Abstract
BackgroundThe importance of fostering the development of empathy in undergraduate students is continuously emphasized in international recommendations for medical education. Paradoxically, some studies in the North-American context using self-reported measures have found that empathy declines during undergraduate medical training. Empathy is also known to be gender dependent- (highest for female medical students) and related to specialty preference - (higher in patient-oriented than technology-oriented specialties). This factor has not been studied in Portuguese medical schools.MethodsThis is a cross-sectional study of undergraduate medical students on self-rated measures of empathy collected at entrance and at the conclusion of the medical degree, and on the association of empathy measures with gender and specialty preferences in one medical school in Portugal. Empathy was assessed using the Portuguese adaptation of the Jefferson Scale of Physician Empathy-students version (JSPE-spv) among three cohorts of undergraduate medical students in the first (N = 356) and last (N = 120) year. The construct validity of JSPE-spv was cross-validated with Principal Component Analysis and Confirmatory Factor Analysis. Reliability was assessed using Cronbach' Alpha. Global JSPE-spv score differences were examined by year of medical school, gender and specialty preferences (people-oriented vs technology-oriented specialties).ResultsThe empathy scores of students in the final year were higher as compared to first year students (F (1,387) = 19.33, p < .001, ɳ2p = 0.48; π = 0.99). Female students had higher empathy scores than male students (F (1,387) = 8.82, p < .01, ɳ 2p = 0.23; π = 0.84). Significant differences in empathy were not found between the students who prefer people-oriented specialties compared to those who favor the technology-oriented specialties (F (1,387) = 2.44, p = .12, ɳ 2p = 0.06; π = 0.06).ConclusionsThis cross-sectional study in one medical school in Portugal showed that the empathy measures of senior year students were higher than the scores of freshmen. A longitudinal cohort study is needed to test variations in students' empathy measures throughout medical school.
Highlights
The importance of fostering the development of empathy in undergraduate students is continuously emphasized in international recommendations for medical education
This cross-sectional study in one medical school in Portugal showed that the empathy measures of senior year students were higher than the scores of freshmen
Responses from first year medical students were collected at the beginning of the medical school and the responses from sixth year students at the end of training
Summary
The importance of fostering the development of empathy in undergraduate students is continuously emphasized in international recommendations for medical education. Despite a general awareness of the importance of physician empathy in patient care, some studies in the North-American context have found a decline in selfreported measures of empathy of undergraduate students throughout medical school [8,9,10] and post-graduate training [11]. In those studies it is suggested that “erosions” in empathy can be associated with the learning context, the “hidden curriculum”, student difficulties in dealing with stressors in medical education, and poor role modelling in the academic and clinical workplaces [12,13]. The effect of undergraduate medical training on the development of medical students’ empathy remains unclear
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