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Harik L, Yamamoto K, Kimura T, Rong LQ, Vogel B, Mehran R, Bairey-Merz CN, Gaudino M. Patient-physician sex concordance and outcomes in cardiovascular disease: a systematic review. Eur Heart J 2024; 45:1505-1511. [PMID: 38551446 DOI: 10.1093/eurheartj/ehae121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/12/2023] [Revised: 02/10/2024] [Accepted: 02/12/2024] [Indexed: 05/09/2024] Open
Abstract
The sex disparity in outcomes of patients with cardiovascular disease is well-described and has persisted across recent decades. While there have been several proposed mechanisms to explain this disparity, there are limited data on female patient-physician sex concordance and its association with outcomes. The authors review the existing literature on the relationship between patient-physician sex concordance and clinical outcomes in patients with cardiovascular disease, the evidence of a benefit in clinical outcomes with female patient-physician sex concordance, and the possible drivers of such a benefit and highlight directions for future study.
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Affiliation(s)
- Lamia Harik
- Department of Cardiothoracic Surgery, Weill Cornell Medicine, 525 E 68th St, New York, NY 10065, USA
| | - Ko Yamamoto
- Department of Cardiology, Hirakata Kohsai Hospital, Osaka, Japan
| | - Takeshi Kimura
- Department of Cardiology, Hirakata Kohsai Hospital, Osaka, Japan
| | - Lisa Q Rong
- Department of Anesthesiology, Weill Cornell Medicine, New York, NY, USA
| | - Birgit Vogel
- Zena and Michael A. Wiener Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Roxana Mehran
- Zena and Michael A. Wiener Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - C Noel Bairey-Merz
- Barbara Streisand Women's Heart Center, Smidt Heart Institute, Cedars-Sinai, Los Angeles, CA, USA
| | - Mario Gaudino
- Department of Cardiothoracic Surgery, Weill Cornell Medicine, 525 E 68th St, New York, NY 10065, USA
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Ortiz-Paredes D, Adam Henet P, Desseilles M, Rodríguez C. Empathy in family medicine postgraduate education: A mixed studies systematic review. MEDICAL TEACHER 2024:1-17. [PMID: 38555732 DOI: 10.1080/0142159x.2024.2328324] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/28/2023] [Accepted: 03/05/2024] [Indexed: 04/02/2024]
Abstract
PURPOSE Empathy is an important construct in patient-physician relationships, particularly critical in family physicians' daily practice. We aimed to understand how empathy has been conceived and integrated into family medicine postgraduate training. MATERIALS AND METHODS Medline, PsyINFO, and Embase were searched in this systematic mixed studies systematic review. Two independent reviewers screened abstracts and full texts. Disagreements were solved through research team consensus-based discussion. Included studies were synthesized thematically. RESULTS A total of 18 studies were included. Four themes were identified. (1) Empathy definition. Included studies stressed the cognitive component of empathy, paired either with a behavioural or an affective response. (2) Empathy modifiers. Starting residency right after medical school, having a role model, having high empathy levels before residency, having children, being married, and being exposed to patient involvement in education were found to have a positive impact on empathy. (3) Empathy-burnout relationship. Whereas greater burnout was related to lower empathy levels, excess empathy seems to favour burnout through 'compassion fatigue.' (4) Educational programs for empathy development. Five programs were identified: a communication workshop, a patient-led program, a mindfulness program, a family-oriented intervention, and an arts-based program. CONCLUSIONS Studies mostly measured the cognitive component of empathy. The moral component of empathy was underrepresented in the conceptualization of empathy and the development of educational interventions. Conflicting evidence exists regarding the decline of empathy levels during the family medicine residency. Longitudinal designs should be privileged when exploring the evolution of empathy levels across the continuum of medical education.
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Affiliation(s)
- David Ortiz-Paredes
- Department of Family Medicine, School of Medicine, Faculty of Medicine and Health Sciences, McGill University, Montreal, Canada
| | - Peterson Adam Henet
- Institute of Neuroscience (IoNS), Faculty of Medicine, Université Catholique de Louvain, Brussels, Belgium
- Pôle Enseignement et recherche, Le Beau Vallon-Soins spécialisés en santé mentale, Namur, Belgium
| | - Martin Desseilles
- Department of Psychology, Faculty of Medicine and Transition Institute, Université de Namur, Namur, Belgium
| | - Charo Rodríguez
- Department of Family Medicine, School of Medicine, Faculty of Medicine and Health Sciences, McGill University, Montreal, Canada
- Institute of Health Sciences Education, Faculty of Medicine and Health Sciences, McGill University, Montreal, Canada
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Bard JT, Chung HK, Shaia JK, Wellman LL, Elzie CA. Increased medical student understanding of dementia through virtual embodiment. GERONTOLOGY & GERIATRICS EDUCATION 2023; 44:211-222. [PMID: 35451921 DOI: 10.1080/02701960.2022.2067850] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/04/2023]
Abstract
Given the growing prevalence of Alzheimer's disease (AD), we assessed the impact of virtually embodying someone with progressive AD. This pilot explored students' understanding of individuals' needs with dementia, as well as, the efficacy of virtual reality (VR) as a curricular tool. Second-year medical students (n = 150) completed a pre-survey, Embodied Labs, Inc. Beatriz Lab VR module, and a post-survey. Most students knew someone with dementia (72%), were a family member of someone with dementia (52%) or had worked with a patient (61%) with dementia. Using paired survey questions, students reported significant increases in understanding how their lives would be affected by dementia (71% vs. 94%) and the needs of a person with dementia (64% vs. 95%) after VR. They reported increased understanding of being a caregiver of someone with dementia (24% vs. 81%) and the impact it can have on the entire family (64% vs. 97%). Overall students agreed this simulation made them think about their approach to clinical skills (94%) and should be utilized more in the curriculum (76%). This pilot study indicated that this VR experience can be used to advance understanding of a person's experiences with dementia and that integrating VR into the medical curricula should be considered.
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Affiliation(s)
- Jason T Bard
- Department of Pathology and Anatomy, Eastern Virginia Medical School, Norfolk, Virginia, USA
| | - Hannah K Chung
- Department of Pathology and Anatomy, Eastern Virginia Medical School, Norfolk, Virginia, USA
| | - Jacqueline K Shaia
- Department of Pathology and Anatomy, Eastern Virginia Medical School, Norfolk, Virginia, USA
| | - Laurie L Wellman
- Department of Pathology and Anatomy, Eastern Virginia Medical School, Norfolk, Virginia, USA
| | - Carrie A Elzie
- Department of Pathology and Anatomy, Eastern Virginia Medical School, Norfolk, Virginia, USA
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AlSaif HI, Alenezi MN, Asiri M, Alshaibani KO, Alrasheed AA, Alsaad SM, Batais MA. Empathy among Saudi Residents at a Tertiary Academic Center during the COVID-19 Pandemic and Its Association with Perceived Stress. MEDICINA (KAUNAS, LITHUANIA) 2022; 58:medicina58091258. [PMID: 36143935 PMCID: PMC9506239 DOI: 10.3390/medicina58091258] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/11/2022] [Revised: 09/06/2022] [Accepted: 09/07/2022] [Indexed: 11/29/2022]
Abstract
Background and Objectives: Empathy is an important attribute of a healthy doctor−patient relationship. Although multiple studies have assessed empathy in different countries, little is known about its levels among Saudi residents and its association with perceived stress. Objectives: To assess the levels of empathy and to identify if there is an association with stress in general and across the demographic and training characteristics of residents. Materials and Methods: A cross-sectional questionnaire-based study was carried out from December 2020 to March 2021 among residents training at a tertiary academic center in Riyadh, Saudi Arabia. Empathy and perceived stress were measured using the Jefferson Scale of Empathy (JSE) and the Perceived Stress Scale (PSS). Results: A total of 229 residents participated. The mean JSE score was 105.25 ± 15.35. The mean JSE scores were significantly higher among residents training in pediatrics (mean difference (MD) = 17.35, p < 0.001), family medicine (MD = 12.24, p = 0.007), and medical specialties (MD = 11.11, p = 0.012) when compared with surgical specialties and anesthesia. In addition, residents who worked 1−4 on-calls per month had a higher mean JSE score (MD = 11.23, p = 0.028) compared with those who worked 7 or more on-calls. Lastly, no correlation between empathy and perceived stress was detected in the whole sample (r = −0.007, p = 0.913); however, there was a correlation among residents training in medical specialties (r = −0.245, p = 0.025). Conclusion: Residents in our study had empathy levels comparable with Asian but lower than Western residents. We recommend qualitative studies that explore potential factors that might affect empathy among residents and studying the association between empathy and perceived stress among medical residents. Postgraduate curricula should incorporate interventions that foster a more empathetic doctor−patient relationship.
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Affiliation(s)
- Haytham I AlSaif
- Department of Family and Community Medicine, College of Medicine, King Saud University, P.O. Box 2925 (34), Riyadh 11461, Saudi Arabia
| | - Mamdouh N Alenezi
- Department of Family and Community Medicine, College of Medicine, King Saud University, P.O. Box 2925 (34), Riyadh 11461, Saudi Arabia
| | - Mohammed Asiri
- Department of Medicine, College of Medicine, King Saud University, P.O. Box 2925 (38), Riyadh 11461, Saudi Arabia
| | | | - Abdullah A Alrasheed
- Department of Family and Community Medicine, College of Medicine, King Saud University, P.O. Box 2925 (34), Riyadh 11461, Saudi Arabia
| | - Saad M Alsaad
- Department of Family and Community Medicine, College of Medicine, King Saud University, P.O. Box 2925 (34), Riyadh 11461, Saudi Arabia
| | - Mohammed A Batais
- Department of Family and Community Medicine, College of Medicine, King Saud University, P.O. Box 2925 (34), Riyadh 11461, Saudi Arabia
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The Effects of Physicians' Communication and Empathy Ability on Physician-Patient Relationship from Physicians' and Patients' Perspectives. J Clin Psychol Med Settings 2022; 29:849-860. [PMID: 35089529 PMCID: PMC8795960 DOI: 10.1007/s10880-022-09844-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/04/2022] [Indexed: 12/30/2022]
Abstract
Physician communication (PC) is central to influencing physician–patient relationship (PPR), and physician empathy (PE) is central to PC. A comprehensive and objective assessment of the mechanisms underlying PPR from the two-way perspective of physicians and patients are important for social development. However, the relationship between these three variables under the two-way perspective is not clear. To examine the effectiveness of PC in predicting PPR from a two-way perspective of physicians and patients and the underlying mechanisms that influence PPR. We selected 2665 physicians and 2983 patients in China and examined the effect of physician empathy on PPR and the mediating role of PC between PE and PPR using structural equation modeling. The results of the physician self-assessment showed that the link between PC and PPR was not significant, while the results of the patient other assessment showed that physician communication was not only effective in predicting the doctor–patient relationship but also mediated the relationship between physician empathy and PPR; further analysis of the underlying mechanisms affecting PPR revealed that the results of the physician self-assessment showed that PC mediated the relationship between perspective-taking and PPR; however, the results of the patient other assessment showed that physician However, patient ratings showed that PC mediated the relationship between perspective-taking and PPR, as well as between empathic concern and PPR. However, patient ratings indicate that PC mediates the relationship between perspective-taking and PPR and between empathic concern and the PPR.
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Holmes MB, Starr JA. A Comparison of Doctor of Physical Therapy Students’ Self-Reported Empathy With Standardized Patients Perceptions of Empathy During a Simulated Telehealth Encounter. J Patient Exp 2022; 9:23743735221112226. [PMID: 35836780 PMCID: PMC9274409 DOI: 10.1177/23743735221112226] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Empathy is an important factor in developing a positive patient–provider relationship. It
has been shown to lead to improved patient outcomes, well-being, and satisfaction. This
study examines the relationship between first-year physical therapy students’
self-reported empathy levels and a patient's perceptions of caregiver empathy during a
standardized patient interview via telehealth. Forty-five students completed a
self-reported empathy survey before the standardized patient encounter using telehealth.
Following the experience, standardized patients rated the perceived empathy demonstrated
by the students during that patient–provider encounter using 2 validated measures. The
mean student self-reported empathy using the Jefferson Scale of Empathy-Health Care
Provider Student (JSE-HPS) version was 123.93 (range 95-135 SD 7.328). The standardized
Jefferson Scale of Patient Perception of Provider Empathy (JSPPPE) scores showed a mean of
23.8 (range 11-32 SD 3.951) and a mean of 3.16 (range 1-5 SD.85) on the Global Rating of
Empathy (GRE). There was no significant correlation found between the JSE-HPS and the
JSPPPE, r = −.47, P = .760, or the GRE
r = −.166, P = .276. The artificial nature of a
standardized patient interaction using the telehealth format for this encounter may have
contributed to the students’ inability to communicate empathy to the patient and may
explain this discrepancy.
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Affiliation(s)
- Mary Beth Holmes
- Department of Physical Therapy, Sargent College, Boston University, Boston, MA, USA
| | - Julie Ann Starr
- Department of Physical Therapy, Sargent College, Boston University, Boston, MA, USA
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Hall JA, Schwartz R, Duong F, Niu Y, Dubey M, DeSteno D, Sanders JJ. What is clinical empathy? Perspectives of community members, university students, cancer patients, and physicians. PATIENT EDUCATION AND COUNSELING 2021; 104:1237-1245. [PMID: 33234440 DOI: 10.1016/j.pec.2020.11.001] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/26/2020] [Revised: 10/06/2020] [Accepted: 11/01/2020] [Indexed: 06/11/2023]
Abstract
OBJECTIVES To explore what undergraduates, community members, oncology patients, and physicians consider empathic behavior in a physician. METHODS 150 undergraduates, 152 community members, 95 physicians, and 89 oncology patients rated 49 hypothetical physician behaviors for how well they fit their personal definition of physician empathy. Dimensions of empathy were explored and compared across groups. RESULTS Three dimensions of empathy were Conscientious and Reassuring, Relationship Oriented, and Emotionally Involved. Relationship Oriented was the most strongly endorsed, followed by Emotionally Involved, with Conscientious and Reassuring coming in last. There were no group differences for Conscientious and Reassuring, but the Relationship Oriented factor was more endorsed by the clinical groups (physicians and patients) than the non-clinical groups. The Emotionally Involved factor was endorsed by physicians notably more than by patients. CONCLUSION What is considered clinical empathy is not the same across individuals and stakeholder groups. PRACTICE IMPLICATIONS Physicians and patients differ in how much they include the physicians' emotionality and emotion-related actions in their definition of empathy. Communication training for physicians that emphasizes behaviors associated with empathy (listening, understanding a person's feelings and perspectives, and showing interest in and concern for the whole person) may enhance patients' perception of clinical empathy.
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Affiliation(s)
- Judith A Hall
- Department of Psychology, Northeastern University, Boston, MA, USA.
| | | | - Fred Duong
- Department of Psychology, Northeastern University, Boston, MA, USA
| | - Yuan Niu
- Department of Psychology, Northeastern University, Boston, MA, USA
| | - Manisha Dubey
- University of North Carolina at Chapel Hill, Gillings School of Global Public Health, Chapel Hill, NC, USA
| | - David DeSteno
- Department of Psychology, Northeastern University, Boston, MA, USA
| | - Justin J Sanders
- Dana-Farber Cancer Institute, Boston, MA, USA; Harvard Medical School, Boston, MA, USA
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Elzie CA, Shaia J. A Pilot Study of the Impact of Virtually Embodying a Patient with a Terminal Illness. MEDICAL SCIENCE EDUCATOR 2021; 31:665-675. [PMID: 34457919 PMCID: PMC8368971 DOI: 10.1007/s40670-021-01243-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 02/05/2021] [Indexed: 05/12/2023]
Abstract
Compassionate end-of-life care matters deeply for patients and their caregivers, but studies continue to demonstrate ways in which physicians fall short. Despite specific training during medical school, many patients report lack of empathy in their providers with respect to end-of-life conversations. This is likely because empathy is simply hard to teach. Numerous activities have been tried to combat the decline in empathy during medical training with little to moderate success. However, virtual reality, which allows users to viscerally experience anything from another person's point of view, could be a game changer for building empathy within medicine. This type of perspective-taking has previously shown to improve understanding, reduce biases, facilitate empathy, and promote prosocial behaviors. In this pilot study, virtual reality was used to allow students to "become a patient" virtually embodying their daily activities, symptoms, and interactions with caregivers. Using the Embodied Labs modules, first-year medical students were able to experience first-hand having a terminal illness, being told no further treatments are available and witnessing loved ones' reactions. Data generated through surveys and reflections indicated a high level of place illusion, plausibility, and embodiment of users. This high level of immersion generated an increase in comfortability with talking about end-of-life issues, produced a better understanding of what patients and their families experience, and promoted a change in the way students would approach clinical skills. Analysis of reflections indicated a high level of empathy for the patient and his family members. Overall, the activity was highly received by students as a valuable learning activity. As such, we propose that virtual reality could be a useful pedagogical tool to facilitate empathy and clinical skills within medical education.
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Affiliation(s)
- Carrie A. Elzie
- Department of Pathology and Anatomy, Eastern Virginia Medical School, Norfolk, VA USA
| | - Jacqueline Shaia
- Department of Pathology and Anatomy, Eastern Virginia Medical School, Norfolk, VA USA
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Hoffstädt H, Stouthard J, Meijers MC, Westendorp J, Henselmans I, Spreeuwenberg P, de Jong P, van Dulmen S, van Vliet LM. Patients' and Clinicians' Perceptions of Clinician-Expressed Empathy in Advanced Cancer Consultations and Associations with Patient Outcomes. Palliat Med Rep 2020; 1:76-83. [PMID: 34223461 PMCID: PMC8241346 DOI: 10.1089/pmr.2020.0052] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/19/2020] [Indexed: 12/16/2022] Open
Abstract
Background: Empathy is a cornerstone of effective communication. However, clinicians' and patients' perceptions of clinician-expressed empathy might differ. The independent perceptions of patients and clinicians on clinician-expressed empathy in advanced cancer consultations and the associations of these perceptions with patient outcomes are unknown. Objective: We assessed (1) patients' and clinicians' independent perceptions of clinician-(self-)expressed empathy in advanced cancer consultations and (2) the associations between these perceptions and affective patient outcomes. Methods: This observational study included data from 41 consultations in the advanced breast cancer setting. Postconsultation, patients' and clinicians' perceptions of clinician-expressed empathy were assessed, as well as patients' (1) pre-post anxiety, (2) post-anxiety, (3) emotional well-being, and (4) satisfaction. Multilevel regression analyses were run to draw conclusions. Results: Patients perceived higher levels of empathy than clinicians, without a significant relationship between the two (mean [M] = 85.47, standard deviation [SD] = 14.00 vs. M = 61.88, SD = 15.30, 0-100 scale; β = 0.14, p < 0.138, 95% confidence interval [CI] = -0.04 to 0.32). Higher patient-perceived empathy was associated with decreased anxiety [(1) β = -0.67, p = 0.039, 95% CI = -1.30 to -0.03; (2) β = -0.15, p = 0.042, 95% CI = -0.30 to -0.01], higher satisfaction (β = 0.05, p < 0.001, 95% CI = 0.03 to 0.08), and lower emotional distress (β = -0.32, p < 0.001, 95% CI = -0.48 to -0.16). There were no associations with clinicians' perceptions [(1) β = -0.34, p = 0.307, 95% CI = -1.00 to 0.31; (2) β = -0.02, p = 0.824, 95% CI = -0.17 to 0.14; (3) β < 0.01, p = 0.918, 95% CI = -0.03 to 0.02; (4) β = 0.08, p = 0.335, 95% CI = -0.08 to 0.25]. Conclusions: Patients' and clinicians' empathy perceptions differed. In improving patient outcomes, the focus should be on patients' perceptions of clinician-expressed empathy. Future research could focus on ways to elicit patients' perceptions of empathy with the higher aim of improving patient outcomes.
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Affiliation(s)
- Hinke Hoffstädt
- Health, Medical and Neuropsychology Unit, Institute of Psychology, Leiden University, Leiden, The Netherlands.,Department of Communication, Nivel (Netherlands Institute for Health Services Research), Utrecht, The Netherlands
| | - Jacqueline Stouthard
- Department of Medical Oncology, Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - Maartje C Meijers
- Health, Medical and Neuropsychology Unit, Institute of Psychology, Leiden University, Leiden, The Netherlands
| | - Janine Westendorp
- Department of Communication, Nivel (Netherlands Institute for Health Services Research), Utrecht, The Netherlands
| | - Inge Henselmans
- Department of Medical Psychology, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, The Netherlands.,Amsterdam Public Health Research Institute, Amsterdam, The Netherlands.,Cancer Center Amsterdam, Amsterdam, The Netherlands
| | - Peter Spreeuwenberg
- Department of Communication, Nivel (Netherlands Institute for Health Services Research), Utrecht, The Netherlands
| | - Paul de Jong
- Department of Medical Oncology, St Antonius Hospital, Utrecht, The Netherlands
| | - Sandra van Dulmen
- Department of Communication, Nivel (Netherlands Institute for Health Services Research), Utrecht, The Netherlands.,Department of Primary and Community Care, Radboud University Medical Center, Radboud Institute for Health Sciences, Nijmegen, The Netherlands.,Faculty of Health and Social Sciences, University of South-Eastern Norway, Drammen, Norway
| | - Liesbeth M van Vliet
- Health, Medical and Neuropsychology Unit, Institute of Psychology, Leiden University, Leiden, The Netherlands.,Department of Communication, Nivel (Netherlands Institute for Health Services Research), Utrecht, The Netherlands.,Leiden Institute for Brain and Cognition (LIBC), Leiden University, Leiden, The Netherlands
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Tengera O, Nankumbi J, Nalwadda G, Muwanguzi PA, Ngabirano TD. Empathy among midwives at a referral hospital in Uganda. INTERNATIONAL JOURNAL OF AFRICA NURSING SCIENCES 2020. [DOI: 10.1016/j.ijans.2020.100238] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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von Knorring J, Semb O, Fahlström M, Lehti A. "It is through body language and looks, but it is also a feeling" - a qualitative study on medical interns' experience of empathy. BMC MEDICAL EDUCATION 2019; 19:333. [PMID: 31484525 PMCID: PMC6727522 DOI: 10.1186/s12909-019-1770-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/29/2017] [Accepted: 08/27/2019] [Indexed: 06/10/2023]
Abstract
BACKGROUND Empathy has long been recognized as a fundamental part of the professionalism of doctors and is considered to be both necessary and beneficial to doctor-patient relationships, although empathy is notoriously difficult to define and measure. Previous research on empathy has mostly consisted of quantitative studies measuring and evaluating empathy levels in students or medical residents. The aim of our qualitative study was to explore the lived experience of empathy among medical interns in Sweden. METHOD We interviewed 16 medical interns, using semi-structured interviews. Content analysis was used to analyse the interviews. RESULTS The analysis led to the emergence of a main theme of empathy as being multifaceted and conflictual, consisting of descriptions (subthemes) of "being" and "doing"; of being uncontrollable and contextual; biased and situated and essential and conflictual. Since the components of empathy were also found to be interwoven, to provide a more holistic presentation of the results, we applied a socio-ecological model to the results inspired by Bronfenbrenner. CONCLUSIONS We concluded that empathy is situated and contextual. By using the socioecological model empathy can be described as a systemic interaction between doctor and patient. Based on this we propose a more holistic approach to empathy in medical education to better prepare students for clinical practice.
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Affiliation(s)
- Johanna von Knorring
- Unit of Professional Development, Department of Clinical Sciences, Umeå University, SE-90187 Umeå, Sweden
| | - Olof Semb
- Unit of Professional Development, Department of Clinical Sciences, Umeå University, SE-90187 Umeå, Sweden
| | - Martin Fahlström
- Unit of Professional Development, Department of Clinical Sciences, Umeå University, SE-90187 Umeå, Sweden
| | - Arja Lehti
- Unit of Professional Development, Department of Clinical Sciences, Umeå University, SE-90187 Umeå, Sweden
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Bernardo MO, Cecilio-Fernandes D, Lima ARDA, Silva JF, Ceccato HD, Costa MJ, de Carvalho-Filho MA. Investigating the relation between self-assessment and patients' assessments of physicians-in-training empathy: a multicentric, observational, cross-sectional study in three teaching hospitals in Brazil. BMJ Open 2019; 9:e029356. [PMID: 31243037 PMCID: PMC6597646 DOI: 10.1136/bmjopen-2019-029356] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
OBJECTIVES This study investigated the associations between self-assessed empathy levels by physicians in training and empathy levels as perceived by their patients after clinical encounters. The authors also examined whether patient assessments were valid and reliable tools to measure empathy in physicians in training. DESIGN A multicentric, observational, cross-sectional study. SETTING This study was conducted in three public teaching hospitals in Brazil. PARTICIPANTS From the 668 patients invited to participate in this research, 566 (84.7%) agreed. Of these, 238 (42%) were male and 328 (58%) were female. From the invited 112 physicians in training, 86 (76.8%) agreed. Of the 86 physicians in training, 35 (41%) were final-year medical students and 51 (59%) were residents from clinical and surgical specialties. The gender distribution was 39 (45%) males and 47 (51%) females. PRIMARY AND SECONDARY OUTCOME MEASURES Physicians in training filled the Jefferson Scale of Physician Empathy (JSE) and the Interpersonal Reactivity Index. Patients answered the Jefferson Scale of Patient's Perceptions of Physician Empathy (JSPPPE) and the Consultation and Relational Empathy Scale (CARE). RESULTS This study found non-significant correlations between patient and physicians-in-training self-assessments, except for a weak correlation (0.241, p<0.01) between the JSPPPE score and the JSE compassionate care subscore. CARE and JSPPPE scales proved to be valid and reliable instruments. CONCLUSIONS Physicians-in-training self-assessments of empathy differ from patient assessments. Knowledge about empathy derived from self-assessment studies probably does not capture the perspective of the patients, who are key stakeholders in patient-centred care. Future research on the development of physician empathy or on outcomes of educational interventions to foster empathy should include patient perspectives.
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Affiliation(s)
- Mônica Oliveira Bernardo
- Radiology, Pontificia Universidade Catolica de Sao Paulo Faculdade de Ciencias Medicas e da Saude, Sorocaba, São Paulo, Brazil
| | - Dario Cecilio-Fernandes
- CEDAR - Center for Education Development and Research in Health Professions, University Medical Center Groningen, Groningen, The Netherlands
| | | | - Julian Furtado Silva
- Internal Medicine, Universidade Estadual de Campinas Faculdade de Ciencias Medicas, Campinas, São Paulo, Brazil
| | - Hugo Dugolin Ceccato
- Internal Medicine, Universidade Estadual de Campinas Faculdade de Ciencias Medicas, Campinas, São Paulo, Brazil
| | - Manuel João Costa
- Life and Health Sciences Research Institute, School of Health Sciences, University of Minho, Braga, Portugal
| | - Marco Antonio de Carvalho-Filho
- CEDAR - Center for Education Development and Research in Health Professions, University Medical Center Groningen, Groningen, The Netherlands
- Internal Medicine, Universidade Estadual de Campinas Faculdade de Ciencias Medicas, Campinas, São Paulo, Brazil
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O’Tuathaigh CMP, Nadhirah Idris A, Duggan E, Costa P, Costa MJ. Medical students' empathy and attitudes towards professionalism: Relationship with personality, specialty preference and medical programme. PLoS One 2019; 14:e0215675. [PMID: 31048851 PMCID: PMC6497245 DOI: 10.1371/journal.pone.0215675] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2018] [Accepted: 04/05/2019] [Indexed: 12/30/2022] Open
Abstract
Background Existing research has suggested that self-reported empathy in medical students is moderated by personality traits and diverse demographic and educational factors including age, gender, nationality, career aspirations, as well as year of curriculum. It is unclear how empathy, personality, and background factors might impact on students’ attitudes towards professionalism in medicine. Methods A cross-sectional questionnaire-based study was conducted in first and final year medical students at an Irish medical school. The following instruments were administered: (a) Jefferson Scale of Empathy; (b) NEO Five-Factor Inventory (NEO-FFI-3); (c) Attitudes towards Professionalism Scale. Demographic and educational variables were also measured. Descriptive and correlational analysis was conducted to examine the association between empathy, personality, professionalism-related attitudes and additional measures. Regression analysis was used to examine determinants of attitudes towards professional behaviour. Results Both selected NEO-FFI personality traits and empathy were independently associated with distinct categories of professional behaviour. Specifically, Openness to Experience was associated with higher empathy scores, and higher ‘Social responsibility’. Extraversion was linked with higher scores on the “Personal characteristics” and “Interactions with team” categories, while Conscientiousness was also positively associated with “Personal characteristics”. In agreement with previous studies, the personality traits most associated empathy were Agreeableness and Openness to Experience. Empathy did not vary according to programme year or career specialty preference. Conclusions This study is the first to show that empathy and personality factors may act as determinants of students’ attitudes towards medical professionalism in a manner which is dependent upon category of professional behaviour.
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Affiliation(s)
- Colm M. P. O’Tuathaigh
- Medical Education Unit, School of Medicine, University College Cork, Cork, Ireland
- * E-mail:
| | | | - Eileen Duggan
- Medical Education Unit, School of Medicine, University College Cork, Cork, Ireland
| | - Patricio Costa
- Life and Health Sciences Research Institute, School of Health Sciences, University of Minho, Braga, Portugal
| | - Manuel João Costa
- Life and Health Sciences Research Institute, School of Health Sciences, University of Minho, Braga, Portugal
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Charitou A, Fifli P, Vivilaki VG. Is empathy an important attribute of midwives and other health professionals?: A review. Eur J Midwifery 2019; 3:4. [PMID: 33537583 PMCID: PMC7839101 DOI: 10.18332/ejm/100612] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2017] [Revised: 12/09/2018] [Accepted: 12/09/2018] [Indexed: 12/30/2022] Open
Abstract
INTRODUCTION This paper is a report of a systematic review to identify and analyze studies of the measurement of empathy in midwives and other health professionals. Empathy has been recognized as an important factor in patient care, with positive outcomes for both patients and health professionals. There is a debate on the definition of empathy, on its measurement and on the possibility of improvement. METHODS Searches were made of the CINAHL, SCOPUS, PubMed and PsychINFO databases using the terms empathy, clinical, midwifery, nursing, medical students, measurement, and health professionals, singly or in combination, to identify literature published in English between 2002-2015. The included papers were critically reviewed and a narrative synthesis was conducted. RESULTS In all, 22 papers met the inclusion criteria by studies that were conducted to measure the levels of empathy in a variety of health professionals and students. Their scores were analyzed in correlation with their sociodemographic factors. CONCLUSIONS Despite numerous studies, many correlations but also differences exist, indicating the complexity of empathy and the need to further study it.
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Affiliation(s)
| | - Polyxeni Fifli
- Department of Midwifery, University of West Attica, Athens, Greece
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Watanabe S, Yoshida T, Kono T, Taketa H, Shiotsu N, Shirai H, Torii Y. Relationship of trainee dentists' self-reported empathy and communication behaviors with simulated patients' assessment in medical interviews. PLoS One 2018; 13:e0203970. [PMID: 30571709 PMCID: PMC6301708 DOI: 10.1371/journal.pone.0203970] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2018] [Accepted: 12/04/2018] [Indexed: 11/21/2022] Open
Abstract
Objectives We aimed to clarify the communication behaviors between trainee dentists and simulated patients (SPs), to examine how the level of trainee dentists’ self-reported empathy influences assessment by SPs in medical interviews. Materials and methods The study involved 100 trainee dentists at Okayama University Hospital and eight SPs. The trainee dentists conducted initial interviews with the SPs after completing the Japanese version of the Jefferson Scale of Empathy (JSE). All interviews were recorded and analyzed using the Roter Interaction Analysis System (RIAS). The SPs assessed the trainees’ communication immediately after each interview. The trainee dentists were classified into two groups (more positive and less positive) according to SP assessment scores. Results Compared with less-positive trainees, the more-positive trainees scored higher in the RIAS category of emotional expression and lower in the medical data gathering category. There was no difference in dental data gathering between the two groups. SP ratings for more-positive trainees were higher for use of positive talk and emotional expression and lower for giving medical information and dental information. Trainees with more positive ratings from SPs had significantly higher JSE total scores. Conclusion The results of this study suggest that responding to the emotions of patients is an important behavior in dentist-patient communication, according to SPs’ positive assessment in medical interviews. Further, SPs’ assessment of trainees’ communication was related to trainees’ self-reported empathy, which indicates that an empathic attitude among dentists is a significant determinant of patient satisfaction.
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Affiliation(s)
- Sho Watanabe
- Department of Comprehensive Dentistry, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, Okayama, Japan
| | - Toshiko Yoshida
- Center for Education in Medicine and Health Sciences (Dental Education), Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, Okayama, Japan
- * E-mail:
| | - Takayuki Kono
- Comprehensive Dental Clinic, Okayama University Hospital, Okayama, Japan
| | - Hiroaki Taketa
- Comprehensive Dental Clinic, Okayama University Hospital, Okayama, Japan
| | - Noriko Shiotsu
- Comprehensive Dental Clinic, Okayama University Hospital, Okayama, Japan
| | - Hajime Shirai
- Comprehensive Dental Clinic, Okayama University Hospital, Okayama, Japan
| | - Yasuhiro Torii
- Department of Comprehensive Dentistry, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, Okayama, Japan
- Comprehensive Dental Clinic, Okayama University Hospital, Okayama, Japan
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Abstract
This paper argues that enthusiasm for empathy has grown to the point at which empathy has taken on the status of an "ideal" in modern medicine. We need to pause and scrutinize this ideal before moving forward with empathy training programs for medical students. Taking empathy as an ideal obscures the distinction between the multiple aims that calls for empathy seek to achieve. While these aims may work together, they also come apart and yield different recommendations about the sort of behavior physicians should cultivate in a given situation. I begin by demonstrating how enthusiasm for empathy has increased dramatically. I then specify precisely what I mean in calling empathy an "ideal." I then describe some dangers associated with taking empathy to be an ideal unreflectively. I discuss the merits of works that provide conceptualizations of empathy that are specifically tailored for the medical domain and conclude that although these works move discussions about empathy in medical care forward, they could do more to foreground the goals and aims underlying calls for increased empathy. I provide specific suggestions as to how exactly we might foreground these goals and aims to further avoid conceptual confusion about empathy in medical education.
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Affiliation(s)
- Riana J Betzler
- Konrad Lorenz Institute for Evolution and Cognition Research, Martinstraße 12, 3400, Klosterneuburg, Austria.
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Wang H, Kline JA, Jackson BE, Laureano-Phillips J, Robinson RD, Cowden CD, d’Etienne JP, Arze SE, Zenarosa NR. Association between emergency physician self-reported empathy and patient satisfaction. PLoS One 2018; 13:e0204113. [PMID: 30212564 PMCID: PMC6136813 DOI: 10.1371/journal.pone.0204113] [Citation(s) in RCA: 34] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2018] [Accepted: 09/03/2018] [Indexed: 12/14/2022] Open
Abstract
Background Higher physician self-reported empathy has been associated with higher overall patient satisfaction. However, more evidence-based research is needed to determine such association in an emergent care setting. Objective To evaluate the association between physician self-reported empathy and after-care instant patient-to-provider satisfaction among Emergency Department (ED) healthcare providers with varying years of medical practice experience. Research design A prospective observational study conducted in a tertiary care hospital ED. Methods Forty-one providers interacted with 1,308 patients across 1,572 encounters from July 1 through October 31, 2016. The Jefferson Scale of Empathy (JSE) was used to assess provider empathy. An after-care instant patient satisfaction survey, with questionnaires regarding patient-to-provider satisfaction specifically, was conducted prior to the patient moving out of the ED. The relation between physician empathy and patient satisfaction was estimated using risk ratios (RR) and their corresponding 95% confidence limits (CL) from log-binomial regression models. Results Emergency Medicine (EM) residents had the lowest JSE scores (median 111; interquartile range [IQR]: 107–122) and senior physicians had the highest scores (median 119.5; IQR: 111–129). Similarly, EM residents had the lowest percentage of “very satisfied” responses (65%) and senior physicians had the highest reported percentage of “very satisfied” responses (69%). There was a modest positive association between JSE and satisfaction (RR = 1.04; 95% CL: 1.00, 1.07). Conclusion This study provides evidence of a positive association between ED provider self-reported empathy and after-care instant patient-to-provider satisfaction. Overall higher empathy scores were associated with higher patient satisfaction, though minor heterogeneity occurred between different provider characteristics.
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Affiliation(s)
- Hao Wang
- Department of Emergency Medicine, Integrative Emergency Services, John Peter Smith Health Network, Fort Worth, TX, United States of America
- * E-mail:
| | - Jeffrey A. Kline
- Department of Emergency Medicine, University of Indiana School of Medicine, Indianapolis, IN, United States of America
| | - Bradford E. Jackson
- Center for Outcomes Research, John Peter Smith Health Network, and University of North Texas Health Science Center, School of Public Health, Fort Worth, TX, United States of America
| | - Jessica Laureano-Phillips
- Office of Clinical Research, John Peter Smith Health Network, Fort Worth, TX, United States of America
| | - Richard D. Robinson
- Department of Emergency Medicine, Integrative Emergency Services, John Peter Smith Health Network, Fort Worth, TX, United States of America
| | - Chad D. Cowden
- Department of Emergency Medicine, Integrative Emergency Services, John Peter Smith Health Network, Fort Worth, TX, United States of America
| | - James P. d’Etienne
- Department of Emergency Medicine, Integrative Emergency Services, John Peter Smith Health Network, Fort Worth, TX, United States of America
| | - Steven E. Arze
- Department of Emergency Medicine, Integrative Emergency Services, John Peter Smith Health Network, Fort Worth, TX, United States of America
| | - Nestor R. Zenarosa
- Department of Emergency Medicine, Integrative Emergency Services, John Peter Smith Health Network, Fort Worth, TX, United States of America
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LaNoue MD, Roter DL. Exploring patient-centeredness: The relationship between self-reported empathy and patient-centered communication in medical trainees. PATIENT EDUCATION AND COUNSELING 2018; 101:1143-1146. [PMID: 29395476 DOI: 10.1016/j.pec.2018.01.016] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/21/2017] [Revised: 01/15/2018] [Accepted: 01/23/2018] [Indexed: 06/07/2023]
Abstract
OBJECTIVE To explore the relationships between self-reported Empathy and the patient-centered communication patterns of physician trainees. METHODS "Eighty-four 3rd year medical students completed the Jefferson Scale of Empathy (JSE - student version) and had recordings of a single OSCE analyzed using the Roter Interactional Analysis System (RIAS). Correlation and regression were employed to explore the relationships among JSE total score, 3 JSE subscales, 10 composite codes of provider communication, and a summary 'patient centered communication' ratio, reflecting the balance of psychosocial and emotional to biomedical communication of the simulated patient and student. RESULTS Results indicate that controlling for other elements of student communication, the RIAS composite of codes reflecting 'emotional responsiveness' (characterized by empathy statements, legitimization, showing concern, partnership statements and medically relevant provider self-disclosure) was positively related to the JSE Total Score while student 'question asking' and 'biomedical counseling' were negatively related to the JSE Score. RIAS-coded communication variables accounted for 32.4% of the JSE Total score. CONCLUSION The relationship between student expressions of emotional responsiveness and predicted self-reported empathy provides concurrent validation evidence for the JSE. PRACTICE IMPLICATIONS Further research is needed in order to elaborate and further explore a Patient-Centeredness latent variable.
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Affiliation(s)
- Marianna D LaNoue
- Department of Family and Community Medicine, Thomas Jefferson University, Philadelphia, PA. USA.
| | - Debra L Roter
- Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD. USA
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Bernardo MO, Cecílio-Fernandes D, Costa P, Quince TA, Costa MJ, Carvalho-Filho MA. Physicians' self-assessed empathy levels do not correlate with patients' assessments. PLoS One 2018; 13:e0198488. [PMID: 29852021 PMCID: PMC5979004 DOI: 10.1371/journal.pone.0198488] [Citation(s) in RCA: 40] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2018] [Accepted: 05/20/2018] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND Empathy 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. OBJECTIVES To 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. METHODS This 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). RESULTS We 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. CONCLUSIONS The lack of correlation between self-assessed empathy levels and patients' perceptions suggests patients be included in the process of empathy evaluation. PRACTICE IMPLICATIONS Training strategies aiming the development of empathy should include patients' evaluations and perspectives.
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Affiliation(s)
- Monica Oliveira Bernardo
- Radiology Department–Faculty of Medicine—Catholic University of São Paulo–Sorocaba–São Paulo—Brazil
| | - Dario Cecílio-Fernandes
- Center for Educational Development Innovation and Research–University Medical Center–University of Groningen–Groningen–The Netherlands
| | - Patrício Costa
- Life and Health Sciences Research Institute—School of Health Sciences—University of Minho–Braga–Portugal
| | - Thelma A. Quince
- Department of Public Health and Primary Care–University of Cambridge–Cambridge—United Kingdom
| | - Manuel João Costa
- Life and Health Sciences Research Institute—School of Health Sciences—University of Minho–Braga–Portugal
| | - Marco Antonio Carvalho-Filho
- Emergency Department–School of Medical Sciences–University of Campinas–Campinas–São Paulo–Brazil
- Center for Educational Development Innovation and Research–University Medical Center–University of Groningen–Groningen–The Netherlands
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Empathy Variation in General Practice: A Survey among General Practitioners in Denmark. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:ijerph15030433. [PMID: 29498682 PMCID: PMC5876978 DOI: 10.3390/ijerph15030433] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/03/2018] [Revised: 02/07/2018] [Accepted: 02/28/2018] [Indexed: 12/30/2022]
Abstract
Background: Previous studies have demonstrated that high levels of physician empathy may be correlated with improved patient health outcomes and high physician job satisfaction. Knowledge about variation in empathy and related general practitioner (GP) characteristics may allow for a more informed approach to improve empathy among GPs. Objective: Our objective is to measure and analyze variation in physician empathy and its association with GP demographic, professional, and job satisfaction characteristics. Methods: 464 Danish GPs responded to a survey containing the Danish version of the Jefferson Scale of Empathy for Health Professionals (JSE-HP) and questions related to their demographic, professional and job satisfaction characteristics. Descriptive statistics and a quantile plot of the ordered empathy scores were used to describe empathy variation. In addition, random-effect logistic regression analysis was performed to explore the association between empathy levels and the included GP characteristics. Results: Empathy scores were negatively skewed with a mean score of 117.9 and a standard deviation of 10.1 within a range from 99 (p5) to 135 (p95). GPs aged 45–54 years and GPs who are not employed outside of their practice were less likely to have high empathy scores (≥120). Neither gender, nor length of time since specialization, length of time in current practice, practice type, practice location, or job satisfaction was associated with odds of having high physician empathy. However, odds of having a high empathy score were higher for GPs who stated that the physician-patient relationship and interaction with colleagues has a high contribution to job satisfaction compared to the reference groups (low and medium contribution of these factors). This was also the trend for GPs who stated a high contribution to job satisfaction from intellectual stimulation. In contrast, high contribution of economic profit and prestige did not contribute to increased odds of having a high empathy score. Conclusions: Albeit generally high, we observed substantial variation in physician empathy levels among this population of Danish GPs. This variation is positively associated with values of interpersonal relationships and interaction with colleagues, and negatively associated with middle age (45–54 years) and lack of outside employment. There is room to increase GP physician empathy via educational and organizational interventions, and consequently, to improve healthcare quality and outcomes.
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McTighe AJ, DiTomasso RA, Felgoise S, Hojat M. Correlation Between Standardize Patients' Perceptions of Osteopathic Medical Students and Students' Self-Rated Empathy. J Osteopath Med 2017; 116:640-6. [PMID: 27669067 DOI: 10.7556/jaoa.2016.127] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
CONTEXT The use of standardized patients (SPs) promotes and enhances interpersonal skill sets of medical students and provides a critical opportunity for students to display their relational competence during simulated patient encounters. OBJECTIVE To investigate whether SPs' ratings of osteopathic medical students' empathy and interpersonal skills correlate with students' self-rated empathy. METHODS The study used a cross-sectional quantitative design. After SP encounters, first-, second-, and third-year osteopathic medical students self-rated empathy using the Jefferson Scale of Empathy medical student version. Standardized patients also assessed students' empathy using the Jefferson Scale of Patient Perceptions of Physician Empathy and interpersonal skills using the Professionalism Assessment Ratings Scale. RESULTS Of 780 first-, second-, and third-year students, 717 students returned the survey (91.9%). In total, 383 students were women (53.4%) and 334 were men (46.6%). Of 717 SP encounters, SPs returned surveys for 648 encounters (90.3%). Ratings from SPs regarding their perceptions of osteopathic medical students' empathetic abilities and interpersonal skills did not correlate with students' self-rated empathy scores. Second- and third-year students were perceived by SPs as having better-developed empathetic and interpersonal skill sets when compared with first-year students. Results of SPs' ratings indicated that the higher the interpersonal skills, the higher the SP-perceived empathy for students across all years (r=0.66; P<.001). CONCLUSION Students' self-rated empathy did not correlate with SP-perceived empathy. However, the findings validated that students' core relational competencies increase as they progress through medical school.
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Casas RS, Xuan Z, Jackson AH, Stanfield LE, Harvey NC, Chen DC. Associations of medical student empathy with clinical competence. PATIENT EDUCATION AND COUNSELING 2017; 100:742-747. [PMID: 27856065 DOI: 10.1016/j.pec.2016.11.006] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/21/2016] [Revised: 09/23/2016] [Accepted: 11/09/2016] [Indexed: 05/17/2023]
Abstract
OBJECTIVE Empathy is a crucial skill for medical students that can be difficult to evaluate. We examined if self-reported empathy in medical students was associated with clinical competence. METHODS This study combined cross-sectional data from four consecutive years of medical students (N=590) from the Boston University School of Medicine. We used regression analysis to evaluate if self-reported empathy (Jefferson Scale of Physician Empathy (JSPE)) predicted scores in clinical clerkships, United States Medical Licensing Examinations, and OBJECTIVE: Structured Clinical Examinations (OSCEs). We separately analyzed overall and OSCE communication scores based on interpersonal skills reported by standardized patients. We controlled for age, gender, debt, and specialty affinity. RESULTS JSPE scores of medical students were positively associated with OSCE communication scores, and remained significant when controlling for demographics. We found that JSPE score was also predictive of overall OSCE scores, but this relationship was confounded by gender and age. JSPE scores were associated with performance in the Pediatrics clerkship, but not other clerkships or standardized tests. CONCLUSION JSPE scores were positively associated with OSCE communication scores in medical students. PRACTICE IMPLICATIONS This study supports that self-reported empathy may predict OSCE performance, but further research is needed to examine differences by gender and age.
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Affiliation(s)
- Rachel S Casas
- Evans Department of Medicine, Boston University School of Medicine, Boston, MA, USA.
| | - Ziming Xuan
- Department of Community Health Sciences, Boston University, Boston, MA, USA.
| | - Angela H Jackson
- Evans Department of Medicine, Boston University School of Medicine, Boston, MA, USA.
| | - Lorraine E Stanfield
- Evans Department of Medicine, Boston University School of Medicine, Boston, MA, USA.
| | - Nanette C Harvey
- Department of Family Medicine, Boston University School of Medicine, Boston, MA, USA.
| | - Daniel C Chen
- Evans Department of Medicine, Boston University School of Medicine, Boston, MA, USA.
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Hojat M, DeSantis J, Gonnella JS. Patient Perceptions of Clinician's Empathy: Measurement and Psychometrics. J Patient Exp 2017; 4:78-83. [PMID: 28725866 PMCID: PMC5513637 DOI: 10.1177/2374373517699273] [Citation(s) in RCA: 47] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
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.
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Affiliation(s)
- Mohammadreza Hojat
- Center for Research in Medical Education and Health Care, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA, USA
| | - Jennifer DeSantis
- Center for Research in Medical Education and Health Care, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA, USA
| | - Joseph S Gonnella
- Center for Research in Medical Education and Health Care, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA, USA
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Canivet D, Peternelj L, Delvaux N, Reynaert C, Razavi D, Libert Y. Lorsque le doute s’installe dans la prise de décision thérapeutique : la nécessité de repenser la formation des oncologues. PSYCHO-ONCOLOGIE 2016. [DOI: 10.1007/s11839-016-0594-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
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