Abstract
IntroductionMedical and healthcare professionals’ empathy for patients is crucially important for patient care. Some studies have suggested that a significant decline in empathy occurs during clinical training years in medical school as documented by self-assessed empathy scales. Moreover, a recent study provided qualitative evidence that communication skills training in an examination context, such as in an objective structured clinical examination, might stimulate perspective taking but inhibit the development of compassionate care. Therefore, the current study examined how perspective taking and compassionate care relate to medical students’ willingness to show empathic behaviour and how these relations may change with communication skills training.MethodsA total of 295 fourth-year Japanese medical students from three universities completed the Jefferson Empathy Scale and a newly developed set of items on willingness to show empathic behaviour twice after communication skills training, pertaining to post-training and retrospectively for pre-training.ResultsThe findings indicate that students’ willingness to show empathic behaviour is much more correlated with perspective taking than with compassionate care. Qualitative descriptive analysis of open-ended question responses revealed a difficulty of feeling compassion despite showing empathic behaviour.DiscussionThese findings shed light on the conceptual structure of empathy among medical students and generate a number of hypotheses for future intervention and longitudinal studies on the relation between communication skills training and empathy.Electronic supplementary materialThe online version of this article (10.1007/s40037-018-0431-z) contains supplementary material, which is available to authorized users.
Highlights
Medical and healthcare professionals’ empathy for patients is crucially important for patient care
Some studies have suggested that a significant decline in empathy occurs during clinical training years in medical school as documented by self-assessed empathy scales
The current study examined how perspective taking and compassionate care relate to willingness to show empathic behaviour and how these relations may change with com
Summary
Learning how to show empathic attitudes to patients Learning the procedure of medical interviewing Learning the importance of patients’ perspective taking Learning the importance of plain explaining Recognizing that communication skill are learnable Influence of communication on physician-patient healing relationship Learning the importance of listening to patients Recognizing that medical interviewing training is a process of socialization Variety of patients’ responses to the same question Learning the importance of efficacy of communication Recognizing that empathy is an essential characteristic of a good physician Learning that appropriate spacing is important Difficulty of patients’ perspective taking Difficulty of empathizing patients’ feelings Difficulty of conveying what doctor wants to patients Difficulty of feeling compassion despite showing empathic behaviour munication skills training. The current study provided some indication that fourth-year medical students may not be able to care a lot about showing compassion because they lack skills that may be needed to facilitate perspective taking With their rather preliminary cognitive schemas of the type of cases under consideration, the average fourth-year medical student may need to allocate their working memory resources to cognitive processes that are needed for perspective taking to such an extent that fewer resources are available for dealing with emotion or compassionate care [32, 33]. Longitudinal studies could provide more insight into how cognitive and emotive processes affect students’ willingness to show empathic behaviour as they learn and enter subsequent stages of training Another factor that may influence students’ focus or lack of focus on compassionate care, even when their cognitive schemas are sufficiently developed to engage in compassionate care, is that of the assessment context.
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