Jefferson Scale Of Empathy Research Articles

Empathy and cultural competence remains stable for medical students: do the humanities have an effect?

There is a paucity of rigorous longitudinal data regarding the relationship between humanities and their effect on multiple psychometrics. Using an observational art course, we assessed pre- and post-course metrics and longitudinal impacts with 120 preclinical medical students taking the "Art of Observation" between 2016 and 2019. Jefferson Scale of Empathy (JSE) and Jeffreys Transcultural Self-Efficacy Tool (TSET) were assessed annually for four years. Budner Tolerance of Ambiguity (TOA) Scale was administered before and after the course. The JSE showed no drop in empathy as students progressed from first to fourth year (p = 0.374). The TSET showed statistically significant increases in cultural self-efficacy (p < 0.001) in the cognitive and practical components but no change in the affective component of the scale. After the art course, TOA significantly improved on two [solubility (p = 0.009) and complexity (p = 0.21)] of the three subscales, but not novelty (p = 0.62). Empathy and cultural self-efficacy remained consistently high throughout medical school and did not decrease during the clinical years in an institution prioritizing the humanities and community engagement. Comfort with cultural competency generally improved throughout training. After taking an art course that emphasizes cognitive flexibility and a multiple perspectival approach, students demonstrated greater tolerance for ambiguity.

Pharmacists' empathy after a postgraduate course in narrative medicine: an observationalstudy.

Narrative medicine is a recent cross-disciplinary approach which through aesthetic activities such as reading fiction and creative writing aims to encourage empathy, reflection, professionalism, and trustworthiness in the encounter between patients and health care professionals. The aim of this study was to evaluate changes in level of empathy after a postgraduate course in narrative medicine among pharmacists conducting medication counselling. During 2020-2021, three courses in narrative medicine among pharmacists with the aim to enhance empathy were held in Odense, Denmark. The primary outcome was the pharmacists' self-reported level of empathy before and after the course measured with Jefferson Scale of Empathy (JSE), which is a validated 20 item scale with higher scores indicating higher levels of cognitive empathy. A total of 33 community and hospital pharmacists participated in the three courses. The pharmacists' median age was 41 years, 91% were female, 76% were working in community pharmacy, and 47% were, according to themselves, rare readers. The pharmacists completed the JSE scale before and after the course. A statistically significant increase was found in mean total JSE score from 109.9 ± 17.1 before the course to 115.7 ± 14.6 after the course (p = 0.0362). Following the course in narrative medicine the level of empathy for the pharmacists according to JSE was enhanced. We recommend that future studies also use patient-reported outcomes to explore if the self-experienced enhanced empathy among pharmacists affects the patients' experience of their encounters.

Effectiveness of different strategies to teach empathy among medical students: A randomized controlled study

ObjectivesTo explore the effectiveness of two educational strategies for teaching empathy to medical students, focusing on their skills and on the theoretical knowledge and self-perception of empathy by patients, professors, and observers. MethodsThis is a randomized controlled study. Clerkship students were divided into two groups: an active group - Role Play and Reflection Group(RRG), and a more traditional group - Lecture Presentation Group(LPG). They were assessed pre- and post-intervention using the Jefferson Empathy Scale(JSPE), ESWIM Empathy Scale, CARE, empathic skills through simulated patient encounters, and a theoretical knowledge test. ResultsA total of 169 students were included. The RRG had higher scores (d=0.81) and greater gains (d=0.82) in empathic skills than the LPG. However, there were no significant differences in knowledge or other scales. Upon assessing skill acquisition (Post–Pre gains), there was a significant increase in both groups for all outcomes, except for JSPE in the LPG group and ESWIM for both groups. ConclusionMedical empathy can be taught, and active learning methodologies can lead to better outcomes, especially on the ability to provide empathic care. Practice implicationsThese findings reinforce existing literature and helps medical schools make informed decisions regarding their teaching methodologies. Trial registryhttps://ensaiosclinicos.gov.br/rg/RBR-8rwx89c.

Comprehensive Analysis of Empathy by Using Jefferson Scale of Empathy – Student Version Among Undergraduate Medical and Dental Students

Empathy is essential in medicine, but many healthcare professionals struggle to integrate empathetic communication in practice. This study aims to assess empathy levels among medical and dental students and their association with age. Objectives: To evaluate empathy levels among medical and dental students using the Jefferson Scale of Physician Empathy-Student Version and examine the correlation with age. Methods: Conducted at a private medical college in Lahore, this study involved 324 medical and dental students. Empathy levels were measured using the Jefferson Scale of Physician Empathy and the data were analyzed with SPSS version 24.0. Non-parametric tests were employed to assess differences in the Jefferson Scale of Physician Empathy and subscale scores among participants, with statistical significance set at p&lt;0.05. Results: The average Jefferson Scale of Physician Empathy score was 66.67 ± 9.5. Among the subscales, "standing in the patient's shoes" had the lowest average score. Bachelor of Dental Surgery students scored slightly higher in perspective-taking and compassionate care, while MBBS students scored higher in standing in the patient's shoes. An inverse relationship between age and empathy scores was observed, with older students exhibiting lower empathy levels. Conclusions: It was concluded that Empathy levels among medical students in Pakistan were lower compared to international studies. Emphasizing empathy in medical education should be a priority to enhance compassionate care and professional development among future healthcare professionals.

Death Anxiety and Depression among Nurses: The Mediating Role of Empathy

Background: The COVID-19 pandemic significantly affected life all over the world. Death anxiety has a significant impact on the mental health of individuals, especially in the health care professionals. The fear and apprehension surrounding mortality has significantly affected nurses, leading to various mental health challenges, including depression. While the awareness of death can impose substantial psychological strain, it can also foster positive traits essential for patient care, such as empathy. Objective: The study identifies the relationship between death anxiety, depression and empathy. It also explores the mediating role of empathy in the relationship between death anxiety and depression among nurses. Method: A cross-sectional research design and a purposive sampling strategy were used to collect data from nurses (N=200) working at different government and private hospitals in Lahore, Pakistan, during the COVID-19 pandemic. The participants' ages ranged from 23 to 52. The Siddiqui-Shah Depression Scale, Urdu-translated versions of the Death Anxiety Scale, and Jefferson Scale of Empathy were administered to nurses. Results: The results reveal a positive relation between death anxiety with depression (r= .43**) and empathy (r = .31**). Death anxiety and empathy were found to be significant predictors of depression. Furthermore, empathy was found to be a significant mediator between death anxiety and depression. Conclusion: Based on the findings, clinical psychologists may devise various interventions/management plans to manage death anxiety and depression among nurses.

Levels of Empathy in Students and Professors with Patients in a Faculty of Dentistry.

Empathy is an attribute that plays an essential role in the dentist-patient therapeutic relationship, clinical care, and treatment adherence, along with providing other benefits. The main objective of this research was to establish the validity, reliability, and invariance of the Jefferson Scale of Empathy and then characterize the empathy levels of students and teachers at a dental school. An observational and cross-sectional study analyzed a sample of undergraduate students and professors from the Universidad Andrés Bello Faculty of Dentistry (Chile) (n = 1727 and n = 267, respectively). The Empathy Scale for Health Professionals (HP) and the same scale for students (HPS) were applied. The Jefferson Empathy Scale presents adequate psychometric properties. The empathy measure has adequate reliability and construct validity, confirming a fit of the three-factor empathy model to the data. The measurement is invariant within the university campus, the sex of the student, and between teacher and student. Teachers present greater empathy than students except in the Perspective Adoption dimension. The Jefferson Empathy Scale is reliable, valid, and invariant among Chilean dental students and professors. Students do not differ from their professors in the cognitive component of empathy, but they present a lower score in the affective component and global empathy. It is inferred that students can develop the affective component of empathy in their interactions with their professors, increasing their overall empathy. Understanding and fostering empathy in dental students and professors can significantly improve patient care and treatment adherence and increase patient and dentist satisfaction.

Reducing Preoperative Anxiety: The Role of Anesthesia Provider Communication and Empathy

Preoperative anxiety is a common and significant issue that can negatively impact patient outcomes. Effective communication and empathy from anesthesia providers have been suggested as crucial factors in mitigating this anxiety. This study aimed to investigate the relationship between anesthesia provider communication and empathy and preoperative anxiety levels in adult patients undergoing elective surgery. A prospective, observational study was conducted at a tertiary care hospital. Adult patients scheduled for elective surgery under general anesthesia were enrolled. Preoperative anxiety was assessed using the State-Trait Anxiety Inventory (STAI) before the anesthesia provider's preoperative visit and again immediately before surgery. Anesthesia provider communication and empathy were evaluated using the CARE (Communication Assessment Tool for Anesthesia Providers) questionnaire and the Jefferson Scale of Empathy (JSE), respectively. A total of 200 patients were included in the study. The mean preoperative anxiety score decreased significantly from before the anesthesia provider's visit to immediately before surgery (p &lt; 0.001). Higher scores on the CARE questionnaire and the JSE were associated with a greater reduction in preoperative anxiety (p &lt; 0.05). Multivariable analysis revealed that both effective communication and empathy independently contributed to reducing preoperative anxiety. Anesthesia provider communication and empathy play a crucial role in reducing preoperative anxiety. Implementing communication and empathy training programs for anesthesia providers may improve patient experiences and surgical outcomes.

Declining empathy trends throughout medical curriculum and association factors of low empathy among medical students and residents: a single center study

BackgroundA physician’s empathy level substantially impacts clinical competence, patient relationships, and treatment outcomes. Yet, understanding empathy trends from medical students to resident doctors within a single institution is limited. This study delves into empathy trends within a single-center academic setting and identifies factors associated with low empathy.MethodsThis cross-sectional study enrolled the second—to sixth-year medical students of Phramongkutklao College of Medicine and the first—to second-year residents at Phramongkutklao Hospital. It utilized a standardized questionnaire covering demographics, family relationships, the Maudsley Personality Inventory (MPI), and the Jefferson Scale of Empathy (JSE). The relationship between variables and JSE scores was analyzed using independent t-test, one-way ANOVA, and Chi-square tests. Multivariable logistic and linear regression analyses examined associated factors and trends across educational levels. A quadratic term was incorporated to evaluate the presence of a nonlinear trend.ResultsA total of 520 participants, comprising 189 (36.4%) preclinical students, 153 (29.4%) clinical students, and 178 (34.2%) residents, completed the survey. The JSE showed a Cronbach’s alpha of 0.83. The average empathy score was 103.8 ± 15.0, with 27.1% of low empathy levels. Specialty preference and sex-adjusted average empathy scores decreased from 114.5 (95%CI: 112.0–117.0) among second-year medical students to 95.2 (95%CI: 92.2–98.2) among second-year residents (Pnon−linear<0.001). The adjusted proportion of low empathy is highest among sixth-year medical students (54.4%, 95%CI: 34.4–73.2%). Factors associated with low empathy included those preferring procedure-oriented specialties (AOR: 4.16, 95%CI: 1.54–11.18) and a higher parental income (AOR: 2.97, 95%CI: 1.09 to 8.10). Subgroup analysis revealed that residents with a GPAX above 3.5 and those in technology-oriented specialties were also associated with lower empathy (AOR: 3.46, 95%CI: 1.40–8.59 and AOR: 2.93, 95%CI: 1.05–8.12, respectively).ConclusionA declining empathy trend was observed among medical students, which then plateaued among residents. Additionally, residents in technology-oriented specialties may require empathy enhancements due to their ongoing patient consultations. Addressing these issues requires collaborative planning between students and teachers to foster empathy throughout the medical curriculum.

The effect of balint practice on reducing stress, anxiety and depression levels of psychiatric nurses and improving empathy level

ObjectiveTo explore the effect of Balint Group in improving stress, negative mood and empathy of psychiatric nurses.MethodIn March 2022-March 2023, 150 psychiatric nurses from four hospitals in Lanzhou were selected for the study, randomly grouped into experimental group and control groups (75 per group), the experimental group participated the Balint Group activities biweekly, the control group only attended mental health knowledge lectures. Job stress, negative emotion and empathy of the two groups before and after the intervention were evaluated and compared by using job stressor Scale, coping style Assessment Scale, self-assessment scale for depression, self-assessment Scale for anxiety and Jefferson Empathy Scale.ResultsAfter intervention, the job stressor scale and coping style evaluation of nurses in the two groups were significantly decreased, and the experimental group was lower than the control group (P < 0.05). The depression and anxiety of nurses in the two groups were significantly improved, and the experimental group was better than the control group (P < 0.05). The differences in the total score and dimensions of Jefferson Empathy scale in the experimental group after intervention were higher than those in the control group (P < 0.05).ConclusionBalint group activities can effectively relieve the stress, depression and anxiety of psychiatric nurses, and improve the ability of empathy at work.

Mediating role of self-compassion in relationship between attachment styles and empathy in nurses

IntroductionEmpathy with the patient is one of the important factors in nursing care. This study aims to investigate the mediating role of self-compassion in the relationship between attachment styles and empathy in nurses.Materials and methodsThis correlational study was conducted using structural equation modeling (SEM) method. The statistical population included nurses working at public hospitals in Yazd City, Iran. A total of 308 nurses were selected by convenience sampling method. The data were collected using self-compassion scale, adult attachment styles scale, Jefferson scale of empathy and analyzed using structural equation analysis in AMOS software.ResultsSecure and anxious/ambivalent insecure attachment styles were positively and negatively correlated with empathy, respectively (p < .01). The path coefficient between avoidant and anxious/ambivalent insecure attachment styles and self-compassion was negative. On the contrary, the path coefficient between secure attachment style and self-compassion was positive. There was a positive correlation between self-compassion and empathy. The indirect path coefficient of secure and anxious/ambivalent insecure attachment styles to empathy through self-compassion. was significant (p < .01).ConclusionThe results showed secure and anxious/ambivalent insecure attachment could directly and indirectly through influencing self-compassion predict empathy in nurses.

Gender Representations, Empathy, and Gender-Based Violence Awareness Among Medical Students: A Proposal for a Specific Training Program.

In recent decades, the topic of gender differences has become central to many areas of study, including medicine. The present study explored gender differences in empathy, gender role ideologies, and gender sensitivity among medical students, highlighting significant variations that can inform medical education and training programs. The study involved 155 students (52.1% male; mean age: 22.68±2.48 years) from the Department of Medicine, Surgery, and Dentistry of the University of Salerno in Baronissi, Southern Italy. Participants completed two standardized scales: the Jefferson Scale of Empathy (JSE) to assess empathy, and the Nijmegen Gender Awareness in Medicine Scale (N-GAMS) to evaluate gender awareness. Six open-ended questions were also included in the gender-based violence representations. The ANOVA analysis reveals significant differences in scores between male and female students across the N-GAMS scales, indicating a strong role of gender in these variations. These findings suggest the necessity for further research to understand the contributing factors and inform targeted interventions in medical education. Additionally, there are significant differences in compassionate care (Factor 2) and walking in the patient's shoes (Factor 3), highlighting the substantial impact of gender on these latter aspects of empathy. These gender differences have significant implications for medical education. Training programs should be tailored to address the specific needs and characteristics of both male and female students. For example, encouraging male students to maintain their gender sensitivity while challenging traditional gender role ideologies can promote a more inclusive approach to patient care. For female students, fostering confidence in their compassionate care abilities and providing opportunities to express empathy in diverse ways can help overcome societal constraints.

Effectiveness of immersive virtual reality in teaching empathy to medical students: a mixed methods study

Empathy in healthcare has been associated with positive outcomes such as increased patient satisfaction and reduced medical errors. However, research has indicated a decline in empathy among medical professionals. This study examined the effectiveness of Immersive Virtual Reality (IVR) for empathy training in medical education. A convergent mixed methods pretest posttest design was utilized. Participants were 1st-year medical students who engaged in an empathy training IVR educational intervention around a scenario depicting older adults struggling with social isolation. Jefferson Scale of Empathy (JSE) questionnaire was administered before and after the intervention to measure the change in empathy levels. Data were analyzed using a paired sample t-test on the pre-/post-test JSE empathy scores to assess the change in empathy scores. Nineteen qualitative semi structured interviews were conducted immediately after the IVR experience and follow-up interviews were conducted six months later. Qualitative data collected from the interviews’ transcripts were analyzed using a thematic and content analysis approach to capture individual experiences. Students (n = 19) scored 5.94 points higher on the posttest JSE questionnaire compared to pretest (p < 0.01) indicating an improvement in empathy levels. Qualitative analysis showed that the IVR training was well received by the students as a valuable empathy-teaching tool. Immersion, presence, and embodiment were identified as the main features of IVR technology that enhanced empathy and understanding of patients’ experiences. The debriefing sessions were identified as a key element of the training. IVR-based training could be an effective teaching tool for empathy training in medical education and one that is well received by learners. Results from the study offer preliminary evidence that using IVR to evoke empathy is achievable.

Is there an association among spirituality, resilience and empathy in medical students?

BackgroundSpirituality has religious and nonreligious dimensions and is often linked to well-being, positive emotions, connection and meaning in life. Both empathy and resilience are important in medical training and future professional practice since they are considered core skills related to professionalism and patient care. Our study aimed to understand the relationships among spirituality, resilience, and empathy in medical students. We also aimed to determine whether there are differences by gender and between medical students in different years of a medical program.MethodsMedical students (n = 1370) of the first to fourth years of a six-year medical program, from six medical schools, completed questionnaires to assess empathy (Jefferson Empathy Scale and Davis Multidimensional Interpersonal Reactivity Scale) and resilience (Wagnild & Young Scale) and to rate their spirituality.ResultsMedical students with high spirituality showed higher scores for both resilience and empathy (p < 0.001). In addition, we observed higher levels of both spirituality and empathy, but not resilience, in female medical students than in male medical students. In contrast, we did not detect significant differences in spirituality, empathy, or resilience between students in different years of medical school.ConclusionMedical students with high levels of spirituality have also higher scores for both empathy and resilience. Spirituality, empathy and resilience have similar values for students in different years of a medical program.

A study of latent profile analysis of empathic competence and factors influencing it in nursing interns: a multicenter cross-sectional study.

Empathy, as one of the fundamental principles of nursing professionalism, plays a pivotal role in the formation and advancement of the nursing team. Nursing interns, as a reserve force within the nursing team, are of significant importance in terms of their ability to empathize. This quality is not only directly related to the degree of harmony in the nurse-patient relationship and the enhancement of patient satisfaction, but also plays a pivotal role in the promotion of the quality of nursing services to a new level. The objective of this study was to gain a deeper understanding of the current state of nursing interns' empathic abilities. To this end, we sought to examine empathic performance under different profile models and to identify the key factors influencing these profile models. The study utilized 444 nursing interns from 11 tertiary general hospitals in Inner Mongolia as research subjects. The study employed a number of research tools, including demographic characteristics, the Jefferson Scale of Empathy, and the Professional Quality of Life Scale. A latent profile model of nursing interns' empathy ability was analyzed using Mplus 8.3. The test of variability of intergroup variables was performed using the chi-square test. Finally, the influencing factors of each profile model were analyzed by unordered multi-categorical logistic regression analysis. The overall level of empathy among nursing interns was found to be low, with 45% belonging to the humanistic care group, 43% exhibiting low empathy, and 12% demonstrating high empathy. The internship duration, empathy satisfaction, secondary traumatic stress, only child, place of birth, and satisfaction with nursing were identified as factors influencing the latent profiles of empathy in nursing interns (p < 0.05). There is considerable heterogeneity in nursing interns' ability to empathize. Consequently, nursing educators and administrators should direct greater attention to interns with lower empathy and develop targeted intervention strategies based on the influences of the different underlying profiles.

Evaluating empathy level amongst the dental students using jefferson scale of physician empathy- health professional students

BackgroundEmpathy is described as one’s ability to perceive and apprehend another person’s feelings, situation, emotions, and problems as their own. Empathetic behavior increases patients’ satisfaction, reduces discomfort, and helps with patient’s satisfaction.ObjectiveTo evaluate the psychometric properties of the Jefferson Empathy Scale and compare the measure of invariance within genders and amongst the public and private sector dental students.MethodThis cross-sectional study utilized JSE-HPS version for research purpose. An exploratory factor analysis was performed to detect underlying factors. Reliability of the study tool was evaluated using Cronbach alpha test. Mann Whitney U test was used to compare the differences in scores between genders and among public and private university students while Student’s t analysis compared the scores according to different domains. The level of significance was ≤ 0.05.ResultsFemales demonstrated higher empathy levels (88.52 ± 14.19) along with private institute students (88.46 ± 13.98). Perspective taking and compassionate care domain was also scored highest by the females (31.73 ± 6.49 & 29.31 ± 6.22) and among second year students (33.30 ± 7.11 & 30.50 ± 7.16). PCA analysis extracted 4 factors namely (i) Health-care-provider’s sense of humor contributed to improved outcome (ii) Health-care provider’s understanding of patients’ feelings and of their families influences treatment outcomes (iii) Understanding body language is as important as verbal communication and (iv) Patients feel better when their feelings are understood, which accounted for the 59.51% of the total variance.ConclusionThe findings revealed that students from private institute and females demonstrated higher empathy score. Moreover, the Jefferson Scale of Empathy (JSE) was found to be a reliable and validated tool for assessment of empathy in our sample population.

Association between burnout and empathy in medical residents.

Burnout is a work-related syndrome that can affect physicians' performance. Empathy is one of the clinical competencies in whose formation many factors play a role. Empathy and burnout are important topics of research in medical sciences, and both are related to the communication between the patient and the physician. This study investigated the relationship between occupational burnout and empathy among medical residents. This cross-sectional study was conducted on 297 medical residents in Ahvaz Jundishapur University of Medical Sciences from January to March 2021. The data collection tools were the Jefferson Scale of Empathy (JSE) and the Maslach Burnout Inventory (MBI). The reliability of the instruments was measured by calculating Cronbach's alpha. Data were analyzed by SPSS-18, using the Pearson correlation test and linear regression models. The average age of the study population was 33.06 ±4.7 years, with more than half being females (57.6%) and married (51.9%). The residents' mean scores of empathy and overall burnout were 102.87 out of 140 and 55.90 out of 132, respectively. The burnout scores showed an inverse correlation with the overall empathy scores (r = -0.123, P = 0.035), and the score of standing in the patient's shoes (r = -0.165, P = 0.004). Linear regression test was used to detect which dimension of empathy was a better predictor for the reduction of burnout scores. Results showed that the best predictor was standing in the patient's shoes (P = 0.014). The findings showed a negative association between empathy and burnout among medical residents, which suggests the need for adjustment of the existing burnout management at the institutional level. Therefore, residents should be supported by managers to reduce burnout and improve their empathic behavior.

IJCM_406A: Association between Empathy and big five personality traits among undergraduate medical students in Mangalore

Background: Empathy in the clinical setting is associated with satisfaction among patients, compliance to therapy and much more positive clinical outcome. This study is to determine the level of empathy among undergraduate medical students, the personality traits, according to the big five model, and to assess the association between empathy and personality traits among undergraduate medical students. Methodology: It was a descriptive study carried out among Second year MBBS students of Kasturba Medical College, Mangalore. Data was collected using Jefferson Scale of Empathy (medical student version), which is a self- administrative inventory that contains 20 questions. Mini-IPIP scale was used to measure big five personality traits, which is a 20-item short form of the International Personality Item Pool Five Factor Model. The collected data was coded and entered onto statistical package for social sciences (SPSS) version 25.0. For comparison across the group Pearson coefficient was used. Results: A positive correlation was found between the level of empathy and the personality traits of agreeableness and openness among the participants at a significant level using Pearson correlation coefficient. People with more agreeableness, indicative of sympathetic and willingness to help others are proportionately empathic. It was also found that women are more neurotic than men, which infers that women are more social and assertive than men. For openness, men are more open, imaginative and creative than women. For agreeableness, men are more cooperative and concerned than women. Women scored more than men for conscientiousness. Conclusion: The study showed a statistically significant difference in the level of empathy among the two genders, with females being more empathic than males. Between the two genders, there was a statistically significant difference among the neuroticism levels, with females being more neurotic than their male counterparts. A positive correlation was found between the level of empathy and the personality traits of agreeableness and openness among the participants.

The Impact of Perspective Taking Training in Student Teachers on Unintended Empathy Components

Empathy training focuses mainly on improving perspective taking (PT) skills, but rarely considers possible changes in other, affective empathy components. In this study, we aimed to examine for unintended changes in the other empathy components emotional concern, personal distress, and fantasy, some of which were not specifically intended. We used a trait (Saarbrücken Personality Questionnaire for Measuring Empathy) and a state (Jefferson Scale for Empathy - Teacher Version) questionnaire respectively. On the trait measures, only the PT score improved, as it was intended by the training. No significant change in the affective factors occurred. Thus, the training showed no undesirable side effects. Looking at the Jefferson Scale factors related to pedagogical situations, significant changes occurred in the areas of perspective taking, emotional understanding of students, pedagogy more important than empathy, and student-centeredness. Since these are only pedagogically relevant changes in attitudes, this is consistent with the goal of the empathy training. Unwanted side effects were not observed here either.

Applying narrative medicine to prepare empathetic healthcare providers in undergraduate pharmacy education in Singapore: a mixed methods study

BackgroundNarrative medicine demonstrated positive impact on empathy in medicine and nursing students. However, this pedagogical approach had not been evaluated in pharmacy education. This study sought to apply and evaluate the narrative medicine approach in extending empathy in Asian undergraduate pharmacy students.MethodsNarrative medicine was applied through workshops which used narratives of people with different experiences and perspectives. First-year undergraduate pharmacy students who volunteered and attended these workshops formed the intervention group (N = 31) and the remaining first-year cohort formed the control group (N = 112). A sequential explanatory mixed methods approach was adopted in which quantitative methods were first used to measure impact on pharmacy students’ empathy using the Jefferson Scale of Empathy– Health Professions Student (JSE-HPS), and qualitative methods (i.e. group interviews) were then used to assess pharmacy students’ emotional responses to narratives, and the perspectives of pharmacy students and faculty of this pedagogical approach.ResultsThere was no difference in JSE-HPS scores between intervention and control groups across baseline (i.e. upon matriculation), pre-intervention, and post-intervention timepoints. Pharmacy students in the intervention group had lower scores in Factor 3 (“Standing in People’s Shoes”) following the intervention. Five themes, guided by internal and external factors in cognition, emerged from the Group Interviews: (1) incongruence between students’ motivation and faculty’s perception, (2) learning context, (3) academic context, (4) cognitive system, and (5) affective system. Themes 1, 4 and 5 referred to internal factors such as students’ motivation, perceived learnings, and feelings. Themes 2 and 3 referred to external factors including workshop materials, activities, content, and facilitation.ConclusionThis study is the first to demonstrate that pharmacy students engaged with the narrative medicine approach as narratives elicited emotional responses, exposed them to diverse perspectives, and deepened their appreciation of the importance of empathy and complexities of understanding patients’ perspectives. Scaffolded educational interventions using narratives and real-life patient encounters, alongside longitudinal measurements of empathy, are necessary to bring about meaningful and sustained improvements in empathy.

Moral sensitivity and caring behavior in nursing interns: the mediating role of empathy.

The main purpose of this study is to analyze the relationship between moral sensitivity, empathy, and caring behaviors and to explore the mediating effect of empathy on moral sensitivity and caring behaviors of nursing interns. A cross-sectional survey was conducted from August to September 2022 in which 261 nursing interns from two Grade 3A Hospitals in Xi'an participated. The questionnaires used in the survey include the General Information Questionnaire (GIQ), the Moral Sensitivity Questionnaire-Revised Version translated into Chinese (MSQ R-CV), the Chinese version of the Jefferson Empathy Scale (JSE), and the Chinese version of the Caring Behavior Inventory (C-CBI). The obtained data were analyzed through descriptive statistics, a one-way analysis of variance (ANOVA), and Pearson's correlation coefficient, and the mediating effect of empathy was tested through structural equations. The overall mean of moral sensitivity of nursing interns in two Grade 3A Hospitals in Xi'an is 40.84 ± 8.73, the overall mean of empathy is 100.51 ± 21.56, and the overall mean of caring behavior is (113.81 ± 21.05). Statistical analysis showed that there is a positive correlation between moral sensitivity and caring behavior of nursing interns (r = 0.376, p < 0.01), between their empathy and moral sensitivity (r = 0.336, p < 0.01), and between their empathy and caring behavior (r = 0.394, p < 0.01). The empathy of nursing interns has a mediated effect on the relationship between moral sensitivity and caring behavior. The mediated effect value was 0.14, accounting for 31.82% of the total effect. The moral sensitivity of nursing interns can have a direct impact on predicting the caring behavior and indirect influences their caring behaviors mediated by empathy, with the latter effect being mediated by empathy. Therefore, nursing educators and hospital administrators should adopt targeted interventions to improve the moral sensitivity and empathy of nursing interns, which can further prove to be beneficial in improving their caring behaviors, leading to enhanced quality of nursing care and reduced nurse-patient conflicts and finally to a stabilized nursing team.