Abstract
BackgroundEvidence based largely on self-report data suggests that factors associated with medical education erode the critical human quality of empathy. These reports have caused serious concern among medical educators and clinicians and have led to changes in medical curricula around the world. This study aims to provide a more objective index of possible changes in empathy across the spectrum of clinical exposure, by using a behavioural test of empathic accuracy in addition to self-report questionnaires. Moreover, non-medical groups were used to control for maturation effects.MethodsThree medical groups (N = 3×20) representing a spectrum of clinical exposure, and two non-medical groups (N = 2×20) matched for age, sex and educational achievements completed self-report measures of empathy, and tests of empathic accuracy and interoceptive sensitivity.ResultsBetween-group differences in reported empathy related to maturation rather than clinical training/exposure. Conversely, analyses of the “eyes” test results specifically identified clinical practice, but not medical education, as the key influence on performance. The data from the interoception task did not support a link between visceral feedback and empathic processes.ConclusionsClinical practice, but not medical education, impacts on empathy development and seems instrumental in maintaining empathetic skills against the general trend of declining empathic accuracy with age.
Highlights
The ability to understand and connect with the emotional state and mind frame of another is referred to as empathy and is thought to be a multidimensional construct encapsulating elements of both affective and cognitive processing [1,2]
Participant Characteristics There were no significant differences between the medical groups and the relevant control group in regard to age, sex, BMI, personality measures and current levels of perceived life stress or emotional distress (Table 1)
The medical and control participants did not differ in terms of median caffeine intake [Controls: 2; medical participants (Meds): 1 (0–6); P = 0.27]; or the median number of cigarettes smoked per day [overall 6% smoked; Controls: 0 (0–10); Meds: 0 (0–5); P = 0.17]
Summary
The ability to understand and connect with the emotional state and mind frame of another is referred to as empathy and is thought to be a multidimensional construct encapsulating elements of both affective and cognitive processing [1,2]. Research investigating empathy levels in medical students and doctors needs to broaden its perspectives beyond the self-report questionnaire [13]. Critical is the absence of control groups in studies using self-report questionnaires to show a decline in empathy in medical students and doctors [4,5,6,7,8,9]. Evidence based largely on self-report data suggests that factors associated with medical education erode the critical human quality of empathy. These reports have caused serious concern among medical educators and clinicians and have led to changes in medical curricula around the world. Non-medical groups were used to control for maturation effects
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