Abstract
BackgroundPrevious studies have suggested that Medical students’ empathy declines during medical school, especially during the clinical studies. The aim of this study was to examine. Changes in medical students’ empathy during their first clinical experience, and to determine the impact of gender and humanities curriculum on empathy changes.MethodsIn this prospective longitudinal study, 262 4th year students from three consecutive classes were assessed. Empathy was assessed before and at 4th-year-end, using the Jefferson Scale of Physician Empathy-Student Version (JSPE-S). The three classes differed in humanities curriculum [limited Medical Humanities (MH(lim)) vs. extended Medical Humanities (MH(ext))], and in admission system [Personal Interview (PI) vs. multiple mini interviews (MMI)].ResultsOverall, there was a small but significant decrease in JSPE-S during the fourth year (114.40 ± 11.32 vs. 112.75 ± 14.19, p = 0.034). Among men there was a statistically significant decline in JSPE-S during the fourth year, and the MH(ext) (but not the MH(lim)) was associated with the decline (t(35) = 2.38, p = 0.023). Women students showed no decline in empathy during the fourth-year of studies, regardless of type of humanities program. In addition, women who participated in MH(ext) had a higher JSPE-S scores during the 4th -year as compared to women who participated in MH(lim).ConclusionPre-clinical humanities program was associated with a decline in empathy among men medical students during the fourth-year of medical studies. Gender differences in response to medical humanities programs require further study.
Highlights
Previous studies have suggested that Medical students’ empathy declines during medical school, especially during the clinical studies
Establishing Jefferson Scale of Physician Empathy-Student Version (JSPE-S) validity evidence We examined convergent validity of JSPE with the Interpersonal Reactivity Index (IRI)
There was no effect for time (F(1,94) = 0.10, p = 0.756) and no interaction between MH program and time (F(1,64) = 0.012, p = 0.914; Table 3, Fig. 2 – Panel 2B). These findings indicate that women who participated in MH(ext) as compared to MH(lim) showed higher JSPE-S scores, and that women who participated in either MH(ext) or MH(lim) did not show a decline in JSPE-S (Table 3)
Summary
Previous studies have suggested that Medical students’ empathy declines during medical school, especially during the clinical studies. Most of the studies on empathy changes during medical studies have suggested that empathy declines, rather. Two longitudinal studies showed a decline in empathy during medical studies [1, 11]. Most of the studies showing a decline in empathy during medical school have suggested that the decline is largest following students’ exposure to clinical life during clerkships [1, 10,11,12]. Reviews of studies reporting on empathy at various stages of physician training suggested that empathy declines during medical school and residency [13], the decline was suggested to be small [14]
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