Higher Empathy Scores Research Articles

Empathy Assessment among Medical Doctors Working at the University College Hospital Ibadan, Nigeria

Background: Empathy is the competence of a physician to understand the patient's situation, perspective and feelings and to act on that understanding in a helpful therapeutic way. Empathy is the backbone of patient-physician communication in clinical care, it can be innate, learnt or acquired in the course of the medical career. This study, evaluated empathy and its correlates among medical doctors working in the University College Hospital, Ibadan, Nigeria. Methods: This was a cross-sectional study of 188 interns, resident and specialist doctors working at the University Hospital College, Ibadan in March-May 2018. Consecutive consenting doctors were given a self-administered questionnaire that collected information on sociodemography, work and empathy using the 20-items Jefferson Scale of Physician Empathy. Data were analyzed using the SPSS version 23 and statistical significance was set at P < 0.05. Results: The majority of the respondents were male (60.1%), between 30 and 39 years (60.6%) old, married (60.6%) and Christians (91.5%). Many worked in the Internal Medicine Department (38.3%), were Senior-Resident doctors (41.0%) and of Yoruba (82.4%) ethnicity. Senior-Residents doctors ([120.2 ± 15.4]; P = 0.009) and Consultants ([117.8 ± 21.4]; P = 0.009) had highest empathy scores. Doctors who are raised in lower social status families, lacked ability in taking patient's perspective ([56.2 ± 12.2]; P = 0.046). Doctors in surgical-related specialities had lower empathy scores, those in medical-related specialities, especially Psychiatrists (127.1 ± 10.1) and Family Physicians (125.8 ± 7.9) had the highest scores (P = 0.034). Doctors who had never learnt about empathy had the lowest score in perspective-taking ([50.5 ± 30.4]; P = 0.041). Duration of practice and work-hours respectively correlated positively ([rs = 0.174]; P = 0.018) and negatively ([rs = −0.206]; P = 0.005) with empathy scores. Conclusions: Medical doctors possessed varying levels of empathy relative to their sociodemographic characteristics, the speciality of choice and level of expertise. Exposure to teachings on empathy and work-related challenges underscores empathic skills.

The Role of the Mirror System in Influencing Musicians' Evaluation of Musical Creativity: A tDCS Study.

Evidence reported in the literature suggests that the mirror system not only plays a role in recognizing motor action but also fosters a better understanding of other people because it helps an individual assume another’s perspective. This led to the idea, supported by research findings, that people with higher empathy scores should show higher activation of the mirror system. Recently, it has been hypothesized that a purely auditory mirror system exists. In this study, we aimed to explore the possibility that this system might play a particular role for musicians. Specifically, this system would impact their response to a new piece of music by using non-invasive brain stimulation to modulate the activation of the mirror system. A sample of 40 young musicians was involved in this study. Half of the participants were randomly assigned to a cathodal stimulation condition, while the other half was used as a control. After listening to a new piece of music, participants were asked to rate the creativity of the piece (by focusing on how interesting, innovative, and exciting the piece was) as well as their general emotional response to it. Their empathy levels were also assessed using the Interpersonal Reactivity Index (IRI). Results showed that the cathodal stimulation of the mirror system negatively affected both the perception of creativity (level of innovation) and the emotional response to the music. There was no significant difference in the ratings of how interesting the piece was perceived. The effect was mediated by the individuals’ level of empathy. Specifically, empathic concern and fantasy dimensions increased the evaluation of creativity. Results also showed that participants reported less emotion with a negative valence in the cathodal stimulation condition.

The Influence of Empathy on Moral Judgments

Empathy is expected to correlate with pro-social attitude s, but what effect does empathy have on judgments of distributive fairness? In our study, we found that participants with higher empathy scores on the Interpersonal Reactivity Index (IRI) were more likely to: (a) favor the use of egalitarian distribution when the joint effort is involved, and (b) deem overly self-interested or opportunistic behavior unfair. Female participants were more consistent in the exercise of moral judgments across diverse scenarios. Furthermore, empathy has several dimensions (e.g., perspective-taking or empathetic concern) and we observed that they interacted with gender and the nature of the hypothetical problem differently in some cases. Although the findings of the study are not counterintuitive, it has identified some avenues for further explorations and highlighted some potential methodological shortcomings of the IRI as a measure of empathetic traits.

Interoception and Empathy Impact Perspective Taking

Adopting the perspective of another person is an important aspect of social cognition and has been shown to depend on multisensory signals from one’s own body. Recent work suggests that interoceptive signals not only contribute to own-body perception and self-consciousness, but also to empathy. Here we investigated if social cognition – in particular adopting the perspective of another person – can be altered by a systematic manipulation of interoceptive cues and further, if this effect depends on empathic ability. The own-body transformation task (OBT) – wherein participants are instructed to imagine taking the perspective and position of a virtual body presented on a computer screen – offers an effective way to measure reaction time differences linked to the mental effort of taking an other’s perspective. Here, we adapted the OBT with the flashing of a silhouette surrounding the virtual body, either synchronously or asynchronously with the timing of participants’ heartbeats. We evaluated the impact of this cardio-visual synchrony on reaction times and accuracy rates in the OBT. Empathy was assessed with the empathy quotient (EQ) questionnaire. Based on previous work using the cardio-visual paradigm, we predicted that synchronous (vs. asynchronous) cardio-visual stimulation would increase self-identification with the virtual body and facilitate participants’ ability to adopt the virtual body’s perspective, thereby enhancing performance on the task, particularly in participants with higher empathy scores. We report that participants with high empathy showed significantly better performance during the OBT task during synchronous versus asynchronous cardio-visual stimulation. Moreover, we found a significant positive correlation between empathic ability and the synchrony effect (the difference in reaction times between the asynchronous and synchronous conditions). We conclude that synchronous cardio-visual stimulation between the participant’s body and a virtual body during an OBT task makes it easier to adopt the virtual body’s perspective, presumably based on multisensory integration processes. However, this effect depended on empathic ability, suggesting that empathy, interoception and social perspective taking are inherently linked.

The Influence of Problematic Mobile Social Media Use on Adolescent Empathy and the Moderating Effect of Peer Attachment

Previous studies have found that the use of social media has an impact on adolescents’ empathy. For example, uploading photos on WeChat, playing online games, and establishing two-way communication enable teenagers to have greater emotional support and can effectively reduce social anxiety, depression, and loneliness as well as enhance intimacy and happiness. To explore the influence of problematic mobile social media use on teenagers’ empathy and the role of peer attachment in their relationship. In this study, the mobile social media use of 1,157 adolescents was measured through an adolescent problematic mobile social media use assessment questionnaire, an interpersonal response index questionnaire, and an adolescent peer attachment questionnaire. According to the theory of emotional sharing, a regulatory model was constructed, and the following conclusions were drawn: (1) problematic mobile social media use is significantly positively correlated with adolescents’ empathy and peer attachment, between which there is a significant positive correlation; and (2) peer attachment plays a moderating role in the relationship between problematic mobile social media use and empathy. When peer communication is high, the positive predictive effect of problematic mobile social media use on empathy is enhanced. The concrete manifestation is that, For low peer attachment individuals, regardless of whether teenagers use mobile social media more or less, they have lower empathy scores, while for high peer attachment individuals, regardless of the mobile social media use, they have higher empathy scores. This result shows that high peer communication can increase teenagers' empathy ability.

The Fox and the Lion: Investigating Associations between Empathy and Emotion Perspective-Taking in Aesop's Fables

Empathy is essential in story comprehension as it requires understanding of the emotions and intentions of the characters. Our study aimed to evaluate the sensitivity of an emotional perspective-taking task using Aesop’s Fables in relation to empathy. Participants ( N = 301) were presented with 15 short fables and were asked to rate on a Likert scale the intensity of the emotions they would feel adopting the perspective of one of the characters (offender, victim) or the observer’s perspective. The given emotions were anger, sadness, disgust, fear, surprise, joy, trust, and anticipation. A data-driven approach revealed that participants’ responses were related to the content of each fable, i.e. whether the offender tricked/hurt the victim or whether the victim managed to avoid the offender’s plot, suggesting successful emotional perspective-taking. Participants also seemed to sympathize with the victim rather than the offender, demonstrating affective sharing processes. Further, participants with high empathy scores exhibited stronger negative emotions from the victim’s perspective compared to those with low empathy, independently of their level of distress. As observers, subjects with both high empathy and distress experienced the strongest negative emotions compared to subjects with low empathy and/or distress. Finally, our task seemed to not be influenced by gender effects. We might therefore suggest that the Aesop’s Fables could be employed in an emotional perspective-task to tap onto different empathy components, thus providing an indirect instrument to study empathy.

Disciplining empathy: Differences in empathy with U.S. medical students by college major.

Citing their students' low levels of empathy, medical educators have scrambled to implement curricula with the hopes of buffering against the corrosive effects of biomedical and clinical experiences in medical school. The assumption undergirding these studies by social scientists and medical educators alike is that immersion in biomedical education and clinical experience erodes students' empathic capacities, and that exposure to humanities and social sciences content will amend these losses. But we do not know if this assumption is correct. In this project, we empirically assess this assumption by utilizing a unique data set constructed from student applicant and survey data from the American Medical College Application Service (AMCAS) and the Association of American Medical Colleges (AAMC). We test whether medical school students (N = 8255) from the United States (U.S.) with different academic backgrounds represented by their college major have different levels of empathy, net of demographic control variables. We report two findings. First, we find that students who majored in humanities or interpretive social sciences disciplines have higher empathy scores than their peers who majored in the positivistic social sciences and STEM (science, technology, engineering, and mathematics) disciplines. Second, we find that the relationship between empathy and time in medical school is more nuanced than we would expect from the existing literature.

Predictors of Physician's Empathy: The Role of Spiritual Well-being, Dispositional Perspectives, and Psychological Well-being.

ObjectivesEmpathy is a core component of an efficient physician-patient relationship. Although students’ preexisting medical views may influence responses to physician-patient relationship, there is little knowledge about the psychological predictive factors of empathic perspective for physician-patient relationship. We aimed to examine whether psychological well-being, dispositional perspective, and spiritual well-being could predict the empathic perspective of medical students regarding the physician-patient relationship.MethodsIn a cross-sectional study, 350 medical students of Babol University of Medical Sciences were recruited at four levels of education including basic sciences, preclinical medicine, clerkship, and internship. The students completed four questionnaires including Jefferson Scale of Empathy - student version, Brief Ryff psychological well-being, Individual Disposition, and Spiritual Well-Being.ResultsThe score of medical student’s perspective to clinical empathy was high (106.1±29.8, range: 20–140), but diminished with further years of education. Female students had higher empathy scores than their male counterparts. Pearson’s correlation coefficient revealed a strong positive significant relationship between student’s perspective to clinical empathy and spiritual well-being (r = 0.56), cognitive empathy (r = 0.51), and psychological well-being (r = 0.43), and tendency to egalitarianism (r = 0.37). The results of stepwise multivariate analysis regression revealed that cognitive empathy (β = 0.300), self-esteem (β = 0.133), and spiritual well-being (β = 0.388) positively predicted student’s perspective to clinical empathy regarding the physician-patient relationship.ConclusionsThe results suggested that promoting empathic care in curricula of medical schools may be more effective if students’ preexisting perspectives, cognitive empathy, self-esteem, spiritual well-being, and tendency to egalitarianism are taken into account.

Differentiating between teaching experience and expertise in the music studio: A pilot study

The purpose of this study was to develop a measure to investigate studio teacher’s observational skill as a function of the observer’s ability to identify effective pedagogical practices. A secondary purpose was to see if observational skill varied as a function of scores on a measure of empathy. Participants ( N = 60) were saxophonists who observed and wrote about the strengths and weaknesses of two 1-minute videos of private saxophone lessons and two private violin videos. To develop expertise criteria, four expert teachers observed the videos for their respective instruments and their responses were converted into lists of strengths and weaknesses. These lists were then compared to participants’ responses and used as criteria for determining the degree to which participants’ analyses matched the experts’ responses. Participants also completed a demographic survey and the Toronto Empathy Questionnaire. Results indicated that the degree to which participants’ analyses matched the experts did not vary as a function of teaching experience. The degree to which participants’ analyses matched the experts also did not vary as a function of empathy scores, though descriptive trends indicated that higher empathy scores were accompanied by a greater degree of match. There was a significant difference in degree of match between the participants and experts for the saxophone and violin videos. Implications for tool refinement and future research are discussed.

Revisiting the trajectory of medical students\u2019 empathy, and impact of gender, specialty preferences and nationality: a systematic review

BackgroundEmpathy allows a physician to understand the patient’s situation and feelings and respond appropriately. Consequently, empathy gives rise to better diagnostics and clinical outcomes. This systematic review investigates the level of empathy among medical students across the number of educational years and how this level relates to gender, specialty preferences, and nationality.MethodIn accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA), the authors conducted a systematic search of studies published between February 2010 and March 2019 investigating the level of empathy among medical students. The databases PubMed, EMBASE, and PsycINFO were searched. Studies employing quantitative methodologies and published in English or Scandinavian language and examining medical students exclusively were included.ResultsThirty studies were included of which 24 had a cross-sectional and 6 a longitudinal study design. In 14 studies, significantly lower levels of empathy were reported by increase in the number of educational years. The remaining 16 studies identified both higher, mixed and unchanged levels. In 18 out of 27 studies it was reported that females had higher empathy scores than males. Only three out of nine studies found an association between empathy scores and specialty preferences. Nine out of 30 studies reported a propensity towards lower mean empathy scores in non-Western compared to Western countries.ConclusionThe results revealed equivocal findings concerning how the empathy level among medical students develops among medical students across numbers of educational years and how empathy levels are associated with gender, specialty preferences, and nationality. Future research might benefit from focusing on how students’ empathy is displayed in clinical settings, e.g. in clinical encounters with patients, peers and other health professionals.

Differential Contributions of Empathy to Math Achievement in Women and Men.

Mathematics forms a foundation for the science, technology, engineering and mathematics (STEM) fields. While considerable work has identified the individual cognitive and external systemic factors that influence math achievement, less is known about personality-like traits that might contribute to success in mathematics, especially among women. This study examines two such traits: systemizing – the tendency to analyze systems and extract underlying rules that govern their behavior – and empathizing – the ability to identify with another’s emotions and respond appropriately. Recently Escovar et al. (2016) found that empathizing was a negative predictor of math skills in children, especially among girls, suggesting that women with higher empathy might be particularly disposed to lower math performance. In the first study, 142 participants (71 female) completed two standardized measures of math achievement and questionnaires to gauge the tendency to empathize and systemize. Surprisingly, higher empathy was associated with better math performance in women, while men displayed the expected pattern of lower empathy being related to higher math scores. In a second study, we extend this finding in women (n = 121) to show that individuals who report higher mathematics achievement in university level course work also have higher empathy scores. Further, while positive attitudes toward mathematics tended to decline from elementary school to college, women whose attitudes increased had higher empathy scores than those who declined. Together, these results suggest that while the tendency to empathize is associated with worse math performance in childhood, it may become a protective factor as women progress through their mathematics education.

Gynecologic Health Care Providers' Willingness to Provide Routine Care and Papanicolaou Tests for Transmasculine Individuals.

Background: Transmasculine individuals who have a cervix may be at risk of cervical cancer, but they face a number of barriers to accessing care, including difficulty finding knowledgable and culturally sensitive providers who are willing to care for transgender patients. We examined gynecologic health care providers' willingness to provide routine care and Papanicolaou tests (Pap tests) to transmasculine individuals, including the role of personal, clinical, and professional factors. Materials and Methods: We surveyed attending physicians, advanced practitioners, and residents in the Women's Health department of a large, integrated Midwest health system (n = 60, 74.1% response rate). Results: A majority of participants were female (68.3%) and white (73.3%). Most had met a transgender person before (79.7%), and 40.7% had cared for a transgender patient in the past 5 years. Most reported willingness to provide routine care (74.6%) and Pap tests (85.0%) to transmasculine people. Bivariate analysis suggests that having met a transgender person (p = 0.028), higher empathy scores (p = 0.015), political views (p = 0.0130), and lower transphobia (p = 0.012) were associated with willingness to provide routine care to transmasculine individuals. Lower transphobia (p = 0.034) and political views (p < 0.001) were also associated with willingness to provide Pap tests to transmasculine people. Conclusions: Providers' willingness was not associated with barriers related to training or knowledge-only with personal biases and experiences. Transgender-inclusive health care training that addresses personal attitudes should be a routine part of training for all health professionals.

Association Between Primary Care Practitioner Empathy and Risk of Cardiovascular Events and All-Cause Mortality Among Patients With Type 2 Diabetes: A Population-Based Prospective Cohort Study.

To examine the association between primary care practitioner (physician and nurse) empathy and incidence of cardiovascular disease (CVD) events and all-cause mortality among patients with type 2 diabetes. This was a population-based prospective cohort study of 49 general practices in East Anglia (United Kingdom). The study population included 867 individuals with screen-detected type 2 diabetes who were followed up for an average of 10 years until December 31, 2014 in the Anglo-Danish-Dutch Study of Intensive Treatment in People With Screen Detected Diabetes in Primary Care (ADDITION)-Cambridge trial. Twelve months after diagnosis, patients assessed practitioner empathy and their experiences of diabetes care during the preceding year using the consultation and relational empathy (CARE) measure questionnaire. CARE scores were grouped into tertiles. The main outcome measures were first recorded CVD event (a composite of myocardial infarction, revascularization, nontraumatic amputation, stroke, and fatal CVD event) and all-cause mortality, obtained from electronic searches of the general practitioner record, national registries, and hospital records. Hazard ratios (HRs) were estimated using Cox models adjusted for relevant confounders. The ADDITION-Cambridge trial is registered as ISRCTN86769081. Of the 628 participants with a completed CARE score, 120 (19%) experienced a CVD event, and 132 (21%) died during follow up. In the multivariable model, compared with the lowest tertile, higher empathy scores were associated with a lower risk of CVD events (although this did not achieve statistical significance) and a lower risk of all-cause mortality (HRs for the middle and highest tertiles, respectively: 0.49; 95% CI, 0.27-0.88, P = .01 and 0.60; 95% CI, 0.35-1.04, P = .05). Positive patient experiences of practitioner empathy in the year after diagnosis of type 2 diabetes may be associated with beneficial long-term clinical outcomes. Further work is needed to understand which aspects of patient perceptions of empathy might influence health outcomes and how to incorporate this understanding into the education and training of practitioners.

Medical students' empathy and attitudes towards professionalism: Relationship with personality, specialty preference and medical programme.

BackgroundExisting research has suggested that self-reported empathy in medical students is moderated by personality traits and diverse demographic and educational factors including age, gender, nationality, career aspirations, as well as year of curriculum. It is unclear how empathy, personality, and background factors might impact on students’ attitudes towards professionalism in medicine.MethodsA cross-sectional questionnaire-based study was conducted in first and final year medical students at an Irish medical school. The following instruments were administered: (a) Jefferson Scale of Empathy; (b) NEO Five-Factor Inventory (NEO-FFI-3); (c) Attitudes towards Professionalism Scale. Demographic and educational variables were also measured. Descriptive and correlational analysis was conducted to examine the association between empathy, personality, professionalism-related attitudes and additional measures. Regression analysis was used to examine determinants of attitudes towards professional behaviour.ResultsBoth selected NEO-FFI personality traits and empathy were independently associated with distinct categories of professional behaviour. Specifically, Openness to Experience was associated with higher empathy scores, and higher ‘Social responsibility’. Extraversion was linked with higher scores on the “Personal characteristics” and “Interactions with team” categories, while Conscientiousness was also positively associated with “Personal characteristics”. In agreement with previous studies, the personality traits most associated empathy were Agreeableness and Openness to Experience. Empathy did not vary according to programme year or career specialty preference.ConclusionsThis study is the first to show that empathy and personality factors may act as determinants of students’ attitudes towards medical professionalism in a manner which is dependent upon category of professional behaviour.

Using resting-state DMN effective connectivity to characterize the neurofunctional architecture of empathy

Neuroimaging studies in social neuroscience have largely relied on functional connectivity (FC) methods to characterize the functional integration between different brain regions. However, these methods have limited utility in social-cognitive studies that aim to understand the directed information flow among brain areas that underlies complex psychological processes. In this study we combined functional and effective connectivity approaches to characterize the functional integration within the Default Mode Network (DMN) and its role in self-perceived empathy. Forty-two participants underwent a resting state fMRI scan and completed a questionnaire of dyadic empathy. Independent Component Analysis (ICA) showed that higher empathy scores were associated with an increased contribution of the medial prefrontal cortex (mPFC) to the DMN spatial mode. Dynamic causal modelling (DCM) combined with Canonical Variance Analysis (CVA) revealed that this association was mediated indirectly by the posterior cingulate cortex (PCC) via the right inferior parietal lobule (IPL). More specifically, in participants with higher scores in empathy, the PCC had a greater effect on bilateral IPL and the right IPL had a greater influence on mPFC. These results highlight the importance of using analytic approaches that address directed and hierarchical connectivity within networks, when studying complex psychological phenomena, such as empathy.

Cross-sectional study of the association between empathy and burnout and drug prescribing quality in primary care.

The aim of this study was to assess whether burnout and empathy levels among general practitioners (GPs) might influence prescribing performance assessed using pharmaceutical prescription quality standard indicators. Cross-sectional descriptive study of 108 GPs from 22 primary care centers in Lleida, Spain, and of centralized data corresponding to 183 600 patients under their care. The study was conducted between May and July 2014. Burnout and empathy were measured using the Spanish versions of the Maslach Burnout Inventory and the Jefferson Scale for Physician Empathy, and prescribing quality was measured using the Catalan Pharmaceutical Prescription Quality Standard (EQPF). Normal distribution of scores was verified using the Chi-square and Kolmogorov-Smirnov-Lilliefors tests. The effect of each of the variables was evaluated using crude odds ratios. Older GPs scored significantly higher in the EQPF (P < 0.05). High empathy scores were positively associated with high EQPF scores. GPs with low burnout also performed better in the EQPF. More empathic, less burned-out, older GPs showed better prescribing performance according to quality indicators. However, further studies are needed to evaluate other factors influencing prescribing habits. The promotion of communication skills may increase empathy and reduce burnout, thus benefiting patients.

Are empathy and emotional intelligence missing in dental practitioner's toolkit in Saudi Arabia? A cross-sectional study.

Empathy and emotional intelligence (EI) of a dentist are two factors vital for developing fruitful relations between clinicians and patients. Establishing a good relationship with patients may improve patients' outcomes. Data on empathy and EI in dental practitioners in the Kingdom of Saudi Arabia is scarce. Hence, we aimed to evaluate and compare empathy and EI among dental practitioners in Abha and Khamis Mushayat cities of Saudi Arabia. We conducted a cross-sectional survey study. A total of 183 dental practitioners who were reachable at survey time were included. A self-administered questionnaire on empathy and EI was structured based on Jefferson Scale of Physician Empathy (health professions version) and Schutte's Emotional Intelligence Scale, respectively. Statistical analysis was done using Mann-Whitney and Kruskal-Wallis tests. No significant difference was observed between both genders regarding empathy and EI (P = 0.73 and 0.97, respectively). Similarly, no significant difference was observed between participants with different qualifications or different work settings (P > 0.05). However, a statistically significant positive correlation was observed between empathy and EI (r = 0.722). Irrespective of gender, qualification, or different work settings, dental practitioners in both cities showed adequate empathy and EI levels. Dentists with high empathy scores seem to show high EI levels. Evaluating and monitoring empathy and EI practice among dental practitioners have paramount importance to improve clinical practice and healing potential of patients. Low levels of empathy and EI practice would suggest modifications to training curriculum or healthcare policies.

The relationship between empathy and emotional intelligence among Iranian nursing students.

ObjectivesTo determine the relationship between empathy and emotional intelligence among Iranian nursing students. MethodsThis is a cross-sectional, descriptive-correlational study that was conducted on three hundred and twenty eligible students, selected using stratified random sampling. Participants were mainly nursing students at Tehran University of Medical Sciences. Data gathering was done using The Jefferson Scale of Empathy and The Schutte Self Report Emotional Intelligence Test. Data were analyzed using SPSS.ResultsThe results showed a strong positive correlation between empathy and emotional intelligence (r=0.499, p <.001). Students in their fourth year had the highest score for empathy (M=109.16, SD=10.16), while first-year students had the highest scores for emotional intelligence (M= 151.68, SD= 17.47). Female students got higher empathy scores than male students (t(318)= 2.524, p= .012). Age had a strong inverse correlation with emotional intelligence (r= 0.143, p= .010).ConclusionsThe results of this study show a correlation between emotional intelligence and empathy among nursing students. Nurses with higher emotional intelligence tend to be better in establishing productive relationships with patients and their families, and if nurses possess empathetic skills, they manage their emotions more effectively. In addition to imparting knowledge and clinical experience, nursing curricula should provide students with opportunities to develop their communication and emotional skills.

Association between emergency physician self-reported empathy and patient satisfaction.

BackgroundHigher physician self-reported empathy has been associated with higher overall patient satisfaction. However, more evidence-based research is needed to determine such association in an emergent care setting.ObjectiveTo evaluate the association between physician self-reported empathy and after-care instant patient-to-provider satisfaction among Emergency Department (ED) healthcare providers with varying years of medical practice experience.Research designA prospective observational study conducted in a tertiary care hospital ED.MethodsForty-one providers interacted with 1,308 patients across 1,572 encounters from July 1 through October 31, 2016. The Jefferson Scale of Empathy (JSE) was used to assess provider empathy. An after-care instant patient satisfaction survey, with questionnaires regarding patient-to-provider satisfaction specifically, was conducted prior to the patient moving out of the ED. The relation between physician empathy and patient satisfaction was estimated using risk ratios (RR) and their corresponding 95% confidence limits (CL) from log-binomial regression models.ResultsEmergency Medicine (EM) residents had the lowest JSE scores (median 111; interquartile range [IQR]: 107–122) and senior physicians had the highest scores (median 119.5; IQR: 111–129). Similarly, EM residents had the lowest percentage of “very satisfied” responses (65%) and senior physicians had the highest reported percentage of “very satisfied” responses (69%). There was a modest positive association between JSE and satisfaction (RR = 1.04; 95% CL: 1.00, 1.07).ConclusionThis study provides evidence of a positive association between ED provider self-reported empathy and after-care instant patient-to-provider satisfaction. Overall higher empathy scores were associated with higher patient satisfaction, though minor heterogeneity occurred between different provider characteristics.

Empathy and Osteopathic Manipulative Medicine: Is It All in the Hands?

The osteopathic medical school curriculum is unique because of the inclusion of training in osteopathic manipulative medicine (OMM). Interest in and use of OMM promotes cognitive training in diagnosing conditions, emotional training in the alleviation of pain, and physical training in the application of OMM. Osteopathic manipulative medicine may mitigate a reduction in empathy levels of medical students and explain why osteopathic medical students do not follow the declining pattern of empathy previously reported in allopathic medical students. To examine whether favorable opinions of OMM are positively correlated with overall student empathy as well as the cognitive, emotional, and behavioral subcomponents of empathy. Institutional review board approval was obtained to measure empathy in medical students attending the Midwestern University/Chicago College of Osteopathic Medicine for this cross-sectional study. The 20-item Jefferson Scale of Empathy medical student version (JSE-S) was distributed via email to first-year students at the beginning of the 2016-2017 academic year and at the end of the academic year to all students. Items were divided into cognitive, emotional, and behavioral categories. Items related to demographics, interest and use of OMM and the osteopathic philosophy, frequency of touch, and personality were also included in the survey. Data were analyzed using SPSS software and presented as mean (SEM). Statistical significance was set at P<.05. Of the 801 students the survey was sent to at the end of the 2016-2017 academic year, 598 students completed the survey, for a response rate of 75%. When accounting for the effect of gender with a multivariate analysis of covariance, there were no differences in empathy scores across school years. When empathy scores from first- and second-year students were combined and compared with combined third- and fourth-year students' scores to examine the difference between empathy in students during academic and clinical training, a difference in the mean (SEM) JSE-S empathy score was noted (114.6 [0.7] and 112.0 [0.7], respectively; P=.01); however, the effect size was small (partial η2=0.01). Interest in OMM and the osteopathic philosophy were significantly associated with higher empathy scores (P<.05; medium effect; partial η2=0.08). Interest in and use of OMM are associated with higher empathy scores and empathy subcomponents. Training and use of OMM should be examined as a mechanism contributing to the durability of empathy in the osteopathic medical profession.