Relationship of trainee dentists' self-reported empathy and communication behaviors with simulated patients' assessment in medical interviews

Dance of two brains: Interval subdivision in alternated condition enhances resistance to interference by others

The accomplishment of interpersonal sensorimotor synchronization is a challenging endeavor because it requires the achievement of a balance between accurate temporal control within individuals and smooth communication between them. This raises a critical question: How does the brain comprehend and process the perceptual information of others to guarantee accurate temporal control of action goals in a social context? A joint synchronization - continuation tapping task was conducted together with varying relative phases (0°/180°) and intervals of tempos (400 ms/800 ms/1600 ms) while neural data was collected using fNIRS (functional near-infrared spectroscopy). Individuals showed better behavioral performance and greater interpersonal brain synchronization(IBS) in the left dorsolateral prefrontal cortex at alternated condition (180° relative phase) compared to symmetric condition (0° relative phase), suggesting that the individual can better maintain behavioral performance and show improved IBS when the partner taps between the individual's gaps. Meanwhile, in most levels of alternated condition, IBS is inversely proportional to interference from partner, implying the counteraction of IBS against interference from others. In addition, when the interval of tempo was 1600 ms, behavioral performance showed a sharp decline, accompanied by a decrease in IBS, reflecting that IBS in SMS reflects effective information exchange between individuals rather than ineffective interference with each other. This study provides insight into the mechanisms underlying sensorimotor synchronization between individuals.

Evaluation of relational factor in patient satisfaction with the treatment received by dental students

INTRODUCTION

The study focused on the importance of the relational factor and empathy in the general satisfaction of patients for the treatment received by university dental students. To achieve this objective, a tool capable of evaluating the most humanistic dimensions (empathy, kindness, trust) in the development of dental treatment has been designed.

MATERIALS AND METHODS

A review of the literature was carried out and, based on its findings, a questionnaire was designed to assess patient satisfaction with the dental student's empathy. It consisted of 20 questions and was completed by 80 patients. The questionnaire was subjected to a validation process using the Delphi method (content validity) and psychometric analysis (construct validity), through a principal components analysis (PCA).

RESULTS

The results of the PCA showed the existence of four components that suggest grouping the 20 questions into three blocks with a sequential structure, in which the questions would describe the patient's satisfaction throughout their treatment: reception and explanation of the treatment; development and progress of treatment; and expectations and completion of treatment. In each of these blocks, satisfaction was determined by a specific humanistic dimension: communication, trust and benevolence.

CONCLUSION

The validated questionnaire is an effective tool to analyse the relational factors that determine patient satisfaction in a treatment. Furthermore, the analysis of the questionnaire suggests that communication, trust and benevolence are elements that acquire singular importance throughout the care process. This analysis is essential for the acquisition of humanistic skills by future professionals and to optimize the dentist-patient relationship.

Quantitative analysis of communication changes in online medication counseling using the Roter Interaction System

BACKGROUND

Quantitative analysis and objective evaluation of communication play an important role in medical communication education. In the process of developing an online methodology for medication counseling practice, we felt the necessity of conducting a quantitative evaluation to enhance its effectiveness.

OBJECTIVES

This study aimed to quantitatively evaluate the communication in each scenario to comprehensively identify the differences between face-to-face and online communication in medication counseling practicum. In addition, we examined how patient satisfaction changes between face-to-face and online interactions.

METHODS

Face-to-face and online role-playing were conducted between simulated patients (SPs) and students acting as pharmacists, and their dialogues were videotaped. The utterances in each recorded dialogue were categorized and analyzed by the Roter interaction analysis system (RIAS). The Japanese version of the Medical Interview Satisfaction Scale (MISS-21J) responses of the SPs were analyzed for the patient satisfaction survey.

RESULT

The results of the RIAS analysis revealed that the socio-emotional category appeared significantly more frequently in face-to-face communication, with more utterances that were more attuned to the feelings of the other person and more considerate of his or her feelings. The ratio of the number of utterances between students and SPs suggested that the communication was more interactive.

CONCLUSION

Based on the respective communication tendencies may have led to higher satisfaction in face-to-face than in online patient satisfaction surveys, less anxiety about illness and medications, and easier trusting relationships. Since it is difficult to grasp the mood of the other party and to open up to them due to the lack of nonverbal information in online dialogue, it is necessary to be more conscious of conversations that capture the feelings of patients in online medication counseling.

Empathy levels among health professional students at a large midwestern public university - a cross-sectional study

BACKGROUND

Empathic care is considered extremely important by patients and providers alike but there is still an ample need for assessing empathy among healthcare students and professionals and identifying appropriate educational interventions to improve it. This study aims to assess empathy levels and associated factors among students at different healthcare colleges at the University of Iowa.

METHODS

An online survey was delivered to healthcare students, including nursing, pharmacy, dental, and medical colleges (IRB ID #202,003,636). The cross-sectional survey included background questions, probing questions, college-specific questions, and the Jefferson Scale of Empathy-Health Professionals Student version (JSPE-HPS). To examine bivariate associations, Kruskal Wallis and Wilcoxon rank sum tests were used. A linear model with no transformation was used in the multivariable analysis.

RESULTS

Three hundred students responded to the survey. Overall JSPE-HPS score was 116 (± 11.7), consistent with other healthcare professional samples. There was no significant difference in JSPE-HPS score among the different colleges (P = 0.532).

CONCLUSION

Controlling for other variables in the linear model, healthcare students' view of their faculty's empathy toward patients and students' self-reported empathy levels were significantly associated with students' JSPE-HPS scores.

Appraisal of empathy among dental interns and postgraduate students at King Abdulaziz University: A cross-sectional study

PURPOSE/OBJECTIVES

Empathetic communication of dentists with their patients is a primary characteristic of their health care. This study aims to evaluate dental students' empathy levels during the transitional period of internship and postgraduate studies of different specialties at one of the oldest dental schools in Saudi Arabia and explore how this empathy was affected by gender, age, and study duration.

METHODS

In this study, the self-reported empathy level among the participants was assessed using the Jefferson scale of empathy-student version (JSE-HPS). This survey includes a 20-question Likert scale formulated to measure clinical empathy in health care professionals. The JSE-HPS was distributed to all registered dental interns and postgraduate students during the academic year 2019-20 in King Abdulaziz University Faculty of Dentistry (KAUFD), Jeddah, Saudi Arabia.

RESULTS

Mean total score of empathy of the participants was (101.07 ± 14.8) with a response rate of 89%. A statistically significant higher empathy score appeared among dental postgraduate students in general (p = 0.04) and specifically among the females (p = 0.04) and those with postgraduate programs for more than four years, (p = 0.02). Dental postgraduate students scored significantly higher in the parameters of standing in patients' shoes (p = 0.02).

CONCLUSION

Gender, academic level, and duration of postgraduates' studies influenced empathy more than the age of the dental graduates in KAUFD. Our recommendation is to integrate empathy into the dental curriculum emphasizing interactive communication skills and early patient contact.

Establishing Validity Evidence for Parallel Patient-Provider Empathy Scales to Drive Self-reflection

Objective. Student pharmacists must cultivate self-awareness to ensure that they can assess their skill development and abilities, including affective domain skills such as empathy. External feedback can augment development, but validated assessments are needed for accuracy. Thus, the objectives of this study were to establish validity evidence for the revised version of the Kiersma-Chen Empathy Scale (KCES-R), compare student self-perceptions and simulated patient perceptions of student empathy using a parallel patient scale (KCES-PV), and evaluate student reflections on the encounter.Methods. Student pharmacists completed an assessment of their self-perceptions of empathy (KCES-R) before and after the patient encounter. Simulated patients completed the KCES-PV regarding the student pharmacists' empathy immediately after the encounter. Student pharmacists also watched their encounter videos and completed a self-reflection on their use of empathy. Responses were analyzed using statistical tests, whereas students' reflections were examined using thematic analysis.Results. Results showed that the KCES-R contains two factors with high internal consistency and can detect changes in empathy. Student pharmacists' self-perceptions of their empathy abilities appeared higher than when their empathy abilities were evaluated by simulated patients. Student pharmacists had a strong belief in the importance of expressing empathy during patient encounters and indicated a need for further development.Conclusion. This study provides validity evidence for the use of the KCES-R and presents a parallel scale that may be used by simulated patients. Validated parallel scales along with reflective practice could be a potential avenue to grow self-awareness and empathy by allowing students to receive feedback and then reflect on their perceived versus actual demonstration of the skill.

Empathy, personality traits, and emotional management in 2nd and 4th-year dentistry students: a single-center study

BACKGROUND

Patients fearing dental interventions are at risk of delaying or skipping much-needed treatments. Empathic communication could lead to a higher rate of compliance from patients within this group. Empathy, the big five personality traits, and emotion management abilities are all known to influence the quality of communication between dentists and patients. This study was conducted to analyze whether there is a correlation between these factors in dentistry students.

METHODS

Dentistry students in their 2nd and 4th year of study were asked to complete questionnaires assessing empathy, emotion management, and personality traits. Out of a total of 148 eligible participants, 53 students (34%) volunteered to participate. For empathy, the Jefferson Scale of Physician Empathy (students' version; JSPE-S) and the Interpersonal Reactivity Index (IRI) were used. Personality traits were assessed using the Short Big Five Inventory (BFI-s), and the Situational Test of Emotional Management (STEM) to measure emotional management ability.

RESULTS

Higher scores for emotion management were significantly correlated with the female gender (p ≤ 0.005) and with higher scores in openness (p ≤ 0.05). Students with higher scores in openness also achieved higher scores on the IRI subscales: Perspective taking (p ≤ 0.05), Fantasy (p ≤ 0.01), Empathic concern (p ≤ 0.05), and Personal distress (p ≤ 0.05). For JSPE-S, no correlation with emotion management and personality traits was found.

CONCLUSION

Empathy and emotion management might not be significantly related in dentistry students. Regarding personality traits, students who scored higher on openness also indicated higher abilities in emotion management. These findings should be taken into consideration when planning communication courses for dentistry students, as it might be possible to independently train empathy and emotion management as part of emotional intelligence.

Effect of absenteeism on the performance of medical sciences students: gender differences

The effects of the learning environment on academic performance can be investigated according to a broad range of factors using a diversity of approaches. Many differences in academic performance have been associated with the sex of the student. Objectives: This study aims to understand the impact of absenteeism on the final grades earned by full-time medical laboratory sciences undergraduate students and whether this is affected by sex. Academic performance was analyzed using students' final grades from two consecutive semesters (January to April and September to December 2019). The differences between male (n = 43) and female (n = 72) students were evaluated by Pearson's correlation. During the semester, all teaching and assessment methods were standardized across both course sections to avoid confounding effects derived from the teaching method. Academic performance was assessed both objectively (multiple-choice questions) and subjectively (short essay questions). The mean scores of male and female students during two semesters were significantly different (p = 0.0180). To correlate marks with absenteeism, the correlation coefficient (r) was negative, which indicates an inverse correlation between absence rate and scores. Interestingly, a statistically significant correlation between absenteeism and final grades was found in the male sample population (p = 0.0011 for the first semester; p = 0.0255 for the second semester) that was not observed for their female counterparts (p = 0.2041; p = 0.1537). The results indicate that academic performance among women is not solely dependent on class attendance but likely involves other factors such as self-learning, and group discussion. The mean scores of female medical sciences students were significantly higher than the male students for two consecutive semesters. Male overall scores seem to be conditional on the instructor's explanation. This sex-based variation in academic performance revealed by taking absenteeism rate into account warrant further investigation.

Impact of physician empathy on patient outcomes: a gender analysis

BACKGROUND

Empathy in primary care settings has been linked to improved health outcomes. However, the operationalisation of empathy differs between studies, and, to date, no study has concurrently compared affective, cognitive, and behavioural components of empathy regarding patient outcomes. Moreover, it is unclear how gender interacts with the studied dimensions.

AIM

To examine the relationship between several empathy dimensions and patient-reported satisfaction, consultation's quality, and patients' trust in their physicians, and to determine whether this relationship is moderated by a physician's gender.

DESIGN AND SETTING

Analysis of the empathy of 61 primary care physicians in relation to 244 patient experience questionnaires in the French-speaking region of Switzerland.

METHOD

Sixty-one physicians were video-recorded with two male and two female patients. Six different empathy measures were assessed: two self-reported measures, a facial recognition test, two external observational measures, and a Synchrony of Vocal Mean Fundamental Frequencies (SVMFF), measuring vocally coded emotional arousal. After the consultation, patients indicated their satisfaction with, trust in, and quality of the consultation.

RESULTS

Female physicians self-rated their empathic concern higher than their male counterparts did, whereas male physicians were more vocally synchronised (in terms of frequencies of speech) to their patients. SVMFF was the only significant predictor of all patient outcomes. Verbal empathy statements were linked to higher satisfaction when the physician was male.

CONCLUSION

Gender differences were observed more often in self-reported measures of empathy than in external measures, indicating a probable social desirability bias. SVMFF significantly predicted all patient outcomes, and could be used as a cost-effective proxy for relational quality.

Variabilidad empática en estudiantes de odontología. Consecuencias aún no entendidas en América Latina

Introducción. La empatía es un atributo que permite a los odontólogos establecer una relación intersubjetiva con sus pacientes, lo que contribuye a un tratamiento exitoso, entre otros beneficios. Objetivo. Determinar si hay variabilidad en los niveles de empatía entre dos poblaciones de estudiantes de odontología y describir teóricamente las implicaciones generales de esta variabilidad en estrategias de intervención. Materiales y métodos. Estudio exploratorio transversal. La población de estudio consistió de estudiantes de odontología de 1er a 5to año de la Universidad Santiago de Cali, Colombia (n=610; N=647) y la Universidad San Sebastián, Chile (n=535; N=800). En ambos grupos, la empatía se midió con la Escala de Empatía de Jefferson (Versión S). Para el análisis de los datos se utilizó estadística descriptiva (media y desviación estándar). La consistencia interna de los datos se estimó mediante el alfa de Cronbach y el coeficiente de correlación intraclase. Se realizó un análisis de varianza factorial: tres factores estudiados: Universidad (U), Curso (C) y Sexo (S). El nivel de significancia estadística utilizado fue de α≤ 0.05 y β≤ 0.20. Resultados. Se observaron diferencias en el nivel de empatía y algunas de sus tres dimensiones entre los estudiantes de ambas universidades y entre los cursos (1er-5to año). No se observaron diferencias entre sexos. Conclusiones. Existe variabilidad en los niveles de empatía entre los estudiantes de ambas universidades. Para aumentar los niveles de empatía en esta población en Latinoamérica se requiere la implementación de estrategias específicas de intervención empática en cada programa de odontología ofrecido en la región.

A Model of Factors Determining Nurses' Attitudes towards Learning Communicative Competences

The aim of the study was to assess the empirical model of factors determining the attitude towards acquiring communicative competences among nurses participating in the program of specialist training courses. Research was conducted using a cross-sectional study. A representative group of 1010 Polish registered nurses that took part in the postgraduate education course answered a self-report survey (three instruments: NEO-PI-R questionnaire, Communication Skills Attitude Scale (CSAS), and Empathy Understanding Questionnaire (KRE II)) from the beginning of March to the end of May 2018, which was evaluated using path analysis. The research results conducted confirmed the soundness of the created theoretical model (χ² = 0.278, p = 0.598, RMSEA < 0.05). It was proved that acquiring communicative competences in nurses is determined by factors such as professional experience, empathic tendency, and the intensity of agreeableness, whereby these factors are bound with each other creating a homogeneous network. The developed model demonstrated that skills can most effectively be shaped in an individual’s attitude based on positive mentoring in work environment.

What impact does postgraduate clinical training have on empathy among Japanese trainee dentists?

BACKGROUND

Enhancing empathy in healthcare education is a critical component in the development of a relationship between healthcare professionals and patients that would ensure better patient care; improved patient satisfaction, adherence to treatment, patients' medication self-efficacy, improved treatment outcomes, and reduced patient anxiety. Unfortunately, however, the decline of empathy among students has been frequently reported. It is especially common when the curriculum transitions to a clinical setting. However, some studies have questioned the significance and frequency of this decline. Thus, the purpose of this study was to determine the impact of postgraduate clinical training on dental trainees' empathy from cognitive, behavioral, and patients' perspective.

METHODS

This study included 64 trainee dentists at Okayama University Hospital and 13 simulated patients (SPs). The trainee dentists carried out initial medical interviews with SPs twice, at the beginning and the end of their clinical training. The trainees completed the Japanese version of the Jefferson Scale of Empathy for health professionals just before each medical interview. The SPs evaluated the trainees' communication using an assessment questionnaire immediately after the medical interviews. The videotaped dialogue from the medical interviews was analyzed using the Roter Interaction Analysis System.

RESULTS

No significant difference was found in the self-reported empathy score of trainees at the beginning and the end of the clinical training (107.73 [range, 85-134] vs. 108.34 [range, 69-138]; p = 0.643). Considering the results according to gender, male scored 104.06 (range, 88-118) vs. 101.06 (range, 71-122; p = 0.283) and female 109.17 (range, 85-134) vs. 111.20 (range, 69-138; p = 0.170). Similarly, there was no difference in the SPs' evaluation of trainees' communication (10.73 vs. 10.38, p = 0.434). Communication behavior in the emotional responsiveness category for trainees in the beginning was significantly higher than that at the end (2.47 vs. 1.14, p = 0.000).

CONCLUSIONS

Overall, a one-year postgraduate dental training program neither reduced nor increased trainee dentists' empathy levels. Providing regular education support in this area may help trainees foster their empathy.

Medical students' empathy and attitudes towards professionalism: Relationship with personality, specialty preference and medical programme

Background

Existing research has suggested that self-reported empathy in medical students is moderated by personality traits and diverse demographic and educational factors including age, gender, nationality, career aspirations, as well as year of curriculum. It is unclear how empathy, personality, and background factors might impact on students’ attitudes towards professionalism in medicine.

Methods

A cross-sectional questionnaire-based study was conducted in first and final year medical students at an Irish medical school. The following instruments were administered: (a) Jefferson Scale of Empathy; (b) NEO Five-Factor Inventory (NEO-FFI-3); (c) Attitudes towards Professionalism Scale. Demographic and educational variables were also measured. Descriptive and correlational analysis was conducted to examine the association between empathy, personality, professionalism-related attitudes and additional measures. Regression analysis was used to examine determinants of attitudes towards professional behaviour.

Results

Both selected NEO-FFI personality traits and empathy were independently associated with distinct categories of professional behaviour. Specifically, Openness to Experience was associated with higher empathy scores, and higher ‘Social responsibility’. Extraversion was linked with higher scores on the “Personal characteristics” and “Interactions with team” categories, while Conscientiousness was also positively associated with “Personal characteristics”. In agreement with previous studies, the personality traits most associated empathy were Agreeableness and Openness to Experience. Empathy did not vary according to programme year or career specialty preference.

Conclusions

This study is the first to show that empathy and personality factors may act as determinants of students’ attitudes towards medical professionalism in a manner which is dependent upon category of professional behaviour.