Empathy In Medical Students Research Articles

Influence of Role Models and Unstructured Relationship on Changes in Medical Student Character, Medical-Specific Empathy, and General Empathy

Purpose: Medical student empathy and character changes are of great interest with clear implications for patient interactions. With much focus on deleterious education culture, this study focuses more on what may bolster empathy and character. Building from interventions highlighting role models, the authors hypothesize the importance of informal relational connections within medical school may promote both modest empathy and character development. Materials and Method: This study uses unique secondary data that follows a cohort of medical students over time, with two surveys about a year apart. The data is unique not only in the inclusion of time, but also in various relational measures and both a medical-specific empathy as well as a general empathy measure. This allows for modeling change in medical student empathy. Results and Conclusion: First, general and medical-specific empathy appear to function different. At baseline, receiving positive character feedback from an attending/resident is positively related to medical empathy while negative feedback is inversely related to medical empathy and burnout is related only to general empathy. Over the next year, being around an admirable physician increased both types of empathy, seeing burnt out specialists increased medical empathy, and a sense of calling generally bolsters empathy. Second, exposure to morally admirable role models is broadly, although modestly, related to character development. It is positively associated with expectations for faculty to teach, shape, and train character, and with an increased sense that bad people may not make good physicians. Finally, exposure to these role models tends to increase one’s sense of calling to the profession. While not dramatic, informal relationships can be an important part of professionalization and may affect general and medical-specific empathy differently, and shift changes in student character.

Enhancing Empathy in Medical Students by Focused Learner Centered Activities

Enhancing Empathy in Medical Students by Focused Learner Centered Activities

The role of medical students in advocacy for rare diseases – Experience from a Low- and Middle-Income Country (LMIC)

2023 marks the Year of the Zebra, a year to celebrate hope for those with rare diseases. While each individual rare disease affects few, collectively everyone living with a rare disease makes up a total of over 300 million people worldwide. The annual celebration of rare disease day allows communities to advocate for visibility, inclusion and better healthcare for those with lesser well known conditions. Having a rare disease and living in a developing country like Pakistan, where quality healthcare is itself a rare commodity, predisposes those with rare diseases to many challenges. In this light, learning from patient journeys and advocating for rare diseases is a step in the right direction to better care. In this short communication, we share experiences from Pakistan of medical students spearheading one such effort as stakeholders in the care for rare. We also discuss the importance of teaching health advocacy as part of the medical education framework, helping nurture empathy in medical students, who we hope to be leaders of better care in the future.

Enhancing Empathy in Medical Students by Focused Learner Centered Activities

To determine the change in empathy levels of medical students during their progress in professional years internship, and to examine change in empathy after targeted empathy enhancing activities during the course of medical school. Longitudinal Study. Shifa College of Medicine/ Shifa Tameer-e-Millat University, Islamabad, from January 2015 to December 2019. Student version of Jefferson Scale of Physician Empathy was administered sequentially from 2015 to 2019 which evaluated the change in empathy of medical students in a class of 2019. Targeted empathy-enhancing activities included patient-centered module in year-three and stress management workshops in the final year of medical school. Empathy scores rose from the first year of study (4.27 ±0.38) to the third year (4.52 ±0.70). It fell over the next two years of study (4.25 ±0.62 & 4.21 ±0.40) before rising again during the internship (4.39 ±0.43) with focused empathy-enhancing activities. Patient-centered module which focused on activities that help develop empathy may have been a factor in the increase of empathy scores in the third year and internship. Placing recurring formal activities throughout all clinical years may help in enhancing empathy in medical students. Medical student empathy, Empathy enhancing targeted activities, JSPE.

Comparative empathy in male and female medical students: A cross-sectional, online, and survey-based study

Background: Empathy is a capability of a person to observe a subject and recognize and briefly feels the subject’s emotional state based on visual and aural inputs. Empathy is an important quality for doctors as they are involved in patient care. Aims and Objectives: We aimed to assess the level of empathy in a sample of students studying MBBS and compare the empathy according to gender. Materials and Methods: This study was a cross-sectional observational study carried out by an online survey. Medical students of our college were invited to participate in this survey. We collected data from up to 50 males and 50 females for a comparative test. The eight-item form of the empathy quotient-8 was used to assess the level of empathy among students. Scores between male and female students were compared by unpaired t-test. Result: A total of 50 males and 50 females participated in this study. Their mean age was 20.12 ± 2.14 years. One-sample t-test showed that overall students have more than average level of empathy. The gender-wise comparison showed that there was no difference in empathy between male and female students. Conclusion: From this study, we can conclude that medical students have more than average level of empathy and there is no gender difference in the level of empathy. However, this was an experience from a single institution. Further studies may be conducted to ascertain the level and comparative level of empathy between males and females with a large sample taken from different Indian states.

Fatigue, Pro-Social Attitude and Quality of Life as Predictors of Empathy in Medical and Social-Oriented Students

Empathy is significant in professions that require establishing proper contact as a condition for providing help. Identifying factors related to empathy is important for understanding how to teach empathic behavior. The main goal of this study was to find variables related to empathy in a group of students from two universities: medical and social oriented (N = 1701). The study group consisted of female (81%) and male (19%) participants, aged between 18-20 (37%), 21-23 (49%), or 24 years and above (14%). A self-designed questionnaire was used to collect socio-demographical information, with additional questions (social self-esteem, prosocial attitude, subjective quality of life). Empathy was measured with the EQ-40, fatigue with CHFQ-PL, and stress with PSS-10. The results showed a statistically significant regression model for empathy. A high quality of life and having feelings of pleasure when helping other people allows to predict a high level of empathy, especially among females. Higher levels of fatigue and social self-esteem, the latter of which is measured here by the belief that you are more important than others, predicts lower empathy. There were no differences between students from two different kinds of universities when taking into consideration stress levels, subjective quality of life, and prosocial attitude. However, students from the medical university were more exhausted and more convinced that their value was greater than others, as compared to the students studying social sciences. When teaching empathic behavior, it is beneficial to attempt to maintain or restore students' well-being and reduce fatigue and to teach how to achieve such effects in the future. Learning the balance between compassion, willingness to help, and self-compassion also seems to be important.

Why might medical student empathy change throughout medical school? Protocol for a systematic review and thematic synthesis of qualitative studies

IntroductionSeveral studies suggest that medical student empathy declines throughout medical school. However, no studies have systematically investigated why. The objective of our proposed review is to conduct a systematic review...

When patients teach students empathy: a systematic review of interventions for promoting medical student empathy.

Despite growing emphasis on empathic care, numerous studies demonstrate diminishing empathy in medical students. Involving patient educators in medical curricula may be a solution. Therefore, we conducted a systematic review to evaluate patient-involved interventions that promote empathy among medical students. A literature search of MEDLINE, Embase, PsycINFO, and ERIC databases was performed using the keywords "empathy," "medical student," and their synonyms. Results were independently screened in duplicate. Conflicts were resolved by group consensus. All English studies describing interventions that promote empathy in medical students engaging patient educators were included. Relevant data was extracted and summarized. 1467 studies were screened. 14 studies were included, of which 10 were pilot studies. Studies included patient involved interventions such as storytelling (5/14), shadowing patients (3/14), recorded videos (3/14), or combinations of methods (3/14). Qualitative measurements of empathy included written feedback and group discussions. Quantitative measurements included validated scales measuring empathy. All studies demonstrated increase in empathy among medical students. Participants reported satisfaction with training and patients reported being proud of giving back by training future physicians. Interventions engaging patient educators were shown to have a positive impact on medical student empathy. Furthermore, patient-led education was shown to increase medical student understanding of subject and knowledge retention while empowering patients. Further implementation of patient-involved education is an important step forward in patient-partnered care and may identify additional advantages of patient engagement in medical education.

A Qualitative Study of Preclinical Medical Students Randomized to Patient-Partnered vs Traditional Clinical Experiences.

Longitudinal patient-partnered experiences may promote medical student empathy, but evaluation of such programs is limited. The aim of this study was to compare areas of learning among first-year medical students randomized to a patient-centered track (PCT) or traditional track (TT) longitudinal clinical experience. PCT students (n=24) were paired with 2 patients and a physician to participate in their patients' care across multiple settings. TT students (n=56) were paired with a physician preceptor and participated in caring for a variety of patients in a single setting. This qualitative study used a phenomenological approach to template analysis, examining and comparing student reflective essays for areas of learning. Three domains of learning emerged: 1) Focus of learning (biomedical, patient-centered); 2) Roles and relationships (clinical skills, relationship-building, teaching from preceptor and patients); and 3) Context of care (health systems science, interprofessional care). PCT students described patient-centered learning, relationship-building, and patients' role as teachers. In contrast, TT students emphasized biomedical learning, clinical skills development, and teaching from physician preceptors. Longitudinal patient-partnered clinical experiences provide rich opportunities for preclinical students to cultivate empathy and develop patient-centered values.

Research on the Relationship between Empathy, Belief in a Just World, and Childhood Trauma in Pre-Clinical Medical Students.

Objective: To explore the relation between empathy, belief in a just world, and childhood trauma in pre-clinical medical students. Method: Answers were collected from 880 pre-clinical medical students to questionnaires such as the Jefferson Scale of Physician Empathy-Students Version (JSPE-S), the Belief in a Just World Scale, and the Childhood Trauma Questionnaire, in November 2021. Results: The empathy of pre-clinical medical students was positively correlated with their belief in a just world (r = 0.194, p < 0.01) and negatively correlated with their childhood trauma (r = −0.256, p < 0.01); the mediating effect analysis showed that belief in a just world had a partial mediating effect on empathy and childhood trauma. Conclusion: Belief in a just world plays a mediating role between empathy and childhood trauma among pre-clinical medical students.

Motivation to Impact: Medical Student Volunteerism in the COVID 19 Pandemic.

ObjectiveVolunteerism represents an important mechanism to promote resilience, empathy, and general well-being in medical students, a group that stands to benefit. Medical students report feelings of fatigue, burnout, exhaustion, and stress that correlates with poor academic performance, and significant decline in empathy over the 3rd year of both MD and DO programs. Volunteer motivations have been shown to mediate participant well-being. The relationship between medical student volunteer motivations and specific outcomes during the COVID-19 pandemic has not been addressed.MethodsWe characterized features of medical student volunteers during the COVID-19 pandemic in 2020, including volunteering motivation using the Volunteer Functions Inventory, the types of activities in which they participated, and the physical, psychosocial, and emotional outcomes they experienced following volunteering.ResultsAltruistic and humanitarian values–centric motivation predicts positive volunteering outcomes including increased resilience, ability to deal with disappointment and loss, and ability to cope with the COVID-19 pandemic. Values-centric motivation also increases volunteer empathy independent of educational stage. Values-centric participants were more likely to select volunteering activities with patient contact, which promotes student empathy and resilience. Conversely, career-centric motivation does not predict positive outcomes. These students are more likely to engage in research-oriented activities.ConclusionsThe efficacy of integrating volunteerism into medical school curricula may be limited by professional pressure that manifests as career-oriented motivation. We propose that practical integration should promote altruistic and humanitarian values–centric participant orientation to the volunteering process, which is associated with enhanced recruitment, preservation of empathy, and additional positive volunteering outcomes of interest.

Building Compassion and Empathy in Medical Students through Shakespeare’s Romeo and Juliet

With the aim of introducing medical humanities to medical colleges in Iraq, the researcher, who teaches English to medical students at Al-Nahrain University in Baghdad, initiated the idea of a performance of Shakespeare’s most popular play Romeo and Juliet. The main aim was to promote empathy and compassion for medical students after realizing that biomedical sciences have detached them from these feelings. Through activities in the English Language lectures, students, particularly 2nd and 3rd year, reflected on stories and passages in a way that lacked any connection or empathy. In one of the units of their English coursebook, there are two pages dedicated to Shakespeare’s play Romeo and Juliet. With the idea of the pair of star-crossed lovers, who suffer misfortunes brought upon them by causes quite independent of any flaw of character or immorality of conduct in both or either of them, the researcher found in the play a work of art that can create empathy and compassion in the readers as well as the audience, and hence came the idea of the performance. The researcher chose an abridged version of the play found on the Internet. To link the play with science to avoid objection from the scientific institution, the researcher added a scene taken from a speech by the scientist Fatima AlZahra’a Alatraktchi comparing the secret communication of bacteria with this Shakespearean play. The paper is about the reception of the idea of the play by the students at the medical college, who were overjoyed when they read the call for actors for the play and immediately a huge number of them showed interest in taking part in the performance. Though the performance was supposed to take place in mid-March, it was postponed because of the end-of-term exams. The paper deals with the manners of building empathy and compassion among the medical college community. Finally, the paper tries to show the importance of introducing literature and arts to medical students with the aim of giving more emphasis to the study of humanities disciplines in medical colleges in Iraq in the future.

The relationship between oxytocin levels with empathy and breastfeeding intention in female medical students: A cross-sectional study

Scientific evidence regarding the relationship of oxytocin to social and emotional behavior is consistently reported. This study aims to analyze the relationship between empathy and breastfeeding intention with oxytocin levels in medical students. A cross-sectional study of 59 female students at the Faculty of Medicine and Health, Universitas Muhammadiyah Jakarta in April 2018–June 2019 selected by purposive sampling technique. The measurement of empathy level using the ©Jafferson Emphatic Scale Student Version (JES-SV) questionnaire, breastfeeding intention using the Infant Feeding Intentions (IFI) questionnaire, and oxytocin levels using the Enzyme-Linked Immunosorbent Assay (ELISA). Analysis of the relationship between oxytocin levels with empathy and breastfeeding intention used the independent samples t-test. The results showed that students' age (p = 0.030) and education stage (p = 0.036) were related to empathy. Age (p = 0.001) and education stage (p = 0.004) of students were also associated with serum oxytocin levels respectively. Empathy was significantly related to breastfeeding intention (p = 0.033). Oxytocin serum levels of female medical students are associated with empathy (p = 0.016) and breastfeeding intention (p= <0.001). Further studies on the role of oxytocin on empathy and breastfeeding intention need to include other factors to obtain more comprehensive information. Empathy and breastfeeding intention was not only associated with oxytocin levels. Psychological or educational interventions during the learning process at the academic and professional levels are also needed to support the process of forming these two social aspects.

의과대학생들의 공감능력에 따른 잠재집단 유형과 학습소진, 삶의 질, 자존감과의 관계

Objectives The purpose of this study is to identify what types of potential groups exist according to the empathy of medical students and to explore the differences between psychological factors such as academic burnout, quality of life, and self-esteem by group and the variables that affect empathy. Methods To achieve the purpose of the study, quantitative data on empathy, academic burnout, quality of life, and self-esteem were collected from 2nd year students of pre-medical students in area C. For the analysis, basic statistical analyses such as model-based latent group analysis, analysis of variance, T-test, and regression analysis were used. Results As a result of the study, there were 4 latent groups of students according to empathy and statistically significant differences were confirmed in psychological factors according to empathy. Also, a significant difference was found in psychological factors between the group with high empathy and the group with low empathy. It was confirmed that various psychological factors were influencing the empathy of children. Conclusions Therefore, when planning empathy education for medical students in the future, it is necessary to check the level of empathy of each student and to accurately identify the psychological factors related to this. Also, if customized teaching is made based on this, the effect of empathy education can be further improved.

Correlation between medical student empathy and a Korean nationwide comprehensive clinical assessment score at a medical school in Korea.

Empathy is the ability to understand and communicate a patient’s situation, perspective, and feelings. When demonstrated by healthcare professionals, this can improve patient adherence, satisfaction, and treatment outcomes. Empathic students have stronger affective skills and can acquire, develop, reinforce, and display strong affective behaviors, abilities, and attitudes.We measured student empathy using the Student Version of the Jefferson Scale of Empathy (JSE-S) and assessed 3-year sequential clinical comprehensive assessment scores conducted by the Korean Medical Education Assessment Corporation to determine the relationship between JSE-S and clinical comprehensive assessment scores.The study population comprised of 80 males (74%) and 28 females (26%), among which 38 (35%) and 62 (57%) students wanted to become private physicians and attending faculty, respectively. Regarding future majors, 58 students (54%) considered medical fields, whereas 40 students (37%) considered surgical fields. No significant differences in Korean JSE-S were observed according to medical student gender, career aspirations, or future major fields.The modified Korean version of the JSE-S has 18 items. Item-total score correlations and Cronbach α evaluated the internal consistency reliability of the scale. The reliability of the Korean JSE-S was 0.910 by Cronbach α coefficient.Female students had better scores than males. Students who wanted to be an attending faculty had better scores than others who wanted to be private physicians; however, these findings were not statistically significant. Significantly higher scores were seen among students aspired to work in the medical field (65.6 ± 8.8) versus in the surgical field (60.4 ± 8.2) in their 5th year (P < .01).We were unable to show the positive correlations between the empathy scale and comprehensive assessment results. Among female medical students, comprehensive assessment results were inversely correlated with empathy toward the patient, but this was not statistically significant.The modified Korean JSE-S has acceptable reliability. Every student had a better comprehensive assessment after studying the medical curriculum between the 4th and 6th years. The current nationwide assessment tool does not measure student empathy.

Does a sense of gratitude protect against empathy loss in medical students? An exploratory study.

Introduction: The promotion of physicians’ empathy (PE) skills in medical school plays a central role in physician-patient communication. However, a significant decline in empathy among medical students during their training has been repeatedly reported. Gratitude could be a possible protective factor for PE. However, as some students do not seem to be affected by this empathy loss, this study explores the relationship between gratitude and PE. Methods: Using validated questionnaires (JSPE-S, IRI and GQ-6), 88 medical students at LMU München evaluated their self-assessed PE and gratitude. In addition, they went through four OSCE stations focusing on general medicine, in which their empathy and communication skills were assessed by simulated patients (SP) and by an assessor using the Berlin Global Rating. Correlations were analysed using Pearson's correlation coefficient and gender differences were analysed using Mann-Whitney U-tests. Results: In the self-assessment, there was a significant, moderate correlation between students' attitude towards empathy (JSPE-S) and their gratitude (GQ-6) and a weak correlation between the IRI subscale “Empathy” and the GQ-6. In terms of the performance-based assessment, there were also weak correlations between PE or communication skills and gratitude. There were no gender-specific differences in the gratitude of the students. Conclusion: We were able to demonstrate a correlational relationship between gratitude and empathy in medical students. Whether gratitude acts causally as a protective or supportive factor for empathy remains open. A causal relationship of gratitude to empathy should therefore be examined in a prospective study design.

General empathy and medical empathy in Mexican medical students: Integration of an empathic profile.

To identify the association between general empathy and medical empathy. Detect predictors of the level of medical empathy from general empathy. To determine the psychosocial profile that describes the relationship between general empathy, medical empathy, and demographic and academic characteristics in medical students. Descriptive cross-sectional design. Medical students completed the Interpersonal Reactivity Index (IRI) and the Jefferson Scale of Physician Empathy-student version (JSPE-S). Relatively high levels of general and medical empathy were detected. The total score of the IRI and the JSPE-S and their dimensions correlated positively (r = 0.14-0.52), except for the dimension personal distress of the IRI. The score of the IRI dimension empathic concern was the best predictor of the JSPE-S score and its dimensions (b = 0.27-0.54). Four profiles were detected: 1) men, preference for technology-oriented specialty, less empathy; 2) pre-clinical period students, less empathy; 3) students of the clinical period, greater empathy; and 4) women, preference for patient-oriented specialty, greater empathy. General and medical empathy are associated. Differentiated empathic profiles will allow the design of instructional strategies in empathy according to the specific needs of each one.

Combination of Teddy Bear Hospital and Virtual Reality Training increases empathy of medical students

Introduction: In paediatric practice, healthcare professionals are required to connect with the child and interact at his/her level. However, it can be very difficult for medical students to put themselves in the shoes of the young child, to empathize and understand how a child actually feels while being treated. The Teddy Bear Hospital (TBH) can serve as a platform for medical students to learn how to communicate and empathise with children. Additionally, virtual reality (VR) can be used to portray a child’s viewpoint. This study aims to assess how TBH and VR can improve learning outcomes for medical students. Methods: A cohort study was conducted on 20 first-year medical students taking part in TBH sessions. The medical students did a Pre-, Post- and 1-year Post-intervention Jefferson Scale of Empathy to assess their empathy levels. They also completed a 1-year Post-intervention quantitative and qualitative survey on their experience. Results: There was a significant increase in Jefferson score compared to Pre-intervention (116.95 ± 8.19) for both Post-intervention (121.65 ± 11.03) and 1-year Post-intervention (123.31 ± 8.86). More than 80% believed that participating in TBH improved their confidence and ability to interact with children, while 50% felt that VR scenarios helped prepare them for the TBH. Thematic analysis of qualitative responses described (1) Personal development, (2) Insights into interacting with children, and (3) Structure and curriculum. Conclusion: TBH improved empathy and communication with children among pre-clinical medical students and the use of VR can be used to augment sessions.

Relationship between empathy and personality traits in students of a Public Sector Medical University

Introduction: Empathy among medical students and doctors, is rather unexplored part of medical flora and fauna which may vary with each personality.&#x0D; Objective: to determine the correlation between empathy and personality traits of final year medical students.&#x0D; Materials and Methods: This cross-sectional study was conducted at Rawalpindi Medical University, Pakistan. A total of 144 medical students were included in the study. For personality traits assessment and empathy assessment, Big Five Inventory and Interpersonal Reactivity Index were used. All the data was analyzed using SPSS version 20.&#x0D; Results: The mean score for empathy scale was found to be 61.25 ± 10.0. Females were more empathetic than males in all subscales but pointedly so in empathetic concern scale. Overall empathy scale was strongly correlated with Agreeableness and Neuroticism (P&lt;0.001). Perspective taking scale was positively related with Agreeableness and openness, Empathy concern scale was positively related with Agreeableness, and Personal Distress was positively related with Conscientiousness and Neuroticism. The demographic factors of age and gender explained only 1.7%, 6.8%, 2.4% and 2.0% of the variance in the four scales of empathy. After adjustment for age and gender, perspective taking was positively associated with Agreeableness and Openness and Personal distress was associated with Agreeableness, Neuroticism and Openness.&#x0D; Conclusion:&#x0D; We conclude that personality traits have a substantial correlation with empathy and its subscales. So we need to evaluate the personality of a medical student and tailor a set of rules for each individual consistent with their persona to develop empathy in them.

A Cross-Sectional Study on Empathy and its Association With Stress in Medical Students

Introduction: Empathy is the cornerstone of the doctor-patient relationship and a crucial quality associated with better patient compliance and clinical outcomes. This study aims to assess the level of empathy and its association with the level of stress in 3rd and 4th year medical students Methods: This cross-sectional study was conducted in Kathmandu Medical College after taking ethical approval from the Institutional Review Committee and informed written consent from all the participants. The respondents completed a structured questionnaire including demographic profile, Jefferson Scale of Empathy-Student Version, and Perceived Stress Scale. Data were entered and analyzed in Statistical Package for the Social Sciences version 20. Results: A total of 255 questionnaires were obtained with a response rate of 85.2%. The mean empathy score was 101.79 (SD = 11.26) and the mean perceived stress score was 18.55(SD = 5.56). There was a statistically significant negative correlation between empathy and stress (p-value &lt;0.01) and similar negative correlations were seen in sub-group analysis. Female students had higher empathy scores compared to their male counterparts (p-value &lt;0.01). Fourth-year students reported lower empathy scores than third-year students (p-value &lt;0.05). Conclusion: Stress was found to be a significant determinant of empathy among medical students. Medical educators must be aware of this and should try to incorporate means to alleviate stress in medical education. Furthermore, effective stress management techniques to preserve empathy in medical students with a view to improve clinical competency and achieve optimum patient care needs to be studied.