Abstract
BackgroundThe perceived importance of clinical empathy may decline among students during medical training. Several interventions have been shown to be effective in promoting or preserving medical students’ empathic abilities, such as empathy skills training or Balint groups. Although narrative medicine training shares some features with these interventions, no randomized study to date examined the efficacy of narrative medicine training. This study aimed to assess the effects of Balint groups and narrative medicine training on clinical empathy measured by the self-rated Jefferson’s School Empathy Scale - Medical Student (JSPE-MS©) among fourth-year medical students.MethodsStudents who gave their consent to participate were randomly allocated in equal proportion to Balint groups, narrative medicine training or to the control group. Participants in the intervention groups received either seven sessions of 1.5-h Balint groups or a 2-h lecture and five sessions of 1.5-h narrative medicine training from October 2015 to December 2015. The main outcome was the change in JSPE-MS© score from baseline to one week after the last session.ResultsData from 362 out of 392 participants were analyzed: 117 in the control group, 125 in the Balint group and 120 in the narrative medicine group. The change in JSPE-MS© score from baseline to follow-up was significantly higher in the Balint group than in the control group [mean (SD): 0.27 (8.00) vs. -2,36 (11.41), t = 2.086, P = 0.038]. The change in JSPE-MS© score in the narrative medicine group [mean (SD): − 0.57 (8.76)] did not significantly differ from the changes in the control group (t = 1.355, P = 0.18) or the Balint group (t = 0.784, P = 0.43). Adjusting for participants’ characteristics at baseline, Balint groups remained associated with better outcomes compared to the control group (β = 2.673, P = 0.030).ConclusionsBalint groups may promote clinical empathy to some extent among medical students, at least in the short run.
Highlights
The perceived importance of clinical empathy may decline among students during medical training
Among the 392 students who were randomized, 17 did not complete the JSPE-MS© at follow-up and 13 had missing data regarding living status. This resulted in a final sample of 362 participants, including 117 in the control group, 125 in the Balint group and 120 in the narrative medicine group (Fig. 1 – Flow diagram)
The change in JSPE-MS© score from baseline to follow-up was significantly higher in the Balint group than in the control group [mean (SD): 0.27 (8.00) vs. -2,36 (11.41), t = 2.086, P = 0.038]
Summary
The perceived importance of clinical empathy may decline among students during medical training. In order to promote medical students’ empathic abilities, several interventions have been proposed, such as empathy skills training [9, 10], narrative medicine [11,12,13] or Balint groups [14, 15] These interventions build on the hypothesis that at least some of the four abovementioned components of clinical empathy (i.e. affective, cognitive, motivational and behavioral) are teachable. The extent to which the components that are theoretically targeted by a specific intervention are and modified remains unclear, such differences suggest that different interventions may target different components of empathy
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