Higher Levels Of Empathy Research Articles

Personal and professional development through sustainable partnerships in education Serbian experiences from the I-TAP-PD Erasmus+ project

The aim of this research is to evaluate how the partnership between teachers and artists was built in the context of Serbia. In conducting it, we sought answers to the following research question: What was the role of I-TAP-PD in the personal and professional development of teachers and artists in Serbia? It is based on the phenomenological theory of reflection in action. Research participants include three teacher-artist pairs. The residencies were delivered between August 2021 and June 2022. The data was collected with pre-residency questionnaires, reflective journals, classroom observation, post-residency group interviews. All qualitative data was analysed using thematic analysis. The results show that artists and teachers, in terms of sustainable partnership in researched practices in Serbia, identified the understanding of the “other“ as the most important aspect of the process of learning and teaching. In this endeavour, professionals developed high levels of empathy and their self-esteem notably increased.

The attitude of senior pupils to the role of a witness to cyberbullying

Cyberbullying as a scientific problem is one of the popular topics in foreign and domestic literature, but the main attention of researchers is primarily focused on the relationship that arises between the aggressor and the victim. The purpose of the study, the results of which are recorded in the article, is to identify personal characteristics that contribute to or hinder the manifestations of adequate behavior of high school students who have witnessed a cyberbullying situation. The key research tool was the Cyberbullying Witness Behavior Questionnaire. An additional analysis of the personal characteristics of high school students was carried out by means of an Emotional Intelligence Questionnaire and a Short questionnaire of the "dark triad" of qualities; socio-demographic information about the respondents was also collected. In total, 268 high school students aged 16 to 18 years took part in the study (approximately an equal number of girls and boys). The study showed that an adequate type of perception of cyberbullying situations prevails in this age group, but there were also some contradictions that were fixed in the processes of interaction between parents and teachers. Students of boys and girls aged 16-18 years, who have a higher level of empathy and emotional intelligence, show a more adequate attitude to the role of a witness to cyberbullying, while schoolchildren whose personalities are characterized by elements of psychopathic accentuation are more likely to show an inadequate attitude in the appropriate situation. In conclusion, the authors conclude that systematic work on the development of aggressive behavior control skills among high school students, taking into account all personal characteristics, will contribute to reducing the number of manifestations of violence in relationships within high school students' collectives.

The Role of Empathic Communication in the Relationship between Servant Leadership and Workplace Loneliness: A Serial Mediation Model.

Researchers have increasingly concentrated on loneliness in the workplace as a crucial factor influencing the mental health of employees and the viability of telework. In contrast, the current understanding of the strategies mitigating workplace loneliness and how leaders utilize their behaviors to impact followers' loneliness remains limited. Since servant leadership values the emotional needs of followers and displays a high level of empathy, this study investigated the direct and indirect effects of servant leadership on workplace loneliness. In this study, 267 employees (mean age = 31.5 years) from 28 provinces in China were recruited to participate in this survey. We proposed that servant leaders motivate their own empathic communication and other followers' empathic communication to reduce lonely followers' workplace loneliness. This research further examined the relationship between the leader's and colleagues' empathic communication, and the two jointly mediate the connection between servant leadership and followers' workplace loneliness. We constructed a serial mediation model to examine the relationships between servant leadership, leader's empathic communication, colleagues' empathic communication, and workplace loneliness. The results indicate that servant leadership creates a cycle of empathy and provides insights into building a culture of empathy to improve employee well-being.

Communication and empathy of nursing students in patient care through telenursing: A comparative cross-sectional study

BackgroundPhone calls and videoconferences are the most widely used systems to interact with patients in real time. Patient care through phone calls or videoconferences is different from an in-person meeting. Interpersonal communication skills, self-confidence communication skills and empathy with the patient may be affected during phone calls or videoconferences. AimThe objective of this study was to describe the interpersonal communication skills, self-confidence communication skills and empathy of nursing students during patient care through phone calls or videoconferences. DesignA cross-sectional study. ParticipantsA total of 170 nursing students participated from the University of Almeria. The subjects were randomly assigned to the phone call group or videoconference group. MethodsThe students contacted standardised patients through phone calls or videoconferences. Questionnaires were used to assess interpersonal communication skills with patient, empathy, and self-confidence in communication skills. Data collection was carried out between March and May 2022. ResultsNo statistically significant differences were found between self-confidence in communication skills with the patient and the type of consultation, nor were statistically significant differences found between the empathy of the nursing students and the type of consultation. The students who used videoconference reported higher patient interpersonal communication skills than the students who made phone calls. Finally, the participants who made videoconferences obtained a higher score in dimension therapeutic use of self than those who made phone calls. ConclusionsNursing students have shown a high level of empathy and interpersonal communication skills with patients and a moderate level of self-confidence in communication skills, both when interacting with patients through phone calls and videoconferences. Finally, differences were found in interpersonal communication skills with patient and type of consultation. In particular, interpersonal communication skills with the patient are greater when the nursing students make a videoconference.

Association between empathy levels in physicians and patient satisfaction scores in a cardiovascular clinic

Abstract Introduction A good doctor-patient relationship is crucial to medical practice. A fundamental element that drives this relationship is the empathy of the treating physician, which has also been validated as a predictor of clinical competence and patient results. Purpose We conducted an original study to correlate empathy values of our physicians and patient satisfaction surveys. In this subanalysis, we evaluated whether age, sex or time since qualifying as specialist had an impact on empathy values. Methods In our originaly study we sought to correlate the empathy values of our physicians in our cardiovascular clinic with the results of outpatient satisfaction surveys, measured with HCAPS, using a linear regression model. The Jefferson Empathy scale is a self reported 20 question survey, answered through a 1-7 Likert scale, with a maximum score of 140 points. It is further subclassified into 3 categories: "Perspective", "Care with compassion" and "Stepping into patient's shoes". The HCAPS survey is a patient satisfaction query, with 5 items that inquire as to the patient's perception of being treated with respect by the physician, the interest shown in their problems, the time dedicated to the consult, and the quality of the explanation of their chief concern and treatment options. It is anwered through a Likert scale from "Totally diasgree" to "Totally agree". There is also a final question that asks for a global impression. Results 65 doctors answered the Empathy survey, 30.8% of them women. Mean age was 48.8 years, and over half were under 50 years old. 81% had been practicing for over 5 years. 61671 HCAPS surveys were analyzed, corresponding to those 65 practitioners. Mean Empathy score was 120.7 (DS 11.1). We found that patients perceived greater respectful treatment (p=0.03) and had their treatment options better explained to them (p=0.02) by physicians with higher levels of empathy. The other HCAPS queries had a positive, though non statistically significant, relationship with Empathy scores. Doctors with higher scores in the subcategory "stepping into patient's shoes" had a significant increase in patient's perception of the interest shown in their concerns (p=0.01). There were no differences in physicians' empathy levels according to their age, gender, or time since qualifying as a specialist. Discussion These results validate empathy as a key skill in the doctor-patient relationship, and show that high levels of this personality attribute lead to better patient satisfaction results. Our results differ from other published work in that we found no difference in empathy levels according to gender or practice time, whereas most previous literature found that women and longer practice time were positively associated with empathy levels.

Acquisition of Communicative Skills by Foreign Students in a Multicultural Learning Environment

The study's relevance was determined by the lack of attention towards specific aspects of foreign students' acquisition of communicative skills in a multicultural setting and the need to record the psychological and pedagogical circumstances of academic activities that facilitate successful intercultural communication skills acquisition. This study aimed to provide evidence for theoretical claims and describe the experiment that aimed to validate the psychological and pedagogical conditions under which foreign students can acquire communicative skills within a multicultural environment at Kazakh University. To investigate the cognitive, emotional, and personality-based behavioural components of communicative skills, a range of valid methods were selected. The study was conducted using a mixed method. The research comprised 22 students from China, 14 students from the Republic of Korea, 19 students from Afghanistan, 20 students from the Republic of Iran, and 9 students from Vietnam, all pursuing their education in Kazakhstan at two universities. The research results showed that high levels of empathy and ethnic tolerance were obtained by 26.4% of the experimental group and 28.2% of the control group students respectively. It was found that conflict situations were more likely to arise as a result of competition, which was confirmed by 36.8% of the experimental group and 34.8% of the control group. The results obtained have significantly broadened the parameters of foreign students' learning and work activity's communicative and personality aspects.

B - 99 The Effects of Traumatic Brain Injury on Empathy and Quality of Life.

The focus of this present research was to investigate the relationship between empathy and quality of life in individuals with moderate-to-severe TBI. Individuals with moderate-to-severe TBI between ages 18 and 65 (N&#3f39) completed the Quality of Life after Brain Injury (QOLIBRI) and Empathy Quotient (EQ). Performance on the EQ was correlated with QOLIBRI (r(1,37) = 0.398, p = 0.012). Based on their EQ scores, the participants were divided into three groups: below-average empathy (N = 9), average empathy (N = 16), and above average empathy (N = 14). There was a statistically significant difference in the total QOLIBRI scores across the three empathy groups (F (2, 36) = 5.037, p = 0.012). Post-hoc analysis, indicated those with lower EQ scores also reported lower QOLIBRI scores. This work provides evidence that those with low empathy may have a worse quality of life after brain injury relative to those with higher levels of empathy. Understanding the relationship between empathy and quality of life for individuals with brain injury can inform professionals where to target interventions such that improvements in empathy may also increase quality of life.

Students’ empathy in the context of extremist risks

In unstable conditions, the scale of extremism as a form of illegal actions tends to grow. The statistical decrease in the number of extremist crimes was the result of legislative changes. In the risk group, there are primarily young people from 18 to 30 years old, who are more susceptible to psychological pressure from extremist and terrorist organizations, and especially the student youth, who have already begun to escape from parental control but still did not achieve the full adult responsibility. Public calls for extremist acts are based on various social-psychological mechanisms of influence and aim specifically at this age group. A low level of emotional intelligence, empathy and psychological well-being is essential for entering an extremist environment. In January- February 2022, a survey was conducted to test the hypothesis of a relationship between the level of empathy and propensity to violent extremism. The article presents the results of this survey, such as the lack of direct relationship between the level of empathy and the age. The survey’s unexpected result is that the general level of boys’ empathy is higher than that of girls, and girls are more likely to be extremist when they have a higher level of empathy. Thus, an increasing level of the youth’s empathy seems to be a way to prevent extremist behavior withing a comprehensive program but not a universal strategy for countering youth extremism. The article can become a basis for an effective pedagogical strategy to prevent extremism and to reduce the youths’ risks of being involved in it. The developed approach should take into account the gender peculiarities of empathy, which influence the manifestations of violent extremism.

Mapping the Relationship Between Parental Authority, Cessation of Innovation and Emotional Empathy Among College Students

The current study examined the connections between parental authority, cessation of innovation, and emotional empathy among students. College students (300) completed questionnaires utilizing convenient sampling. The parental authority questionnaire (PAQ), Urdu version by Shaiza Khalid (2004), was used in the current study to investigate parenting styles. The creative behaviour inventory (CBI), developed by Hocevar(1979), was translated into Urdu by the researcher and was used to examine the discontinuation of innovation in the current study. The emotional empathy scale (EES) in Urdu by Ashraf (2004)was utilized toto investigate the emotional empathy variable. Participants in the study were first-, second-, third-- ---, and fourth-year college students. Male college students comprised 47.7% of the sample, while female students comprised 55.3%. The study's findings indicate that males exhibited higher levels of emotional empathy than females. Based on socioeconomic background, upper-class members exhibit high levels of inventiveness, whereas middle-class members have high levels of emotional empathy. College-age males score well on parental authority. Additionally, research indicates that parental authority negatively impacts both creativity and emotional empathy among college students. To extend the generalized ability, future research should expand the population size. And the geographical area of the study can be developed.

Differences in empathy levels among physicians based on specialty: a nationwide cross-sectional study.

A physician's ability to empathize is crucial for patient health outcomes, and this differs according to speciality, personal characteristics, and environmental factors. This study aimed to examine the empathy levels among physicians based on their specialities and to identify the influencing factors. A nationwide, online, cross-sectional survey was conducted using the Nikkei Business Publication online physician member homepage. Participants were 5441 physicians in Japan registered as members of Nikkei Medical Online across 20 specialities. We used the Jefferson Scale of Empathy (JSE) to measure the physicians' empathy levels. Cronbach's alpha was 0.84. The mean JSE score was 100.05, SD = 15.75. Multivariate analyses showed that the highest JSE scores were for general medicine [+5.58, 95% confidence interval (CI) 2.60-8.56], general surgery (+3.63, 95% CI 0.97-6.28), psychiatry (+3.47, 95% CI 1.76-5.17), and paediatrics (+1.92, 95% CI 0.11-3.73). Factors associated with higher JSE scores were being female (+5.86, 95% CI 4.68-7.04), managers (+1.11, 95% CI 0.16-2.07), working in a small hospital (+2.19, 95% CI 0.23-4.15), and with children (+3.32, 95% CI 2.29-4.36). A significant decrease in the empathy levels was found when the parent of the participant was also a medical provider. Being a general medicine physician or a female physician in a high position who has children was positively and significantly correlated with high empathy levels.

Empathy and resilience in health care professionals

Empathy and resilience have an indirect effect on raising the level of the quality of care, as empathy is the basis for good interactions between medical workers and patients, and resilience, as a dynamic process, helps caregivers adapt well to difficult working conditions, risks or traumas experienced. The development of empathy and resilience of these medical workers is possible by a training method already employed among medical students in order to both improve the quality of care, but also to more effectively prevent professional burnout. The purpose of the study was to determine the level of empathy and the level of resilience, their possible correlations with each other, as well as the relationship of these variables with socio-demographic variables.The study was carried out in 2021 among 31 doctors and 45 nurses using two main tools - the Emotional-Cognitive Empathy Questionnaire (EEP)by Ewa Wilczek-Rużyczka and the Resilience Measurement Scale(SPP-25) by Nina Oginska-Bulik and Zygfryd Juczynski, as well as a socio-demographic questionnaire.The most valuable results of the study turned out to be the demonstration of statistically significant concordant associations of empathy level with resilience level both in general, and their individual factors as statistically significant intercorrelations. In addition, statistically significant differences were shown in the case of cognitive empathy - higher levels of empathy were found among people with longer work experience and women when compared to men. In the case of the level of other components of empathy, as well as resilience, differences so as to be statistically significant could not be confirmed.It is recommended that empathy and resilience training sessions be implemented for health care workers, and that the study be continued with larger research groups, with additional control groups, to refine the programs of these training sessions.

Changes in the empathy levels of a group of undergraduate medical students: A longitudinal study

Background. The concept of empathy in students has gained significant attention in medical education. Whether implementing formal educational interventions to promote long-term and effective empathy levels leads to sustained increased empathy levels in students, is however less clear. Objectives. The study aimed to evaluate the trajectory of medical students’ self-perceived empathy levels during their 6-year MB ChB degree. Methods. A longitudinal, prospective study was conducted over 4 years. A cohort of 292 medical students was invited to participate. Participants completed the Jefferson Scale of Empathy for Students (JSE-S) at three intervals during their studies. The students attended two workshops related to empathic patient interactions during this time. The JSE-S mean score by age and gender was compared, making use of a linear regression model. Results. A total of 119 students completed the study. Students’ total empathy levels were similar during the first and the last measuring point (110), but there was a significant rise in the intermediate measuring point (113.3). When the male and female cohorts’ scores were interpreted separately, both genders demonstrated a similar pattern to the total score, although females’ JSE-S scores were higher than the males. Conclusion. The results of the study confirm that educational interventions can increase students’ self-perceived empathy levels; however, we suggest that students require reinforcement and multiple opportunities to practise and observe empathic communication with patients to sustain high levels of empathy. Follow-up sessions to specifically target the promotion of empathy should be implemented; otherwise the long-term effect of educational interventions might be limited.

Peace-Oriented Mindset and How to Measure it.

This article presents the concept of a Peace-Oriented Mindset (POM), based on peace psychology and the significance of conflict-related context. It highlights the role of preventing conflicts through creating an enabling and peace-supportive milieu, facilitated by individuals with specific peace-oriented capabilities. The phenomenon of POM is analyzed, as well as delineated in the context of the current knowledge in this field. Next, the method used to construct a questionnaire measuring the POM is presented. The POM scale is verified on an N = 1074 representative sample, documenting high reliability. Factor analysis confirms the conjecture that there are three dimensions of the POM: Cognitive, performative, and doability conviction. Moreover, social norms are documented. A cross-segment comparison delivers several insights, e.g., that women have a higher POM level than men and that those who consider themselves leaders or innovators and those who are involved in social activities have a higher POM level than those who do not. The POM concept and scale are valuable resources for identifying future peacebuilders, especially from conflicted communities, as well as for training future youth leaders in the field of peacebuilding. Finally, indications for future studies are discussed, e.g., for verifying the hypothesis that individuals who score high in POM also have higher levels of empathy and compassion.

Using Virtual Patients to Support Empathy Training in Health Care Education: An Exploratory Study.

Empathy is essential for effective patient care. Yet, research shows suboptimal empathy in patient-practitioner interactions. Intelligent virtual patient simulations may offer an effective educational tool for empathy training. This observational study explored the quality of speech pathology of students' empathy responses in virtual patient simulations. Using the 7-point Empathic Communication Coding System (ECCS), we examined 72 students' empathic communication during a 12-week virtual patient interview series as part of their standard curriculum across 4 cohorts (a total of 388 empathic responses). The ECCS data were tallied and graphically displayed. We compared year groups (cohorts from 2015 to 2018), changes over semester, and differences between virtual patients. Median ECCS scores were 4 of a maximum of 6 (interquartile range, 3) across all interviews. Most students (89%) scored between a level 2 (implicit recognition) and level 5 (confirmation) with only a few responses scoring at the lowest 2 levels of empathy (0: denial, 0.5%; 1: automatic recognition, 2%) or the highest level of empathy (6: shared feeling or experience, 9%). Students consistently acknowledged patients' feelings and often offered an action, solution, or reassurance. However, shared feelings or experiences were infrequent. Although virtual patient simulations do not replace experiential learning such as simulation, standardized patients, and clinical practicum, they offer a safe environment to practice skills. This article provides support for designing larger controlled clinical trials and provides insights for educators on how to design virtual patient empathic opportunities of varying complexity for students.

I Read, Therefore I Am: Examining Nonmedical Reading and Its Relationship to Empathy in Anesthesia Training.

High levels of empathy among resident physicians are associated with improved patient outcomes. Empathy may be learned and practiced when reading nonmedical writing through narrative transportation, a process by which readers identify with characters and become emotionally involved in the plot. We hypothesized that residents and fellows who reported more nonmedical reading would have higher empathy levels and that empathy would decrease during training. An emailed survey was sent to program directors of Accreditation Council on Graduate Medical Education-accredited anesthesiology residency and fellowship programs, with a request to distribute the survey to trainees. The Toronto Empathy Questionnaire, reading volume, and demographics were included in the survey. Response data were analyzed using a multiple variable regression model. Of 136 responses, 119 were included for data analysis. Seventeen partially completed surveys were excluded. Higher empathy scores were reported among women (P < .0001) and residents who worked 60 to 80 hours per week (P = .039). Age, postgraduate year of training, relationship status, time spent with family, and avid reading were not significantly associated with increased empathy. In this study, we examined whether nonmedical fiction reading would increase empathy in medical trainees. Our study was not able to find any significant association with time spent reading and increased empathy; however, we found that trainees who worked more hours, specifically 60 to 80 hours, had higher empathy scores. Limitations for this study included a smaller sample size. Further research should be done in this field to determine if there are other intangible factors that affect empathy in trainees.

Empathy and ethical sensitivity among intensive and critical care nurses: A path analysis.

Intensive and critical care nurses need to demonstrate ethical sensitivity especially in recognizing and dealing with ethical dilemmas particularly as they often care for patients living with life-threatening conditions. Theories suggest that there is a convergence between nurses' empathy and ethical sensitivity. Evidence in the literature indicates that nurses' emotional, demographic, and work characteristics are associated with their level of empathy and ethical sensitivity. To investigate the relationship between nurses' empathy and ethical sensitivity, considering their emotional states (depression, anxiety, and stress), demographic and work characteristics, and test an empirical model describing potential predictors of empathy (as a mediator) and ethical sensitivity using path analysis. Using a cross-sectional design, the philosophical theory of care ethics and empathy was extended and adopted as a conceptual framework for this study and tested by path analysis. Data were collected from 347 intensive care nurses recruited by ten educational-medical hospitals in Iran using a questionnaire between February and March 2021. The study was reviewed by the Ethical Advisory Board in Iran and conducted according to the Declaration of Helsinki. Study participants demonstrated a mild level of stress, anxiety, and depression, alongside a relatively high level of empathy and ethical sensitivity. Nurses with good socioeconomic status had higher empathetic behavior with patients than those with weak status. Nurses aged over 40 who had received ethics training and had higher work experience were associated with higher ethical sensitivity compared to nurses under 20years of age. Empathy directly affected ethical sensitivity; however, anxiety had an indirect effect on ethical sensitivity through empathy. Among demographic factors, age had a positive direct effect on ethical sensitivity. Less anxiety and a high level of empathy contribute to higher levels of ethical sensitivity among intensive and critical care nurses.

Student perceptions of diverse accents of English in a multilingual London post-1992 university

ABSTRACT Previous research in language attitudes has focused primarily on the attitudes of international students toward different accents of English, the attitudes of home or domestic students in the UK remain still under researched. However, the higher education sector in England is not homogenous, with the two-tier system between research-intensive universities and teaching intensive, or post-1992 universities. There is a lack of understanding of the language attitudes toward diverse accents of English of this underrepresented group of students found primarily in post-1992 institutions. With this in mind, this article has explored student perceptions of diverse accents at a post-1992 university through the Bakhtinian notion of heteroglossia. Contrary to previous attitude studies, our findings suggest that the participants have higher levels of empathy toward varieties of English signaled through accent and that the heteroglossic context of London had had a positive impact on those attitudes. However, the participants still expressed a detectable tension between conforming to the imposed norms of standard language use and pushing against them. The paper concludes with a call to challenge traditional deficit views of multilingualism and increase student critical language awareness in a safe structured environment.

Defending Others Online: The Influence of Observing Formal and Informal Social Control on One's Willingness to Defend Cyberhate Victims.

This paper examines factors correlated with online self-help-an informal form of social control vis-à-vis intervention-upon witnessing a cyberhate attack. Using online surveys from 18- to 26-year-old respondents in the United States, we explore the roles of various types of online and offline formal and informal social control mechanisms on the enactment of self-help through the use of descriptive statistics and ordinal logistic regression. The results of the multivariate analyses indicate that online collective efficacy is positively related to self-help, as is having close ties to individuals and groups offline and online. Formal online social control, however, is not significantly related to engaging in self-help. Other findings demonstrate that personal encounters with cyberhate affect the likelihood that an individual will intervene when witnessing an attack, and that individuals with high levels of empathy are more likely to intervene to assist others. This work indicates that pro-social online behavior is contagious and can potentially foster online spaces in which harmful behaviors, such as propagating cyberhate, are not condoned.

Empathic nurses with sufficient job resources are work-engaged professionals who deliver more individualized care.

This study examined whether nurse work engagement mediated the associations of job resources (collegial support and autonomy) and a personal resource (empathy) with individualized care delivery, in both hospital and long-term care settings. We also explored potential setting-specific differences in how strongly the resources were associated with work engagement and individualized care delivery among nurses. We conducted a cross-sectional study in three hospitals and two long-term care facilities. In total, 454 nurses completed a web-based survey including validated measures on resources (collegial support, autonomy, empathy), work engagement and individualized care delivery. Data were analysed using mediation and moderated mediation analyses. In both settings, all resources were indirectly associated with individualized care delivery via work engagement. Empathy was also directly associated with individualized care delivery, and a stronger association was found in the long-term care setting than in the hospital setting. The present study showed work engagement to mediate the associations of job resources and empathy with individualized care delivery in both hospital and long-term care settings. Individualized care delivery was furthermore directly facilitated by high levels of empathy, especially among nurses working in long-term care settings. Patients may benefit from better individualized care delivery by empathic nurses who are more work-engaged in the face of sufficient job resources in their practice environment. Nurses are better able to deliver individualized care when provided with sufficient job resources (collegial support and autonomy) that support their being work-engaged professionals. Furthermore, empathic nurses also reported being able to better support patient individuality. These findings can be translated to policies of hospitals and long-term care facilities, to optimize job resources and enhance empathy and thus facilitate the support of patient individuality by nurses. This study adhered to the STROBE guidelines. Nurses were involved in the design and data collection of the study.

Empathies” Rather than “Empathy” in The Clinical Context Of General Medicine: Acute Or Chronic Diseases, Physical Or Mental Health Problems and Types Of Doctor-Patient Relationships

Empathy has been a widely discussed topic in practice, education, and research. Understanding and recognizing this concept is considered fundamental to medical practice. Thus, it has acquired the status of "ideal" in modern medicine. But, in reality it is a complex and heterogeneous phenomenon. Furthermore, the idealization of empathy has made it difficult to reach a consensus on a definition and the effects of its different components. Thus, it is important to reflect on several aspects: 1. Empathic tendencies can be "risky strengths." Excessive empathy can also be dangerous for the patient. A high level of empathy without a corresponding high level of assertiveness can harm the patient as the doctor forgets her / his professional tasks. Empathy and assertiveness are two axes of the same plane: a high level of empathy must be associated with a high level of assertiveness. There is a certain point where the doctor should no longer adjust to the patient; 2. Empathy must be conceptualized within a broader biopsychosocial approach that includes (in addition to assertiveness) other psychological phenomena that occur in the consultation, and that are interconnected, such as doctor-patient relationship, transference and countertransference and the placebo effect; 3. The empathy-assertiveness of the doctor depends on multiple conditions, some related to the doctor, others to the patient, as such or as people, others to the disease, others to the context. Thus, this empathy-assertiveness can be different in different pathologies, modes of doctor-patient relationship, and in acute disease or chronic disease; 4. Empathy must be rebalanced by a "doctor-centered empathy."