Jefferson Scale Of Physician Empathy Research Articles

Physicians' self-assessed empathy levels do not correlate with patients' assessments.

BackgroundEmpathy is a fundamental humanistic component of patient care which facilitates efficient and patient-centered clinical encounters. Despite being the principal recipient of physician empathy little work on how patients perceive/report receiving empathy from their physicians has been undertaken. In the context of doctor-patient interactions, knowledge about empathy has mostly originated from physicians’ perspectives and has been developed from studies using self-assessment instruments. In general, self-assessment may not correlate well with the reality observed by others.ObjectivesTo investigate: 1—the relationship between physicians’ self-assessed empathy and patients’ measures of physicians’ empathy; 2 –Environmental factors that could influence patients’ perceptions; and 3 –the correlation between two widely used psychometric scales to measure empathy from the perspective of patients.MethodsThis is an observational study which enrolled 945 patients and 51 physicians from radiology, clinical, and surgical specialties. The physicians completed the Jefferson Scale of Physician Empathy (JSE) and the International Reactivity Index (IRI), and patients completed the Consultation and Relational Empathy scale (CARE), and the Jefferson Scale of Patient’s Perceptions of Physician Empathy (JSPPPE).ResultsWe did not observe any significant correlation between total self-assessed empathy and patients’ perceptions. We observed a small correlation (r = 0,3, P<0,05) between the sub-dimension Perspective Taking-JSE and JSPPPE. JSPPPE and CARE had a positive and moderate correlation (0,56; p<0,001). Physicians’ gender and sector influenced the JSPPPE score. Sector, medical specialty and the nature of the appointment (initial versus subsequent) influenced the CARE measure.ConclusionsThe lack of correlation between self-assessed empathy levels and patients’ perceptions suggests patients be included in the process of empathy evaluation.Practice implicationsTraining strategies aiming the development of empathy should include patients’ evaluations and perspectives.

Are alexithymia and empathy predicting factors of the resilience of medical residents in France?

ObjectivesTo explore resilience, resilience predicting factors and resilience distribution in French medical residents. MethodsA cross-sectional study was conducted in which general practice residents (n = 380) were asked to answer the Jefferson Scale of Physician Empathy, the Connor-Davidson Resilience Scale, and the Toronto Alexithymia Scale. One hundred thirty-seven (137) responses were collected. The scores of the different scales have been calculated. The score differences were examined using the Student’s t-test or analysis of variance. The correlations were estimated using the Pearson correlation coefficient. The relationships between scores were analysed by multiple linear regression. The heterogeneity of the sample was examined by non-hierarchical cluster analysis. ResultsResilience and empathy were positively correlated (r(135) = .36, p< .001). Alexithymia was negatively correlated with resilience, r(135) = -.40,p<.001, and empathy, r(135) = -.38, p<.001. Resilience was influenced by alexithymia, b = -.284, p = .001, empathy, b= .255, p = .002, gender (female < male), b = -.231, p = .002 and year of formation, β= .157, p = .036. Two clusters of residents were characterized. They differed by their empathy and resilience profiles and by alexithymia trait. ConclusionsAlexithymia, empathy, gender and year of formation correspond to predicting factors of resilience. This suggests that the resilience of vulnerable residents can be enhanced by increasing their empathy and by reducing their alexithymia. Thus, teaching teams could sustain their students’ well-being through educational programs aiming to develop their understanding of their own emotions and those of their patients.

Differences in Empathy Levels of Medical Students Based on Gender, Year of Medical School and Career Choice.

To measure mean empathy scores of Pakistani medical students and to explore any association of empathy scores with gender, medical school year and future career choice. Cross-sectional survey. Shifa College of Medicine, Shifa Tameer-e-Millat University, during the academic year 2015-2016. The student version of Jefferson Scale of Physician Empathy (JSPE) was distributed to the students electronically via the student portal. Response that were completed in full were included in the study. Descriptive statistics was used to analyse student demographic data. The student score on the JSPE was reported as the mean (out of 7) of each item. Independent samples t-test was employed to check the significant differences between genders. Empathy score with advancing year of study was investigated using ANOVA. ANOVA with post-hoc Tukey's test was used to study the relationship between career choice and empathy score. The response rate was 70.94%. The mean score was 4.51 ±0.69. Females obtained greater, but statistically insignificant (p=0.08) empathy score (4.58) as compared to the male students (4.45). No statistically significant difference was seen between scores on the survey across the five academic years (F=0.88, p=0.47). Students who selected medicine and allied as career choice showed a significantly higher empathy score than those who opted for surgery. The internal consistency reliability (Cronbach's alpha) was 0.78. There were low levels of empathy in Pakistani medical students. Students with interest in medicine and allied showed higher empathy scores compared to surgical or technical specialties. No association of empathy scores with gender and medical school year was observed.

Associations between emotional intelligence, empathy and personality in Japanese medical students

BackgroundIt is known that empathic communication is important for physicians to achieve higher patient satisfaction and health outcomes. Emotional intelligence (EI), empathy and personality in medical students predict students’ individual disposition and their emotional and empathic perceptions. This study aimed to investigate: 1) The association between empathy, EI and personality, and 2) Gender differences in the association between empathy, EI and personality.MethodParticipants were 357 1st year medical students from 2008 to 2011 at one medical school in Japan. Students completed self-report questionnaires comprising three validated instruments measuring EI: Trait Emotional Intelligence Questionnaire-Short Form (TEIQue-SF), empathy: Jefferson Scale of Physician Empathy- student version (JSPE) and personality: NEO-Five-Factor Inventory (NEO-FFI), which explores 5 dimensions of personality Neuroticism (N), Extraversion (E), Openness to experience (O), Agreeableness (A), and Conscientiousness (C).ResultsPearson Correlations showed weak association between TEIQue-SF and JSPE. TEIQue-SF and NEO-FFI showed positive correlation for E and C, and strong negative correlation for N and weak positive correlation for A and O. Weak positive correlation between JSPE and the NEO-FFI were observed for E and A. Although effect sizes were small, N, A and empathy were significantly higher in females (unpaired t-test). However, hierarchical multiple-regression analysis when controlling for gender and personality showed no association between EI, empathy and gender. A, TEIQue-SF and N were found to make small contributions in respect of predictions for JSPE. Personality contributed significantly to the prediction of TEIQue-SF. N had the largest independent negative contribution (β = − 0,38).ConclusionIn our study population of 1st year medical students, females had significantly higher N, A and empathy scores than males. Medical students’ N score was strongly negatively associated with EI. Empathy was weakly associated with EI and A. However, when controlling gender and personality in regression analysis, gender did not affect EI and empathy, rather personality is the most important factor. Our findings indicate that N is a major factor that negatively affects EI. It is important to mitigate N using thoughtful training, taking into account students’ personalities, to reduce N. In future studies, we will assess how communication trainings for students might enhance EI.

Does medical students' empathy change during their 5-year MBBS degree?

Research evidence over the past 20 years has established that doctors' ability to empathize with their patients is a crucial component of effective health care. Consequently, teaching and reinforcing empathy has entered undergraduate medical education curricula; however, there have been mixed results in terms of its effectiveness. While there is evidence that empathy fluctuates during undergraduate medical training, there has been very little longitudinal research looking at medical students' empathy levels over their full course of study. The aim of the current study was to investigate whether medical students' empathy changed during their 5-year MBBS degree. Students completed the medical student version of the Jefferson Scale of Physician Empathy (JSPE) at the start of Year 1 and then near the end of Years 2, 3, 4, and 5 during 2009-2015. Total empathy score for students who had completed the JSPE in all 5 years of medical training was compared over time using nonparametrical statistical analysis. Results indicated that medical students' empathy varies with empathy being highest at the start of the medical course in Year 1, declining to a low in Year 3 and then rising again in Years 4 and 5. There was a tendency for female students to have higher empathy scores compared to male students in each of the 5 years, with scores significantly different in Years 2, 3, and 4. However, there were no differences in empathy scores according to the students' age. The decline in empathy in the early years of undergraduate medical training is a concern. Medical educators should teach and reinforce empathy during early years of undergraduate medical training in a sustainable way to guard against declining empathy levels. Specific interventions targeted at increasing empathy in male students might be warranted in the future.

Empathy, burn-out and the use of gut feeling: a cross-sectional survey of Danish general practitioners

ObjectiveResearch has suggested that physicians’ gut feelings are associated with parents’ concerns for the well-being of their children. Gut feeling is particularly important in diagnosis of serious low-incidence diseases in...

Correlates of Empathy Level in Incoming Medical Residents in a Large Peruvian Hospital

Background: Empathy is an important ability for interpersonal relationships, of special interest in the relationship between physician and patient. However, despite its importance, there has been very little work done on the study and evaluation of medical empathy in Peru. Objectives: The study was aimed at evaluating level of empathy in medical residents entering Hospital Nacional Guillermo Almenara Irigoyen (HNGAI), a large hospital in Lima, Peru and at evaluating its correlation with some important contextual and developmental variables. Material and Methods: This was an observational cross-sectional study conducted on 107 incoming medical residents from a total of 142. The Jefferson Scale of Physician Empathy (JSPE) was used and sociodemographic, professional and academic variables were collected. An exploratory data analysis was performed with SPSS 20. Results: The mean score of empathy level was 116.07. Although interesting rends were noted, no significant differences were found between level of empathy and specialty choice (“People-oriented”: 116.28 versus “technology-oriented”: 115.65; p = 0.837); gender (men: 114.74 versus women: 117.43; p = 0.341); and desire to study the selected specialty (desire: 116.37 versus no desire: 111.17; p = 0.333). Significant correlations were found between empathy level and “having a professional mentor for treating patients” (p = 0.024) and “affiliation to a religion”(p = 0.025). There was no significant correlation between level of empathy and age of the resident (r = 0.089; p = 0.373). Conclusions: Residents who identified themselves as affiliated to a religion as well as those who had a professional mentor for treating patients obtained higher scores of empathy level. While the study reflected positively on the establishment of a research program on empathy, further studies, including longitudinal ones are warranted.

Empathy and burnout: a study on residents from a Singapore institution.

Empathy and burnout are two entities that are important in a physician's career. They are likely to relate to each other and can be heavily influenced by surrounding factors, such as medical education, local practices and cultural expectations. To our knowledge, empathy and burnout studies have not been performed in Singapore. This study was designed to evaluate empathy and burnout levels using the Jefferson Scale of Physician Empathy (JSPE) and Maslach Burnout Inventory (MBI) among residents in Singapore, and compare them with the United States (US) literature. The JSPE, MBI and a self-designed questionnaire were completed by 446 trainees at a residency-sponsoring institution in Singapore. Residents in Singapore had lower empathy and higher rates of burnout compared to US literature. Physician empathy was associated with burnout: residents with higher empathy scores had higher personal accomplishment (p < 0.001, r = 0.477, r2 = 0.200); and lower emotional exhaustion (p < 0.001, r = 0.187, r2 = 0.035) and depersonalisation (p < 0.001, r = 0.321, r2 = 0.103) scores. Residents in Singapore had lower empathy and higher burnout scores compared to the US literature. Further research into the underlying cause is imperative to guide intervention.

Empathy in Internal Medicine Residents at Community-based Hospitals: A Cross-sectional Study.

Introduction:Many research reports revealed declining empathy in medical schools that continues in postgraduate years of training.Objective:The aim of this study is to examine the self-reported empathy levels of internal medicine (IM) residents in 3 community-based teaching hospitals.Methods:The Jefferson Scale of Physician Empathy, Health Professionals version, is an online, self-administered, questionnaire that was offered to 129 current and incoming residents at 1 osteopathic and 2 allopathic, IM training programs in Flint, Michigan.Results:Forty-five residents responded (35% response rate). Our residents’ cumulative mean empathy score was 112.5 with a SD of 12.72, which is comparable with the cumulative empathy scores for IM residents at university hospitals. There was an increase in empathy score from the beginning level of training, postgraduate year 0 (PGY0), to the PGY1 level, and a noticeable, although statistically non-significant, decrease in empathy score for both PGY2 and PGY3 residents. The graduating residents’ scores were higher compared with incoming residents.Conclusions:The cumulative mean empathy score in community-based IM residents showed an increase in the beginning of residents’ training and decrease in empathy score by the end of training. There were significant differences in empathy scores by level of training at individual hospitals. This might be related to different targeted curricula.

EMPATHY AND BURNOUT AMONG PHYSICIANS PROVIDING REANIMATOLOGICAL AND SURGICAL TREATMENT

Background. Among scientific publications it is observed that in medicine the aspect of interpersonal connection is underestimated while providing medical help (Steinhausen et al., 2014), and not enough attention is being allocated to the effect of a physician’s empathy in the treatment process (Hojat et al., 2002a). The lack of scientific publications shows that this topic is under-researched and relevant. Thus, the purpose of the study was to determine relationships between empathy and burnout among practicing physicians. Methods. A total of 185 practicing physicians who provide reanimatological and surgical treatment participated in the research. A questionnaire was designed for the study, consisting of the Jefferson Scale of Physician Empathy (Hojat, 2016), Copenhagen Burnout Inventory (Kristensen Borritz, Villadsen, &amp; Christensen, 2005). Results. Research revealed that the expressiveness of empathy between doctors is not related to sex, age, work experience and speciality (p &gt; .05). Also, it was found that younger physicians experienced more work-related burnout (p = .04). the study showed that there was no statistically significant relationship between empathy and burnout among physicians (p &gt; .05). Conclusions. Research showed that physician’s empathy was not related to demographic factors. Findings revealed that younger doctors experienced more work-related burnout than the older ones. Finally, connection between empathy and burnout was not found.

Levels of Empathy Orientation after the Implementation of a New Curriculum

Objective: To compare the level of empathy orientation of the students in the Dentistry Program from the Universidad Metropolitana according to gender and levels of education after the implementation of a new curriculum. Material and Methods: An exploratory and transversal research was made. The studied population are the students from the first and the fifth academic year in the Dentistry Undergraduate Program from the Universidad Metropolitana (Barranquilla, Colombia) (n = 371, N = 482; 76.97% of the population) First: 92; Second: 83; Third: 60; Fourth: 71 and Fifth: 65, being females = 235 and males = 136. Data collection was done in March 2016 for the present study and in 2012. The Jefferson Scale of Physician Empathy was applied to participants. Results: For the Academic Years factor, the means in the first undergraduate years are similar with an increase in the last two undergraduate years; females have superior values than males. However, the behavior of these means is different when analyzing the combined levels of both factors. The female gender increases steadily in the first four years and decreases in the fifth year; The male gender goes down from first to second place and increases steadily until the fifth year surpassing the female in this last year. Conclusion: The general results obtained on empathy have improved compared to those results from 2012. The questions that obtained significant scores were those related to the cognitive component. This could be explained by the incorporation of a greater number of community activities into vulnerable population.

Empathy and specialty preference in medical students. Follow-up study and feedback

Abstract Introduction The evolution of empathy among medical students according to gender and specialty preference is explored using several validated scales. The value of our feedback to the medical students at the end of the study is also assessed. Materials and methods A total of 151 students completed the initial questionnaire, including the following scales: Jefferson Scale of Physician Empathy (JSPE), Interpersonal Reactivity Index (IRI), and Empathy Quotient (EQ). The final questionnaire was completed by 99 of them. Results According to the EQ classification, it was found that 7.3% of students had low empathy, 49.7% average, 36.4% above average, and 6.6% very high. Empathy was higher among women in IRI-FS, IRI-EC, and EQ. Students who preferred people-oriented specialties score higher in JSPE and EQ. The IRI-Fantasy Scale was the only scale that shows increased scores on follow-up and in students with preference for people-oriented specialties. Discussion This study shows that most of the medical students in our sample had a good level of empathy. Empathy was unchanged throughout the follow-up. Medical students had different profiles of empathy. In extreme profiles, feedback could offer advice in the process of choosing a specialty to best suit their empathic skills.

Reconsidering the 'Decline' of Dental Student Empathy within the Course in Latin America.

The controversy over the presence of empathic decline within the course in students of medicine, dentistry and healthsciences in general, has not fully been studied. This controversy could be partially solved if massive studies of empathy levels are madein similar cultural, social and economic contexts. Empathy levels within the course were studied in eighteen dental schools from six countries in Latin America(2013). The mean of the empathy levels were used to study the behavior between first and fifth academic years. The values of empathylevels within the course were observed by applying the Jefferson Scale of Physician Empathy, the Spanish version. All these studieswere cross-sectional. The value of means observed, were subjected to regression studies and further adjustment curves were obtainedand the coefficient of determination were calculated. Six different models of behavior were observed, which found that five of them suffer empathic decline within the course, butwith different final results: in some the decline persists until the fifth academic year and in others, this decline 'recovers' persistently untilthe fifth academic year. The sixth model is characterized by a constant and persistent increase of levels of empathy within the courseuntil the last academic year. There are six different models for the behavior of means of levels of empathy within the course evaluated by a commonmethodology in eighteen dental schools from six countries of Latin America. These findings support the existence of variability ofempathic response and a comprehensive approach is needed to find the causes that give rise to this variability. In dental students of Latin America, there is variability in the behavior of the distribution in means between the academicyears of the dentistry schools examined in this study.

Influence of different teaching modes on empathy capacity of higher vocational nursing students

Objective To explore the influence of different teaching modes on empathy capacity of higher vocational nursing students, so as to provide reference for cultivating high-quality nursing talents. Methods By cluster sampling, second year nursing students enrolled in 2014 to Jiangsu Vocational College of Medicine with a 3-year length of schooling were selected. 150 students from 3 classes with college-hospital cooperative teaching mode as 1+1+1 were selected as observation group, and another 158 students from 3 in-campus classes with traditional teaching mode as 2+1 were selected as control group. The students' empathy capacity was investigated by Jefferson Scale of Physician Empathy (JSPE) . Results After the intervention, total score in JSPE, scores of point of view, emotional nursing and transpositional consideration were (87.26±5.15) , (34.85±3.58) , (37.70±2.69) and (15.69±4.53) , all higher than those in the control group (81.36±5.71) , (32.57±3.15) , (34.72±4.81) and (14.17±3.41) , and the differences were statistically significant (t=8.967, 5.141, 5.865, 3.337; P<0.05) . Conclusions The college-hospital cooperative teaching mode as 1+1+1 can improve nursing students' empathy capacity, which makes it worth promoting. Key words: Students, nursing; Empathy capacity; Teaching mode

Developing Empathy: Does Experience Through Simulation Improve Medical-Student Empathy?

This study used a role-play experience of stroke to improve student empathy for patients with neurological deficits. Participants were 4th- and 5th-year medical students (n = 62). Students worked in pairs, one as patient, and the other as carer/observer. To simulate middle cerebral artery infarction, the patient was fitted with a leg splint, their arm was placed in a sling with the hand taped closed, and they wore glasses that blocked half of their visual field in each eye to simulate homonymous hemianopia. The patient then attended to their daily duties and completed a list of tasks. All participants completed the Jefferson Scale of Physician Empathy (student version) before and after the role-play exercise and wrote a reflection about their experience. There was a statistically significant increase in mean empathy scores from baseline to post-participation. Students found the experience valuable and reported increased recognition of the time taken to complete tasks, receiving odd looks and stares, feeling judged, and greater understanding of stigma and of the experiences of people with disabilities. This role-play of a stroke experience improved medical-student empathy. Role-play experiences could be used more widely in clinical education.

The complexity of empathy during medical school training: evidence for positive changes.

Empathy is an essential aspect of clinical care, associated with improved patient satisfaction, increased adherence to treatment, and fewer malpractice complaints. Previous studies suggest that empathy declines during medical training. However, past research relied on a single narrowly operationalised, self-report measure of empathy. As empathy is a complex socio-emotional construct, it is critical to assess changes across its distinct components using multiple measures in order to better understand how it is influenced by medical training. In a longitudinal study, medical students completed a series of self-report and behavioural measures twice per year during the first 3years of their study (2012-2015). These included the previously used Jefferson Scale of Physician Empathy (JSPE), designed to assess empathy in the clinical context, the Questionnaire of Cognitive and Affective Empathy (QCAE), designed to assess overall empathy and its main components, and behavioural measures of sensitivity to others' pain and understanding of others' emotions, both of which are important aspects of empathy. The employment of multiple measures allowed for a more complete assessment of medical students' empathy and related processes. In reflection of findings in previous work, students' empathy assessed by the JSPE decreased over training. However, on the QCAE, aspects of students' empathy, specifically overall cognitive empathy and its subcomponent perspective taking, and the emotion contagion subcomponent of affective empathy improved, whereas the remaining subcomponents remained stable. During medical school, students also exhibited comparable growth in their understanding of others' emotions and increased sensitivity to others' pain. Changes in empathy during medical school cannot be simply characterised as representing an overall decline. Indeed, aspects of empathy thought to be valuable in positive physician-patient interactions improve during training. Overall, this study points to the importance of assessing the distinct components of empathy using multiple forms of measurement in order to better understand the mechanisms involved in empathy changes in medical practice.

Developing self-empathy in medical students and physicians to improve patient outcomes

This article was migrated. The article was not marked as recommended. The noble calling of medicine attracts men and women who want to help others, and who are well-aware that they will be faced, from their earliest days of training, with patients' illness, pain and suffering. Compassion, and what is also sometimes called empathy, is the basis for humanistic, patient-centered care. Today we are experiencing a crisis of burnout among medical students and compassion-fatigue among physicians, which results in emotional exhaustion, and depersonalization, leading to decreased compassion and empathy with diminished quality of care for patients. Studies have shown that a steep decline in empathy, as measured by the Jefferson Scale of Physician Empathy and other instruments, occurs with greatest frequency in the clinical experience years of medical students. What can ensue are feelings of depersonalization, emotional exhaustion and decreased effectiveness that can lead to depression, anxiety, and even an increased risk of suicide. To counter this alarming trend, the authors introduce the concept of self-empathy, which is new in the context of medical education. This is a way to develop empathy for others, thereby improving the well-being of medical students and practitioners, so that they can better care for their patients. It is critical that the study and practice of self-empathy be integrated into medical school curricula and in continuing education for physicians so that it becomes part of their day-to-day life.

Nurturing virtues of the medical profession: does it enhance medical students’ empathy?

ObjectivesTo examine if the empathy levels of first-year medical students are amenable to didactic interventions idealized to promote values inherent to medical professional identity. MethodsThis is a pretest-posttest study designed to assess the empathy levels of first-year medical students (n=166) comprising two consecutive classes of a Brazilian medical school, performed before and after a didactic intervention. Students attended a course based on values and virtues related to medical professional identity once a week over four months. Every didactic approach (interviews with patients and physicians, supervised visits to the hospital, and discussion of videotaped simulated consultations) was based on “real-world” situations and designed to promote awareness of the process of socialization. Students filled out the Jefferson Scale of Physician Empathy (JSPE) on the first and last days of this course, and the pretest-posttest analysis was performed using the Wilcoxon Signed Rank Test. ResultsThe mean pretest JSPE score was 117.9 (minimum 92, maximum 135) and increased to 121.3 after the intervention (minimum 101, maximum 137). The difference was significant (z=-5.2, p<.001.), with an effect size of 0.40. The observed increase was greater among students with lower initial JSPE scores. ConclusionsEmpathy is a fundamental tool used to achieve a successful physician-patient relationship, and it seems to permeate other virtues of a good physician. This study’s results suggest that medical students’ empathy may be amenable to early curricular interventions designed to promote a positive development of their professional identity, even when empathy is not central in discussion.

Medical school selection criteria as predictors of medical student empathy: a cross-sectional study of medical students, Ireland

ObjectivesTo determine whether performance in any of the Health Professions Admissions Test (HPAT) sections, most specifically the interpersonal understanding section, correlates with self-reported empathy levels in medical students.SettingThe study was...

A Quantitative Study of Empathy in Pakistani Medical Students: A Multicentered Approach.

Objective:To examine the empathy level of undergraduate medical students in Pakistan. Three hypotheses are developed based on the literature review. (1) Female medical students have a higher level of empathy than do male students. (2) Empathy scores vary during the medical school years in Pakistani students. (3) Medical students interested in people-oriented specialties would score higher than the students interested in technology-oriented specialties. Methods: This is a quantitative inquiry approach using a cross-sectional design of 1453 students from 8 Pakistani medical schools, both private and state. The sample consists of 41.1% (n = 597) male students and 58.9% (n = 856) female students. Empirical data are collected using the Jefferson Scale of Physician Empathy (JSPE), a well-validated self-administered questionnaire. Results: The mean empathy score among students is 4.77 with a standard deviation of 0.72. The results show that there is no statistically significant association between the empathy scores and gender, t(1342.36) = −0.053, P = .95). There is a statistically significant difference between the empathy scores and the years of medical school, F(14, 1448) = 4.95, P = .01. Concerning the specialty interests, there is no statistically significant difference between the empathy score and specialty interests. Conclusion: The findings of this study showed that in Western countries, medical students performed better than Pakistani medical students on the empathy scale. This finding has important implications for Pakistani medical educators to improve the interpersonal skills of medical students in the context of patient care. Inconsistent with our expectations and experiences, our findings do not support that female medical students scored better than their male counterparts on the empathy scale. Because of the nature of a cross-sectional study, it is impossible to argue the decline of empathy during medical school training.