Jefferson Scale Of Patient Perceptions Research Articles

Impact of a longitudinal course on medical professionalism on the empathy of medical students

ObjectiveMedical education should enhance empathy. We examined, using self-assessment instruments and standardized patients (SPs), the impact on empathy, of a multi-year intervention (years 4–6 of medical training) that uses reflective learning approaches. Methods241 final-year medical students participated; 110 from the 2018 graduation class (non-intervention group) and 131 from the 2019 graduation class (intervention group). Participants completed two self-reported empathy questionnaires – the Jefferson Scale of Empathy-Students (JSE-S) and the Interpersonal Reactivity Index (IRI) – and a personality questionnaire, the NEO Five-Factor Inventory. Additionally, SPs in a simulated station assessed participants’ empathy with two patient-reported instruments: the Consultation and Relational Empathy (CARE) scale and the Jefferson Scale of Patient Perceptions of Physician Empathy (JSPPPE). ResultsEmpathy scores were significantly higher in the intervention group compared to the non-intervention group when assessed by the SP (p < 0.001). No differences were found in self-reported questionnaires between the two groups. ConclusionA longitudinal, multi-year reflection-based intervention enhanced empathy amongst medical students as assessed by SPs, but not when assessed by student self-reported measures. Practice ImplicationsMulti-year reflective learning interventions during clinical training nurture empathy in medical students. Assessments completed by SPs or patients may enhance the evaluation of empathy.

Effects of weight bias training on student nurse empathy: A quasiexperimental study

AimThis study aimed to identify the efficacy of weight bias training on the empathy skills of student nurses when working with a person with obesity. BackgroundWeight bias with nurses harboring negative attitudes towards patients with obesity results in inferior care and patients' reluctance to seek medical care. Empathy is a communication skill used in nursing to build trust and rapport with patients to provide optimal patient-centered care. MethodsThis study used a quasi-experimental design with 121 undergraduate nursing students in their first semester of the nursing program. The students completed learning activities on weight bias, including reading an article on weight bias, watching a video showing an individual with obesity's experiences in the healthcare setting and participating in a group discussion and reflection on the article and video. In addition, students completed the Jefferson Scale of Empathy-Health Professions Students’ version before and after the learning activities. Following the learning activities, students participated in a simulation activity with a standardized patient wearing an obesity suit. The standardized patient completed the Jefferson Scale of Patient Perceptions of Nurse Empathy to rate the patient's perception of the nursing student's level of empathy based on their interactions in the simulation scenario. ResultsA comparison of the scores on the Jefferson Scale of Empathy-HPS showed there was not a significant difference in the scores before learning activities (M = 15.45, SD = 12.7) and post-learning activities (M = 15.94, SD = 11.5); t(120) = 0.476, p = .635. Data analysis identified significant changes in empathy scores on the Jefferson Scale of Empathy-HPS in the accelerated second-degree cohort with differences in scores before learning activities (M = 113.7, SD = 10.5) and post-learning activities (M = 116.5, SD = 13.4); t(50) = 2.02, p = .049. The traditional cohort did not have a significant change in empathy scores. Empathy scores and the patient's perception of empathy scores showed no relationship. Most (79 %) of the patient's perception of empathy scores was moderate. Student comments in this study support the findings that some nursing students harbor weight bias towards individuals with obesity. ConclusionThere is a need to identify learning activities that eliminate weight bias in the nursing student population and result in the student's ability to demonstrate appropriate communication skills and nursing behaviors in a nondiscriminatory manner to the patient with obesity. To improve empathy behaviors, students should practice communication skills throughout the nursing curriculum.

There is Little or No Association Between Independently Assessed Communication Strategies and Patient Ratings of Clinician Empathy.

Quality of care is increasingly assessed and incentivized using measures of patient-reported outcomes and experience. Little is known about the association between measurement of clinician communication strategies by trained observers and patient-rated clinician empathy (a patient-reported experience measure). An effective independent measure could help identify and promote clinician behaviors associated with good patient experience of care. (1) What is the association between independently assessed clinician communication effectiveness and patient-rated clinician empathy? (2) Which factors are associated with independently assessed communication effectiveness? One hundred twenty adult (age > 17 years) new or returning patients seeking musculoskeletal specialty care between September 2019 and January 2020 consented to video recording of their visit followed by completion of questionnaires rating their perceptions of providers' empathy levels in this prospective study. Patients who had operative treatment and those who had nonoperative treatment were included in our sample. We pooled new and returning patients because our prior studies of patient experience found no influence of visit type and because we were interested in the potential influences of familiarity with the clinician on empathy ratings. We did not record the number of patients or baseline data of patients who were approached, but most patients (> 80%) were willing to participate. For 7% (eight of 120 patients), there was a malfunction with the video equipment or files were misplaced, leaving 112 records available for analysis. Patients were seen by one provider among four attending physicians, four residents, or four physician assistants or nurse practitioners. The primary study question addressed the correlation between patient-rated clinician empathy using the Jefferson Scale of Patient Perceptions of Physician Empathy and clinician communication effectiveness, independently rated by two communication scholars using the Liverpool Communication Skills Assessment Scale. Based on a subset of 68 videos (61%), the interrater reliability was considered good for individual items on the Liverpool Communication Skills Assessment Scale (intraclass correlation coefficient [ICC] 0.78 [95% confidence interval (CI) 0.75 to 0.81]) and excellent for the sum of the items (that is, the total score) (ICC = 0.92 [95% CI 0.87 to 0.95]). To account for the potential association of personal factors with empathy ratings, patients completed measures of symptoms of depression (the Patient-Reported Outcome Measurement Information System depression computerized adaptive test), self-efficacy in response to pain (the two-item Pain Self-Efficacy Questionnaire), health anxiety (the five-item Short Health Anxiety Inventory), and basic demographics. Accounting for potentially confounding variables, including specific clinicians, marital status, and work status in the multivariable analysis, we found higher independent ratings of communication effectiveness had a slight association (odds ratio [OR] 1.1 [95% CI 1.0 to 1.3]; p = 0.02) with higher (dichotomized) ratings of patient-rated clinician empathy, while being single was associated with lower ratings (OR 0.40 [95% CI 0.16 to 0.99]; p = 0.05). Independent ratings of communication effectiveness were slightly higher for women (regression coefficient 1.1 [95% CI 0.05 to 2.2]); in addition, two of the four attending physicians were rated notably higher than the other 10 participants after controlling for confounding variables (differences up to 5.8 points on average [95% CI 2.6 to 8.9] on a 36-point scale). The observation that ratings of communication effectiveness by trained communication scholars have little or no association with patient-rated clinician empathy suggests that either effective communication is insufficient for good patient experience or that the existing measures are inadequate or inappropriate. This line of investigation might be enhanced by efforts to identify clinician behaviors associated with better patient experience, develop reliable and effective measures of clinician behaviors and patient experience, and use those measures to develop training approaches that improve patient experience. Level I, prognostic study .

Validation of the Jefferson Scale of Patient Perception of Physician Empathy Spanish (Spain) Version in Primary Care.

Empathy is considered a prerequisite for a successful physician-patient relationship. The Jefferson Scale of Patient Perceptions of Physician Empathy (JSPPPE) is a regularly-used, patient-rated measure of physician empathy. The aim of this study is to translate and analyze the reliability and validity of the JSPPPE Spanish (Spain) version (Sp-JSPPPE) in primary care in order to use it with medical trainees. After translation and back translation of the JSPPPE, 369 patients from 21 primary care physicians in Pamplona (Navarre, Spain) completed the Sp-JSPPPE, a sociodemographic questionnaire, the Spanish (Spain) Consultation and Relational Empathy Measure (Sp-CARE), and a question about overall satisfaction. We studied internal reliability (Cronbach's α and ordinal α), homogeneity (corrected item-total correlations), construct validity (confirmatory factor analysis [CFA]) and concurrent validity (Spearman's correlation) of Sp-JSPPPE. Cronbach's α and ordinal α were 0.870 and 0.919, respectively, for the Sp-JSPPPE, and all corrected item-total correlations exceeded the accepted cutoff of 0.30, demonstrating high internal reliability and homogeneity. CFA corroborated the one-factor structure proposed in the original version. The total score for the Sp-JSPPPE was significantly correlated with sp-CARE (Spearman's ϱ 0.651, P&lt;.001) and with overall patient satisfaction (Spearman's ϱ 0.504, P&lt;.001). The results support the reliability and validity of the Sp-JSPPPE in primary care. Sp-JSPPPE could be useful in empathy assessment of medical trainees, both graduate and postgraduate, in the Spanish context.

A Pilot Study to Compare the Standardized Patient's Perception of Empathy Among the American Medical Graduates and International Medical Graduates Applying for Residency Training in the United States

Abstract:&#x0D; Background:&#x0D; Empathy is an essential ingredient of patient-centered care. Traditional neurology clerkship does not provide a structured way to teach, evaluate and inculcate the virtue of empathy among our medical students while dealing with various complex neurological conditions. We designed an innovative Objective Structured Clinical Evaluations (O.S.C.E.s) entitled as Empathetic Neurological Care (ENC) O.S.C.E.s as a part of clerkship evaluation to assess empathy among American Medical Graduates (A.M.G.s) and International Medical Graduates (I.M.G.s). We aim to illustrate the model of Empathetic Neurological Care (ENC) O.S.C.E. &amp; to report the comparative analysis of empathy scores among the A.M.G.s and I.M.G.s.&#x0D; Methods:&#x0D; This is a pilot study comparing empathy among A.M.G.s and I.M.G.s, measured by the Standardized Patients (SPs) using the Jefferson Scale of Patient Perceptions of Physician Empathy (5-Point Likert Type Scale) during pre-designed ENC-OSCEs. The proposed curriculum included complex neurological cases involving breaking bad news (e.g., delivering the diagnosis of A.L.S.), opioid addiction counseling, disclosing medical error (stroke), and explaining the diagnosis of non-epileptic seizures.&#x0D; Conclusion: A.M.G.s scored higher empathy as compared to I.M.G.s by the S.P.s during ENC-OSCEs. We highlight the importance of focused empathy training with assessment during neurology clerkship rotations for A.M.G.s &amp; the need of formal curricular training as a part of the orientation program at the beginning of residency training for I.M.G.s.&#x0D;

The Intricate Relationship Between Client Perceptions of Physician Empathy and Physician Self-Assessment: Lessons for Reforming Clinical Practice.

Objectives: Clinical empathy is an important predictor of patient outcomes. Several factors affect physician’s empathy and client perceptions. We aimed to assess the association between physician and client perception of clinical empathy, accounting for client, physician, and health system factors. Methods: We conducted a hospital-based cross-sectional study in 3 departments (family medicine, internal medicine, and surgery) of King Saud Medical City in Riyadh, Saudi Arabia. We interviewed 30 physicians and 390 clients from 3 departments. Physicians completed the Jefferson Scale of Empathy (JSE) and the clients responded to the Jefferson Scale of Patient Perceptions of Physician Empathy (JSPPPE). We used a hierarchical multilevel generalized structural equation approach to model factors associated with JSE and JSPPPE and their inter-relationship. Results: Mean (SD) score of client-rated physician empathy was 26.6 (6) and that of physician self-rated was 111 (12.8). We found no association between the 2 (b = 0.06; 95% confidence intervals CI: −0.1, 0.21), even after adjusting for client, physician, and health system factors. Physician's nationality (0.49; 0.12, 0.85), adequate consultation time (1.05; 0.72, 1.38), and trust (1.33; 0.9, 1.75) were positively associated whereas chronic disease (−0.32; −0.56, −0.07) and higher waiting times (−0.26; −0.47, −0.05) were negatively associated. Conclusion: A physician's self-assessed empathy does not correlate with clients’ perception. We recommend training and monitoring to enhance clinical empathy.

Does the white coat influence satisfaction, trust and empathy in the doctor–patient relationship in the General and Family Medicine consultation? Interventional study

ObjectivesTo understand the influence of the white coat on patient satisfaction, opinions about medical clothing, perception about confidence, empathy and medical knowledge and the satisfaction and comfort level of physicians...

Patient Satisfaction and Physician Empathy at a Hellenic Air Force Health Service.

Patient satisfaction and physician empathy are important indicators of health care services quality. The purpose of this study is to investigate the factors related to the health care users' perception about physician empathy and their satisfaction with the services offered by the Medical Department of a Hellenic Air Force Combat Wing Health Service. One hundred and twenty six individuals who randomly visited the Medical Department from January to February 2019 participated in the survey. The "Measuring the satisfaction of visitors to hospital outpatient clinics" questionnaire by Aletras etal. and the Greek version of the "Jefferson Scale of Patient Perceptions of Physician Empathy" questionnaire were used for data collection. High satisfaction scores were found in relation to the medical staff (mean 20.45, max 25), the examination room (mean 18.23, max 25), the nursing staff/secretarial support (mean 16.93, max 25), and the overall satisfaction (mean 17.15, max 25). The satisfaction score related to the infirmary was low (mean score 8.8, max 25). Physician empathy score was extremely high (mean 21.2, max 25). Statistically significant correlations were detected between physician empathy satisfaction score and the medical staff, nursing staff/secretarial support, and the overall satisfaction scores (P < .001). Health care users reported high physician empathy and overall satisfaction scores but low infirmary satisfaction scores. The more positively that patients evaluated physician empathy, the more satisfaction that patients had with other measures.

Are Patient Linguistic Tones Associated with Mental Health and Perceived Clinician Empathy?

Musculoskeletal specialists have the expertise to distinguish between (1) symptoms that correspond well with observed pathophysiology and (2) disproportionate or incongruent symptoms that may suggest mental and social health opportunities. There is evidence that patient verbal and nonverbal communication can help with this discernment. This study carried this line of research one step further by addressing whether patient linguistic tones, as assessed with use of Linguistic Inquiry and Word Count (LIWC), are associated with symptoms of depression and health anxiety. We also sought associations between both patient and clinician linguistic tones and patient-perceived clinician empathy. A secondary analysis of transcripts of video and audio recordings of 109 adult patients seeking musculoskeletal specialty care was performed. Patients also completed questionnaires quantifying symptoms of depression (PROMIS [Patient-Reported Outcomes Measurement Information System] Depression computerized adaptive test), self-efficacy when in pain (Pain Self-Efficacy Questionnaire, 2-question version), symptoms of health anxiety (5-item Short Health Anxiety Inventory [SHAI-5]), and perceived clinician empathy (Jefferson Scale of Patient Perceptions of Physician Empathy [JSPPPE]). LIWC was used to detect the relative strength of various emotional tones, cognitive processes, and core drives and needs. Bivariate and multivariable regression analyses sought factors associated with symptoms of depression, symptoms of health anxiety, and patient perception of clinician empathy. With greater levels of depression, patients express less emotion overall as detected with use of computational linguistic analysis. After accounting for demographic variables, there were no specific linguistic tones associated with health anxiety and symptoms of depression. Stronger negative linguistic tones were associated with lower pain self-efficacy. Greater perceived clinician empathy was associated with more words spoken by the clinician and the patient, greater patient use of adjectives, lower prevalence of patient tones of "analytic," lower clinician tones of "social," and greater tones of "cause." Musculoskeletal specialists cannot depend on people experiencing symptoms of psychological distress to verbally express their feelings. Specialists may be more likely to identify important symptoms of psychological distress if they anticipate lower emotional expressiveness and are attentive to specific words, concepts, and mannerisms known to be associated with distress.

Physician empathy and patient enablement: survey in the Portuguese primary health care.

BackgroundEmpathy is the capacity to understand and resonate with the experiences of other people. Patient enablement is the degree to which a patient feels strengthened in terms of being able to deal with, understand and manage their disease.MethodsSecondary cross-sectional analysis of existing data from 2 independent datasets (456 primary health care patients), with the application of two validated questionnaires, Jefferson Scale of Patient Perceptions of Physician Empathy (JSPPPE) and Patient Enablement Instrument (PEI).ObjectiveEvaluate medical empathy and patients’ enablement after consultation with their family doctors and to verify if there was an association between these two concepts.ResultsThe median value of JSPPPE-VP score was 6.60 (interquartile range 1.00) and of PEI/ICC score was of 1.83 (interquartile range 0.67). Regarding empathy (JSPPPE-VP), patients taking chronic medication had a slight but significantly higher median score than patients not taking them (6.70 versus 6.60, P = 0.049), although regression modelling did not confirm any relevant predictor of JSPPPE-VP score. Regarding enablement (PEI/ICC), we found significantly higher scores on younger patients, as well as, on more educated and professionally active ones (P < 0.001). Multivariable linear regression and Poisson regression modelling confirmed such variables as statistically significant potential predictors.ConclusionsA significant positive association was found between empathy score (JSPPPE-VP) and enablement score (PEI/ICC), when adjusted to sociodemographic cofactors. On this linear regression model, age category and educational level were also significantly associated with empathy score, with the same pattern found on bivariate analysis.

Does a Previsit Phone Call from the Surgeon Reduce Decision Conflict?

Background: There is some evidence that previsit strategies can make in-person visits more productive and efficient. We compared between people who received a phone call before a musculoskeletal specialty visit and people who did not with respect to several factors: (1) decision conflict (difficulty deciding between two or more options), (2) perceived clinician empathy after an in-person visit, and (3) arrival for the scheduled in-person appointment. We also recorded the specialist's opinion that the phone call alone could adequately replace an in-person visit while maintaining quality, safety, and effectiveness. Materials and Methods: In this prospective randomized-controlled trial, 122 patients were enrolled and randomized to receive a previsit phone call by an orthopedic surgeon before a scheduled visit or not. After the in-person visit, patients completed a (1) demographic questionnaire including age, gender, race/ethnicity, marital status, level of education, work status, and comorbidities; (2) Decision Conflict Scale; and (3) Jefferson Scale of Patient Perceptions of Physician Empathy. Results: No significant difference was found between the two groups in decision conflict, perceived empathy, or not attending the scheduled visit. Of the 55 successful phone calls, the surgeon felt that 50 (91%) had the potential to safely and effectively replace an in-person visit. Conclusion: Although a previsit phone call did not reduce decision conflict or improve the patient experience as measured after one visit, there may be merit in studying an increased number of touch points, particularly with some subsets of illness featuring substantial stress or misconceptions. The identified potential for the application and transfer of specialty expertise through telephone alone also merits additional study.

59. FAMILY-CENTERED COMMUNICATION: A QUALITATIVE AND QUANTITATIVE ANALYSIS OF RESIDENT RESPONSE TO COMMUNICATION TRAINING

Background Pediatricians must utilize effective communication skills to establish a relationship with both their patients and their patients’ families. We modified the Erikson Institute Fussy Baby Network's FAN (Facilitating Attuned Interactions) communication tool to teach pediatric residents to communicate with families using an empathy-driven process. Objective Improve pediatric residents’ empathy, communication skills, and mindful self-regulation in their interactions with families. Design Eighteen pediatric residents from 1 institution and 7 pediatric fellows from another were trained to use the FAN Family Communication Tool to guide their clinical encounters and were followed for 6 months. At 3 time points (0, 3, and 6 months) patients completed the Jefferson Scale of Patient Perceptions of Physician Empathy (JSPPPE) and the Consultation and Relational Empathy (CARE) surveys, and trainees completed the Jefferson Scale of Physician Empathy (JSPE) and the Kentucky Inventory of Mindfulness Skills (KIMS). At the end of the study 11 residents and mentors were interviewed, and transcripts were coded on NVivo software using open and focused coding. Results Residents demonstrated a rise in scores on the JSPE (p=0.044) and the KIMS (p Conclusions Family-centered communication training can improve physician-perceived empathy and mindfulness. Trainees used the FAN to develop a comprehensive view of a family's concerns by understanding and engaging with their emotions. Improved self-awareness allowed trainees to process their emotions to reduce stress and improve communication during encounters. Increasing empathetic and mindful interactions during patient encounters could thus improve clinical outcomes and ultimately benefit patient well-being.

Validation of a Modified Jefferson Scale of Empathy for Observers to Assess Trainees.

"Demonstrate insight and understanding into emotion" is a competency amenable to simulation-based assessment. The Jefferson Scale of Patient Perceptions of Physician Empathy (JSPPPE) has validity evidence for patients to assess provider empathy. A version adapted for a third-party observers does not exist. Our aim was to modify the JSPPPE and use recorded standardized encounters to obtain validity evidence. This cross-sectional study used video and data collected from 2 pediatric residencies. In 2018, 4 raters reviewed 24 videos of 12 interns communicating with standardized patients (SP) in 2 encounters and completed a modified JSPPE for observers (JSEO). Reliability between raters was established using Intraclass Correlations (ICC). JSEO mean scores were correlated to Essential Elements of Communication (EEC), JSPPPE, and faculty composite interpersonal communication (IC) scores using Spearman Rank. The mean ICC for all 4 raters was 0.573 (0.376-0.755). When ICC was calculated for pairs of raters, Rater 1 was an outlier. ICCs for mean scores for pairs among the 3 remaining raters was 0.81 to 0.84. Mean JSEO scores from the four raters correlated with the JSPPPE (rho=0.45, P=.03) and IC (rho=0.68, P < .001), but not the EEC (rho=0.345, P=.1). We found validity evidence for the use of a modified JSPPPE for an observer to assess empathy in a recorded encounter with a SP. This may be useful as medical educators shift toward competency-based tracking. The brevity of this tool and potential assessment using video are also appealing.

Improving Patient Experience by Teaching Empathic Touch and Eye Gaze: A Randomized Controlled Trial of Medical Students

Background:Empathy is critical for optimal patient experience with health-care providers. Verbal empathy is routinely taught to medical students, but nonverbal empathy, including touch, less so. Our objective was to determine whether instruction encouraging empathic touch and eye gaze at exit can impact behaviors and change patient-perceived empathy.Materials:A randomized, controlled, double-blinded trial of 34 first-year medical students was conducted during standardized patient (SP) interviews. A video either encouraging empathic touch and eye gaze at exit or demonstrating proper hand hygiene (control) was shown. Encounter videos were analyzed for touch and eye gaze at exit. The Jefferson Scale of Patient Perceptions of Physician Empathy was used to measure correlations. Intervention students were surveyed regarding patient touch.Results:Of this, 23.5% of intervention students touched the SP versus zero controls; 88.2% of intervention students demonstrated eye gaze at exit. Eye gaze at exit positively impacted patient-perceived empathy (correlation = 0.48, P > .001). Survey responses revealed specific barriers to touch.Conclusion:Medical students may increase perceived empathy using eye gaze at exit. Instruction on empathic touch and sustained eye gaze at exit at the medical school level may be useful in promoting empathic nonverbal communication. Medical educators should consider providing specific instructions on how to appropriately touch patients during history-taking. This is one of the few studies to explore touch with patients and the first ever to report the positive correlation of a health provider’s sustained eye gaze at exit with the patient’s perceived empathy. Further studies are needed to explore barriers to empathic touch.

Cross-cultural adaptation and validation of the Jefferson Scale of Patient's Perceptions of Physician Empathy (JSPPPE) for the Portuguese population.

ObjectivesTo translate the Jefferson Scale of Patient Perceptions of Physician Empathy (JSPPPE) to the European Portuguese spoken language and to verify its reliability and validity.MethodsCultural adaptation and linguistic translation from English to European Portuguese, revision of translations, semantics equivalence, and grammar correction of the Portuguese wording were made. Readability of the Portuguese version was verified and the analysis of internal consistency and correlation with the subscale “physician–patient relationship” of the Portuguese version of European Task Force on Patient Evaluation of General Practice Care Scale (EuroPEP) were made. Reliability was tested by intertemporal stability and internal consistency. Validity of criteria and construction was also verified.ResultsThe Portuguese translation was adapted to the 8th or 9th grade level, easy to understand. There was the need to change the visual appearance of the scale, answers below sentences. Interclass correlation coefficient for reliability varied between 0.737 and 1.000 and Cronbach’s α between 0.806 and 0.877. Validity was verified by comparing values of socio-demographic variables for JSPPPE index and for EuroPEP with no differences. Correlation values between the total score and its five items varied from 0.806 to 0.934. Criterion validity against EuroPEP had a correlation of 0.831.ConclusionThis study fulfilled the necessary steps to translate, verify the validity and the reliability of the Portuguese version of the JSPPPE, with minimum layout alteration. All five items were maintained. The authors recommend the use of the JSPPPE in research and clinical practice.

Patient Perception of Empathy from Emergency Medicine Residents

Background and Hypothesis: This project analyzes the effect of years of training and gender of ED providers on patients’ perception of empathy from them. The project will also explore how patient characteristics may impact the patients’ perception of empathy from the ED providers. &#x0D; It is expected that women providers in their third year of training will exhibit higher scores of empathy. It has been previously demonstrated that white women with a college education have the worst perceptions of empathy from their ED providers. &#x0D; Experimental Design or Project Methods: Eligible patients from Eskenazi/Methodist Hospital, who have had a CT scan ordered, will be enrolled via convenience sample. Patient perceptions of physician empathy will be assessed via the “Empathy Behavior Survey for Patients” (EBS) and “Jefferson Scale of Patient Perceptions of Physician Empathy” (JSPPPE). Patient demographic data and information about the provider ordering the CT scan will be recorded as well. &#x0D; Results: On the EBS/JSPPE, 1st, 2nd, and 3rd year residents were given scores of 51/31.5, 51/31, and 51.5/33 respectively. Male residents were given a median score of 51 on the EBS and 32 on the JSPPPE. Female residents were given a median score of 50.5 and 31 on the JSPPPE. White female patients with a college education gave a score of 50.5 on the EBS and a 32.5 on the JSPPPE. &#x0D; Conclusion and Potential Impact: Years of training or gender do not seem to have an impact on patient perception of empathy nor do White female patients with a college education.

Empatía médica en residentes y tutores de medicina familiar y comunitaria. La visión del profesional y del paciente

AimTo determine the degree of clinical empathy among family medicine residents and tutors. To gauge whether there is a relationship between physicians’ self-perceived empathy levels and their patients’ assessments. Study designObservational, cross-sectional survey. LocationPrimary Care Teaching Unit. Madrid. ParticipantsA survey was sent by email to all the Teaching Unit's family medicine tutors and residents. Responses were received from 50 residents (39.4%) and 41 tutors (45%). In addition, 428 patients were opportunistically recruited at a healthcare centre and their doctors were also interviewed. Primary measurement instrumentsEmpathy was measured using the Jefferson Scale of Empathy and the Jefferson Scale of Patient Perceptions of Physician Empathy. ResultsThe tutors scored 2.53 points higher for cognitive empathy than the residents (P=.04). Emotional empathy scores declined among older tutors (r= −0.32; P=.05). The Spanish students (82% of the total) without previous work experience scored higher for overall empathy (P=.02). Final-year residents recorded significantly worse empathy assessments than the other residents. A positive correlation (r=0.72; P=.01) was observed between physicians’ self-perceived empathy and their patients’ perceptions. ConclusionsResidents with previous work experience, final-year residents and those of Latin American origin score lower for empathy. There is a strong relationship between physicians’ self-perceived empathy and their patients’ views of their empathy levels.

Impact of Empathy in the Patient-Doctor Relationship on Chronic Pain Relief and Quality of Life: A Prospective Study in Spanish Pain Clinics.

To assess the impact of the empathy of physicians, perceived by patients with chronic pain, regarding pain relief and health-related quality of life (HR-QoL). A prospective noninterventional study was conducted in 2,898 patients with moderate to severe chronic pain who were referred to pain clinics. The same physician visited each patient at baseline and after one and three months. Study questionnaires included the Jefferson Scale of Patient Perceptions of Physician Empathy (JSPPPE), the Life Orientation Test-Revised (LOT-R), the Pain Coping Questionnaire (CAD-R), the Brief Pain Inventory Short Form (BPI-SF), and the EuroQol-5D (EQ-5D). Regression analyses were used to evaluate the independent contribution of the changes in perceived empathy over pain intensity and improvement of HR-QoL. BPI-SF scores for pain intensity, rated as worst, least, average, and current pain, decreased significantly (P < 0.001) from baseline to month 3, with reductions of 33.7%, 42.5%, 40.0%, and 46.9%, respectively. Pain intensity decreased from 6.3 ± 1.5 at baseline to 4.7 ± 1.8 at one month and 3.8 ± 1.9 at three months (P < 0.050). Significant (P < 0.001) improvements in the EQ-5D tariff (+37.1%) and EQ-5D VAS (+26.7%) were also recorded. In the linear regression analysis, JSPPPE and LOT-R, but not CAD-R, were significantly associated with pain relief and HR-QoL. Physicians' empathy and patients' dispositional optimism have a role in determining positive outcomes in patients with chronic pain. Physicians' empathy may therefore be a suitable, yet relatively unexplored, target for intervention.

Enhancing Student Empathetic Engagement, History-Taking, and Communication Skills During Electronic Medical Record Use in Patient Care

To examine whether an intervention on proper use of electronic medical records (EMRs) in patient care could help improve medical students' empathic engagement, and to test the hypothesis that the training would reduce communication hurdles in clinical encounters. Seventy third-year medical students from the Sidney Kimmel Medical College at Thomas Jefferson University were randomly divided into intervention and control groups during their six-week pediatric clerkship in 2012-2013. The intervention group received a one-hour training session on EMR-specific communication skills, including discussion of EMR use, the SALTED mnemonic and technique (Set-up, Ask, Listen, Type, Exceptions, Documentation), and role-plays. Both groups completed the Jefferson Scale of Empathy (JSE) at the clerkship's start and end. At clerkship's end, faculty and standardized patients (SPs) rated students' empathic engagement in SP encounters, using the Jefferson Scale of Patient Perceptions of Physician Empathy (JSPPPE), and their history-taking and communication skills. Faculty mean ratings on the JSPPPE, history-taking skills, and communication skills were significantly higher for the intervention group than the control group. SP mean ratings on history-taking skills were significantly higher for the intervention group than the control group. Both groups' JSE mean scores increased pretest to posttest, but the changes were not significant. The intervention group's posttest JSE mean score was higher than the control group's, but the difference was not significant. The findings suggest that a simple intervention providing specialized training in EMR-specific communication can improve medical students' empathic engagement in patient care, history-taking skills, and communication skills.

Patient Perceptions of Clinician's Empathy: Measurement and Psychometrics.

The prominence of reciprocal understanding in patient–doctor empathic engagement implies that patient perception of clinician’s empathy has an important role in the assessment of the patient–clinician relationship. In response to a need for an assessment tool to measure patient’s views of clinician empathy, we developed a brief (5-item) instrument, the Jefferson Scale of Patient Perceptions of Physician Empathy (JSPPPE). This review article reports evidence in support of the validity and reliability of the JSPPPE.