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Schrötter S, Kropp P, Müller B. Comparison of empathy profiles of medical students at the start and in the advanced clinical phase of their training. GMS JOURNAL FOR MEDICAL EDUCATION 2024; 41:Doc7. [PMID: 38504859 PMCID: PMC10946216 DOI: 10.3205/zma001662] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Figures] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Revised: 09/20/2023] [Accepted: 11/14/2023] [Indexed: 03/21/2024]
Abstract
Background The National Competence Based Catalogue of Learning Objectives for Undergraduate Medical Education (NKLM) cites empathy as a basic competence for medical doctors. Based on a multidimensional concept of clinical empathy, empathy profiles of medical students at the start of their training and in the 9th semester were identified and compared in order to draw conclusions for the conception of effective course offers. Method Using the Saarbrücker Personality Questionnaire on Empathy (SPF-IRI), self-rated empathy was recorded in a cross-sectional study of medical students (1st semester: N=192/9th semester: N=221). Two Stage Clustering was performed for data analysis. Result Three empathy profiles which could be meaningfully delineated by content were identified: 1. reflected, functional empathy, 2. unreflected, burdensome empathy and 3. distancing and avoidance. Students in the 9th semester mostly tended toward unreflected, burdensome empathy. Only one-third appeared capable of feeling empathy with patients while at the same time adequately regulating their own emotions and thus protecting themselves from emotional overload. Conclusion An adequately reflected and functional empathy among medical students can neither be assumed at the start of their training, nor do existing course offers appear to provide sufficient training for this. Empathy should thus be implemented as a competence which needs to be promoted over the entire course of study. Emotion regulation plays a key role.
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Affiliation(s)
- Susanne Schrötter
- Universitätsmedizin Rostock, Institut für Medizinische Psychologie und Medizinische Soziologie, Rostock, Germany
| | - Peter Kropp
- Universitätsmedizin Rostock, Institut für Medizinische Psychologie und Medizinische Soziologie, Rostock, Germany
| | - Britta Müller
- Universitätsmedizin Rostock, Institut für Medizinische Psychologie und Medizinische Soziologie, Rostock, Germany
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Abbiati M, Cerutti B. Do students' personality traits change during medical training? A longitudinal cohort study. ADVANCES IN HEALTH SCIENCES EDUCATION : THEORY AND PRACTICE 2023; 28:1079-1092. [PMID: 36729195 PMCID: PMC10624741 DOI: 10.1007/s10459-023-10205-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/26/2022] [Accepted: 01/03/2023] [Indexed: 06/18/2023]
Abstract
Many medical schools incorporate assessments of personal characteristics, including personality traits, in their selection process. However, little is known about whether changes in personality traits during medical training affect the predictive validity of personality assessments. The present study addressed this issue by examining the stability of personality traits and their predictive validity over a 6-year medical training course. Participants were two cohorts of Swiss medical students (N = 272, 72% of students admitted to Year 2) from whom we collected demographic data, Swiss medical studies aptitude test (EMS) scores, Big Five personality traits scores measured at three times and scores on the multiple-choice and objective structured clinical examination parts of the final medical examination. Our findings indicated that personality traits had medium-to-high rank-order stability (r > .60 over 3 years and r > .50 over 6 years). Mean-level changes were moderate for agreeableness (d = + 0.72) and small for neuroticism and conscientiousness (d = -0.29, d = -0.25, respectively). Individual reliable change indices ranged from 4.5% for openness to 23.8% for neuroticism. The predictive validity was similar to that of the first three years of follow-up. To the best of our knowledge, this is the first study to investigate changes in personality across undergraduate curriculum. Medical students' personality traits were mostly stable across medical school and retain their predictive validity. Consequently, this study supports the use of tools measuring constructs underlying personality traits in selection. In addition, this study confirms that examination formats could favor students with certain personality traits.
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Affiliation(s)
- Milena Abbiati
- Unit of Development and Research in Medical Education (UDREM), University of Geneva, Medical School, 1 rue Michel Servet, 1211, Geneva, Switzerland.
- Psychiatry Department, Unit of Forensic Psychiatry (IPL), Lausanne University Hospital, Lausanne, Switzerland.
| | - Bernard Cerutti
- Unit of Development and Research in Medical Education (UDREM), University of Geneva, Medical School, 1 rue Michel Servet, 1211, Geneva, Switzerland
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Luo S, Wang J, Xie Z, Tong DYK. When and why are employees willing to engage in voice behavior: a power cognition perspective. CURRENT PSYCHOLOGY 2023:1-12. [PMID: 37359604 PMCID: PMC10111083 DOI: 10.1007/s12144-023-04638-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/31/2023] [Indexed: 06/28/2023]
Abstract
Previous studies have found that sense of power is an important predictor of employee voice; however, the mechanism underlying the relationship between these factors remains unclear. To explore this mechanism, 642 valid questionnaires from 45 enterprises were used to conduct an empirical test based on the approach-inhibition theory of power. The results showed that sense of power can affect error risk taking positively, error risk taking mediates the relationship between sense of power and employee voice; and power congruence moderates both the direct relationship between sense of power and employee voice and their indirect relationship via error risk taking. This study thus provides a useful reference for improving employees' enthusiasm for voice behavior and can help enhance the competitiveness of enterprises.
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Affiliation(s)
- Shiwen Luo
- School of International Business, Zhejiang Financial College, Hangzhou, 310018 China
| | - Jie Wang
- Business & Tourism Institute, Hangzhou Vocational & Technical College, Hangzhou, 310018 China
| | - Zaiyang Xie
- School of Management, Zhejiang University of Technology, Hangzhou, 310023 China
| | - David Yoon Kin Tong
- Faculty of Business, International University of Malaya-Wales, Kuala Lumpur, 50480 Malaysia
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Berney A, Carrard V, Berney S, Schlegel K, Gaume J, Gholam M, Bart PA, Preisig M, Wac K, Schmid Mast M, Bourquin C. Study protocol for the ETMED-L project: longitudinal study of mental health and interpersonal competence of medical students in a Swiss university using a comprehensive framework of empathy. BMJ Open 2021; 11:e053070. [PMID: 34862292 PMCID: PMC8647527 DOI: 10.1136/bmjopen-2021-053070] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [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
INTRODUCTION Physician interpersonal competence is crucial for patient care. How interpersonal competence develops during undergraduate medical education is thus a key issue. Literature on the topic consists predominantly of studies on empathy showing a trend of decline over the course of medical school. However, most existing studies have focused on narrow measures of empathy. The first aim of this project is to study medical students' interpersonal competence with a comprehensive framework of empathy that includes self-reported cognitive and affective empathy, performance-based assessments of emotion recognition accuracy, and a behavioural dimension of empathy. The second aim of the present project is to investigate the evolution of mental health during medical school and its putative link to the studied components of interpersonal competence. Indeed, studies documented a high prevalence of mental health issues among medical students that could potentially impact their interpersonal competence. Finally, this project will enable to test the impact of mental health and interpersonal competence on clinical skills as evaluated by experts and simulated patients. METHODS AND ANALYSIS This project consists of an observational longitudinal study with an open cohort design. Each year during the four consecutive years of the project, every medical student (curriculum years 1-6) of the University of Lausanne in Switzerland will be asked to complete an online questionnaire including several interpersonal competence and mental health measures. Clinical skills assessments from examinations and training courses with simulated patients will also be included. Linear mixed models will be used to explore the longitudinal evolutions of the studied components of interpersonal competence and mental health as well as their reciprocal relationship and their link to clinical skills. ETHICS AND DISSEMINATION The project has received ethical approval from the competent authorities. Findings will be disseminated through internal, regional, national and international conferences, news and peer-reviewed journals.
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Affiliation(s)
- Alexandre Berney
- Psychiatric Liaison Service, Lausanne University Hospital, Lausanne, Switzerland
- Faculty of Biology and Medicine, University of Lausanne, Lausanne, Switzerland
| | - Valerie Carrard
- Psychiatric Liaison Service, Lausanne University Hospital, Lausanne, Switzerland
- Faculty of Biology and Medicine, University of Lausanne, Lausanne, Switzerland
| | - Sylvie Berney
- Faculty of Biology and Medicine, University of Lausanne, Lausanne, Switzerland
- Service of General Psychiatry, Lausanne University Hospital, Lausanne, Switzerland
| | - Katja Schlegel
- Institute of Psychology, University of Bern, Bern, Switzerland
| | - Jacques Gaume
- Faculty of Biology and Medicine, University of Lausanne, Lausanne, Switzerland
- Alcohol Treatment Centre, Lausanne University Hospital, Lausanne, Switzerland
| | - Mehdi Gholam
- Institute of Mathematics, EPFL, Lausanne, Switzerland
| | - Pierre-Alexandre Bart
- Faculty of Biology and Medicine, University of Lausanne, Lausanne, Switzerland
- Department of Internal Medicine, Lausanne University Hospital, Lausanne, Switzerland
| | - Martin Preisig
- Faculty of Biology and Medicine, University of Lausanne, Lausanne, Switzerland
- Centre for Psychiatric Epidemiology and Psychopathology, Lausanne University Hospital, Lausanne, Switzerland
| | - Katarzyna Wac
- Department of Computer Science, University of Geneva, Geneva, Switzerland
| | - Marianne Schmid Mast
- Department of Organizational Behavior, University of Lausanne, Lausanne, Switzerland
| | - Céline Bourquin
- Psychiatric Liaison Service, Lausanne University Hospital, Lausanne, Switzerland
- Faculty of Biology and Medicine, University of Lausanne, Lausanne, Switzerland
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Xu H, Xue R, Hao S. Attitudes toward patient-centeredness, personality and empathy of Chinese medical students. PERSONALITY AND INDIVIDUAL DIFFERENCES 2021. [DOI: 10.1016/j.paid.2021.110777] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
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Park J, Blatt B, Greenberg L. Does Medical Students' High Expression of Empathy Correlate with Their Choice of Primary Care Residencies? South Med J 2021; 114:8-12. [PMID: 33398353 DOI: 10.14423/smj.0000000000001192] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
OBJECTIVES There are many factors that influence medical students' (MS) decisions when choosing a career. Some prominent factors include life-work balance, indebtedness, and flexibility of work hours. Whereas the expression of empathy has many positive correlates with a trusting and meaningful physician-patient interaction, only a few studies have analyzed the association of MS empathy expression and primary care residency selection. The results of these studies about the relationship of MS expression of empathy and their selection of primary care specialties have been conflicting, depending on the empathy instrument used. In addition, there have been other variables that have affected career decision making in more recent years not previously encountered. The objectives of our study were to analyze the association of The George Washington University School of Medicine and Health Sciences (GWU) MS Interpersonal Reactivity Index (IRI) scores and their residency selection, to compare our results with previous studies to determine whether the IRI provided more definitive relationships between empathy and career choice, and to assess whether our results confirmed the theoretical construct linking empathy with primary care physicians. METHODS GWU third-year MS (MS3s), representing the classes of 2008-2011, completed the perspective taking and empathy subscales of the IRI, which measure cognitive and affective empathy, respectively. MS empathy scores for individual specialty were compared to those scores in internal medicine (IM) using a linear regression model. Empathy scores for patient-oriented versus technology-oriented specialties and primary versus surgical specialties were compared using the independent t test. RESULTS A total of 593 (77.5%) MS3s had mean IRI scores of 45.1 (standard error 4.8), higher than a recent study involving MS. There were no significant differences between patient- and technology-oriented specialties (-0.65 to 0.88), primary care versus surgical residencies (-0.87 to 1.4), and women versus men (-0.20 to 1.4). Our study did not clarify previous conflicting studies in the literature. CONCLUSIONS There are no significant differences in expression of empathy in GWU students who chose patient- versus technology-oriented and primary care versus surgical residencies. The authors can only speculate why students' high expression of empathy was not associated with selecting primary care residencies, namely, women are outnumbering men entering medicine and are selecting technology-related specialties previously identified predominantly with men, and millennials have specific traits inherent in their generation that can affect their specialty choice. The results of our study shed doubt that the theoretical construct linking MS high empathy expression and choice of primary care careers is valid today.
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Affiliation(s)
- Joseph Park
- From The George Washington University School of Medicine and Health Sciences, Washington, DC
| | - Benjamin Blatt
- From The George Washington University School of Medicine and Health Sciences, Washington, DC
| | - Larrie Greenberg
- From The George Washington University School of Medicine and Health Sciences, Washington, DC
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Litten V, Roberts LD, Ladyshewsky RK, Castell E, Kane R. Empathy and psychopathic traits as predictors of selection into business or psychology disciplines. AUSTRALIAN JOURNAL OF PSYCHOLOGY 2020. [DOI: 10.1111/ajpy.12263] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- Verity Litten
- School of Psychology and Speech Pathology, Curtin University, Perth, Western Australia, Australia,
| | - Lynne D. Roberts
- School of Psychology and Speech Pathology, Curtin University, Perth, Western Australia, Australia,
| | - Richard K. Ladyshewsky
- School of Psychology and Speech Pathology, Curtin University, Perth, Western Australia, Australia,
| | - Emily Castell
- School of Psychology and Speech Pathology, Curtin University, Perth, Western Australia, Australia,
| | - Robert Kane
- School of Psychology and Speech Pathology, Curtin University, Perth, Western Australia, Australia,
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Givron H, Desseilles M. Decline of Empathy after the First Internship: Towards a More Functional Empathy? SANTE MENTALE AU QUEBEC 2020. [DOI: 10.7202/1070246ar] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Research has shown a decline in empathy as medical studies progress. Among various hypotheses, an explanation track evoked is the first contact with the internship.
Objectives This quasi-experimental study was designed to examine the impact of the first internship in medical students. Our research question was: “to what extent the first internship may decreased the empathy’s scores of our 3d year medical students?”
Methods We measured the empathy of 220 third year medical students before and after their first internship (3 weeks) in family medicine. Using online surveys methodology, we collected data about empathy (“Interpersonal Reactivity Index”: IRI), epidemiology, professional orientation choices.
Results Statistical analyses revealed a small but significant decrease in IRI’s “fantasy,” “empathic concern” and “personal distress” subscales.
Conclusion These results suggest a potential impact of the first internship on empathic skills. The fact that the students’ score for the “personal distress” subscale (which characterizes a difficulty in managing their emotions) decreases is actually a rather good thing. These data raise the question of the “function” of this loss of empathy. The fact that this score decreases after first internship, may indicate a positive change for these medical students: towards better emotional regulation and more functional affective empathy.
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Affiliation(s)
- Hélène Givron
- Département de Psychologie, Faculté de médecine, Université de Namur, Belgique
- Institut Transitions, Université de Namur, Belgique
| | - Martin Desseilles
- Institut Transitions, Université de Namur, Belgique
- Clinique Psychiatrique des Frères Alexiens, Henri-Chapelle, Belgique – Département de Psychologie, Faculté de médecine, Université de Namur, Belgique
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Huang L, Thai J, Zhong Y, Peng H, Koran J, Zhao XD. The Positive Association Between Empathy and Self-Esteem in Chinese Medical Students: A Multi-Institutional Study. Front Psychol 2019; 10:1921. [PMID: 31496978 PMCID: PMC6712570 DOI: 10.3389/fpsyg.2019.01921] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2019] [Accepted: 08/05/2019] [Indexed: 12/30/2022] Open
Abstract
Background Empathy is an important element of the physician-patient relationship and is a critical personality trait for medical students. However, research has shown that it declines during undergraduate medical education. It is still unclear how empathy interrelates with the psychological elements of medical students, in particular, self-esteem. This study examined the relationship between empathy and self-esteem to explore other possible methods to improve medical students’ empathy. Methods A stratified sampling strategy was used to select 1690 medical students from 3 medical institutions in Shanghai as study participants. The questionnaires used to collect data included the Jefferson Scale of Physician Empathy-Student Version (JSPE-S), the Rosenberg Self-esteem Scale (RSES), and a self-made inventory on personal information. Descriptive analysis, independent t-test, One-Way ANOVA, and linear regression were used to analyze the data. Results The mean empathy score among medical students was 102.73 with SD = 12.64. Multiple regression analysis revealed that, “age,” “perception of the importance of empathy,” “academic pressure,” “desire to be a doctor after graduation,” and “self-esteem” were significant predictors of empathy (P < 0.05) and the adjusted R2 was 0.462. The correlation matrix between empathy and self-esteem was significant (r = 0.510, P < 0.01). Self-esteem explained 15.5% of the variation of empathy in the final regression model. Conclusion There was a positive association between self-esteem and empathy. Self-esteem is one of many factors which contribute to medical students’ empathy. Age, academic pressure, attitude toward empathy and future career also play a critical role in medical student empathy. Enhancing medical students’ self-esteem may be an efficacious way to improve medical students’ empathy.
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Affiliation(s)
- Lei Huang
- Department of Psychiatry, Tongji Hospital, Tongji University School of Medicine, Shanghai, China.,Medical Education Division, Tongji Hospital, Tongji University School of Medicine, Shanghai, China
| | - Jessica Thai
- College of Medicine, University of Nebraska Medical Center, Omaha, NE, United States
| | - Yuan Zhong
- Medical Education Division, Tongji Hospital, Tongji University School of Medicine, Shanghai, China
| | - Hao Peng
- School of Medicine, Tongji University, Shanghai, China
| | - Jessica Koran
- College of Medicine, University of Nebraska Medical Center, Omaha, NE, United States
| | - Xu-Dong Zhao
- School of Medicine, Tongji University, Shanghai, China.,Shanghai East Hospital Affiliated to Tongji University, Shanghai, China.,Shanghai Pudong New Area Mental Health Center, Tongji University School of Medicine, Shanghai, China
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Ponnamperuma G, Yeo SP, Samarasekera DD. Is empathy change in medical school geo-socioculturally influenced? MEDICAL EDUCATION 2019; 53:655-665. [PMID: 30891799 DOI: 10.1111/medu.13819] [Citation(s) in RCA: 36] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/31/2018] [Revised: 10/08/2018] [Accepted: 01/09/2019] [Indexed: 05/24/2023]
Abstract
CONTEXT There is convincing evidence that physician empathy leads to better patient care. As a result, there has been considerable research interest in investigating how empathy changes during undergraduate medical studies. Early (generally North American) studies raised concerns that medical training causes a decline in empathy. More recent studies (conducted around the world) have begun to suggest that either a slight increase or decrease in empathy occurs during undergraduate medical training, which has led some to argue that empathy changes indiscriminately (with no discernible pattern). This paper explores whether there is evidence to suggest that empathy changes indiscriminately or with a discernible geo-sociocultural pattern during undergraduate medical training. METHODS Literature that investigated change in empathy during undergraduate medical training was reviewed. Cross-sectional and longitudinal studies were tabulated separately according to their respective geographical locations. The tabulated results were analysed to investigate whether empathy changed similarly or differently within different geographical locations. RESULTS The studies reviewed indicate similar patterns of empathy change within approximate geo-sociocultural clusters. Whereas US studies predominantly show small but significant decreases in empathy, Far Eastern studies mostly show small but significant increases in empathy as undergraduates progress through the medical course. CONCLUSIONS These results suggest that change in empathy during undergraduate medical education is not as indiscriminate (patternless) as once thought. Additionally, these results support the notion that empathy is a locally construed global construct.
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Affiliation(s)
- Gominda Ponnamperuma
- Centre for Medical Education, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Su Ping Yeo
- Centre for Medical Education, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Dujeepa D Samarasekera
- Centre for Medical Education, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
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Li CQ, Ma Q, Liu YY, Jing KJ. Are parental rearing patterns and learning burnout correlated with empathy amongst undergraduate nursing students? Int J Nurs Sci 2018; 5:409-413. [PMID: 31406856 PMCID: PMC6626275 DOI: 10.1016/j.ijnss.2018.07.005] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2017] [Revised: 06/25/2018] [Accepted: 07/09/2018] [Indexed: 12/19/2022] Open
Abstract
Objective Empathy can help establish harmonious nurse-patient relationships. We aimed to assess the status of empathy, and explore the relationship between learning burnout, parental rearing patterns and empathy amongst nursing students. Method A questionnaire survey that employed the Learning Burnout Scale, the Short-Form Egna Minnenav Barndoms Uppfostran (s-EMBU) and the Jefferson Scale of Empathy was conducted amongst 562 nursing students. The data were analysed on the basis of descriptive statistic and correlation analysis was used. Results Empathy is negatively correlated with learning burnout, parental rejection and overprotection and showed no positive correlation with parental emotional warmth. Conclusions Educators should pay attention to nursing students' feelings and learning burnout status and take positive measures to improve the empathy level of the students. Positive parental rearing patterns also help cultivate empathy.
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Affiliation(s)
- Chao-Qun Li
- School of Nursing, Hebei University, Baoding, Hebei, China
| | - Qian Ma
- School of Nursing, Hebei University, Baoding, Hebei, China
| | - Yu-Ying Liu
- School of Nursing, Hebei University, Baoding, Hebei, China
| | - Kun-Juan Jing
- School of Nursing, Hebei University, Baoding, Hebei, China
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12
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Visser CLF, Wilschut JA, Isik U, van der Burgt SME, Croiset G, Kusurkar RA. The Association of Readiness for Interprofessional Learning with empathy, motivation and professional identity development in medical students. BMC MEDICAL EDUCATION 2018; 18:125. [PMID: 29879967 PMCID: PMC5991439 DOI: 10.1186/s12909-018-1248-5] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/01/2017] [Accepted: 05/31/2018] [Indexed: 05/20/2023]
Abstract
BACKGROUND The Readiness for Interprofessional Learning Scale is among the first scales developed for measurement of attitude towards interprofessional learning (IPL). However, the conceptual framework of the RIPLS still lacks clarity. We investigated the association of the RIPLS with professional identity, empathy and motivation, with the intention of relating RIPLS to other well-known concepts in healthcare education, in an attempt to clarify the concept of readiness. METHODS Readiness for interprofessional learning, professional identity development, empathy and motivation of students for medical school, were measured in all 6 years of the medical curriculum. The association of professional identity development, empathy and motivation with readiness was analyzed using linear regression. RESULTS Empathy and motivation significantly explained the variance in RIPLS subscale Teamwork & Collaboration. Gender and belonging to the first study year had a unique positive contribution in explaining the variance of the RIPLS subscales Positive and Negative Professional Identity, whereas motivation had no contribution. More compassionate care, as an affective component of empathy, seemed to diminish readiness for IPL. Professional Identity, measured as affirmation or denial of the identification with a professional group, had no contribution in the explanation of the variance in readiness. CONCLUSIONS The RIPLS is a suboptimal instrument, which does not clarify the 'what' and 'how' of IPL in a curriculum. This study suggests that students' readiness for IPE may benefit from a combination with the cognitive component of empathy ('Perspective taking') and elements in the curriculum that promote autonomous motivation.
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Affiliation(s)
- Cora L. F. Visser
- VUmc School of Medical Sciences & VUmc Amstel Academy, VU University Medical Center, Postbus 7057, 1007 MB Amsterdam, the Netherlands
| | - Janneke A. Wilschut
- Department of Epidemiology & Biostatistics, Decision Modeling Center, VU University Medical Center, Amsterdam, the Netherlands
| | - Ulviye Isik
- VUmc School of Medical Sciences, VU University Medical Center, Amsterdam, The Netherlands
- LEARN! Research Institute for Learning and Education, Faculty of Psychology and Education, VU University Amsterdam, Amsterdam, the Netherlands
| | - Stéphanie M. E. van der Burgt
- VUmc School of Medical Sciences, VU University Medical Center, Amsterdam, The Netherlands
- LEARN! Research Institute for Learning and Education, Faculty of Psychology and Education, VU University Amsterdam, Amsterdam, the Netherlands
| | - Gerda Croiset
- VUmc School of Medical Sciences, VU University Medical Center, Amsterdam, The Netherlands
- Present Address: UMC Groningen, Groningen, the Netherlands
| | - Rashmi A. Kusurkar
- VUmc School of Medical Sciences, VU University Medical Center, Amsterdam, The Netherlands
- LEARN! Research Institute for Learning and Education, Faculty of Psychology and Education, VU University Amsterdam, Amsterdam, the Netherlands
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Barrera-Gil D, Estrada-Méndez N, Arévalo Y, Calzadilla-Núñez A, Díaz-Narváez VP. [Empathy in medical students in the Republic of El Salvador: Cross-sectional study]. J Healthc Qual Res 2018; 33:136-143. [PMID: 30337018 DOI: 10.1016/j.jhqr.2018.03.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2018] [Revised: 02/27/2018] [Accepted: 03/05/2018] [Indexed: 12/30/2022]
Abstract
OBJECTIVE To evaluate empathy in medical students of the Evangelical University, Republic of El Salvador. MATERIAL AND METHODS A cross-sectional study was conducted in which empathy levels, as well as the reliability of the data, were measured in 640 students. The mean and standard deviation were estimated in two factors: gender and courses studied. The data were processed using bi-factorial variance analysis (modeliii), calculating the effect size, power of the test, and the possible growth potential of the empathy and of each of its components considering the gender. The level of significance was α≤.05 and β≥0.80. The SPSS 22.0 statistics program was used. RESULTS Differences were found between courses and gender. The differences between courses in empathy are due to values by males in specific components. The model of decline in empathy and in the component, compassionate care, is not fulfilled. CONCLUSIONS The levels of empathy between the genders were higher in males than in females, and similar in the compassionate care component. This is not consistent with the idea that women have higher levels of empathy than the men. There are differences in the behaviour of the means depending on the course and gender, and the empathy decline model is fulfilled only in two of its components. The characteristics indicated constitute the diagnosis of the empathy situation and constitute a guide to construct an intervention.
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Affiliation(s)
- D Barrera-Gil
- Facultad de Medicina, Universidad Evangélica de El Salvador, San Salvador, El Salvador
| | - N Estrada-Méndez
- Departamento de Investigaciones, Facultad de Odontología, Universidad Evangélica de El Salvador, San Salvador, El Salvador
| | - Y Arévalo
- Departamento de Investigaciones, Facultad de Odontología, Universidad Evangélica de El Salvador, San Salvador, El Salvador
| | - A Calzadilla-Núñez
- Facultad de Salud, Terapia Ocupacional, Universidad Bernardo O'Higgins, Santiago, Chile
| | - V P Díaz-Narváez
- Facultad de Ciencias de la Salud, Universidad de Atacama, Copiapó, III Región, Chile.
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Abe K, Niwa M, Fujisaki K, Suzuki Y. Associations between emotional intelligence, empathy and personality in Japanese medical students. BMC MEDICAL EDUCATION 2018; 18:47. [PMID: 29587725 PMCID: PMC5870303 DOI: 10.1186/s12909-018-1165-7] [Citation(s) in RCA: 43] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/27/2017] [Accepted: 03/19/2018] [Indexed: 05/26/2023]
Abstract
BACKGROUND It is known that empathic communication is important for physicians to achieve higher patient satisfaction and health outcomes. Emotional intelligence (EI), empathy and personality in medical students predict students' individual disposition and their emotional and empathic perceptions. This study aimed to investigate: 1) The association between empathy, EI and personality, and 2) Gender differences in the association between empathy, EI and personality. METHOD Participants were 357 1st year medical students from 2008 to 2011 at one medical school in Japan. Students completed self-report questionnaires comprising three validated instruments measuring EI: Trait Emotional Intelligence Questionnaire-Short Form (TEIQue-SF), empathy: Jefferson Scale of Physician Empathy- student version (JSPE) and personality: NEO-Five-Factor Inventory (NEO-FFI), which explores 5 dimensions of personality Neuroticism (N), Extraversion (E), Openness to experience (O), Agreeableness (A), and Conscientiousness (C). RESULTS Pearson Correlations showed weak association between TEIQue-SF and JSPE. TEIQue-SF and NEO-FFI showed positive correlation for E and C, and strong negative correlation for N and weak positive correlation for A and O. Weak positive correlation between JSPE and the NEO-FFI were observed for E and A. Although effect sizes were small, N, A and empathy were significantly higher in females (unpaired t-test). However, hierarchical multiple-regression analysis when controlling for gender and personality showed no association between EI, empathy and gender. A, TEIQue-SF and N were found to make small contributions in respect of predictions for JSPE. Personality contributed significantly to the prediction of TEIQue-SF. N had the largest independent negative contribution (β = - 0,38). CONCLUSION In our study population of 1st year medical students, females had significantly higher N, A and empathy scores than males. Medical students' N score was strongly negatively associated with EI. Empathy was weakly associated with EI and A. However, when controlling gender and personality in regression analysis, gender did not affect EI and empathy, rather personality is the most important factor. Our findings indicate that N is a major factor that negatively affects EI. It is important to mitigate N using thoughtful training, taking into account students' personalities, to reduce N. In future studies, we will assess how communication trainings for students might enhance EI.
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Affiliation(s)
- Keiko Abe
- Medical Educational Development Center, Gifu University, Gifu, Japan
- College of Nursing, Aichi Medical University, Nagakute, Japan
| | - Masayuki Niwa
- Medical Educational Development Center, Gifu University, Gifu, Japan
| | - Kazuhiko Fujisaki
- Medical Educational Development Center, Gifu University, Gifu, Japan
| | - Yasuyuki Suzuki
- Medical Educational Development Center, Gifu University, Gifu, Japan
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The influence of academic discipline on empathy and psychopathic personality traits in undergraduate students. PERSONALITY AND INDIVIDUAL DIFFERENCES 2018. [DOI: 10.1016/j.paid.2017.11.025] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
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16
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Ferreira-Valente A, Monteiro JS, Barbosa RM, Salgueira A, Costa P, Costa MJ. Clarifying changes in student empathy throughout medical school: a scoping review. ADVANCES IN HEALTH SCIENCES EDUCATION : THEORY AND PRACTICE 2017; 22:1293-1313. [PMID: 27465064 DOI: 10.1007/s10459-016-9704-7] [Citation(s) in RCA: 61] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/08/2016] [Accepted: 07/21/2016] [Indexed: 05/07/2023]
Abstract
Despite the increasing awareness of the relevance of empathy in patient care, some findings suggest that medical schools may be contributing to the deterioration of students' empathy. Therefore, it is important to clarify the magnitude and direction of changes in empathy during medical school. We employed a scoping review to elucidate trends in students' empathy changes/differences throughout medical school and examine potential bias associated with research design. The literature published in English, Spanish, Portuguese and French from 2009 to 2016 was searched. Two-hundred and nine potentially relevant citations were identified. Twenty articles met the inclusion criteria. Effect sizes of empathy scores variations were calculated to assess the practical significance of results. Our results demonstrate that scoped studies differed considerably in their design, measures used, sample sizes and results. Most studies (12 out of 20 studies) reported either positive or non-statistically significant changes/differences in empathy regardless of the measure used. The predominant trend in cross-sectional studies (ten out of 13 studies) was of significantly higher empathy scores in later years or of similar empathy scores across years, while most longitudinal studies presented either mixed-results or empathy declines. There was not a generalized international trend in changes in students' empathy throughout medical school. Although statistically significant changes/differences were detected in 13 out of 20 studies, the calculated effect sizes were small in all but two studies, suggesting little practical significance. At the present moment, the literature does not offer clear conclusions relative to changes in student empathy throughout medical school.
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Affiliation(s)
- Alexandra Ferreira-Valente
- Life and Health Sciences Research Institute (ICVS), School of Health Sciences, University of Minho, Campus de Gualtar, Gualtar, 4710-057, Braga, Portugal
- 3B PT Government Associate Laboratory, Braga, Guimarães, Portugal
- University Lusíada of Lisbon, Lisbon, Portugal
| | - Joana S Monteiro
- USF Odisseia, Maia, Portugal
- Faculty of Medicine, Oporto University, Porto, Portugal
| | | | - Ana Salgueira
- Life and Health Sciences Research Institute (ICVS), School of Health Sciences, University of Minho, Campus de Gualtar, Gualtar, 4710-057, Braga, Portugal
- 3B PT Government Associate Laboratory, Braga, Guimarães, Portugal
| | - Patrício Costa
- Life and Health Sciences Research Institute (ICVS), School of Health Sciences, University of Minho, Campus de Gualtar, Gualtar, 4710-057, Braga, Portugal
- 3B PT Government Associate Laboratory, Braga, Guimarães, Portugal
- Faculty of Psychology and Education Sciences, University of Porto, Porto, Portugal
| | - Manuel J Costa
- Life and Health Sciences Research Institute (ICVS), School of Health Sciences, University of Minho, Campus de Gualtar, Gualtar, 4710-057, Braga, Portugal.
- 3B PT Government Associate Laboratory, Braga, Guimarães, Portugal.
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17
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Song Y, Shi M. Associations between empathy and big five personality traits among Chinese undergraduate medical students. PLoS One 2017; 12:e0171665. [PMID: 28187194 PMCID: PMC5302826 DOI: 10.1371/journal.pone.0171665] [Citation(s) in RCA: 49] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2016] [Accepted: 01/24/2017] [Indexed: 12/18/2022] Open
Abstract
Background Empathy promotes positive physician-patient communication and is associated with improved patient satisfaction, treatment adherence and clinical outcomes. It has been suggested that personality traits should be taken into consideration in programs designed to enhance empathy in medical education due to the association found between personality and empathy among medical students. However, the associations between empathy and big five personality traits in medical education are still underrepresented in the existing literature and relevant studies have not been conducted among medical students in China, where tensions in the physician-patient relationship have been reported as outstanding problems in the context of China’s current medical reform. Thus, the main objective of this study was to examine the associations between empathy and big five personality traits among Chinese medical students. Methods A cross-sectional study was conducted in a medical university in Northeast China in June 2016. Self-reported questionnaires including the Interpersonal Reactivity Index (IRI) and Big Five Inventory (BFI) and demographic characteristics were distributed. A total of 530 clinical medical students became our final subjects. Hierarchical regression analysis was performed to explore the effects of big five personality traits on empathy. Results Results of this study showed that big five personality traits accounted for 19.4%, 18.1%, 30.2% of the variance in three dimensions of empathy, namely, perspective taking, empathic concern and personal distress, respectively. Specifically, agreeableness had a strong positive association with empathic concern (β = 0.477, P<0.01), and a moderate association with perspective taking (β = 0.349, P<0.01). Neuroticism was strongly associated with personal distress (β = 0.526, P<0.01) and modestly associated with perspective taking (β = 0.149, P<0.01). Openness to experience had modest associations with perspective taking (β = 0.150, P<0.01) and personal distress (β = -0.160, P<0.01). Conscientiousness had a modest association with perspective taking (β = 0.173, P<0.01). Conclusion This study revealed that big five personality traits were important predictors of self-reported measures of both cognitive and affective empathy among Chinese medical students. Therefore, individualized intervention strategies based on personality traits could be integrated into programs to enhance empathy in medical education.
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Affiliation(s)
- Yang Song
- English Department, School of Fundamental Sciences, China Medical University, Shenyang North New Area, Shenyang, Liaoning Province, P.R.China
| | - Meng Shi
- English Department, School of Fundamental Sciences, China Medical University, Shenyang North New Area, Shenyang, Liaoning Province, P.R.China
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18
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Quince TA, Kinnersley P, Hales J, da Silva A, Moriarty H, Thiemann P, Hyde S, Brimicombe J, Wood D, Barclay M, Benson J. Empathy among undergraduate medical students: A multi-centre cross-sectional comparison of students beginning and approaching the end of their course. BMC MEDICAL EDUCATION 2016; 16:92. [PMID: 26979078 PMCID: PMC4791909 DOI: 10.1186/s12909-016-0603-7] [Citation(s) in RCA: 54] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/17/2015] [Accepted: 02/24/2016] [Indexed: 05/13/2023]
Abstract
BACKGROUND Although a core element in patient care the trajectory of empathy during undergraduate medical education remains unclear. Empathy is generally regarded as comprising an affective capacity: the ability to be sensitive to and concerned for, another and a cognitive capacity: the ability to understand and appreciate the other person's perspective. The authors investigated whether final year undergraduate students recorded lower levels of empathy than their first year counterparts, and whether male and female students differed in this respect. METHODS Between September 2013 and June 2014 an online questionnaire survey was administered to 15 UK, and 2 international medical schools. Participating schools provided both 5-6 year standard courses and 4 year accelerated graduate entry courses. The survey incorporated the Jefferson Scale of Empathy-Student Version (JSE-S) and Davis's Interpersonal Reactivity Index (IRI), both widely used to measure medical student empathy. Participation was voluntary. Chi squared tests were used to test for differences in biographical characteristics of student groups. Multiple linear regression analyses, in which predictor variables were year of course (first/final); sex; type of course and broad socio-economic group were used to compare empathy scores. RESULTS Five medical schools (4 in the UK, 1 in New Zealand) achieved average response rates of 55 % (n = 652) among students starting their course and 48 % (n = 487) among final year students. These schools formed the High Response Rate Group. The remaining 12 medical schools recorded lower response rates of 24.0 % and 15.2 % among first and final year students respectively. These schools formed the Lower Response Rate Group. For both male and female students in both groups of schools no significant differences in any empathy scores were found between students starting and approaching the end of their course. Gender was found to significantly predict empathy scores, with females scoring higher than males. CONCLUSIONS Participant male and female medical students approaching the end of their undergraduate education, did not record lower levels of empathy, compared to those at the beginning of their course. Questions remain concerning the trajectory of empathy after qualification and how best to support it through the pressures of starting out in medical practice.
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Affiliation(s)
- Thelma A Quince
- />Primary Care Unit, Department of Public Health, Primary Care University of Cambridge, IPH, Robinson Way, Cambridge, CB2 0SR UK
| | - Paul Kinnersley
- />Institute of Medical Education, Medical School, Cardiff University 2nd floor, Neuadd Meirionydd, Heath Park, Cardiff, CF14 4XN UK
| | - Jonathan Hales
- />Department of Medical and Social Care Education, University of Leicester, University Road, Leicester, LE1 7RH UK
| | - Ana da Silva
- />College of Medicine, University of Swansea, Swansea, Wales SA2 8PP UK
| | - Helen Moriarty
- />Department of Primary Health Care and General Practice, University of Otago, Wellington, 23a Mein Street, PO Box 7343, Wellington, New Zealand
| | - Pia Thiemann
- />Primary Care Unit, Department of Public Health, Primary Care University of Cambridge, IPH, Robinson Way, Cambridge, CB2 0SR UK
| | - Sarah Hyde
- />Primary Care Unit, Department of Public Health, Primary Care University of Cambridge, IPH, Robinson Way, Cambridge, CB2 0SR UK
| | - James Brimicombe
- />Primary Care Unit, Department of Public Health, Primary Care University of Cambridge, IPH, Robinson Way, Cambridge, CB2 0SR UK
| | - Diana Wood
- />School of Clinical Medicine, University of Cambridge, Box 111 Cambridge Biomedical Campus, Cambridge, CB2 0SP UK
| | - Matthew Barclay
- />Primary Care Unit, Department of Public Health, Primary Care University of Cambridge, IPH, Robinson Way, Cambridge, CB2 0SR UK
| | - John Benson
- />Primary Care Unit, Department of Public Health, Primary Care University of Cambridge, IPH, Robinson Way, Cambridge, CB2 0SR UK
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Persson BN, Kajonius PJ. Empathy and universal values explicated by the empathy-altruism hypothesis. The Journal of Social Psychology 2016; 156:610-619. [PMID: 26885864 DOI: 10.1080/00224545.2016.1152212] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Research reports that empathy is on the decline in present-day society, together with an increasing trend in self-enhancing values. Based on the empathy-altruism hypothesis, we investigated whether these constructs are interlinked by analyzing the relationships between emotional and cognitive empathy and 10 universal values. In the first study, using a middle-aged U.S. sample, the results showed that empathy was strongly and positively related to altruistic values and negatively to self-enhancing values in a pattern that aligned with the empathy-altruism hypothesis. In a second confirmation study, these findings were replicated and extended, while also controlling for the Big Five personality traits, to discount that empathy is only captured by basic personality. Only emotional empathy, not cognitive empathy, accounted for up to 18% additional variance in altruistic values, which further confirmed the emphasis on feelings, as postulated by the empathy-altruism hypothesis.
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Affiliation(s)
| | - Petri J Kajonius
- a University of Skövde.,b University West , Trollhättan.,c University of Gothenburg
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