Erosion of empathy during medical training by gender. A cross-sectional study

Abstract

Introduction. Empathy erosion may be defined as a sudden decline in the levels of empathy that occurs as of the third year of medical school and continues until the fifth year. According to some authors, this process is normal during medical training and may be considered a model of empathic behavior. The objective of this study was to verify whether empathy erosion is a general phenomenon in the schools of medicine included in the study and its relation to gender. Design. Exploratory, cross-sectional study. Population. Students from first through sixth year of the School of Medicine of Universidad del Azuay (Cuenca, Ecuador) and from first through fifth year of the School of Medicine of Corporación Universitaria Rafael Nuñez (Colombia). Material and methods. The levels of overall empathy and of each component were estimated using the Jefferson Scale of Empathy, which was administered in both schools during July and August of 2016. The significance level was established at α < 0.05. Results. Universidad del Azuay: n= 278 (98% of all students); women= 112; men= 166; Corporación Universitaria Rafael Nuñez: n= 756 (77.86% of all students); women= 434; men= 322. The model of erosion of empathy is not fulfilled at the level of overall empathy or of each studied component according to gender. Conclusions. Empathy erosion is a specific element of several different models of empathic response (and of its components). Men and women do not have the same empathic response. Such response, in the studied conditions, is variable.

Empathic decline and training in nursing students

“…It is known that empathy has components that are affective-emotional (CC) and cognitive (PT and AUO) (5) . Some authors have suggested that the CC component is difficult to teach, and that it is a product of, or is related to (or both), the moral formation of subjects, family environments, and religiosity (in some cases), among other factors (5)(6)(7)(8)(9)(10) , while the cognitive components (given their nature) are susceptible to being taught (5)(6) . On the other hand (7)(8) , it should be noted that the presence of empathic decline is based on the findings of studies of means of levels of empathy in medical students (11) .…”

“…However, some authors have found evidence that the empathic decline in students does not always occur; this has been found in various health careers (3,(9)(10)(18)(19)(20) . It has been suggested (21) that empathic decline is a particular case of various behaviors of means of empathy throughout courses or years of study, and that there is variability in this behavior.…”

“…The "simple fact" is that empathy is a dialectical synthesis of its three components. Therefore, the expression of empathy is nothing more than the very expression of the particular correlation that can occur between these components which, in turn, in their "determination", operate on them, in addition to intrinsic factors, as well as extrinsic factors (9)(10)(11)(12)(13) . These circumstances make it necessary to be stricter in decisions to carry out intervention That is because detailed examination of the components and the causes that produce certain behaviors in each component will constitute a specific guide for the empathic-educational intervention in the sense of the actions that could be derived from this intervention.…”

“…The combination of these results implies that in order to increase levels of empathy among nursing students, factors that maintain the stability of levels of empathy between courses must be taken into consideration. This knowledge could allow action to reduce the effect of factors that participate in the erosion of levels of empathy and, at the same time, reinforce the factors that contribute to the increase of empathy in future nurse practitioners (10,(16)(17)21) . This knowledge could also be useful in other healthcare professions in which empathy is a main competency for establishing relationships with persons receiving care and contributing to solutions to the new challenges that are faced by the nursing profession (30) .…”

Consideraciones sobre la declinación empática en estudiantes de medicina en Latinoamérica

“…Al respecto, estudios realizados (5-10) han observado la existencia de la declinación (2). Sin embargo, otros autores han observado variabilidad en la distribución de los valores de empatía a través de los años académicos o cursos (11)(12)(13)(14)(15)(16)(17).…”