Developing a new empathy-specific admissions test for applicants to medical schools: A discourse-pragmatic approach

Abstract

The ability to empathise with patients is an important professional skill for doctors. Medical students practise this skill as part of their medical education, and are tested on their use of empathy within their final examination. Evidence shows that appropriate training makes a difference but that natural aptitude also plays a role. Most medical schools, therefore, probe applicants' basic understanding of empathy at admissions interviews. The purpose of the project presented in this paper was to apply existing understanding of how empathy may be communicated in a clinical context (building on a literature review by Pounds [2011]) to develop a new empathy-specific medical admissions interview station, probing applicants' empathic communicative performance (not just theoretical knowledge) and fitting the widely used Multiple Mini Interview (MMI) format. The paper outlines how this tool was developed, trialled and implemented by: (1) conceptualising empathic communication in discourse-pragmatic terms - that is, as a set of specific but context-dependant empathic speech acts; and (2) formulating and trialling a written and two oral versions of a situational test, capable of probing the applicants' ability to communicate empathically in everyday conversation and suitable for use at Norwich Medical School and other similar educational institutions.

Project-based learning approach to increase medical student empathy

“…Still, lectures were given throughout the semester on the concept of empathy and some communication skills, which are considered a key component of empathy [10]. As the theoretical foundation, students were introduced to the Satir model of communication styles [12] and an empathic communication skills model suggested by Pounds et al [13]. Students practiced such communication skills through some small-group learning activities.…”

“…who the interviewee was and why they chose to interview him or her), some vignettes of the interviewee that they recorded during the interview, and the group's reflection on the interviewwhat thoughts and feelings they shared with the interviewee and the meaning of empathy that they learned from their project assignments. The video was chosen as an artifact for this project because videos enable one to capture nonverbal signs the interviewee shows and to see whether students noticed them and responded effectively during the interview, which is an important component of empathic communication [13]. The groups were critiqued during the showcase of the videos in the final week of the course on how effective the empathic communication was, what lessons they learned about empathy from this project and the quality of their video production.…”

Use of video vignettes to assess medical school applicants’ empathetic abilities in Multiple Mini Interviews

“…Candidates used a tablet and a headset to watch the video, and were asked to assess the extent to which the doctor showed empathy and elicited the feelings and views of the patient, as these are considered key elements of empathy in doctor-patient interactions [20]. During the interview, the candidate discussed with the assessor on the extent to which the doctor showed empathy in communicating with the patient and about the importance of empathic communication in patientdoctor relationship.…”

“…Candidates' various non-cognitive attributes has been assessed in MMIs. In particular, empathy, which is "a personality trait that enables one to identify with another's situation, thoughts, or condition by placing oneself in their situation," [19] is an important attribute in doctors, and therefore, many medical schools assess candidates' basic understanding of empathy at admission interviews [20].…”

“…However, research on how to assess empathy for student selection purpose is scant [20]. Thus, in the present study, we examined the feasibility of using a video-based case in the MMI.…”