Challenging some assumptions about empathy

Journal of Compassionate Health Care, 2015

Background: Empathy is a difficult characteristic to define, teach and assess; the 'nebulous' properties of empathic behaviour often means that educators fail to incorporate the explicit teaching and assessment of empathy within the curriculum. One solution suggested is that teaching empathy in an interprofessional education setting is an effective educational approach in developing empathic behaviours. Method: Student participants from Monash University, Deakin University, University of South Australia, and Edith Cowan University completed a self-reporting survey package pre and post two-hour empathy workshop consisting of the Jefferson Scale of Empathy -Health Profession -Student version (JSE-HP-S). Results: A total of 293 students from 12 different medical and health care professions participated in the empathy workshops. The majority of participants were from Monash University n = 230 (78 %), the nursing profession n = 59 (20 %), < 26 years of age n = 215 (73 %) and enrolled in first year studies n = 123 (42 %). Using a paired t-test repeated measure self-reported empathy levels improved at p < 0.0001, mean 114.34 vs. 120.32 (d = 0.22). Conclusion: This project has shown that self-reported empathy levels have been shown to statistically improve following DVD simulation-based workshops.

Advances in medical education and practice, 2014

Background: Empathy is paramount in the health care setting, optimizing communication and rapport with patients. Recent empirical evidence suggests that empathy is associated with improved clinical outcomes. Therefore, given the importance of empathy in the health care setting, gaining a better understanding of students' attitudes and self-reported empathy is important. The objective of this study was to examine self-reported empathy levels of students enrolled in different health disciplines from two large Australian universities. Materials and methods: A total of 1,111 students from two different universities enrolled in eight different health professions were administered the Jefferson Scale of Physician Empathy -Health Profession Students version, a 20-item 7-point Likert scale questionnaire to evaluate self-reported empathy levels. Results: A total of 1,111 students participated in this study. The majority of participants were from Monash University (n=771), with 340 students from Edith Cowan University. No statistically significant differences were found between universities: Monash University (mean 110.1, standard deviation [SD] 11.8); Edith Cowan University (mean 109.2, SD 13.3, P=0.306). The mean female empathy score (mean 110.8, SD 11.7) was significantly higher than the mean male score (mean 105.3, SD 13.5; P,0.0001; d=0.44). Paramedic students had significantly lower empathy scores (mean 106.3, SD 12.73) than all other participants except nursing students (P,0.0001). Conclusion: Results relating to sex are reflective of previous studies. There is some discrepancy in results relating to empathy and its incline/decline as students progress through a program. Further study is warranted to explore why there are variations in empathy levels in students of different health disciplines. Note: For further information on the Jefferson scale of Physician Empathy please see hojat M, Mangione s, et al. (2001). The Jefferson scale of Physician Empathy: Development and Preliminary Psychometric Data. Educa tional and Psychological Measurement. 61(2):349-365. 25 Abbreviation: sD, standard deviation. Note: For further information on the Jefferson scale of Physician Empathy please see hojat M, Mangione s, et al. (2001). The Jefferson scale of Physician Empathy: Development and Preliminary Psychometric Data. Educa tional and Psychological Measurement. 61(2):349-365. 25 Abbreviation: sD, standard deviation.

Journal of Clinical Nursing, 2012

Aims and objectives. To determine whether a specific training course will enhance empathic skills in student nurses during a 3year degree course. The study considers levels of empathy in student nurses and assesses whether these can be increased. Background. Empathy is accepted as a critical component of supportive relationships. Many scholars have argued that empathy provides health professionals with the capacity to improve the health of patients, so it should ideally be taught to make health professionals more responsive to patient needs. Design. Cohort longitudinal study. Methods. Data were collected using the Italian version of the Balanced Emotional Empathy Scale (BEES). The study was designed to guarantee repeated measurements of levels of emotional empathy in the pre-and postintervention phases. This allowed us to evaluate the development and improvement of empathy and to measure the effects of extra training on the students' empathy skills. Two groups took part in the study: the Intervention and the Control Groups. Students in the Intervention Group attended additional seminars and laboratories in small groups with tutors to learn and develop communicative and empathic abilities. Results. One hundred and three participants (76% women) completed the study. Data showed that the training course was effective, especially for women: BEES scores 31AE60 at pre-intervention phase and 42AE91 at the end of the academic course. Results regarding men were less clear, and the study discusses these unexpected, anomalous findings. Conclusion. According to literature, men and women have different empathic traits, and we found that they show disparate empathic tendencies. More women than men took advantage of the training course. In any case, our data show that specific training courses are effective. Relevance to clinical practice. As our study shows, empathy is a skill that may be taught. So it would be advisable to introduce these into the traditional nursing curriculum.

The purpose of this study was to examine changes in empathy during an academic year among undergraduate nursing students. The research followed a descriptive methodology with a sample of 214 undergraduate nursing students who completed the Jefferson Scale of Empathy at the beginning and at the end of 2006-2007 academic year. Data were collected using a questionnaire. Results showed a statistically significant decline of empathy for nursing students who were exposed more than others to patient encounters during study period (F (2, 211) = 4.2, p< 0.01). Findings were consistent with those found among medical students in that nursing students' encounters with patients, though not very clear on those who had less encounters with clients. The authors suggested that changes to the modalities of teaching may be contributing a disconnect in human connections, due to an emphasis on self-directed and simulated learning experiences. Further studies to identify whether findings of the research impacted on patient outcomes and nurse-students were recommended. Keywords: Empathy enigma, clinical experience, nurse-patient relationship, nursing students.

Journal of Nursing & Healthcare

Background: Healthcare providers’ empathetic attitude towards patient care significantly plays a role in the success of patient-centered outcome. However, across the empathy literature, there have been numerous studies which indicate that there had been a significant change in the level of empathy among nursing students in line with the length of their clinical exposure. Considering these studies, little is known on the factors affecting empathy. Hence, this study has purported to explore the factors influencing nursing students’ level of empathy. Methods: A descriptive-correlational research design was utilized. This study employed factor analysis to explore the factors which influence student nurses’ level of empathy. Data was analyzed through SPSS Version 21. Inclusion criteria are regular nursing students with at least 18 years of age, on their 15th week of RLE and are currently enrolled in the academic year 2017-2018. A total of 255 nursing students were purposively selected fr...

Acta Bio Medica : Atenei Parmensis, 2019

Background and aim: An empathic approach is considered fundamental in order to ensure the identification of patient needs and to provide the appropriate care, although the studies on the development of empathic attitude during nursing course reported conflicting results. Different empathic tendencies have been observed in the two genders: many studies showed greater empathy in females. Methods: To assess empathy level of students enrolled in the academic year 2015/16 at an Italian University nursing course, the Balanced Emotional Empathy Scale (BEES) was administered at the start of Year 1 (n=118), at the mid-point of Year 2 (n=99) and at the end of Year 3 (n=67). Data were statistically analyzed. Results: Cronbach’s values were satisfactory (0.87 at Year 1, 0.89 at Year 2, 0.79 at Year 3), confirming the good internal reliability of BEES. The nursing students obtained a total BEES mean ± SD score of 37.0 ± 19.5 at Year 1, 33.5 ± 22.6 at Year 2 and 35.4 ± 16 at Year 3, without any s...

ISRN Nursing, 2011

Background. Empathic communication skills are critical to providing high-quality nursing care to holistically understand the patient&#39;s perspective. A survey research design was used to address the research questions discussed in this study. Data consisted of responses from nursing students attending accredited programs in the southeastern United Sates using the Jefferson Scale of Physician Empathy Nursing Student Version R (JSPE-R).Findings. Comparisons of the total scores from JSPE Versions S and R yielded similar means and standard deviations with 115 and 114.57, respectively, and standard deviations of 10 and 10.94, respectively. The results of a one-samplet-test failed to render statistical significance (), indicating that the overall attitudes of nursing students and medical students are similar. The 25th, 50th, and 75th percentiles and overall instrument reliability were also comparable.Conclusions. This paper supports the emergence of alternative factor analysis structure...

2019

Background: A review of previous studies on nursing students’ empathy showed contradictory results with reducing or increasing empathy in nursing students and other students in the healthcare field during academic years of education at the university. Methods: The descriptive study with comparative design was conducted to determine the level of empathy and its changes in 122 undergraduate nursing students from the first to the fourth year of study. The data were collected using Jefferson Scale ofPhysician Empathy Nursing Student Version-R (JSE- NS version R) . Data were analyzed with descriptive and analytical tests by SPSS version 20. Results: Results showed that the mean score of empathy in all nursing students was 91.8 ± 28.7 (range: 20-140). Changes of empathy across the academic education years indicated that it was significantly declined in the fourth year of education, compared to the first year (p&lt;0.001). The mean score of empathy in more than 76% of nursing students in t...

International Nursing Review, 2012

The effect of a structured empathy course on the students of a medical and a nursing school. International Nursing Review 59, 532-538

Empathy - An Evidence-based Interdisciplinary Perspective

There is conceptual ambiguity in defining empathy, which is further amplified when trying to define clinical empathy. The construct of empathy has been an ongoing debate: sometimes being interpreted as a cognitive attribute, other times as an emotional state of mind. Our preferred definition is moral, emotive, cognitive and behavioural dimensions working in harmony to benefit the patient. Understanding the feelings, attitudes and experiences of a patient is the first step towards a potent and effective interview and, thereby, therapeutic agreement. Thus, clinical empathy may be the most powerful tool for a successful collaboration between the patient and the doctor. This chapter discusses the history of clinical empathy starting with Sir William Osler's definition of 'neutral empathy' where he argues that physicians need to neutralise their emotions so that they can 'see into' and, thereby, be able to 'study' the patient's 'inner life', to Halpern's insightful observations about the power of empathy, which 'lies in its ability to help us cross the divide between clinicians and patients created by their very different circumstances'. This is followed by a summary of the literature deliberating the increasing concern among medical educators and medical professionals regarding the decline in medical students' empathy during medical school, which brings us to our research question: are there significant changes in empathy levels over time in undergraduate medical education? This body of work reports on a cross-sectional study of all medical students enrolled at an Australian medical school, known for its cultural, social and religious diversity, in 2011. The research instrument used consisted of a survey encompassing questions on demographics in addition to the Jefferson Scale of Physician Empathy, Student version (JSPE-S). Empathy levels were compared while controlling for effects of age, gender, marital status, religious belief, ethnicity/cultural background, year of medical training, previous education and level of completion of programmes promoting altruism in an attempt to identify their effect on the levels of empathy. A total of 404 students participated in the study. The scores of the JSPE-S ranged from 34 to 135 with a mean score of 109.07 ± 14.937. This is considered moderate to high when compared to reported scores in previous studies on medical students. Female medical students had significantly higher empathy scores compared to their male counterparts in total and

International Journal of Nursing Practice

International journal of nursing practice, 2012

McKenna L, Boyle M, Brown T, Williams B, Molloy A, Lewis B, Molloy L. International Journal of Nursing Practice 2012; 18: 246–251Levels of empathy in undergraduate nursing studentsEmpathy and absence of prejudice and stigma are instrumental in facilitating effective nurse–patient relations. This study assessed empathy levels and regard for specific medical conditions in undergraduate nursing students. A cross-sectional study was undertaken using paper-based versions of the Jefferson Scale of Physician Empathy (JSPE) and Medical Condition Regard Scale (MCRS), along with a brief set of demographic questions. Participants reported good empathy levels on JSPE. Attitudes towards intellectual disability, chronic pain, acute mental illness and terminal illness rated well on MCRS. Attitudes towards substance abuse, however, were lower. There were no significant differences between age groups, gender or year level of study.Overall results of this study were positive. Nursing students demonstrated acceptable empathy levels. Attitudes towards patients who abuse substances highlight an area that needs both further exploration and addressing. Attitudes towards mental health diagnoses were particularly favourable given that these often attract stigma and negative attitudes.

Medical Teacher, 2011

Background: Empathy is necessary for communication between patients and physicians to achieve optimal clinical outcomes. Aim: To examine associations between Simulated Patients' (SPs) assessment of medical students' empathy and the students' selfreported empathy. Methods: A total of 248 third-year medical students completed the Jefferson Scale of Physician Empathy (JSPE). SPs completed the Jefferson Scale of Patient Perceptions of Physician Empathy (JSPPPE), and a global rating of empathy in 10 objective clinical skills examination encounters during a comprehensive end of third-year clinical skills examination. Results: High correlation was found between the scores on the JSPPPE and the global ratings of empathy completed by the SPs (r ¼ 0.87, p 5 0.01). A moderate but statistically significant correlation was observed between scores of the JSPE and the JSPPPE (r ¼ 0.19, p 5 0.05). Significant differences were observed on the JSPE and global ratings of empathy among top, middle and low scorers on the JSPPPE in the expected direction. Conclusions: While significant associations exist between students' self-reported scores on the JSPE and SPs' evaluations of students' empathy, the associations are not large enough to conclude that the two evaluations are redundant.

Journal of Medical Ethics, 2011

Empathy is commonly regarded as an essential attribute for doctors and there is a conviction that empathy must be taught to medical students. Yet it is not clear exactly what empathy is, from a philosophical or sociological point of view, or whether it can be taught. The meaning, role and relevance of empathy in medical education have tended to be unquestioningly assumed; there is a need to examine and contextualise these assumptions. This paper opens up that debate, arguing that 'empathy', as it is commonly understood, is neither necessary nor sufficient to guarantee good medical or ethical practice.

Medical education, 2013

Most medical schools focus upon aspects of interpersonal functioning such as empathy in the doctor-patient relationship with the aim of training clinically competent doctors. This study investigated the relationship between empathy and clinical competence among medical students. Fifty-seven medical students participated in the study. Clinical competence was assessed in an objective structured clinical examination (OSCE). Empathy was rated by an independent observer of the clinical interaction in OSCE stations. In addition, empathy was self-rated using the Jefferson Scale of Physician Empathy-Student Version. Observed behaviour indicative of empathy, as rated objectively by an independent observer, was strongly associated with clinical competence. The strong association between the behavioural manifestation of empathy and clinical competence was evident across a range of medical conditions and types of consultation. In addition, observable empathy was strongly associated with patient...