Empathy as a Function of Clinical Exposure - Reading Emotion in the Eyes

Handford, Cameron; Lemon, James C.; Grimm, Michael; Vollmer‐Conna, Ute

doi:10.1371/journal.pone.0065159

Cited by 63 publications

(62 citation statements)

References 33 publications

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“…Importantly our scores are not only in line with previously published data but also concur with a more recent study conducted among medical students in Australia 14 , 29. The study done in Australia also found no difference among different years of training; in this study there was also no difference in RMET scores between medical students and a group of older more experienced physicians who were also surveyed.…”

Section: Discussionsupporting

confidence: 93%

An exploration of changes in cognitive and emotional empathy among medical students in the Caribbean

Youssef

Nunes

et al. 2014

Int J Med Educ

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Objectives:This study explored the empathy profile of students across five years of medical training. In addition the study examined whether the Jefferson Scale for Physician Empathy correlated with a measure of cognitive empathy, the Reading the Mind in the Eyes Test and a measure of affective empathy, the Toronto Empathy Questionnaire.Methods:The study was a comparative cross-sectional design at one Caribbean medical school. Students were contacted in class, participation was voluntary and empathy was assessed using all three instruments Descriptive statistics were calculated and differences between groups evaluated using non-parametric tests.Results:Overall 669 students participated (response rate, 67%). There was a significant correlation between the Jefferson Scale of Physician Empathy and the Toronto Empathy Questionnaire (P = 0.48), both scales indicating a decline in medical student empathy scores over time. There was, however, little correlation between scores from the Reading the Mind in the Eyes Test and the Jefferson Scale of Physician Empathy. Female students demonstrated significantly higher scores on all three measures.Conclusions:Medical students’ lower empathy scores during their final years of training appear to be due to a change in the affective component of empathy. These findings may reflect an adaptive neurobiological response to the stressors associated with encountering new clinical situations. Attention should be paid not only to providing empathy training for students but also to teaching strategies for improved cognitive processing capacity when they are encountering new and challenging circumstances.

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Section: Discussionsupporting

confidence: 93%

An exploration of changes in cognitive and emotional empathy among medical students in the Caribbean

Youssef

Nunes

et al. 2014

Int J Med Educ

View full text Add to dashboard Cite

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“…First, the sample size is small compared with those of recent work that has examined changes in empathy over time during medical training as assessed by the JSPE, as well as its factor validity . However, this sample size is comparable with those in much of the other longitudinal research on changes in empathy over the course of medical school, and this is the first study, to the present authors’ knowledge, to assess and compare empathy changes in medical students as assessed by the JSPE, or empathy in the context of the physician–patient interaction, and by a more general measure of students’ capacity for empathy, the QCAE, along with measures designed to assess the behavioural manifestation of this capacity. Additionally, there may be potential bias as a result of the self‐selection of participants in that patterns of change may be different in students who did not volunteer for the study.…”

Section: Discussionmentioning

confidence: 85%

“…Recent work failed to find changes in empathy during medical school or found declines in only some aspects of empathy and none in others . There is some evidence for increases in behavioural aspects of empathy . This suggests that empathy changes during medical training may be more complex than can be represented by an overall decline.…”

Section: Introductionmentioning

confidence: 98%

“…However, relying on this sole measure as a primary form of assessment is potentially misleading, given that it focuses on one component of empathy and neglects the complex integration across empathic components and processes, which makes it difficult to understand the mechanisms underlying observed changes. Indeed, some work indicates that changes in components of empathy measured behaviourally demonstrate different patterns across medical training than do self‐report measures . Additionally, there is evidence that self‐reported empathy as measured by the JSPE does not correlate with observer‐reported empathy, which is more pertinent to the physician–patient relationship as the patient's perception of the physician's empathy is going to shape how that patient responds to the physician.…”

Section: Introductionmentioning

confidence: 99%

“…Indeed, some work indicates that changes in components of empathy measured behaviourally demonstrate different patterns across medical training than do self-report measures. 14 Additionally, there is evidence that self-reported empathy as measured by the JSPE does not correlate with observer-reported empathy, 29 which is more pertinent to the physician-patient relationship as the patient's perception of the physician's empathy is going to shape how that patient responds to the physician. This, along with the lack of consensus on how reliable those changes are across medical training, 12,13 makes it critical to further our understanding of what contributes to those alterations by assessing both cognitive and affective facets of empathy alongside the behavioural expressions of those components.…”

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confidence: 99%

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The complexity of empathy during medical school training: evidence for positive changes

2017

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Background Empathy is an essential aspect of clinical care, associated with improved patient satisfaction, increased adherence to treatment, and fewer malpractice complaints. Previous studies suggest that empathy declines during medical training. However, this past research relied on a single narrowly operationalized self-report measure of empathy. As empathy is a complex socio-emotional construct, it is critical to assess changes across its distinct components using multiple measures, to better understand how medical training influences empathy. Methods In a longitudinal design, medical students completed a series of self-report and behavioral measures twice a year during the first three years of their study (2012 – 2015). These included the previously used Jefferson Scale of Physician Empathy (JSE), designed to assess empathy in the clinical context, the Questionnaire of Cognitive and Affective Empathy (QCAE), designed to assess overall empathy and its main components, and behavioral measures of sensitivity to others’ pain and understanding of other’s emotions, both important aspects of empathy. Employing multiple measures allowed for a more complete assessment of medical students’ empathy and related processes. Results Replicating previous work, students’ empathy assessed by the JSE decreased over training. However, on the QCAE, aspects of students empathy, specifically overall cognitive empathy and it’s subcomponent perspective-taking and the emotion contagion subcomponent of affective empathy improved while the remaining subcomponents stayed stable. Students also exhibited comparable growth in their understanding of others’ emotions and increased sensitivity for others’ pain during medical school. Conclusions Changes in empathy during medical school cannot be simply characterized as an overall decline. Indeed, aspects of empathy thought to be valuable in positive patient physician interactions improve during training. Overall, this study points to the importance of assessing the distinct components of empathy using multiple forms of measurement in order to better understand the mechanisms involved in empathy changes in medical practice.

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Healthcare experience affects pain‐specific responses to others' suffering in the anterior insula

Corradi‐Dell'Acqua,

Hofstetter,

Sharvit

et al. 2023

Human Brain Mapping

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Medical students and professional healthcare providers often underestimate patients' pain, together with decreased neural responses to pain information in the anterior insula (AI), a brain region implicated in self‐pain processing and negative affect. However, the functional significance and specificity of these neural changes remains debated. Across two experiments, we recruited university medical students and emergency nurses to test the role of healthcare experience on the brain reactivity to other's pain, emotions, and beliefs, using both pictorial and verbal cues. Brain responses to self‐pain was also assessed and compared with those to observed pain. Our results confirmed that healthcare experience decreased the activity in AI in response to others' suffering. This effect was independent from stimulus modality (pictures or texts), but specific for pain, as it did not generalize to inferences about other mental or affective states. Furthermore, representational similarity and multivariate pattern analysis revealed that healthcare experience impacted specifically a component of the neural representation of others' pain that is shared with that of first‐hand nociception, and related more to AI than to other pain‐responsive regions. Taken together, our study suggests a decreased propensity to appraise others' suffering as one's own, associated with a reduced recruitment of pain‐specific information in AI. These findings provide new insights into neural mechanisms leading to pain underestimation by caregivers in clinical settings.

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Empathy as a Function of Clinical Exposure - Reading Emotion in the Eyes

Cited by 63 publications

References 33 publications

An exploration of changes in cognitive and emotional empathy among medical students in the Caribbean

An exploration of changes in cognitive and emotional empathy among medical students in the Caribbean

The complexity of empathy during medical school training: evidence for positive changes

Healthcare experience affects pain‐specific responses to others' suffering in the anterior insula

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