Empathy assessment in healthcare students is highly heterogeneous: A systematic review and meta-analysis (2012-2016)

Empathy level towards patients among thai dental students: a cross-sectional study

BACKGROUND

This study aimed to develop the Jefferson scale of Empathy - Health Professions student version (JSE-HPS) for the dental student in the Thai version and assess the empathy level in students across gender, universities, and year of dental education.

METHODS

JSE-HPS original version was translated to develop the draft Thai JSE-HPS version and was administered to 5 dental students for a pilot test. The final questionnaires (JSE-HPS) were completed by 439 dental students from five public universities and one private in Thailand in the 2021-2022 academic year. The internal consistency and reliability (test-retest) of the questionnaires were tested by using Cronbach's alpha and intraclass correlation coefficient (ICC). Factor analysis was used to examine the underlying factors of the JSE-HPS (Thai language).

RESULTS

The JSE-HPS represented good internal consistency (Cronbach's α = 0.83). Factor analysis revealed, "Compassionate Care", "Perspective Taking" and "Ability to stand in Patients' Shoes" as the first, second, and third factors, respectively. The mean empathy score of dental students was 114.30 (SD = 13.06) from the total score of 140. There were no significant differences in the empathy levels among genders, study programs, grades, universities, regions, types of universities, and years of study.

CONCLUSION

The findings confirm the reliability and validity of the JSE-HPS (Thai version) to measure the empathy level among dental students. Integrating empathic elements into the dental curriculum will help student learning to be more effective and improve treatment outcomes.

Relationship between self-reported cognitive and behavioural empathy among medical students

OBJECTIVE

The aim of this study was to explore the relationship between cognitive and behavioural empathy in medical students.

METHODS

Fourteen 4th year medical students recruited on the basis of their scores on the self-reported Jefferson Scale of Empathy (JSE-S) were divided into two groups: low JSE-S scorers (n = 8) (M = 96.75, SD = 10.3) and high JSE-S scorers (n = 6) (M = 121.3, SD = 2.94). They were discreetly videotaped while taking history with an incognito standardized patient. Students' behavioural empathy was measured using the Verona Coding System (VR-CoDES-P) and rating of non-verbal behaviour.

RESULTS

Patients expressed the same number of concerns per encounter in both groups but gave more cues to high-scorers (p = 0.029). However, students of both groups demonstrated the same amount of verbal empathy (high: 16% vs low: 15% p = 1.00). High JSE-S scorers' non-verbal communication tended to be rated slightly higher than low JSE-S-scorers with a higher use of facial expression (p = 0.008).

CONCLUSION

This study did not reveal any differences of students' verbal empathy to patients' cues and concerns between low and high JSE_S scorers.

PRACTICE IMPLICATIONS

The VR-CoDES_P is a useful tool to assess medical students and physicians empathic behaviour, allowing to disentangle the different components of empathy.

The association between dispositional mindfulness and empathy among undergraduate nursing students: A multicenter cross-sectional study

The aim of this study was to explore the role of gender, age, and academic year in shaping dispositional mindfulness (DM) and the association between DM facets and empathy dimensions in a sample of undergraduate nursing students. In a multicenter cross-sectional study design, the Five Facet Mindfulness Questionnaire (FFMQ), the Interpersonal Reactivity Index (IRI), and socio-demographic questions were administrated to a convenience sample of Italian nursing students. 622 nursing students (82.2% female) participated in the study (response rate = 86.15%). Females had higher levels of Acting with Awareness (p < .001, d = .54) and lower levels of Non-reacting (p < .001, d = .52) facets of DM than males. Older students displayed higher scores on the Observing (r = .112, p = .005) and on the Non-reacting (r = .187, p < .001) FFMQ subscales than younger ones. No statistically significant differences in DM levels between the three academic years were found (ps > .202). After controlling for socio-demographic factors, DM facets were generally positively related to Perspective Taking (βs from .131 to .208, ps < .007) and Empathic Concern (βs from −.156 to .189, ps < .001), whereas negatively related to Personal Distress (βs from −.141 to −.261, ps < .001). Nursing students with higher levels of DM were more able to consider others’ cognitive perspective and to feel compassion, and were less emotionally distressed when facing tense interpersonal situations. Tailored mindfulness interventions might be useful to foster functional empathy within nursing undergraduate programs.

The Effectiveness of Teaching Clinical Empathy to Medical Students: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

PURPOSE

Clinical empathy is a necessary trait to provide effective patient care, despite differences in how it is defined and constructed. The aim of this study was to examine whether empathy interventions in medical students are effective and how confounding factors potentially moderate this effect.

METHOD

The authors performed a systematic review and meta-analysis. They searched the literature published between 1948 and 2018 for randomized controlled trials that examined empathy interventions in medical students. The search (database searching, citation tracking, hand-searching relevant journals) yielded 380 studies, which they culled to 16 that met the inclusion criteria. For the meta-analysis, they used a random effects model to produce a pooled estimate of the standardized mean difference (SMD), then completed subgroup analyses.

RESULTS

The authors found evidence of the possibility of response and reporting bias. The pooled SMD was 0.68 (95% confidence interval 0.43, 0.93), indicating a moderately positive effect of students developing empathy after an intervention compared with those in the control groups. There was no evidence of publication bias, but heterogeneity was significantly high (I = 88.5%, P < .01). Subgroup analyses indicated that significant moderating factors for developing empathy were age, country, scope of empathy measurement, type of empathy intervention, and presence of rehearsal. Moderating factors with limited evidence were sex, study quality, journal impact factor, and intervention characteristics.

CONCLUSIONS

Despite heterogeneity and biases, empathy interventions in medical students are effective. These findings reinforce arguments in the literature and add considerable rigor from the meta-analysis. The authors propose a conceptual model for educators to follow when designing empathy interventions in medical students.