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Guo R. Development of a resilience safety culture model for the hazardous materials processing industry. INTERNATIONAL JOURNAL OF OCCUPATIONAL SAFETY AND ERGONOMICS 2024:1-10. [PMID: 38923418 DOI: 10.1080/10803548.2024.2357938] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/28/2024]
Abstract
Many previous cases have demonstrated that hazardous materials processing industry (HMPI) accidents always result in huge losses and HMPI companies which suffer accidents are difficult to quickly restore. This has demanded an effective way to solve the two problems. Resilience safety culture (RSC) combines conventional safety culture and resilience engineering. It aims at giving an organization the abilities of continually operating or timely recovering during or after a major unexpected event. RSC fits the safety demands of the HMPI well. The present study develops a RSC model for the HMPI. Firstly, through literature review, 12 model elements with 16 hypothesized relationships are developed. These hypothesis are then tested by 618 samples with structural equation modelling. Finally, an HMPI RSC model with 12 elements and 12 relationships is established. Model validity is verified by a comparison study on the proposed model and two existing models with the fuzzy analytic hierarchy process.
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Affiliation(s)
- Renlin Guo
- Safety Culture Institute, Beijing Zhongqi Anhuan Information Science Research Institute, People's Republic of China
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Del Barrio LG, Rodríguez-Díez C, Gea A, Arbea L, Pereira J, Díez N. Impact of a longitudinal course on medical professionalism on the empathy of medical students. PATIENT EDUCATION AND COUNSELING 2024; 119:108042. [PMID: 37978022 DOI: 10.1016/j.pec.2023.108042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/20/2023] [Revised: 07/08/2023] [Accepted: 10/28/2023] [Indexed: 11/19/2023]
Abstract
OBJECTIVE Medical education should enhance empathy. We examined, using self-assessment instruments and standardized patients (SPs), the impact on empathy, of a multi-year intervention (years 4-6 of medical training) that uses reflective learning approaches. METHODS 241 final-year medical students participated; 110 from the 2018 graduation class (non-intervention group) and 131 from the 2019 graduation class (intervention group). Participants completed two self-reported empathy questionnaires - the Jefferson Scale of Empathy-Students (JSE-S) and the Interpersonal Reactivity Index (IRI) - and a personality questionnaire, the NEO Five-Factor Inventory. Additionally, SPs in a simulated station assessed participants' empathy with two patient-reported instruments: the Consultation and Relational Empathy (CARE) scale and the Jefferson Scale of Patient Perceptions of Physician Empathy (JSPPPE). RESULTS Empathy scores were significantly higher in the intervention group compared to the non-intervention group when assessed by the SP (p < 0.001). No differences were found in self-reported questionnaires between the two groups. CONCLUSION A longitudinal, multi-year reflection-based intervention enhanced empathy amongst medical students as assessed by SPs, but not when assessed by student self-reported measures. PRACTICE IMPLICATIONS Multi-year reflective learning interventions during clinical training nurture empathy in medical students. Assessments completed by SPs or patients may enhance the evaluation of empathy.
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Affiliation(s)
- Loreto García Del Barrio
- Department of Radiology, Clínica Universidad de Navarra, Pamplona, Spain; Department of Medical Education, Universidad de Navarra, Pamplona, Spain
| | | | - Alfredo Gea
- Department of Medical Education, Universidad de Navarra, Pamplona, Spain; Department of Preventive Medicine and Public Health, Universidad de Navarra, Pamplona, Spain
| | - Leire Arbea
- Department of Medical Education, Universidad de Navarra, Pamplona, Spain; Department of Oncology, Clínica Universidad de Navarra, Pamplona, Spain
| | - José Pereira
- Department of Medical Education, Universidad de Navarra, Pamplona, Spain; Department of Family Medicine, McMaster University, Canada
| | - Nieves Díez
- Department of Medical Education, Universidad de Navarra, Pamplona, Spain; Department of Pathology, Anatomy and Physiology, Universidad de Navarra, Pamplona, Spain.
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Benmaamar S, Amri H, El Harch I, El Fakir S, El Rhazi K. Measurement Properties of an Arabic Version of the Jefferson Scale of Empathy (JSE) in Moroccan Medical Students. JOURNAL OF ADVANCES IN MEDICAL EDUCATION & PROFESSIONALISM 2024; 12:37-44. [PMID: 38313423 PMCID: PMC10837466 DOI: 10.30476/jamp.2023.100266.1884] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/19/2023] [Accepted: 11/15/2023] [Indexed: 02/06/2024]
Abstract
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.
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Affiliation(s)
- Soumaya Benmaamar
- Laboratory of Epidemiology, Clinical Research and Community Health, Faculty of Medicine, Pharmacy and Dentistry, Sidi Mohamed Ben Abdellah University, Fez, Morocco
- Laboratory of Epidemiology and Health Sciences Research, Sidi Mohamed Ben Abdellah University, Fez, Morocco
- Hassan II University Hospital of Fez, Fez, Morocco
| | - Halima Amri
- Faculty of Medicine, Pharmacy and Dentistry, Sidi Mohamed Ben Abdellah University, Fez, Morocco
| | - Ibtissam El Harch
- Laboratory of Epidemiology, Clinical Research and Community Health, Faculty of Medicine, Pharmacy and Dentistry, Sidi Mohamed Ben Abdellah University, Fez, Morocco
- Laboratory of Epidemiology and Health Sciences Research, Sidi Mohamed Ben Abdellah University, Fez, Morocco
- Hassan II University Hospital of Fez, Fez, Morocco
| | - Samira El Fakir
- Laboratory of Epidemiology, Clinical Research and Community Health, Faculty of Medicine, Pharmacy and Dentistry, Sidi Mohamed Ben Abdellah University, Fez, Morocco
- Laboratory of Epidemiology and Health Sciences Research, Sidi Mohamed Ben Abdellah University, Fez, Morocco
- Hassan II University Hospital of Fez, Fez, Morocco
| | - Karima El Rhazi
- Laboratory of Epidemiology, Clinical Research and Community Health, Faculty of Medicine, Pharmacy and Dentistry, Sidi Mohamed Ben Abdellah University, Fez, Morocco
- Laboratory of Epidemiology and Health Sciences Research, Sidi Mohamed Ben Abdellah University, Fez, Morocco
- Hassan II University Hospital of Fez, Fez, Morocco
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Ghardallou M, Zedini C, Sahli J, Ajmi T, Khairi H, Mtiraoui A. Psychometric properties of a French version of the Jefferson Scale of Empathy. INTERNATIONAL JOURNAL OF MEDICAL EDUCATION 2022; 13:205-214. [PMID: 35920177 PMCID: PMC9904998 DOI: 10.5116/ijme.62d2.8497] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/25/2021] [Accepted: 07/16/2022] [Indexed: 06/15/2023]
Abstract
OBJECTIVE To assess the reliability and construct validity of a French version of the Jefferson Scale of Empathy-Students. METHODS A cross-sectional study was performed among undergraduate medical students in Tunisia. A total of 833 students completed a French version of the JSE-S using convenience sampling. To identify the internal consistency aspect of the reliability, Cronbach's alpha coefficient was computed. Moreover, to assess the construct validity, the sample was randomly divided into two groups. Data from the first group (n=415) were subjected to exploratory factor analysis (EFA), with principal axing factoring (PAF) and oblimin rotation, to re-examine the underlying factor structure of the scale. Data from the second group (n=419) were used for confirmatory factor analysis (CFA) to confirm its latent variable structure. Some goodness-of-fit indices were used to assess the hypothesized model. Gender groups were compared using a t-test to check the known-group validity. RESULTS Reliability analysis reported an acceptable level of internal consistency, with an overall Cronbach's alpha of 0.78 (95% CI [0.75,0.80]). EFA identified a two-factor structure, accounting for 27.4% of the total variance. The two-factor model produced good fit indices when item correlated errors were considered (χ2/df = 1.95, GFI = 0.92, CFI = 0.90, PCFI = 0.79, PGFI = 0.73 and RMSEA = 0.04). Female students had a statistically significant higher empathy scores than male students (t (830) = - 4.16, p < .001). CONCLUSIONS The findings support the construct validity and reliability of a French version of the JSE for medical students. This instrument appears to be useful for investigating empathy among French-speaking populations.
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Affiliation(s)
- Mariem Ghardallou
- University of Sousse, Faculty of Medicine of Sousse, Department of Community Medicine, Research Laboratory LR12ES03, Tunisia
| | - Chekib Zedini
- University of Sousse, Faculty of Medicine of Sousse, Department of Community Medicine, Research Laboratory LR12ES03, Tunisia
| | - Jihene Sahli
- University of Sousse, Faculty of Medicine of Sousse, Department of Community Medicine, Research Laboratory LR12ES03, Tunisia
| | - Thouraya Ajmi
- University of Sousse, Faculty of Medicine of Sousse, Department of Community Medicine, Research Laboratory LR12ES03, Tunisia
| | - Hedi Khairi
- University of Sousse, Faculty of Medicine of Sousse, Research Laboratory LR12ES03, Tunisia
| | - Ali Mtiraoui
- University of Sousse, Faculty of Medicine of Sousse, Department of Community Medicine, Research Laboratory LR12ES03, Tunisia
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Blanco Canseco JM, Blanco Alfonso A, Caballero Martínez F, Hawkins Solís MM, Fernández Agulló T, Lledó García L, López Román A, Piñas Mesa A, Vara Ameigeiras EM, Monge Martín D. Medical empathy in medical students in Madrid: A proposal for empathy level cut-off points for Spain. PLoS One 2022; 17:e0267172. [PMID: 35604951 PMCID: PMC9126362 DOI: 10.1371/journal.pone.0267172] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2022] [Accepted: 04/03/2022] [Indexed: 11/18/2022] Open
Abstract
This study evaluates the degree of empathy among medical students and its influencing factors at three critical moments of their degree studies (beginning of first year and end of third and sixth years) as well as establishes low-, medium-, and high-empathy cut-off points to obtain valid and reliable results that can be extrapolated to the general population. This cross-sectional study of the eight (public and private) medical schools in the province of Madrid, used an electronic questionnaire with the Jefferson Scale of Empathy (JSE), Medical Student Well-Being Index, and other independent characteristics as measuring instruments. Of the 2,264 student participants, 1,679 (74.0%) were women, with a 50.7% participation rate. No significant differences were found in empathy levels by academic year. Regarding range, percentile and cut-off point tables were established to identify students with high, medium, and low empathy levels. Women (p<0.001), volunteer workers (p<0.001), and those preferring general specialties (internal medicine, psychiatry, pediatrics, or family medicine) scored higher on the JSE (p<0.02). Moreover, 41.6% presented high level of psychological distress. Women reported a lower well-being level and a higher risk of psychological distress (p = 0.004). In sum, the empathy of medical students in Madrid did not differ among the three critical moments of their university studies. The established cut-off points could be taken into account when accessing the medical degree and identifying students with low levels of empathy to implement curricular interventions to rectify this perceived deficiency. There was a high percentage of medical students with high levels of psychological distress.
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Affiliation(s)
- José Manuel Blanco Canseco
- School of Medicine, Universidad Francisco de Vitoria, Pozuelo de Alarcón, Madrid, Spain
- Valle de la Oliva Healthcare Centre, Majadahonda, Madrid, Spain
| | - Augusto Blanco Alfonso
- Reina Victoria Healthcare Centre, School of Medicine, Universidad Autónoma de Madrid, Madrid, Spain
| | | | | | | | - Lourdes Lledó García
- Dean Faculty of Medicine and Health Sciences, Universidad de Alcalá, Madrid, Spain
| | | | | | | | - Diana Monge Martín
- School of Medicine, Universidad Francisco de Vitoria, Pozuelo de Alarcón, Madrid, Spain
- * E-mail:
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Potts LC, Bakolis I, Deb T, Lempp H, Vince T, Benbow Y, Waugh W, Kim S, Raza S, Henderson C. Anti-stigma training and positive changes in mental illness stigma outcomes in medical students in ten countries: a mediation analysis on pathways via empathy development and anxiety reduction. Soc Psychiatry Psychiatr Epidemiol 2022; 57:1861-1873. [PMID: 35451604 PMCID: PMC9375761 DOI: 10.1007/s00127-022-02284-0] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/18/2021] [Accepted: 03/31/2022] [Indexed: 12/30/2022]
Abstract
PURPOSE Studies of mental illness stigma reduction interventions have been criticised for failing to evaluate behavioural outcomes and mechanisms of action. This project evaluates training for medical students entitled 'Responding to Experienced and Anticipated Discrimination' (READ), developed to focus on skills in addition to attitudes and knowledge. We aimed to (i) evaluate the effectiveness of READ with respect to knowledge, attitudes, and clinical communication skills in responding to mental illness-related discrimination, and (ii) investigate whether its potential effectiveness was mediated via empathy or/and intergroup anxiety. METHODS This is an international multisite non-randomised pre- vs post-controlled study. Eligible medical students were currently undertaking their rotational training in psychiatry. Thirteen sites across ten countries (n = 570) were included in the final analysis. RESULTS READ was associated with positive changes in knowledge (mean difference 1.35; 95% CI 0.87 to 1.82), attitudes (mean difference - 2.50; 95% CI - 3.54 to - 1.46), skills (odds ratio 2.98; 95% CI 1.90 to 4.67), and simulated patient perceived empathy (mean difference 3.05; 95% CI 1.90 to 4.21). The associations of READ with knowledge, attitudes, and communication skills but not with simulated patient perceived empathy were partly mediated through student reported empathy and intergroup anxiety. CONCLUSION This is the first study to identify mediating effects of reduced intergroup anxiety and increased empathy in an evaluation of anti-stigma training that includes behavioural measures in the form of communication skills and perceived empathy. It shows the importance of both mediators for all of knowledge, skills, and attitudes, and hence of targeting both in future interventions.
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Affiliation(s)
- Laura C. Potts
- Department of Biostatistics and Health Informatics, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, SE5 8AF UK
| | - Ioannis Bakolis
- Department of Biostatistics and Health Informatics, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, SE5 8AF UK ,Health Service and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
| | - Tanya Deb
- South London and Maudsley NHS Foundation Trust, London, UK
| | - Heidi Lempp
- Centre for Rheumatic Diseases, King’s College London, London, UK
| | - Tushar Vince
- GKT School of Medical Education, Faculty of Life Sciences and Medicine, King’s College London, London, UK
| | - Yasmin Benbow
- Health Service and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
| | - William Waugh
- GKT School of Medical Education, Faculty of Life Sciences and Medicine, King’s College London, London, UK
| | - San Kim
- GKT School of Medical Education, Faculty of Life Sciences and Medicine, King’s College London, London, UK
| | - Syed Raza
- GKT School of Medical Education, Faculty of Life Sciences and Medicine, King’s College London, London, UK
| | - Claire Henderson
- Health Service and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
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Capdevila-Gaudens P, García-Abajo JM, Flores-Funes D, García-Barbero M, García-Estañ J. Depression, anxiety, burnout and empathy among Spanish medical students. PLoS One 2021; 16:e0260359. [PMID: 34855803 PMCID: PMC8638989 DOI: 10.1371/journal.pone.0260359] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2021] [Accepted: 11/09/2021] [Indexed: 12/30/2022] Open
Abstract
Medical Education studies suggest that medical students experience mental distress in a proportion higher than in the rest of the population In the present study, we aimed to conduct a nationwide analysis of the prevalence of mental health problems among medical students. The study was carried out in 2020 in all 43 medical schools in Spain, and analyzes the prevalence of depression, anxiety, empathy and burnout among medical students (n = 5216). To measure these variables we used the Beck Depression Inventory Test for assessing depression, the Maslach Burnout Inventory Survey for Students was used for burnout, the State-Trait Anxiety Inventory (STAI) was used to assess anxiety state and trait and the Jefferson Empathy Scale 12 to obtain empathy scores. In relation to depression, the data indicate an overall prevalence of 41%, with 23.4% of participants having moderate to severe levels, and 10% experiencing suicidal ideation. Burnout prevalence was 37%, significantly higher among 6th year than among 1st year students. Anxiety levels were consistent with those reported previously among medical students (25%), and were higher than in the general population for both trait and state anxiety. The prevalence of trait anxiety was higher among women. Empathy scores were at the top end of the scale, with the highest-scoring group (>130) containing a greater percentage of women. Similarly to those published previously for other countries, these results provide a clear picture of the mental disorders affecting Spanish medical students. Medicine is an extremely demanding degree and it is important that universities and medical schools view this study as an opportunity to ensure conditions that help minimize mental health problems among their students. Some of the factors underlying these problems can be prevented by, among other things, creating an environment in which mental health is openly discussed and guidance is provided. Other factors need to be treated medically, and medical schools and universities should therefore provide support to students in need through the medical services available within their institutions.
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Affiliation(s)
- Patricia Capdevila-Gaudens
- 6th Year Student at Pompeu Fabra University, Spanish Council of Medical Students (CEEM), Barcelona, Spain
| | - J. Miguel García-Abajo
- 6th Year Student at the Autonomous University of Madrid, Spanish Council of Medical Students (CEEM), Madrid, Spain
| | - Diego Flores-Funes
- University Expert in Statistics and Specialist in General Surgery and Digestive System, Murcia Health Service, Murcia, Spain
| | - Mila García-Barbero
- Former Chairwoman of the Spanish Society of Medical Education (SEDEM), University Miguel Hernandez, Alicante, Spain
| | - Joaquín García-Estañ
- SEDEM and Center of Studies on Medical Education, University of Murcia, Murcia, Spain
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Mohan Kumar P, Praveen D, Praveen G, Arun Bhupathi P, Ravi Kanth M, Uloopi KS. Awareness, Knowledge, Attitude and Empathy Levels of Dental Postgraduates Towards Their Patients During Practice and Research-A Questionnaire Based Survey. J Patient Exp 2021; 8:23743735211056521. [PMID: 34790863 PMCID: PMC8591639 DOI: 10.1177/23743735211056521] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
Empathy is vital in ensuring the quality of the patient-clinician relationship. Empathy in the health care setting is the ability to understand a patient's experiences and feelings and communicate this understanding for better clinical outcomes in dental treatments. The study aimed to compare levels of empathy in post-graduate dental students across the different years of the master's degree course. Questionnaire forms distributed among post graduate students and awareness, knowledge, attitude, and empathy levels towards their patients were assessed. Responses of all the post-graduate students of all specialties in a dental institute were subjected to statistical analysis to know and compare their empathy towards the patients during their clinical practice and research throughout their three-year master's degree. The mean empathy score was 52.01 (maximum of 100), with a standard deviation of 6.69. The empathy scores decreased slightly from the first to the third year of the master's degree. The participant's age, marital status, place of residence, and specialties of dental post-graduation showed much significant difference in empathy levels. The study found slight significant gender differences in empathy among the participants. The empathy scores declined gradually very slightly as they were promoted to the next level in the course. The increase in empathy levels found in this study is more significant than those reported in similar studies due to the inclusion of educational and orientation programs at the time of admission into post-graduate studies.
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Affiliation(s)
- P Mohan Kumar
- Department of Periodontics and Implantology, Vishnu Dental College, West Godavari, Andhra Pradesh, India
| | - D Praveen
- Department of Conservative Dentistry & Endodontics, Vishnu Dental College, West Godavari, Andhra Pradesh, India
| | - G Praveen
- Department of Public Health Dentistry, Vishnu Dental College, West Godavari, Andhra Pradesh, India
| | - P Arun Bhupathi
- Department of Orthodontics, Vishnu Dental College, West Godavari, Andhra Pradesh, India
| | - M Ravi Kanth
- Department of Oral and Maxillofacial Pathology, Vishnu Dental College, West Godavari, Andhra Pradesh, India
| | - KS Uloopi
- Department of Pedodontics, Vishnu Dental College, West Godavari, Andhra Pradesh, India
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Modeling of 3R (Reduce, Reuse and Recycle) for Sustainable Construction Waste Reduction: A Partial Least Squares Structural Equation Modeling (PLS-SEM). SUSTAINABILITY 2021. [DOI: 10.3390/su131910660] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
There is a lack of awareness and knowledge among the Malaysian construction industry about waste management reduction. Numerous nations worldwide have understood and have incorporated the concept of the 3R (reduce, reuse, and recycle) in waste management, and it has worked out well. This study investigated construction waste issues and developed a model for sustainable reduction by applying 3R using a partial least squares structural equation modeling PLS-SEM in Malaysia. The research methodology adopted the quantitative and qualitative approaches by sending a survey questionnaire to the relevant stakeholders to obtain their views or perceptions and interviewing an expert in the related field about waste reduction in the Malaysian construction industry. Three hundred thirty questionnaires were collected within six months of submission. The significant factors are determined using mean ranking for the reduce, reuse and recycle elements. Based on the results, the exploratory power of the study model is considered sustainable with R2 values of 0.83%. At the same time, the results of relationships between improving factors, policy-related factors, construction waste generated, and sustainable construction waste reduction were significant. Also, the findings revealed that the top factors for waste generation on reducing, reusing, and recycling are lack of design and documentation, and lack of guidance for effective construction waste-collecting. The paper will explore different and dynamic practices, such as recycling, reuse of construction waste management cost reduction, enabling stakeholders and managers to estimate and quantify the actual size of CWM costs and benefits for sustainable development goals.
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Serrada-Tejeda S, Sánchez-Herrera-Baeza P, Rodríguez-Pérez MP, Máximo-Bocanegra N, Martínez-Piédrola RM, Trugeda-Pedrajo N, Huertas-Hoyas E, Pérez-de-Heredia-Torres M. Cultural adaptation and psychometric properties of the Jefferson empathy scale health professions students' version in SpanishOccupational therapy students. BMC MEDICAL EDUCATION 2021; 21:472. [PMID: 34488731 PMCID: PMC8419898 DOI: 10.1186/s12909-021-02845-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 03/18/2021] [Accepted: 07/16/2021] [Indexed: 06/13/2023]
Abstract
BACKGROUND In occupational therapy, empathy is a fundamental concept and has a positive impact on health and quality of care outcomes for patients. It is a basic and essential concept that should prevail in the training of occupational therapy students. The aim of this study is to validate and cross-culturally adapt the Jefferson Medical Empathy Scale, version for health professionals (JSE-HPS) in a sample of Spanish university students of occupational therapy. METHODS A cross-sectional descriptive study was conducted between 2019 and 2020. A convenience sample was selected, consisting of 221 students from the four courses of the Occupational Therapy degree at the Universidad Rey Juan Carlos during the 2019-20 academic year. Each of the participants voluntarily and anonymously completed a sociodemographic data sheet (including age and sex), in addition to the following assessment scales: JSE-HPS and the Interpersonal Reactivity Index (IRI). RESULTS A culturally adapted version of the JSE-HPS that guarantees conceptual and grammatical equivalence specific to the study population was obtained. The psychometric analysis of the translated version showed a Cronbach coefficient α of 0.786. The test-retest reliability analysis showed an intraclass correlation coefficient of 0.90 (95% CI = 0.86-0.93, p < 0.0001). Confirmatory factor analysis (CFA) showed positive results (χ2 = 269.095, df = 167, p < 0.001, Confirmatory Fit Index [CFI] = 0.90, Root Mean Square Error of Approximation [RMSEA] = 0.04). CONCLUSION The cultural adaptation and psychometric results suggest that the Spanish version of the JSE-HPS is a valid and reliable way to evaluate the empathic ability of occupational therapy students.
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Affiliation(s)
- Sergio Serrada-Tejeda
- Department of Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine, Rey Juan Carlos University, Avenida de Atenas s/n. CP.28922, Alcorcón, Madrid, Spain
| | - Patricia Sánchez-Herrera-Baeza
- Department of Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine, Rey Juan Carlos University, Avenida de Atenas s/n. CP.28922, Alcorcón, Madrid, Spain.
| | - Mª Pilar Rodríguez-Pérez
- Department of Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine, Rey Juan Carlos University, Avenida de Atenas s/n. CP.28922, Alcorcón, Madrid, Spain
| | - Nuria Máximo-Bocanegra
- Department of Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine, Rey Juan Carlos University, Avenida de Atenas s/n. CP.28922, Alcorcón, Madrid, Spain
| | - Rosa Mª Martínez-Piédrola
- Department of Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine, Rey Juan Carlos University, Avenida de Atenas s/n. CP.28922, Alcorcón, Madrid, Spain
| | - Nuria Trugeda-Pedrajo
- Department of Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine, Rey Juan Carlos University, Avenida de Atenas s/n. CP.28922, Alcorcón, Madrid, Spain
| | - Elisabet Huertas-Hoyas
- Department of Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine, Rey Juan Carlos University, Avenida de Atenas s/n. CP.28922, Alcorcón, Madrid, Spain
| | - Marta Pérez-de-Heredia-Torres
- Department of Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine, Rey Juan Carlos University, Avenida de Atenas s/n. CP.28922, Alcorcón, Madrid, Spain
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Guihard G. Measurement invariance analysis of two empathy scales in a sample of French first year students registered in health formation. CURRENT PSYCHOLOGY 2021. [DOI: 10.1007/s12144-021-01936-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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García Del Barrio L, Rodríguez-Díez C, Martín-Lanas R, Costa P, Costa MJ, Díez N. Reliability and validity of the Spanish (Spain) version of the consultation and relational empathy measure in primary care. Fam Pract 2021; 38:353-359. [PMID: 33340321 DOI: 10.1093/fampra/cmaa135] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND Empathy is an essential competence in the medical field. There are no validated patient-rated empathy measures in Spanish (Spain). The Consultation and Relational Empathy (CARE) measure is a widely used patient-rated measure of physician empathy. OBJECTIVE To analyse the reliability and validity of the Spanish (Spain) version of the CARE measure in primary care. METHODS After translation, back translation and pilot testing, a convenient sample of 369 patients recruited through 21 primary care physicians in five primary care centres in Pamplona (Navarre, Spain) completed the Spanish (Spain) CARE (Sp-CARE) measure. The number of 'does not apply' or blank responses was calculated to assess acceptability. We analysed internal reliability by means of Cronbach's alpha and ordinal alpha and homogeneity with corrected item-total correlations. The construct validity was examined by confirmatory factor analysis (CFA) and concurrent validity by Spearman's correlation. RESULTS We observed high acceptability; only 37 (1%) responses were marked 'does not apply' and only 3 (0.08%) were left blank. Cronbach's alpha and ordinal alpha for the Sp-CARE measure were 0.953 and 0.970, respectively, and all corrected item-total correlations exceeded the accepted cut of 0.30, demonstrating high internal reliability and homogeneity. CFA corroborated the one-factor structure proposed in the original version. The Sp-CARE measure total score was significantly correlated with overall patient satisfaction (Spearman's rho 0.45, P < 0.001). CONCLUSION The results support the reliability and validity of the Sp-CARE measure as a patient-rated empathy measure in the primary care setting.
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Affiliation(s)
| | - Cristina Rodríguez-Díez
- Department of Medical Education, School of Medicine, Universidad de Navarra, Pamplona, Spain
| | - Raquel Martín-Lanas
- Department of Psychiatry and Medical Psychology, Clínica Universidad de Navarra, Pamplona, Spain
| | - Patricio Costa
- Life and Health Sciences Research Institute, School of Health Sciences, University of Minho, Braga, Portugal
| | - Manual J Costa
- Life and Health Sciences Research Institute, School of Health Sciences, University of Minho, Braga, Portugal
| | - Nieves Díez
- Department of Medical Education, School of Medicine, Universidad de Navarra, Pamplona, Spain
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Cui L, Zhu Y, Qu J, Tie L, Wang Z, Qu B. Psychometric properties of the critical thinking disposition assessment test amongst medical students in China: a cross-sectional study. BMC MEDICAL EDUCATION 2021; 21:10. [PMID: 33407421 PMCID: PMC7786903 DOI: 10.1186/s12909-020-02437-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/27/2020] [Accepted: 12/08/2020] [Indexed: 06/12/2023]
Abstract
BACKGROUND Critical thinking disposition helps medical students and professionals overcome the effects of personal values and beliefs when exercising clinical judgment. The lack of effective instruments to measure critical thinking disposition in medical students has become an obstacle for training and evaluating students in undergraduate programs in China. The aim of this study was to evaluate the psychometric properties of the CTDA test. METHODS A total of 278 students participated in this study and responded to the CTDA test. Cronbach's α coefficient, internal consistency, test-retest reliability, floor effects and ceiling effects were measured to assess the reliability of the questionnaire. Construct validity of the pre-specified three-domain structure of the CTDA was evaluated by explanatory factor analysis (EFA) and confirmatory factor analysis (CFA). The convergent validity and discriminant validity were also analyzed. RESULTS Cronbach's alpha coefficient for the entire questionnaire was calculated to be 0.92, all of the domains showed acceptable internal consistency (0.81-0.86), and the test-retest reliability indicated acceptable intra-class correlation coefficients (ICCs) (0.93, p < 0.01). The EFA and the CFA demonstrated that the three-domain model fitted the data adequately. The test showed satisfactory convergent and discriminant validity. CONCLUSIONS The CTDA is a reliable and valid questionnaire to evaluate the disposition of medical students towards critical thinking in China and can reasonably be applied in critical thinking programs and medical education research.
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Affiliation(s)
- Liyuan Cui
- Institute for International Health Professions Education and Research, China Medical University, Shenyang, 110122, China
- China Medical University Library, China Medical University, Shenyang, 110122, China
| | - Yaxin Zhu
- Institute for International Health Professions Education and Research, China Medical University, Shenyang, 110122, China
| | - Jinglou Qu
- Institute for International Health Professions Education and Research, China Medical University, Shenyang, 110122, China
- Department of Postgraduate Administration, The First Hospital of China Medical University, Shenyang, 110122, China
| | - Liming Tie
- Institute for International Health Professions Education and Research, China Medical University, Shenyang, 110122, China
- The Third Clinical Department, China Medical University, Shenyang, 110122, China
| | - Ziqi Wang
- Institute for International Health Professions Education and Research, China Medical University, Shenyang, 110122, China
| | - Bo Qu
- Institute for International Health Professions Education and Research, China Medical University, Shenyang, 110122, China.
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Thangarasu S, Renganathan G, Natarajan P. Empathy Can Be Taught, and Patients Teach it Best. JOURNAL OF MEDICAL EDUCATION AND CURRICULAR DEVELOPMENT 2021; 8:23821205211000346. [PMID: 33796792 PMCID: PMC7975442 DOI: 10.1177/23821205211000346] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/30/2021] [Accepted: 02/15/2021] [Indexed: 06/10/2023]
Abstract
Empathy toward patients is an essential skill for a physician to deliver the best care for any patient. Empathy also protects the physician from moral injury and decreases the chances for malpractice litigations. The current graduate medical education curriculum allows trainees to graduate without getting focused training to develop empathy as a core competency domain. The tools to measure empathy inherently lack validity. The accurate measure of the provider's empathy comes from the patient's perspectives of their experience and their feedback, which is rarely reaching the trainee. The hidden curriculum in residency programs gives mixed messages to trainees due to inadequate role modeling by attending physicians. This narrative style manuscript portrays a teachable moment at the bedside vividly. The teaching team together reflected upon the lack of empathy, took steps to resolve the issue. The attending demonstrated role modeling as an authentic and impactful technique to teach empathy. The conclusion includes a proposal to include the patient's real-time feedback to trainees as an essential domain under Graduate Medical Education core competencies of professionalism and patient care.
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Affiliation(s)
- Sudhagar Thangarasu
- Paul L. Foster School of Medicine, Texas Tech
University Health Sciences Center El Paso-Transmountain, El Paso, TX, USA
| | - Gowri Renganathan
- Paul L. Foster School of Medicine, Texas Tech
University Health Sciences Center El Paso-Transmountain, El Paso, TX, USA
| | - Piruthiviraj Natarajan
- Department of Internal Medicine—Transmountain
Campus, Texas Tech University Health Sciences Center El Paso, El Paso, TX, USA
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Blanco JM, Caballero F, Álvarez S, Plans M, Monge D. Searching for the erosion of empathy in medical undergraduate students: a longitudinal study. BMJ Open 2020; 10:e041810. [PMID: 33384394 PMCID: PMC7780525 DOI: 10.1136/bmjopen-2020-041810] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/07/2020] [Revised: 12/04/2020] [Accepted: 12/08/2020] [Indexed: 12/30/2022] Open
Abstract
OBJECTIVE To analyse the trajectory of empathy throughout the degree programme of medicine in a Spanish school of medicine. DESIGN Longitudinal, prospective 5-year study, between October 2014 and June 2019. SETTING Students from a Spanish university of medicine. PARTICIPANTS Two voluntary cohorts of undergraduate medical students from two different school years were invited to participate (n=135 (cohort 1, C1) and 106 (cohort 2, C2) per school year). Finally, a total number of 174 students (102 (C1, 71.6% women) and 72 (C2, 70.8% women) students, respectively) were monitored for 5 years. Each cohort was divided in two subcohorts of paired and unpaired students that were analysed to check possible social desirability bias. PRIMARY OUTCOME MEASURE The Jefferson Scale of Empathy (JSE). RESULTS The cohort of 102 students (C1) monitored between their first and fifth years of study (71.6% women) showed an improvement among paired women of 2.15 points in total JSE score (p=0.01) and 2.39 points in cognitive empathy (p=0.01); in the unpaired female cohort the increase was of 2.32 points (cognitive empathy) (p=0.02). The cohort of 72 students (C2) monitored between their second and sixth years of study (70.8% women) displayed a cognitive empathy increase of 2.32 points (p=0.04) in the paired group of women. There were no significant differences between paired and unpaired results for either cohort. Empathy scores among men did not decrease. CONCLUSIONS The empathy of medical students at our school did not decline along grade years. In fact, it improved slightly, particularly cognitive empathy, among women. This paper contributes to enlarge data from Europe, where longitudinal studies are scarce. It supports the idea that there may be global geo-sociocultural differences; however, more studies comparing different school settings are needed.
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Affiliation(s)
- José Manuel Blanco
- School of Medicine, Universidad Francisco de Vitoria, Madrid, Spain
- Valle de la Oliva Healthcare Centre, Madrid, Spain
| | | | - Santiago Álvarez
- School of Medicine, Universidad Francisco de Vitoria, Madrid, Spain
| | | | - Diana Monge
- School of Medicine, Universidad Francisco de Vitoria, Madrid, Spain
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Qu J, Zhu Y, Cui L, Yang L, Lai Y, Ye X, Qu B. Psychometric properties of the Chinese version of the TeamSTEPPS teamwork perceptions questionnaire to measure teamwork perceptions of Chinese residents: a cross-sectional study. BMJ Open 2020; 10:e039566. [PMID: 33191259 PMCID: PMC7668380 DOI: 10.1136/bmjopen-2020-039566] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
OBJECTIVES The purpose of this research was to evaluate the psychometric properties of the TeamSTEPPS Teamwork Perception Questionnaire (T-TPQ) among the Chinese residents. DESIGN Cross-sectional study. SETTING A clinical hospital of the China Medical University in Liaoning Province, China. PARTICIPANTS A total of 664 residents were enrolled in this research. The valid response rate was 83.0% (664 of 800 residents). MAIN OUTCOME MEASURES Internal consistency and test-retest reliability were used to assess the reliability of the questionnaire. The construct validity of the Chinese T-TPQ was evaluated by confirmatory factor analysis. Furthermore, the concurrent, convergent and discriminant validity were analysed. RESULTS Cronbach's α coefficient of the T-TPQ in Chinese language was 0.923. Except for the communication dimension (0.649), the Cronbach's α coefficient of all dimensions were satisfactory. The T-TPQ and its five dimensions reported a good test-retest reliability (0.740-0.881, p<0.01). Moreover, the results of the confirmatory factor analysis demonstrated that the construct validity of the Chinese T-TPQ was satisfactory. All dimensions significantly correlated with the Hospital Survey on Patient Safety Culture (HSOPSC) teamwork within units dimension and the Safety Attitudes Questionnaire (SAQ) teamwork climate dimension (p<0.01), and the questionnaire showed satisfactory convergent and discriminant validity. CONCLUSIONS The T-TPQ in Chinese language demonstrated good psychometric characteristics and was a reliable and valid questionnaire to measure the Chinese health professionals' perception of teamwork. Thus, the Chinese version of the T-TPQ could be applied in teamwork training programmes and medical education research.
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Affiliation(s)
- Jinglou Qu
- Institute for International Health Professions Education and Research, China Medical University, Shenyang, China
- Department of Postgraduate Administration, The First Hospital of China Medical University, Shenyang, China
| | - Yaxin Zhu
- Institute for International Health Professions Education and Research, China Medical University, Shenyang, China
| | - Liyuan Cui
- Institute for International Health Professions Education and Research, China Medical University, Shenyang, China
- China Medical University Library, China Medical University, Shenyang, China
| | - Libin Yang
- Center for Higher Education Research and Teaching Quality Evaluation, Harbin Medical University, Harbin, China
| | - Yanni Lai
- Medical Education Office, Fudan University, Shanghai, China
| | - Xuechen Ye
- Institute for International Health Professions Education and Research, China Medical University, Shenyang, China
| | - Bo Qu
- Institute for International Health Professions Education and Research, China Medical University, Shenyang, China
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17
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Williams B, Beovich B. A systematic review of psychometric assessment of the Jefferson Scale of Empathy using the COSMIN Risk of Bias checklist. J Eval Clin Pract 2020; 26:1302-1315. [PMID: 31742843 DOI: 10.1111/jep.13293] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/24/2019] [Revised: 07/01/2019] [Accepted: 07/06/2019] [Indexed: 12/14/2022]
Abstract
INTRODUCTION Empathic communication in health care may enhance positive patient and health care professional relationships, patient satisfaction and can buffer professional burnout. The Jefferson Scale of Empathy (JSE) was developed based on the need to quantitatively measure levels of empathy, particularly in health care settings. Evaluating the utility of empathy is underpinned by the psychometric rigour of the instruments used to measure it. The aim of this study was to critically evaluate the current evidence on the measurement properties of the JSE. METHODS Two reviewers independently searched six databases for papers describing psychometric assessment of the JSE from January 2000 to July 2018 inclusive. The studies were independently assessed for methodological quality using the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) Risk of Bias checklist. RESULTS The search strategy resulted in the retrieval of 985 papers, of which 59 were included in this study. The majority of papers reported on measures of structural validity and internal consistency, and it was in these areas which the highest quality of reporting was demonstrated. Additionally, there was a generally very good quality in reporting of convergent validity. Reliability, measurement error, cross-cultural validity were reported with less than optimum quality. CONCLUSION The JSE demonstrates robust structural validity, internal consistency, and convergent validity. These measurement properties are generally well reported in the literature in studies of good methodological quality, and thus may be interpreted with relative confidence when used in empathy research. However, current evidence is limited for the properties of reliability, measurement error, and cross-cultural validity. Thus, a degree of caution should be considered in drawing conclusions when using the JSE with regard to these properties. It is recommended that future examinations of the JSE refer to the COSMIN guidelines to ensure complete and well-reported psychometric data are included.
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Affiliation(s)
- Brett Williams
- Department of Community Emergency Health and Paramedic Practice, Monash University, Melbourne, Victoria, Australia
| | - Bronwyn Beovich
- Department of Community Emergency Health and Paramedic Practice, Monash University, Melbourne, Victoria, Australia
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Assing Hvidt E, Søndergaard J, Hvidt NC, Wehberg S, Büssing A, Andersen CM. Development in Danish medical students' empathy: study protocol of a cross-sectional and longitudinal mixed-methods study. BMC MEDICAL EDUCATION 2020; 20:54. [PMID: 32075639 PMCID: PMC7031973 DOI: 10.1186/s12909-020-1967-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/31/2020] [Accepted: 02/12/2020] [Indexed: 05/05/2023]
Abstract
BACKGROUND Clinical empathy has been associated with positive outcomes for both physicians and patients such as: more accurate diagnosis and treatment, increased patient satisfaction and compliance, and lower levels of burnout and stress among physicians. International studies show mixed results regarding the development of empathy among future physicians associating medical education with decline, stability or increase in empathy levels. These mixed results are due to several study limitations. In Denmark, no investigation of Danish medical students' empathy trajectory has yet been conducted wherefore such a study is needed that optimizes the study design of earlier studies. METHODS The aim of the study is to examine and analyze empathy levels and empathy changes among Danish medical students from the four medical faculties in Denmark, employing a cross-sectional and longitudinal mixed-methods design including a control group of non-medical students. By supplementing cross-sectional and longitudinal questionnaire studies with a focus group interview study it is the aim to identify and analyze factors (including educational) that are perceived by medical students to influence the development of empathy and its expression in clinical care. DISCUSSION The results of the study will provide insight into the trajectory of medical students' empathy and in undergraduate and graduate students' experiences with and perceptions of empathy development. In addition, the study will provide evidence to support further research on how targeted educational programmes can best be designed to educate empathic and patient-centered physicians.
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Affiliation(s)
- E Assing Hvidt
- Research Unit of General Practice, Department of Public Health, University of Southern Denmark, J.B. Winsløwsvej 9 A, 5000, Odense, Denmark.
- Department for the Study of Culture, University of Southern Denmark, Campusvej 55, 5230, Odense M, Denmark.
| | - J Søndergaard
- Research Unit of General Practice, Department of Public Health, University of Southern Denmark, J.B. Winsløwsvej 9 A, 5000, Odense, Denmark
| | - N C Hvidt
- Research Unit of General Practice, Department of Public Health, University of Southern Denmark, J.B. Winsløwsvej 9 A, 5000, Odense, Denmark
| | - S Wehberg
- Research Unit of General Practice, Department of Public Health, University of Southern Denmark, J.B. Winsløwsvej 9 A, 5000, Odense, Denmark
| | - A Büssing
- Institute of Integrative Medicine, Witten/Herdecke University, Gerhard-Kienle-Weg 4, 58313, Herdecke, Germany
| | - C M Andersen
- Department for Psychology, University of Southern Denmark, Campusvej 55, 5230, Odense M, Denmark
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Yi K, Kang M, Li D, Wang Z, Bai J, Xu H, Ma S. A multi-institutional and cross-sectional study on empathy in Chinese medical students: differences by student cadre or not, future career preference, and father's education status. BMC MEDICAL EDUCATION 2020; 20:24. [PMID: 31992284 PMCID: PMC6988276 DOI: 10.1186/s12909-020-1935-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/30/2019] [Accepted: 01/13/2020] [Indexed: 05/27/2023]
Abstract
BACKGROUND The aims of this study were to examine the factor structure of the Chinese version of the Jefferson Scale of Empathy for medical students (JSE-S) and investigate differences in empathy scores among Chinese medical students according to gender, student cadre or not, future career preference, and parents' education. METHODS Medical students from three universities completed an online questionnaire containing the JSE-S. Exploratory factor analysis was conducted to determine the factor structure, and group comparisons of empathy scores were examined via t-tests and analysis of variance. RESULTS Four factors emerged from the factor analysis: "perspective taking," "compassionate care," "standing in the patient's shoes," and an uninterpretable factor. The results indicated that students who were female, held positions as student cadres, preferred to become a doctor, and whose fathers had a high school education or below tended to have more empathy. CONCLUSIONS Overall, the findings provide information on the dimensions of empathy applicable to Chinese medical students and confirm the factors found in the original measure. The dimensions have implications for developing empathy among medical students throughout the world. Educators can use the information to design interventions to foster empathy among students in the context of medical education reform in many countries, including China.
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Affiliation(s)
- Kangqi Yi
- School of Public Health, Fudan University, Shanghai, China
| | - Mingyi Kang
- Experimental Teaching Center of Basic Medical Science, School of Basic Medical Sciences, Fudan University, Shanghai, China
| | - Dongju Li
- Experimental Teaching Center of Basic Medical Science, School of Basic Medical Sciences, Fudan University, Shanghai, China
| | - Zhipeng Wang
- School of Social Development and Public Policy, Fudan University, Shanghai, China
| | - Jinsong Bai
- Experimental Teaching Center of Basic Medical Science, School of Basic Medical Sciences, Fudan University, Shanghai, China
| | - Huiming Xu
- Shimen Second Road Community Health Service Center, Shanghai, China
| | - Shulan Ma
- Experimental Teaching Center of Basic Medical Science, School of Basic Medical Sciences, Fudan University, Shanghai, China.
- Medical Education and Medical Humanities Research Center, School of Basic Medical Sciences, Fudan University, P.O. Box 192, 138 Yi-Xue-Yuan Road, Shanghai, 200032, China.
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Díaz Valentín MJ, Garrido Abejar M, Fuentes Chacón RM, Serrano Parra MD, Larrañaga Rubio ME, Yubero Jiménez S. Validation to the Spanish of the Jefferson empathy scale health professions students version and its psychometric properties in nursing students. Nurse Educ Pract 2019; 40:102629. [PMID: 31568983 DOI: 10.1016/j.nepr.2019.102629] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2018] [Revised: 04/10/2019] [Accepted: 09/19/2019] [Indexed: 12/14/2022]
Abstract
The ability to empathize with patients has a positive effect on health outcomes and quality of care. This study aimed to evaluate the psychometric characteristics of the Spanish version of the Jefferson Scale of Empathy-Health Profession Student version (JSE-HPS) in a sample of 422 nursing students and to compare their factorial structure with that of the original scale. In this study, the Cronbach α value was 0.828. These analyses showed that the scale has a factorial structure with three dimensions and all the items loaded adequately (>0.36) except for item 18 (0.266). The main factor, ̔Perspective taking̕ grouped 10 items; the second factor, ̔Compassionate care̕, grouped 6 items, and the third factor, ̔Standing in the patient's shoes̕, grouped 3 items; 42.2% of the variance was explained. The results of the confirmatory factor analysis suggest that the Spanish version of the JSE-HPS is a valid and reliable way to evaluate the empathic capacity of nursing students.
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Fragkos KC, Sotiropoulos I, Frangos CC. Empathy assessment in healthcare students is highly heterogeneous: A systematic review and meta-analysis (2012-2016). World J Meta-Anal 2019; 7:1-30. [DOI: 10.13105/wjma.v7.i1.1] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/27/2018] [Revised: 12/16/2018] [Accepted: 12/30/2018] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Clinical empathy leads to improved patient satisfaction and better clinical outcomes. Currently, there are multiple empathy scales with minimal or no efforts to produce an integrated definition of clinical empathy which can be assessed sufficiently by only a few scales. Moreover, there is an unclear overall reliability of these empathy scales, hence limiting comparative evaluation.
AIM To examine which empathy scales have been used in healthcare students and to estimate their overall internal consistency.
METHODS A systematic review was performed with inclusion criteria any empirical study with quantitative data examining empathy of healthcare students toward patients between 2012 and 2016. A random effects model was used to produce a pooled estimate of the Cronbach’s alphas. The Hakstian-Whalen transformation was used for analyses based on the Rodriguez-Maeda method. Heterogeneity was quantified using the I2 statistic and further investigated with subgroup analysis and meta-regression. Publication bias was assessed using funnel plots, Egger’s test, Begg’s test, and the trim and fill analysis.
RESULTS Thirteen scales have been used to assess clinical empathy in healthcare students from forty nine studies with total sample size 49384 students. The most frequently used scale is the Jefferson Scale of Physician Empathy followed by Davis’ Interpersonal Reactivity Index. The overall reliability was 0.805 (95%CI 0.786-0.823), which is acceptable, but there was heterogeneity and publication bias. Some heterogeneity was explained by the different countries of the studies under investigation and student types but most heterogeneity remained unexplained.
CONCLUSION The results indicate that scales have satisfactory internal consistency but there are a multitude of scales, definitions and empathy components. Future research should focus on standardizing scales and creating consensus statements regarding the definition of empathy and use of appropriate scales.
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Affiliation(s)
- Konstantinos C Fragkos
- GI Services, University College London Hospitals NHS Foundation Trust, London NW1 2PG, United Kingdom
- Medical School, University College London, London WC1E 6BT, United Kingdom
| | - Ioannis Sotiropoulos
- Department of Accounting and Finance, University of Ioannina, Psathaki 481 00 Preveza, Greece
| | - Christos C Frangos
- Greek Research Institute for the Study of Quantitative, Social and Biomedical Problems, Athens 141 21, Greece
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[Clinical empathy among family and community medicine residents and tutors. The view of physicians and patients]. Aten Primaria 2018; 52:185-192. [PMID: 30522783 PMCID: PMC7063160 DOI: 10.1016/j.aprim.2018.04.009] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2018] [Revised: 04/16/2018] [Accepted: 04/26/2018] [Indexed: 12/30/2022] Open
Abstract
Objetivo Determinar el grado de empatía de residentes y tutores de medicina de familia. Saber si existe relación entre la empatía autopercibida por los médicos y la valorada por sus pacientes. Diseño Estudio observacional transversal mediante encuesta. Emplazamiento Unidad Docente de Atención Primaria, Madrid. Participantes Se envió una encuesta por correo electrónico a todos los tutores y residentes de familia de la Unidad Docente. Respondieron 50 residentes (39,4%) y 41 tutores (45%). Un total de 428 pacientes fueron captados de forma oportunista en un Centro de Salud. Se entrevistó a sus médicos. Mediciones principales La empatía se midió mediante la Escala de Empatía Médica de Jefferson y la Escala de Percepciones de los Pacientes sobre la Empatía Médica de Jefferson. Resultados Los tutores puntuaron 2,53 puntos más alto en empatía cognitiva que los residentes (p = 0,04). Las puntuaciones de la empatía emocional de los tutores son menores en aquellos de mayor edad (r = −0,32; p < 0,05). Los residentes españoles (el 82%) y sin experiencia laboral previa puntuaron más alto en empatía global (p = 0,02). Los residentes de último año obtuvieron calificaciones significativamente más bajas en empatía que el resto de sus compañeros. Se observó correlación positiva (r = 0,72; p = 0,01) entre la autopercepción de la empatía del profesional y la referida por sus pacientes. Conclusiones Los residentes con experiencia profesional previa, los de último año de residencia y los de origen latinoamericano presentan puntuaciones más bajas de empatía. Existe fuerte relación entre la empatía autopercibida por los médicos y la visión que sus pacientes tienen sobre la misma.
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Hojat M, DeSantis J, Shannon SC, Mortensen LH, Speicher MR, Bragan L, LaNoue M, Calabrese LH. The Jefferson Scale of Empathy: a nationwide study of measurement properties, underlying components, latent variable structure, and national norms in medical students. ADVANCES IN HEALTH SCIENCES EDUCATION : THEORY AND PRACTICE 2018; 23:899-920. [PMID: 29968006 PMCID: PMC6245107 DOI: 10.1007/s10459-018-9839-9] [Citation(s) in RCA: 102] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/23/2018] [Accepted: 06/18/2018] [Indexed: 05/22/2023]
Abstract
The Jefferson Scale of Empathy (JSE) is a broadly used instrument developed to measure empathy in the context of health professions education and patient care. Evidence in support of psychometrics of the JSE has been reported in health professions students and practitioners with the exception of osteopathic medical students. This study was designed to examine measurement properties, underlying components, and latent variable structure of the JSE in a nationwide sample of first-year matriculants at U.S. colleges of osteopathic medicine, and to develop a national norm table for the assessment of JSE scores. A web-based survey was administered at the beginning of the 2017-2018 academic year which included the JSE, a scale to detect "good impression" responses, and demographic/background information. Usable surveys were received from 6009 students enrolled in 41 college campuses (median response rate = 92%). The JSE mean score and standard deviation for the sample were 116.54 and 10.85, respectively. Item-total score correlations were positive and statistically significant (p < 0.01), and Cronbach α = 0.82. Significant gender differences were observed on the JSE scores in favor of women. Also, significant differences were found on item scores between top and bottom third scorers on the JSE. Three factors of Perspective Taking, Compassionate Care, and Walking in Patient's Shoes emerged in an exploratory factor analysis by using half of the sample. Results of confirmatory factor analysis with another half of the sample confirmed the 3-factor model. We also developed a national norm table which is the first to assess students' JSE scores against national data.
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Affiliation(s)
- Mohammadreza Hojat
- Center for Research in Medical Education and Health Care, Sidney Kimmel Medical College at Thomas Jefferson University, 1015 Walnut Street, Suite 320, Philadelphia, PA, 19107, USA.
| | - Jennifer DeSantis
- Center for Research in Medical Education and Health Care, Sidney Kimmel Medical College at Thomas Jefferson University, 1015 Walnut Street, Suite 320, Philadelphia, PA, 19107, USA
| | - Stephen C Shannon
- American Association of Colleges of Osteopathic Medicine, Bethesda, MD, USA
| | - Luke H Mortensen
- American Association of Colleges of Osteopathic Medicine, Bethesda, MD, USA
| | - Mark R Speicher
- American Association of Colleges of Osteopathic Medicine, Bethesda, MD, USA
| | - Lynn Bragan
- American Association of Colleges of Osteopathic Medicine, Bethesda, MD, USA
| | - Marianna LaNoue
- Center for Research in Medical Education and Health Care, Sidney Kimmel Medical College at Thomas Jefferson University, 1015 Walnut Street, Suite 320, Philadelphia, PA, 19107, USA
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Blanco JM, Caballero F, García FJ, Lorenzo F, Monge D. Validation of the Jefferson Scale of Physician Empathy in Spanish medical students who participated in an Early Clerkship Immersion programme. BMC MEDICAL EDUCATION 2018; 18:209. [PMID: 30208887 PMCID: PMC6134759 DOI: 10.1186/s12909-018-1309-9] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/04/2017] [Accepted: 08/10/2018] [Indexed: 06/01/2023]
Abstract
BACKGROUND The Jefferson Scale of Physician Empathy is the most widely used instrument to measure empathy in the doctor-patient relationship. This work pursued cultural adaptation and validation of the original scale, in its health professions version (JSE-HP), for medical students who participate in an Early Clerkship Immersion Programme of a Spanish university. METHODS The questionnaire was replied by 506 1st, 2nd, 3rd and 5th year medical students from Universidad Francisco de Vitoria, Madrid, in 2014 and 2016. Internal consistency was analysed by means of Cronbach's alpha, and reliability by means of test-retest using the intraclass correlation coefficient and the Bland-Altman method. The construct validity was checked by means of confirmatory factor analysis and association with other empathy-related variables. Criterion validity was compared using Davis' Interpersonal Reactivity Index. RESULTS Cronbach's alpha was 0.82 (range 0.80-0.85). Item-total score correlations were positive and significant (median 0.45, p < 0.01). The test-retest intraclass correlation coefficient was 0.68 (0.42-0.82). The factor analysis confirmed the three original factors: "perspective taking", "compassionate care" and "standing in the patient's shoes". Women and students who preferred specialities focused on persons obtained the best scores. The JSE-HP scores were positively correlated with Interpersonal Reactivity Index, personality traits were associated with empathy, clinical interview skills and Objective Structured Clinical Examinations. CONCLUSION The results support the validity and reliability of JSE-HP applied to Spanish medical students.
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Affiliation(s)
- José M. Blanco
- Valle de la Oliva Healthcare Centre, Enrique Granados 2, 28222, Majadahonda, Madrid, Spain
- C/Alimoche 30. Urb. Molino de la Hoz, Las Rozas de Madrid, 28232 Madrid, Spain
| | - Fernando Caballero
- School of Health Sciences, Universidad Francisco de Vitoria, Ctra. Pozuelo-Majadahonda (M-515) Km. 1.800, 28223, Pozuelo de Alarcón, Madrid, Spain
| | - Fernando J. García
- Applied Epidemiology Department of the National Epidemiology Centre, Instituto de Salud Carlos III, C/Sinesio Delgado, 28029 Madrid, Spain
| | - Fernando Lorenzo
- School of Health Sciences, Universidad Francisco de Vitoria, Ctra. Pozuelo-Majadahonda (M-515) Km. 1.800, 28223, Pozuelo de Alarcón, Madrid, Spain
| | - Diana Monge
- School of Health Sciences, Universidad Francisco de Vitoria, Ctra. Pozuelo-Majadahonda (M-515) Km. 1.800, 28223, Pozuelo de Alarcón, Madrid, Spain
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Díez-Goñi N, Rodríguez-Díez MC. Why teaching empathy is important for the medical degree. Rev Clin Esp 2017; 217:332-335. [PMID: 28237408 DOI: 10.1016/j.rce.2017.01.005] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2016] [Revised: 11/12/2016] [Accepted: 01/08/2017] [Indexed: 12/30/2022]
Abstract
Empathy is a basic skill in the exercise of medicine and increases patient and physician satisfaction and improves clinical results. However, the teaching of empathy is poorly covered in the teaching plans. A number of studies have observed a reduction in empathy during the final training courses. The reasons for this decline include, the students' excessive academic workload, the prioritisation of acquiring medical expertise over humanistic knowledge, the patient load in hospitals and health centres and the physicians' need to distance themselves from their patients. Nevertheless, intervention studies through simulation with standardised patients have shown an increase in empathy in students, which can be evaluated through the Jefferson scales: JSE-S and JSPPPE. The teaching of empathy to medical students is an important commitment in the curricular programs of medical schools.
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Affiliation(s)
- N Díez-Goñi
- Unidad de Educación Médica, Facultad de Medicina, Universidad de Navarra, Pamplona, España.
| | - M C Rodríguez-Díez
- Unidad de Educación Médica, Facultad de Medicina, Universidad de Navarra, Pamplona, España
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