Assessment of students' attitudes towards physicians' empathy is essential in medical education and in practice because empathy is vital in physician-patient communication. To cross-culturally adapt the Jefferson Scale of Physician Empathy (S-version, JSPE-S) into a German version, examine its psychometric properties in comparison to the original US version (psychometric equivalence), and to compare the level of attitude towards empathy to the original US version and to other cultural adaptations. The German version was administered to the 2010 2nd year medical students cohort at the Medical University of Vienna, Austria (n = 516). Item-total score correlations were all positive. Reliability was high (Cronbach's alpha = .82); a 6-7 weeks test-retest correlation for a subsample was .45. In an explanatory factor analysis, a four-factor solution emerged and is akin to published results of the original JSPE-S. This study provides an example of successful cross-cultural adaptation of an assessment instrument. The German adaptation of the JSPE at hand will pave the way for future international research regarding the concept of empathy and its outcomes.

The role of empathy in human social interaction has been examined in several research fields, including medical education (ME) and social neuroscience (SN). SN yields insights into empathy based on neurobiological processes, and such information may also be relevant to ME. In this reflection article, the authors first critically review current definitions and concepts of empathy in ME and link them to recent SN findings. In the light of recent evidence from SN, research in ME regarding the positive and negative effects of empathy for physicians and patients is discussed, as well as the question whether (future) physicians differ from the general population with regard to empathic skills. Commonly used SN paradigms and ME approaches to assess empathy are contrasted, a joint approach is advocated, and implications for further interdisciplinary studies are outlined. Finally, the authors delineate the contribution of SN to the question of whether empathy is teachable, and argue that SN findings represent a potential for new ME training approaches. In conclusion, the authors discuss how the incorporation of perspectives on empathy from different research areas would benefit ME, and suggest the translation and integration of such findings into ME research approaches.

SummaryBackgroundGender-specific differences in the attitudes towards doctor-patient communication among medical students and physicians were assessed.MethodsA total of 150 medical students and 51 physicians from different departments took part in the study. The association, attitude and experiences regarding doctor-patient communication were assessed with a series of tools and questionnaires.ResultsFemale doctors and students tended to describe the doctor-patient communication with positive attributes, such as “helpful”, “sentimental”, “voluble”, “sociable”, “gentle”, “yielding” and “peaceful”. Male students and physicians, on the other hand, described doctor-patient communication as “overbearing”, “robust” and “inhibited”. The most frequent associations females had with the term doctor-patient communication were “empathy”, “confidence”, “openess”, while the most frequent association of the male colleagues was “medical history”. Female doctors reported speaking about the psychosocial situation of the patient significantly more often and believed in higher patient satisfaction by sharing more information. Furthermore, they reported having longer conversations with a more equal partnership than their male colleagues. Compared to male students, female students were willing to take part in training their communication skills more often and had more interest in research about doctor-patient communication. Male medical students reported self-doubt during conversations with female patients, while one third of the male physicians talked about “the power over the patient”.ConclusionsThis study indicates a gender-dependent communication style influenced by stereotypes. At the establishment of communication training these differences should be taken into account, especially to strengthen male communication skills and improve their attitudes.

BackgroundSeveral research areas, including medical education (ME), focus on empathy as an important topic in interpersonal relationships. This focus is central to the use of communication skills related to empathy and even more crucial to provide information in a way that makes patients feel more involved in the treatment process. Psychoanalysis (PA) provides its initial concept of empathy based on affective aspects including findings from neuroscience and brain research. Enhancing cooperation between ME and PA can help to integrate both aspects of empathy into a longitudinal training program.DiscussionThe condition of psychoanalytic empathy definitions is the understanding of unconscious processes. It is important to primarily attend especially the dominant affects towards the patient before interpreting his or her behaviour, since in explaining the emerging affects, the analyst has to empathize with the patient to understand the (unconscious) reasons for its behaviour. A strong consideration of nonverbal communication, clinical perceptions, intuitive interaction, contagion-like processes and their implementation and empowerment in medical and therapeutic curricula is one way of beneficially using interdisciplinary approaches to yield empathy in clinical interaction.ConclusionEstablished methods of PA, like training of containment, reflective functioning, affective holding and giving meaningful interpretations in accordance with countertransferential and transferential aspects may help to put a focus on the clinican-patient-interaction and the preservation of the physicians’ (mental) health. In consequence of the discussion of various training methods that take the theoretical and practical concepts of empathy into account, we aim for an implementation of the named methods in the medical curricula.