Perceptions Of Physician Empathy Research Articles

A comparison of medical students’ self-reported empathy with simulated patients’ assessments of the students’ empathy

Background: Empathy is necessary for communication between patients and physicians to achieve optimal clinical outcomes.Aim: To examine associations between Simulated Patients’ (SPs) assessment of medical students’ empathy and the students’ self-reported empathy.Methods: A total of 248 third-year medical students completed the Jefferson Scale of Physician Empathy (JSPE). SPs completed the Jefferson Scale of Patient Perceptions of Physician Empathy (JSPPPE), and a global rating of empathy in 10 objective clinical skills examination encounters during a comprehensive end of third-year clinical skills examination.Results: High correlation was found between the scores on the JSPPPE and the global ratings of empathy completed by the SPs (r = 0.87, p < 0.01). A moderate but statistically significant correlation was observed between scores of the JSPE and the JSPPPE (r = 0.19, p < 0.05). Significant differences were observed on the JSPE and global ratings of empathy among top, middle and low scorers on the JSPPPE in the expected direction.Conclusions: While significant associations exist between students’ self-reported scores on the JSPE and SPs’ evaluations of students’ empathy, the associations are not large enough to conclude that the two evaluations are redundant.

Rebuttals to Critics of Studies of the Decline of Empathy

In Reply: We thank the authors of the three letters to the editor for their constructive comments regarding our review. The possibility of empathy decline during medical education is a serious issue that needs to be carefully considered and further discussed. First, all three letters recommend the use of statistical effect-size measures, given the “different types of Likert scales.” We agree that this is a potential problem, and in our review we specifically reported results in Table 1 for each of the 11 studies separately, so readers could see that empathy decline was quite small in every study—regardless of scale. We also reported in the text the mean decline for each of the three empathy instruments separately (−0.2 for the Interpersonal Reactivity Index–Empathy Concern subscale with a five-point scale, −0.2 for the Jefferson Scale of Physician Empathy [JSPE] with a seven-point scale, and −0.3 for the Balanced Emotional Empathy Scale with a nine-point scale) to further emphasize that the declines were nearly identical and quite small—regardless of instrument. We thought that, for these studies, the results reported in terms of the original measurement scale were more direct and more meaningful (actual magnitude of decline in empathy scores in terms of the rating scale anchors) than results on a standardized effect-size scale (reported in standard deviation units). We agree that the JSPE is based on an extensive research base and has a solid psychometric foundation—possibly the most researched and widely used instrument in medical education. Our question is whether physicians' self-reports of empathy are indicators of patients' perceptions of physician empathy—two recent studies showed modest (r = 0.48) and nonsignificant (r = 0.24) correlations—and in particular whether the very small/weak declines in physician self-reported empathy in the 11 studies warrant concerns about diminished patient perceptions and impact on care. We also agree that a 100% response rate may be “unobtainable” in most studies, and we certainly do not have an “expectation of a 100% response rate.” However, we stress that the self-report empathy declines reported were small and that response bias is an especially plausible threat to the validity of small effects. In brief, the 11 studies we reviewed are exemplary quasi-experimental studies, but as with all quasi-experimental studies, plausible threats to validity necessarily qualify research conclusions (such as empathy decline), as must the meaning of the measures (self-reports) used to assess empathy.1 Jerry A. Colliver, PhD Professor, Department of Medical Education, Southern Illinois University School of Medicine, Springfield, Illinois; [email protected]. Melinda J. Conlee Editorial writer, Department of Medical Education, and managing editor, Teaching and Learning in Medicine, Southern Illinois University School of Medicine, Springfield, Illinois. Steven J. Verhulst, PhD Professor, Department of Medical Education, and director, Statistics and Research Consulting, Southern Illinois School of Medicine, Springfield, Illinois. J. Kevin Dorsey, MD, PhD Professor, dean, and provost, Southern Illinois University School of Medicine, Springfield, Illinois.

Differences between Emergency Patients and Their Doctors in the Perception of Physician Empathy: Implications for Medical Education

Differences between Emergency Patients and Their Doctors in the Perception of Physician Empathy: Implications for Medical Education

"Trust Me...": Psychological and Behavioral Predictors of Perceived Physician Empathy.

A sociocognitive model of distal and proximal predictors of empathic judgments was tested among 100 physicians. The authors hypothesized that physician perceived control would affect empathy ratings via physician communication style. Specifically, physicians with high perceived control would use more open communication and be rated as more empathic. Physicians with low perceived control would use a controlling communication style and be rated as less empathic. Physicians completed a medical attribution questionnaire prior to a structured patient consultation exercise, during which patients and assessors rated physician empathy. The exercise was audiotaped, transcribed, and content analyzed for verbal behaviors. Support was found for the hypotheses; however, patients, but not medical assessors, associated empathy with reassurance and provision of medical information.