Development in Danish medical students’ empathy: study protocol of a cross-sectional and longitudinal mixed-methods study

Abstract

Background: Clinical empathy has been associated with positive outcomes for both physicians and patients such as: more accurate diagnosis and treatment, increased patient satisfaction and compliance, and lower levels of burnout and stress among physicians. International studies show mixed results regarding the development of empathy among future physicians associating medical education with decline, stability or increase in empathy levels. These mixed results are due to several study limitations. In Denmark, no investigation of Danish medical students' empathy trajectory has yet been conducted wherefore such a study is needed that optimizes the study design of earlier studies. Methods: The aim of the study is to examine and analyze empathy levels and empathy changes among Danish medical students from the four medical faculties in Denmark, employing a cross-sectional and longitudinal mixedmethods design including a control group of non-medical students. By supplementing cross-sectional and longitudinal questionnaire studies with a focus group interview study it is the aim to identify and analyze factors (including educational) that are perceived by medical students to influence the development of empathy and its expression in clinical care. Discussion: The results of the study will provide insight into the trajectory of medical students' empathy and in undergraduate and graduate students' experiences with and perceptions of empathy development. In addition, the study will provide evidence to support further research on how targeted educational programmes can best be designed to educate empathic and patient-centered physicians.

Searching for the erosion of empathy in medical undergraduate students: a longitudinal study

“…This study adds some evidence about the situation in Europe, where these kinds of studies are scarce, needed 29 and under development. 50 If we take into consideration Western European quality studies selected in the Spatoula et al's meta-analysis, 33 nine cross-sectional and only three longitudinal, we find that they gathered and analysed data (difference in means and 95% CI) from Open access only two European countries: one university in Portugal (cross-sectional), five in another UK university (longitudinal). Also, they analysed 15 universities in the USA, 10 universities in Asia and 2 universities in Africa.…”

Individual differences in empathy in Danish university students: A cross-sectional study

“…Both scales were translated into Danish according to the WHO's guidelines for forward-backward translation (World Health Organisation, 2018) and cognitive interviews were conducted with ten Danish medical majors (Garcia, 2011). An overview of the other scales included in the questionnaire can be found in Assing Hvidt et al (2020).…”

A cross-sectional study of student empathy across four medical schools in Denmark—associations between empathy level and age, sex, specialty preferences and motivation

“…It is a 20-item scale developed to specifically measure medical students' personal orientation toward empathy in respect to patient care. For each item, the students' response is measured on a 7-point Likert scale (1)(2)(3)(4)(5)(6)(7). Reversely coded items were: 1,3,6,7,8,11,12,14,18,19.…”

“…In the questionnaire students also specified university, age, sex (categorized as 18-24 and 25 +), co-habitation status (whether living alone, with spouse/partner or with others), and whether they have children or not, preferences for various specialities (see details below, Table 1), and motivations behind choosing medicine (open-ended question, see details below and Table 2). An overview of the other scales included in the questionnaire can be found in Assing Hvidt et al [5].…”

“…Professional empathy is considered an important attribute and competence to have and further develop for students in the medical education [1]. Defined in the medical literature as the ability to understand a patient's suffering and concerns combined with an ability to communicate this understanding and an intention to help [2][3][4][5], professional empathy has been associated with a number of beneficial patient and physician outcomes: more accurate diagnosis and treatment, increased patient satisfaction and compliance with treatment [3,[6][7][8][9], lower incidence of complaints and lawsuits, and lower levels of burnout and stress among physicians [2,5,10,11]. Moreover, high scores on professional empathy among medical students are associated with increased satisfaction with their education, lower levels of stress and burnout, higher ratings of overall clinical competences given by medical school faculty, better interpersonal skills assessed by patients and greater teamwork skills [2,5,[12][13][14].…”