Levels of Empathy in Students and Professors with Patients in a Faculty of Dentistry

BACKGROUND

Empathy is an attribute that plays an essential role in the dentist-patient therapeutic relationship, clinical care, and treatment adherence, along with providing other benefits. The main objective of this research was to establish the validity, reliability, and invariance of the Jefferson Scale of Empathy and then characterize the empathy levels of students and teachers at a dental school.

MATERIALS AND METHODS

An observational and cross-sectional study analyzed a sample of undergraduate students and professors from the Universidad Andrés Bello Faculty of Dentistry (Chile) (n = 1727 and n = 267, respectively). The Empathy Scale for Health Professionals (HP) and the same scale for students (HPS) were applied.

RESULTS

The Jefferson Empathy Scale presents adequate psychometric properties. The empathy measure has adequate reliability and construct validity, confirming a fit of the three-factor empathy model to the data. The measurement is invariant within the university campus, the sex of the student, and between teacher and student. Teachers present greater empathy than students except in the Perspective Adoption dimension.

CONCLUSIONS

The Jefferson Empathy Scale is reliable, valid, and invariant among Chilean dental students and professors. Students do not differ from their professors in the cognitive component of empathy, but they present a lower score in the affective component and global empathy. It is inferred that students can develop the affective component of empathy in their interactions with their professors, increasing their overall empathy. Understanding and fostering empathy in dental students and professors can significantly improve patient care and treatment adherence and increase patient and dentist satisfaction.

Evaluating empathy level amongst the dental students using jefferson scale of physician empathy- health professional students

BACKGROUND

Empathy is described as one's ability to perceive and apprehend another person's feelings, situation, emotions, and problems as their own. Empathetic behavior increases patients' satisfaction, reduces discomfort, and helps with patient's satisfaction.

OBJECTIVE

To evaluate the psychometric properties of the Jefferson Empathy Scale and compare the measure of invariance within genders and amongst the public and private sector dental students.

METHOD

This cross-sectional study utilized JSE-HPS version for research purpose. An exploratory factor analysis was performed to detect underlying factors. Reliability of the study tool was evaluated using Cronbach alpha test. Mann Whitney U test was used to compare the differences in scores between genders and among public and private university students while Student's t analysis compared the scores according to different domains. The level of significance was ≤ 0.05.

RESULTS

Females demonstrated higher empathy levels (88.52 ± 14.19) along with private institute students (88.46 ± 13.98). Perspective taking and compassionate care domain was also scored highest by the females (31.73 ± 6.49 & 29.31 ± 6.22) and among second year students (33.30 ± 7.11 & 30.50 ± 7.16). PCA analysis extracted 4 factors namely (i) Health-care-provider's sense of humor contributed to improved outcome (ii) Health-care provider's understanding of patients' feelings and of their families influences treatment outcomes (iii) Understanding body language is as important as verbal communication and (iv) Patients feel better when their feelings are understood, which accounted for the 59.51% of the total variance.

CONCLUSION

The findings revealed that students from private institute and females demonstrated higher empathy score. Moreover, the Jefferson Scale of Empathy (JSE) was found to be a reliable and validated tool for assessment of empathy in our sample population.

Family Functioning as an Explanatory Factor of Empathic Behavior in Argentine Medical Students

Empathy is a relevant competence in the study and practice of medicine whose development could depend on the functioning style of each family. This study aims to compare the distribution of empathy levels, about functionality or dysfunction, and the three styles, which can be derived from family functioning in the families of Argentine medical students. Previously providing evidence of the validity of the family functioning measure. As well as provide evidence of the validity of the measure of family functioning.

METHODS

Ex post facto design: 306 Argentine medical students who had already taken the Jefferson Scale of Empathy-Spanish Edition (JSE-S) and the abbreviated Spanish Family Adaptability and Cohesion Evaluation Scale (FACES-20). A gender-weighted linear regression analysis was made, establishing an ANOVA and multiple comparisons via DMS to determine the effect of functional and dysfunctional families' balanced, intermediate and extreme functioning styles concerning empathy.

RESULTS

Students who presented dysfunction in familial cohesion and adaptability showed measures of empathy greater than those classified as functional. Differences of cohesion were statistically significant in compassionate care, perspective taking and general empathy. These components were significantly higher in students from families classified as extreme than balanced ones. Students classified within families with either extreme or dysfunctional styles showed greater levels of empathy than more adaptive and functional ones, except in the 'walking in patient's shoes' component where differences were not observed.

CONCLUSIONS

Individual resilience as an intervening variable in the presence of empathy is discussed.

IMPLICATIONS

The study of empathy, its associated variables, and the conditions of its development remains a central theme in relation to students and professionals of the health sciences. To achieve an effective professional practice, it is necessary to develop human capacities such as empathy and personal resilience.

Comparison of Self-Reported Empathy Levels among Dental Undergraduate Students in Northern India: A Questionnaire-Based Cross-Sectional Study

Context:

Empathy is one of the fundamentals of communication relevant within the practice of dentistry, and the research is limited in this field.

Aims:

The present study was conducted to assess the self-reported empathy levels among dental undergraduate students in Lucknow city of Northern India.

Settings and Design:

A descriptive cross-sectional study was conducted among three dental colleges of Lucknow city during July 2019–September 2019.

Subjects and Methods:

E-survey link was circulated among 790 students through e-mails. It has two parts. The first part included sociodemographic information, wherein the second part, the empathy level of students was assessed using the Jefferson Scale of Physician Empathy-Health Profession Students Version Questionnaire. The possible score range is 20–140: the higher the mean score, the higher the self-reported empathy level.

Statistical Analysis Used:

The data collected were analyzed using SPSS software version 24. Chi-square test was used to test gender distribution differences among different years. One-way analysis of variance including post hoc tests was used to compare the differences between study variables.

Results:

The mean ± standard deviation empathy score was 92.55 ± 11.85, 91.85 ± 12.23, 93.25 ± 11.24, 93.37 ± 12.31, and 88.34 ± 12.01 among the first-year, second-year, third-year, final-year, and interns' students, respectively, with a statistically significant difference.

Conclusion:

It can be concluded from the results of the present study that the mean empathy score was highest among final-year students which is suggestive of the impact of education in behavioral sciences.

Psychometry and empathy levels and its dimensions in postgraduate students of dental specialties

BACKGROUND

Empathy is an attribute that has an important role in the dentist-patient therapeutic relationship, clinical care and adherence to treatment, amongst other benefits. The aim of this research was to determine empathy in dentists in the process of specialisation.

MATERIALS AND METHODS

Through an observational and cross-sectional study, all postgraduate students of Dentistry Faculty of Universidad Andrés Bello (Chile) were analysed (N = 195). The Jefferson Scale of Physician Empathy Scale was applied.

RESULTS

The results show an adequate reliability of the empathy measure (α = 0.819, ω = 0.928). A three-factor structure is evidenced by confirmatory factor analysis (χ² /df = 1.445, GFI = 0.952, RMSEA = 0.047) and adequate factor invariance between men and women. Women showed greater empathy on the global scale and in the perspective adoption dimension, with no gender differences found in the dimension Compassionate care and putting oneself in the other's shoes (POOS). The median empathy reaches 120 points. Below, are placed, the specialty of oral rehabilitation (Med = 114.5), surgery (Med = 117) and periodontics (Med. = 117.5). With superior scores, temporomandibular disorder (Med. = 121), endodontics (Med. = 121), Orthodontics and dentofacial orthopedics Med. = 122), Implantology (Med. = 125) and Pediatric dentistry (Med. = 127.5) are located.

CONCLUSION

Women were more empathetic than men. In general, empathy levels are relatively high, but the common feature in which all students examined in different specialties have low levels in dimension POOS.

Empathy levels decline and sex differences in medicine students from the Caribbean

Introduction: Empathy is an important trait in the training of medical students, as it has been shown to improve the doctor-patient relationship. Objective: To evaluate empathy levels decline and possible sex differences in empathy levels in undergraduate medical students from the Universidad Central del Este, Dominican Republic. Materials and methods: Exploratory cross-sectional study. A Spanish version of the Jefferson Scale of Empathy for Medical Students (S-version) Scale was administered in September 2018 to 1144 1st-year to 5th-year medical students (887 women and 257 men). The reliability of the data was verified using the Cronbach's alpha and the intraclass correlation coefficient (ICC). Data were analyzed using a generalized linear equation model (Type III) and the Wald chi-squared test was used to determine differences in overall empathy levels and the mean scores obtained in each of its three components according to the year of medical training and to sex. Results. Cronbach's alpha was satisfactory (0.839) and the ICC was 0.834 (F=5.68; p=0.005). Variability of the estimated curves in relation to empathic behavior by course (year of medical training) and sex was observed using linear and non-linear regression equations: between courses: Wald χ2==115.6; p=0.0001, and between men and women: χ2 of Wald =12.85; p=0.001. Conclusions. There were sex differences regarding empathy levels in the study population; besides, a decline in empathy levels (overall empathy and Compassionate Care component in men, and Walking in the Patient’s Shoes component in men and women) was also observed as students progressed in their medical training. The behavior of these data raises questions regarding the need to determine the factors causing these differences and the decline in empathy levels.

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.

Psychometry and estimation of cutoff points of Jefferson Scale of empathy in dental students

OBJECTIVE

The objective of this study was to determine the psychometric properties of the 3-dimensional latent model of empathy on the Jefferson Scale of Physician Empathy instrument (version S), and to verify the existence of cutoff points capable of differentiating empathy measures classified as: "high," "medium," and "low" using data collected from observations of students from 11 dental faculties of 5 Central American and Caribbean countries (n = 3082) between 2015 and 2019.

METHODS

This is an exploratory, "a posteriori," and non-experimental study. Factor structure and factor invariance by country and gender were analyzed. Hierarchical cluster analysis and bifactorial analysis were applied, and the data were normalized by cluster and by percentiles within them.

RESULTS

Confirmatory factor analysis showed that the original model was replicable and fit the data, while multigroup analysis allowed assuming an invariant factor structure by country and by gender. There is reliability in the measurement made by the scale and its dimensions.

CONCLUSIONS

The instrument has adequate psychometric properties, and cutoff values obtained allow people with lower or higher levels of empathy and its components to be classified. Therefore, these results solve the problem of comparing the scores and observed levels of empathy between dental schools within and between countries and between genders. Such comparisons were only possible since the original data of each study were made available for traditional statistical methods.

Empathy and Personality Styles in Medical Students

This study aimed to establish the relationship between empathy and personality styles in medical students, considering the differences by gender. The participants were 278 students of the medical career of the Universidad del Azuay, Ecuador. They were evaluated using the Jefferson empathy scale and the Millon Index of Personality Styles. Relationships between empathy and personality styles were examined using Pearson's correlation coefficient and hierarchical multiple linear regression analysis, for comparisons by gender and educational levels; with both Student's t test and analysis of variance used respectively. Results indicated that the factor structure of the empathy scale is invariant between men and women, noticing gender differences in care with compassion and total empathy, with women presenting a higher mean. Differences are observed by educational level, where the general empathy in the first three years grows progressively, and then slightly decrease. In conclusion,  female students present a mean score of total empathy greater than men, with differences of empathy according to educational level

Empatía en estudiantes de medicina de la Universidad del Norte, Colombia. Comparación de dos grupos (2012 y 2015)

Introducción. La empatía es un elemento importante en la relación médico-paciente, por lo que la formación en empatía de los estudiantes de medicina debe ser un objetivo permanente de los programas universitarios.Objetivo. Determinar los cambios generados por actividades académicas de formación en empatía en dos grupos de estudiantes de medicina.Materiales y métodos. Estudio transversal realizado en dos grupos de estudiantes de medicina a los que se les aplicó la versión en español de la escala de empatía médica de Jefferson. El primero se conformó por 426 hombres y 508 mujeres pertenecientes al curso académico de 2015, mientras que el segundo estuvo constituido por 106 hombres y 239 mujeres del curso académico de 2012. Se realizó un análisis de varianza (ANOVA) y se evaluaron las diferencias entre los años académicos y entre géneros, así como las interacciones entre estos dos factores.Resultados. Aunque en general no se encontraron diferencias significativas en las tres dimensiones evaluadas (p>0.05) para los dos grupos, sí se observaron diferencias en las preguntas 4, 17 y 20, correspondientes a la dimensión Toma de perspectiva, y en la pregunta 6, correspondiente a la dimensión Ponerse en el lugar del otro, ya que los valores fueron mayores (p<0.05) en la cohorte de 2012.Conclusión. Las actividades de formación en empatía establecidas en el plan de estudios del programa de medicina no produjeron cambios significativos, por lo que es necesario evaluar y perfeccionar tanto los contenidos del currículo, como los procesos de enseñanza-aprendizaje relacionados con la formación en empatía del programa de Medicina de la Universidad del Norte.

A Cross-Sectional Study of Empathy Among Dental Students at King Abdulaziz University

Empathy is the fundamental substructure of moral behavior. Skillful clinicians may not necessarily be successful dentists if they do not have sufficient empathy. The aim of this study was to assess the level of empathy among dental students at King Abdulaziz University with an emphasis on the effect of gender and study level. A cross-sectional study was carried out among third- to sixth-year dental students of King Abdulaziz University in Jeddah, Saudi Arabia. A validated, self-administered Jefferson Scale of Empathy-Health Care Provider Student Version was distributed in academic year 2016-17 to all 380 students in the third to sixth years. A total of 300 students responded, for a response rate of 78.9%. The results showed that the students' mean empathy score was 84.84±11.28 on a range from 20 to 140. The fifth- and sixth-year students had higher scores than the third- and fourth-year students although the differences were not statistically significant. The mean empathy score of women students was significantly higher (p<0.001) than that of men students, and the women demonstrated significantly better perspective-taking (p<0.001) than the men. This study found that the students were empathetic and had a sense of moral obligation although their mean empathy score was not as high as expected. Integrating empathic, ethical, and professional elements into the dental curriculum is needed.

Empathy among dental students: A systematic review of literature

BACKGROUND

Empathy is just as relevant within dentistry, although research is limited in this field and very less is available in the current literature. The demonstration of empathy by dentists has been correlated with decreased dental fear. The authors systematically reviewed the literature to investigate empathy levels among dental students.

METHODS

A systematic review of the literature was undertaken concerning dental students' empathy, published from November 2016 to June 2018, using manual methods and the PubMed, PMC, PsycINFO, and other databases. Articles not in English and not concerned with dentistry were excluded, and intervention studies intended to enhance empathy, opinion articles, and reviews or reports of nonoriginal research were excluded. Eligible studies were those published from January 1, 2005, to May 31, 2017, in English language. A total of 34 full-text articles were obtained and assessed. Of these 34 papers, only seven publications were considered to have met the inclusion criteria and were directly related to the aim of literature search.

RESULTS

Only seven articles that provided data and evidence describing empathy among dental students were included. Four studies reported that the difference in mean empathy level across the year of study was statistically significant (P < 0.05), and one reported that there was no significant difference in empathy scores between the year levels of study. Three articles reported that males had higher mean empathy score than females, whereas vice versa was found in the remaining four articles.

CONCLUSION

This article demonstrates that there is only a limited evidence to provide the understanding of empathy among dental students. The results indicated that as patient exposure increases, the empathy level decreases among dental students. Furthermore, it is observed that education in behavioral sciences may be effective in increasing self-reported empathy, and further training may be necessary to maintain high levels.

[Empathy in medical students in the Republic of El Salvador: Cross-sectional study]

OBJECTIVE

To evaluate empathy in medical students of the Evangelical University, Republic of El Salvador.

MATERIAL AND METHODS

A cross-sectional study was conducted in which empathy levels, as well as the reliability of the data, were measured in 640 students. The mean and standard deviation were estimated in two factors: gender and courses studied. The data were processed using bi-factorial variance analysis (modeliii), calculating the effect size, power of the test, and the possible growth potential of the empathy and of each of its components considering the gender. The level of significance was α≤.05 and β≥0.80. The SPSS 22.0 statistics program was used.

RESULTS

Differences were found between courses and gender. The differences between courses in empathy are due to values by males in specific components. The model of decline in empathy and in the component, compassionate care, is not fulfilled.

CONCLUSIONS

The levels of empathy between the genders were higher in males than in females, and similar in the compassionate care component. This is not consistent with the idea that women have higher levels of empathy than the men. There are differences in the behaviour of the means depending on the course and gender, and the empathy decline model is fulfilled only in two of its components. The characteristics indicated constitute the diagnosis of the empathy situation and constitute a guide to construct an intervention.

Chilean Dentistry students, levels of empathy and empathic erosion: Necessary evaluation before a planned intervention: Levels of empathy, evaluation and intervention

Objectives

To estimate the general empathy levels and the potential for empathic growth in Dentistry students and demonstrate that the empathic erosion model is not med.

Material and methods

Exploratory and cross-sectional study. Population: First- to fifth-year Dentistry students at Universidad San Sebastián, Santiago Campus (Chile). The total student population (N) was 800. The participants completed the Jefferson Scale of Empathy in its Spanish version for medical students, validated and adapted in Chile. A two-factor analysis of variance (model III) was applied to find differences in the means between academic years, between genders, and in the interaction between these two factors. The data were described using simple arithmetic graphs and then processed with SPSS 22.0. The total growth potential was estimated.

Results

The Sample (n) consisted of 534 students (66.88% of the population studied, 2016). Differences were found between academic years and genders in general empathy and some of its components.

Conclusion

The behavior of empathy levels is not in line with the concept of empathic erosion. This suggests that empathic erosion is a particular and not a general phenomenon. There exists a considerable growth potential for empathy and its components.

Levels of empathy in dental students at Universidad San Sebastián in Concepción, Chile (Chile)

Introducción. La formación de los futuros odontólogos debe estar en sintonía con el desarrollo empático del alumno, por tanto, es necesario realizar un diagnóstico del comportamiento de la empatía.Objetivo. Medir los niveles de empatía en los estudiantes de Odontología de la Universidad San Sebastián, sede Concepción, Chile, según género y año académico.Materiales y métodos. Se aplicó la Escala de Empatía Médica de Jefferson (EEMJ) para estudiantes de medicina (versión en español), adaptada y validada para estudiantes de odontología en 2016. La muestra estuvo constituida por 462 estudiantes de primero a quinto año. Los datos fueron comparados mediante un análisis de varianza trifactorial (modelo III).Resultados. En el factor “años académicos” se observó que las medias en el segundo año son menores que en el primero, pero a partir de tercer año aumentan los niveles de empatía manteniéndose constantes en los restantes años académicos. En el factor “género”, el femenino tuvo valores medios de empatía superiores al masculino.Conclusión. Los factores estudiados (año académico y género) poco explican la variación existente en la empatía de los estudiantes analizados. Es probable que existan otros factores que influyen sobre los niveles de empatía y que permitirían explicar mejor el comportamiento de los valores estimados.