Empathic Divergence: Partially Blunting an Affective Empathic Response While Maintaining Cognitive Empathy is an Important Skill for Medical Students to Acquire

Abstract

Background: Establishing an empathic bond of trust with patients is a trait that is important to learn during medical school. There are two types of empathy: affective and cognitive. Being able to partially blunt a detrimental affective response while maintaining cognitive empathy is beneficial for both the patient and the physician. AIM: To find those students who have partially blunted their affective empathy while maintaining or enhancing their cognitive empathic skills. Methods: Affective and cognitive empathy was measured using the Balanced Emotional Empathy Scale and the Jefferson Scale of Empathy, respectively. The survey instruments were given during entrance into medical school, at the start of years 3-4, and a final administration just before graduation. Students who fit the aim of the study, had blunted their BEES score by -0.5 to -1.5 s.d. below the male or female population norms, as well as being at or above the 75th percentile for JSE scores as established by the Project in Osteopathic Medical Education and Empathy study. Desired specialty choice and sex was also collected at each timepoint. Five specialties are “people-oriented” and have a large amount of patient contact and continuity of care, and include Family and Internal Medicine, Ob/Gyn, Pediatrics and Psychiatry. Most other specialties are more “procedure- or technical-oriented” and are those with little or no patient contact and/or continuity of care (e.g., Surgery, Emergency Medicine, Anesthesiology). Results: Only a small subset of students (n = 15/345) fell within the above parameters upon entering medical school. It was a different, small cadre (n = 13) that had these traits upon graduation. Ergo, there was no student who fell within the parameters for all four years of their undergraduate medical education. Conclusions: Few students had the ability to partially blunt their affective empathic response while maintaining the ability to give a reassuring cognitive empathic response to patients. This indicates an increased emphasis needs to be placed on teaching empathic skills during the basic science years of the curriculum. However, the onus needs to fall upon the physicians who are empathic role-models during the clinical rotation year.