisite for a successful integrated design process. No demonstrable effect was found in the direct relationship of empathy and the outcome of the integrated design process. The line of empathy through communication is not reflected in the direct results. Additionally, this says that influences of empathy on the game results through other processes than communication cannot be demonstrated. However, this study cannot rule out that there was no positive effect of empathy on the outcomes of the integrated design process. Further research with larger datasets needs to conclude what the proportion is of other confounding variables being dominant in game success and how empathy relates to them. All in all, this research has taken first important steps toward recognizing the value of empathy in construction projects and it provides much reason for follow-up research into this topic.