Development and Cross-National Validation of a French Version of the Jefferson Scale of Empathy for Students

Cross-national Psychometric Evaluation of the Jefferson Scale of Empathy-Medical Student Version

This study aimed to examine the factorial structure of the Jefferson Scale of Empathy-Medical student version (JSE-S) and assess items' discriminatory ability at higher and lower empathy levels in medical student populations from different countries and languages. JSE-S datasets were retrieved from previous studies of 4113 first- and/or second-year medical students from Switzerland, Portugal, Italy, Brazil, France, Spain, New Zealand, UK, Ireland, Mexico, and Peru. Parallel principal component analyses and item response theory were applied. Excluding item 18, the Compassionate Care subscale emerged in five samples (Switzerland, Portugal, Italy, France and UK/Ireland), Perspective Taking in three (Switzerland, Portugal and UK/Ireland) and Walking in Patient's Shoes in five (Switzerland, Portugal, Spain, UK/Ireland and Mexico/Peru). All subscales had items providing overlapping information. The JSE-S subscales had reliable high test performance at low empathy levels, while when the JSE-S increased, the standard error also increased. There was no consistent support across countries for the JSE-S three-factorial structure. Items provided redundant information and discriminatory power decreased when aiming to differentiate students at high empathy levels. A JSE-S revision to improve cross-cultural comparability, results' generalizability and validity should focus on suppressing or reformulating items that cannot differentiate medical students' empathy.

Measurement Properties of an Arabic Version of the Jefferson Scale of Empathy (JSE) in Moroccan Medical Students

Introduction

Empathy is an essential communication skill in the doctor-patient relationship. In fact, measuring its level in medical students is becoming increasingly important. There is a Lack of tools to measure it in Morocco. The aim of this study was to validate the Arabic version of the Jefferson Scale of Empathy (JSE) among Moroccan medical students.

Methods

The questionnaire was translated from its original English version to Arabic in accordance with international guidelines for cross-cultural adaptation of self-report measures. After translation and transcultural adaptation, the final Arabic version was administered to a sample of Moroccan medical students. Descriptive statistics at the item level and at the scale level were calculated. The internal consistency, reproducibility, criterion, and construct validity were assessed. A multitrait scale analysis was used to examine construct validity. To measure criterion validity, the Arabic JSE scale was correlated to a visual analog scale (VAS), measuring the level of empathy. The mean of score was compared by gender, year of medical training, and specialty preference using the Student (t) and ANOVA tests. All statistical analyses were performed by SPSS, Version 26.

Results

A total of 201 students participated in the study. The average empathy score was 105.1±13.4. It was higher in female than male students (P=0.003). The Cronbach alpha was 0.76. The instrument has moderate test-retest reliability (ICC=0.6). The results showed a positive and significant correlation between Arabic JSE and VAS ((r=0.28, p<0.0001). The multitrait scaling analysis by testing convergent and discriminant validity confirmed the original scale structure.

Conclusion

The adapted Moroccan version of the Jefferson Scale of Empathy proved to be a valid instrument. It demonstrated an acceptable reliability and validity. Indeed, it can be used in national studies to measure empathy in medical students.

[Correlation between Objective structured clinical examinations (OSCE) and knowledge examination scores and analysis of factors associated with better OSCE success in fourth and fifth year medicine students at Dijon university hospital]

RATIONALE

Objective structured clinical examinations (OSCEs) were introduced to evaluate students not only on their knowledge, but also on their clinical skills and attitudes. The objectives were to study the correlation between OSCE scores and scores obtained to traditional knowledge examinations and to analyse factors associated with better OSCE performance in DFASM1 and 2 students at Dijon university hospital.

METHODS

This was a prospective observational study conducted among all fourth and fifth year medical students in Dijon. The scores on the OSCE elective tests (2022) and the average score on the knowledge tests (2021-2022) were collected and their correlation measured. A questionnaire asked students about their demographic characteristics, their investment in formative and practicum OSCEs, their level of empathy (Jefferson questionnaire) and their personality traits (NEO-Pi-R).

RESULTS

Of 549 students, 513 completed all tests. Scores on OSCE and faculty knowledge tests were correlated (r=0.39, P<0.001). Of these, 111 (20%) students responded to the questionnaire, and 97 were analized. We did not observe any significant difference between students who performed better on OSCEs than on knowledge tests and those who did not, regarding their age, their investment in formative tests, their personality traits or their level of empathy.

CONCLUSION

Our results underline the need to optimize the evaluation of empathy and clinical skills in OSCE tests, using new tools, in order to better discriminate between students on these skills.

Dynamics of career intentions in a medical student cohort: a four-year longitudinal study

BACKGROUND

Medical students' career intentions often change between matriculation and graduation, yet little is known about the precise timing and dynamics of individual students' career decisions. This study expands on previous research by exploring the stability of individual students' career intentions over four years and by analyzing associations between unstable career intentions and students' characteristics.

METHODS

Medical students from two classes were recruited into a cohort during their first academic year and completed a yearly survey over a four-year period (end of pre-clinical curriculum to graduation). Measures included career intention (specialty and practice type), personality, coping strategies, empathy, and motives for becoming a physician. The authors developed a score ranging from 0 to 10 quantifying instability of career intentions (0 = stable; 10 = unstable). The distribution of the score was analyzed descriptively, and the association between the score and other variables was quantified using a stepwise beta regression model.

RESULTS

The sample included 262 students (61% females). The mean score was 3.07 with a median of 3. 18% of students (N = 46) did not change their specialty intention over the four years, whereas 10% (N = 26) changed every year. No further subgroups were identified between these extremes. An intention to work in private practice in year 3 and the motive care for patients were significantly associated with more stable career intentions.

CONCLUSION

Most students are situated on a continuum between the two extremes of being firmly committed and undecided. Extrinsic factors may be more important drivers of these fluctuations than personal characteristics and should be explored in future research. This study's findings also provide avenues for supporting students in their career decision-making.