The Devil is in the Third Year: A Longitudinal Study of Erosion of Empathy in Medical School

Published on Sep 1, 2009in Academic Medicine5.354
· DOI :10.1097/ACM.0B013E3181B17E55
Mohammadreza Hojat67
Estimated H-index: 67
,
Michael J. Vergare17
Estimated H-index: 17
+ 5 AuthorsJoseph S. Gonnella54
Estimated H-index: 54
Sources
Abstract
Purpose This longitudinal study was designed to examine changes in medical students’ empathy during medical school and to determine when the most significant changes occur. Method Four hundred fifty-six students who entered Jefferson Medical College in 2002 (n 227) and 2004 (n 229) completed the Jefferson Scale of Physician Empathy at five different times: at entry into medical school on orientation day and subsequently at the end of each academic year. Statistical analyses were performed for the entire cohort, as well as for the “matched” cohort (participants who identified themselves at all five test administrations) and the “unmatched” cohort (participants who did not identify themselves in all five test administrations). Results Statistical analyses showed that empathy scores did not change significantly during the first two years of medical school. However, a significant decline in empathy scores was observed at the end of the third year which persisted until graduation. Findings were similar for the matched cohort (n 121) and for the rest of the sample (unmatched cohort, n 335). Patterns of decline in empathy scores were similar for men and women and across specialties. Conclusions It is concluded that a significant decline in empathy occurs during the third year of medical school. It is ironic that the erosion of empathy occurs during a time when the curriculum is shifting toward patient-care activities; this is when empathy is most essential. Implications for retaining and enhancing empathy are discussed.
Download
📖 Papers frequently viewed together
2006
340 Citations
589 Citations
200545.54JAMA
2 Authors (Eric B. Larson, Xin Yao)
600 Citations
References52
Newest
#1Myoung Sun Roh (SNU: Seoul National University)H-Index: 8
#2Bong-Jin Hahm (SNU: Seoul National University)H-Index: 15
Last. Dae Hun Suh (SNU: Seoul National University)H-Index: 25
view all 4 authors...
Background: Empathy is an essential element of physician professionalism. Thus, proper evaluation and education of empathy in medical students is important for medical education. Purpose: This study was conducted to evaluate the psychometric properties of the Korean Student-Version of the Jefferson Scale of Physician Empathy (JSPE-S). Methods: The scale was completed cross-sectionally by 493 medical students at Seoul National University College of Medicine in Korea. Results: Item-total correlati...
120 CitationsSource
#1William OslerH-Index: 31
238 Citations
#1Hitomi Kataoka (Okayama University)H-Index: 9
#2Norio Koide (Okayama University)H-Index: 20
Last. Joseph S. Gonnella (Thomas Jefferson University)H-Index: 54
view all 5 authors...
Purpose To examine psychometric properties of a Japanese translation of the Jefferson Scale of Physician Empathy (JSPE), and to study differences in empathy scores between men and women, and students in different years of medical school. Method The student version of the JSPE was translated into Japanese using back-translation procedures and administered to 400 Japanese students from all six years at the Okayama University Medical School. Item-total score correlations were calculated. Factor ana...
246 CitationsSource
#1Mariangela Di Lillo (Thomas Jefferson University)H-Index: 1
#2Americo CicchettiH-Index: 13
Last. Mohammadreza HojatH-Index: 67
view all 5 authors...
AbstractPurposeTo examine the psychometrics of the Jefferson Scale of Physician Empathy (JSPE) among a sample of Italian physicians.MethodThe JSPE was translated into Italian using back-translation procedures to ensure the accuracy of the translation. The translated JSPE was administered to 778 phys
119 CitationsSource
#1Julia Ward (Thomas Jefferson University)H-Index: 7
#2Mary G. SchaalH-Index: 3
Last. Mohammadreza HojatH-Index: 67
view all 6 authors...
Evidence has been reported in support of the reliability and validity of the Jefferson Scale of Physician Empathy (JSPE) when used with physicians, medical students, and nurses. This study examined the psychometrics of a modified version of the scale in undergraduate nursing students. The modified version of the JSPE was administered to 333 nursing students at different levels of training. Three underlying constructs, that is, "Perspective Taking," "Compassionate Care," and "Standing in Patient'...
114 CitationsSource
: Empathy is defined as a predominantly cognitive attribute that involves an understanding of experiences, concerns and perspectives of another person, combined with a capacity to communicate this understanding. Empathy in the context of clinical care can lead to positive patient outcomes including greater patient satisfaction and compliance, lower rates of malpractice litigation, lower cost of medical care, and lower rate of medical errors. Also, health professionals' wellbeing is associated wi...
156 Citations
#1William D.S. Killgore (WRAIR: Walter Reed Army Institute of Research)H-Index: 63
#2Ellen T. Kahn-Greene (WRAIR: Walter Reed Army Institute of Research)H-Index: 5
Last. Thomas J. Balkin (WRAIR: Walter Reed Army Institute of Research)H-Index: 53
view all 6 authors...
Abstract Background and purpose Insufficient sleep can adversely affect a variety of cognitive abilities, ranging from simple alertness to higher-order executive functions. Although the effects of sleep loss on mood and cognition are well documented, there have been no controlled studies examining its effects on perceived emotional intelligence (EQ) and constructive thinking, abilities that require the integration of affect and cognition and are central to adaptive functioning. Patients and meth...
273 CitationsSource
AbstractThe use of narratives, including physicians’ and patients’ stories, literature, and film, is increasingly popular in medical education. There is, however, a need for an overarching conceptual framework to guide these efforts, which are often dismissed as “soft” and placed at the margins of m
163 CitationsSource
#1Bruce W. Newton (University of Arkansas for Medical Sciences)H-Index: 12
#2Laurie BarberH-Index: 5
Last. Patricia S. O'SullivanH-Index: 64
view all 5 authors...
AbstractPurposeTo determine whether vicarious empathy (i.e., to have a visceral empathic response, versus role-playing empathy) decreases, and whether students choosing specialties with greater patient contact maintain vicarious empathy better than do students choosing specialties with less patient
341 CitationsSource
#1Daniel C. R. Chen (BU: Boston University)H-Index: 4
#2Robert A. Lew (BU: Boston University)H-Index: 87
Last. Jay D. Orlander (BU: Boston University)H-Index: 17
view all 4 authors...
Background Empathy is important in the physician–patient relationship. Prior studies have suggested that physician empathy may decline with clinical training.
345 CitationsSource
Cited By933
Newest
#1Elsie Kim Hiok Lim (Singapore Institute of Technology)
#2Gordon Jian Ting Loh (Singapore Institute of Technology)
Last. Meredith T. Yeung (Singapore Institute of Technology)H-Index: 1
view all 8 authors...
Source
#1Sofia Skogevall (MDH: Mälardalen University College)H-Index: 1
#2Inger Holmström (MDH: Mälardalen University College)H-Index: 27
Last. Jakob Håkansson Eklund (Stockholm University)H-Index: 10
view all 4 authors...
AIM To examine telephone nurses' perceived stress, self-efficacy and empathy in their work with answering calls from frequent callers. DESIGN The study is a quantitative questionnaire survey study with a comparative design. METHODS Telephone nurses (N = 199) answered a survey containing three instruments: Perceived Stress Scale, General Self-Efficacy Scale and Jefferson's Scale of Empathy. Correlation analysis, multiple regression analysis and analysis of variance were performed to test the rese...
Source
#1Krzysztof Sobczak (Gdańsk Medical University)H-Index: 3
#2Agata Zdun-Ryżewska (Gdańsk Medical University)H-Index: 4
Last. Agata Rudnik (University of Gdańsk)H-Index: 1
view all 3 authors...
BACKGROUND Empathy is an important competence in the professional development of medical students. The purpose of our study was to compare the levels and scales of empathy in people studying in different educational strategies. METHODS The study was conducted between April 2019 and March 2020. Medicine, nursing, midwifery, physiotherapy, psychology, pedagogy and sociology students were the participants of this study. University students preparing for medical professions (n = 1001) and students o...
Source
#1Sergio Serrada-Tejeda (URJC: King Juan Carlos University)H-Index: 1
#2Patricia Sánchez-Herrera-Baeza (URJC: King Juan Carlos University)H-Index: 3
Last. Marta Pérez-de-Heredia-Torres (URJC: King Juan Carlos University)H-Index: 6
view all 8 authors...
BACKGROUND In occupational therapy, empathy is a fundamental concept and has a positive impact on health and quality of care outcomes for patients. It is a basic and essential concept that should prevail in the training of occupational therapy students. The aim of this study is to validate and cross-culturally adapt the Jefferson Medical Empathy Scale, version for health professionals (JSE-HPS) in a sample of Spanish university students of occupational therapy. METHODS A cross-sectional descript...
Source
#1Baila Elkin (UMN: University of Minnesota)H-Index: 1
#2Eric Martin LaPlant (UMN: University of Minnesota)
Last. Claudio Violato (UMN: University of Minnesota)H-Index: 37
view all 4 authors...
Empathy is central to the physician–patient relationship, and affects clinical outcomes. There is uncertainty about the stability of empathy in medical students over the course of medical school, as well as differences in empathy between men and women. A panel study design was used to follow first year through fourth year medical students (MS1–4) during the 2018–2019 school year. Empathy was measured using the interpersonal reactivity index (IRI), a self-report scale that separates empathy into ...
Source
Source
#1Rana Kilic (University of Liège)
#2Julian Nasello (University of Liège)H-Index: 2
Last. Jean-Marc Triffaux (University of Liège)H-Index: 6
view all 4 authors...
Abstract null null Objectives null Prior research has found a high prevalence of academic burnout among medical students (33–55%), and medical education institutions have begun to address the issue. In this research, we hypothesized an increase in academic burnout during medical education, as supported by previous findings. The second purpose was to identify the significant predictors (among perceived stress, empathy, and perceived social support) of academic burnout and determine their respecti...
Source
#1Dimitrios Papanagnou (Thomas Jefferson University)H-Index: 11
#2Rebecca Jaffe (Thomas Jefferson University)H-Index: 6
Last. Deborah Ziring (Thomas Jefferson University)H-Index: 2
view all 3 authors...
Source
#1Reyhane Hizomi Arani (Tehran University of Medical Sciences)
#2Zohrehsadat Naji (IAU: Islamic Azad University)H-Index: 2
Last. Payman Salamati (Tehran University of Medical Sciences)H-Index: 24
view all 6 authors...
PURPOSE This study was conducted to assess the developmental factors of empathy among medical students of Tehran University of Medical Sciences (TUMS). METHODS To assess the empathy levels, 42 first-year and an equal number of last-year medical students were randomly selected. They answered a questionnaire including the medical student version of the Jefferson Scale, demographic, and some related variables. Statistical analyses were performed using the Chi-square test, T-test, univariate, and mu...
Source
#2Amy Price (Stanford University)H-Index: 15
Source