Clarifying changes in student empathy throughout medical school: a scoping review

Springer Science and Business Media LLC - Tập 22 Số 5 - Trang 1293-1313 - 2017
Ferreira-Valente, Alexandra1,2,3, Monteiro, Joana S.4,5, Barbosa, Rita M.6, Salgueira, Ana1,2, Costa, Patrício1,2,7, Costa, Manuel J.1,2
1Life and Health Sciences Research Institute (ICVS), School of Health Sciences, University of Minho, Braga, Portugal
23B PT Government Associate Laboratory, Braga, Guimarães, Portugal
3University Lusíada of Lisbon, Lisbon, Portugal
4USF Odisseia, Maia, Portugal
5Faculty of Medicine, Oporto University, Porto, Portugal
6USF Rainha D. Amélia, Porto, Portugal
7Faculty of Psychology and Education Sciences, University of Porto, Porto, Portugal

Tóm tắt

Despite the increasing awareness of the relevance of empathy in patient care, some findings suggest that medical schools may be contributing to the deterioration of students’ empathy. Therefore, it is important to clarify the magnitude and direction of changes in empathy during medical school. We employed a scoping review to elucidate trends in students’ empathy changes/differences throughout medical school and examine potential bias associated with research design. The literature published in English, Spanish, Portuguese and French from 2009 to 2016 was searched. Two-hundred and nine potentially relevant citations were identified. Twenty articles met the inclusion criteria. Effect sizes of empathy scores variations were calculated to assess the practical significance of results. Our results demonstrate that scoped studies differed considerably in their design, measures used, sample sizes and results. Most studies (12 out of 20 studies) reported either positive or non-statistically significant changes/differences in empathy regardless of the measure used. The predominant trend in cross-sectional studies (ten out of 13 studies) was of significantly higher empathy scores in later years or of similar empathy scores across years, while most longitudinal studies presented either mixed-results or empathy declines. There was not a generalized international trend in changes in students’ empathy throughout medical school. Although statistically significant changes/differences were detected in 13 out of 20 studies, the calculated effect sizes were small in all but two studies, suggesting little practical significance. At the present moment, the literature does not offer clear conclusions relative to changes in student empathy throughout medical school.

Tài liệu tham khảo

citation_journal_title=International Journal of Social Research Methodology; citation_title=Scoping studies: towards a methodological framework; citation_author=H Arksey, L O’Malley; citation_volume=8; citation_issue=1; citation_publication_date=2005; citation_pages=19-32; citation_doi=10.1080/1364557032000119616; citation_id=CR36

citation_journal_title=Medical Education; citation_title=A preliminary study of empathy, emotional intelligence and examination performance in MBChB students; citation_author=EJ Austin, P Evans, B Magnus, K O’Hanlon; citation_volume=41; citation_issue=7; citation_publication_date=2007; citation_pages=684-689; citation_doi=10.1111/j.1365-2923.2007.02795.x; citation_id=CR1

citation_journal_title=Psychiatria Danubina; citation_title=Empathy among physicians, medical students and candidates; citation_author=A Bratek, W Bulska, M Bonk, M Seweryn, K Krysta; citation_volume=27; citation_issue=Suppl 1; citation_publication_date=2015; citation_pages=S48-S52; citation_id=CR2

citation_journal_title=Journal of General Internal Medicine; citation_title=A cross-sectional measurement of medical student empathy; citation_author=D Chen, R Lew, W Hershman, J Orlander; citation_volume=22; citation_issue=10; citation_publication_date=2007; citation_pages=1434-1438; citation_doi=10.1007/s11606-007-0298-x; citation_id=CR42

citation_journal_title=Medical Teacher; citation_title=Characterizing changes in student empathy throughout medical school; citation_author=DCR Chen, DS Kirshenbaum, J Yan, E Kirshenbaum, RH Aseltine; citation_volume=34; citation_issue=4; citation_publication_date=2012; citation_pages=305-311; citation_doi=10.3109/0142159X.2012.644600; citation_id=CR3

Cohen, J. (1988). Statistical power analysis for the behavioral sciences (2nd ed.). Hillsdale: Lawrence Erlbaum.

citation_journal_title=Academic Medicine; citation_title=Reports of the decline of empathy during medical education are greatly exaggerated: A reexamination of the research; citation_author=JA Colliver, MJ Conlee, SJ Verhulst, JK Dorsey; citation_volume=85; citation_issue=4; citation_publication_date=2010; citation_pages=588-593; citation_doi=10.1097/ACM.0b013e3181d281dc; citation_id=CR4

citation_journal_title=PLoS One; citation_title=Associations between medical student empathy and personality: A multi-institutional study; citation_author=P Costa, R Alves, I Neto, P Marvão, M Portela, MJ Costa; citation_volume=9; citation_issue=3; citation_publication_date=2014; citation_pages=e89254; citation_doi=10.1371/journal.pone.0089254; citation_id=CR5

citation_journal_title=Advances in Health Sciences Education; citation_title=A latent growth model suggests that empathy of medical students does not decline over time; citation_author=P Costa, E Magalhães, MJ Costa; citation_volume=18; citation_issue=3; citation_publication_date=2013; citation_pages=509-522; citation_doi=10.1007/s10459-012-9390-z; citation_id=CR6

citation_journal_title=Journal of Personality and Social Psychology; citation_title=Measuring individual differences in empathy: Evidence for a multidimensional approach; citation_author=MH Davis; citation_volume=44; citation_issue=1; citation_publication_date=1983; citation_pages=113-126; citation_doi=10.1037/0022-3514.44.1.113; citation_id=CR7

citation_journal_title=South East Asian Journal of Medical Education; citation_title=Empathy in medical students as related to gender, year of medical school and specialty interest; citation_author=MI Duarte, MC Branco, ML Raposo, PJ Rodrigues; citation_volume=9; citation_issue=1; citation_publication_date=2015; citation_pages=51; citation_id=CR8

citation_journal_title=Atención Primaria; citation_title=La empatía médica, ¿nace o se hace? Evolución de la empatía en estudiantes de medicina; citation_author=M Esquerda, O Yuguero, J Viñas, J Pifarré; citation_volume=48; citation_issue=1; citation_publication_date=2016; citation_pages=8-14; citation_doi=10.1016/j.aprim.2014.12.012; citation_id=CR9

citation_journal_title=PLoS One; citation_title=Empathy as a function of clinical exposure-reading emotion in the eyes; citation_author=C Handford, J Lemon, MC Grimm, U Vollmer-Conna; citation_volume=8; citation_issue=6; citation_publication_date=2013; citation_pages=e65159; citation_doi=10.1371/journal.pone.0065159; citation_id=CR10

citation_journal_title=Medical Teacher; citation_title=Maintaining empathy in medical school: It is possible; citation_author=I Hegazi, I Wilson; citation_volume=35; citation_issue=12; citation_publication_date=2013; citation_pages=1002-1008; citation_doi=10.3109/0142159X.2013.802296; citation_id=CR11

citation_journal_title=Medical Education; citation_title=Empathy in medical students as related to academic performance, clinical competence and gender; citation_author=M Hojat, JS Gonnella, S Mangione, TJ Nasca, JJ Veloski, JB Erdmann, M Magee; citation_volume=36; citation_issue=6; citation_publication_date=2002; citation_pages=522-527; citation_doi=10.1046/j.1365-2923.2002.01234.x; citation_id=CR12

citation_journal_title=Medical Education; citation_title=An empirical study of decline in empathy in medical school; citation_author=M Hojat, S Mangione, TJ Nasca, S Rattner, JB Erdmann, JS Gonnella, M Magee; citation_volume=38; citation_issue=9; citation_publication_date=2004; citation_pages=934-941; citation_doi=10.1111/j.1365-2929.2004.01911.x; citation_id=CR13

citation_journal_title=Academic Medicine; citation_title=The devil is in the third year: A longitudinal study of erosion of empathy in medical school; citation_author=M Hojat, MJ Vergare, K Maxwell, G Brainard, SK Herrine, GA Isenberg, JS Gonnella; citation_volume=84; citation_issue=9; citation_publication_date=2009; citation_pages=1182-1191; citation_doi=10.1097/ACM.0b013e3181b17e55; citation_id=CR14

citation_journal_title=Academic Medicine; citation_title=Measurement of empathy among Japanese medical students: Psychometrics and score differences by gender and level of medical education; citation_author=HU Kataoka, N Koide, K Ochi, M Hojat, JS Gonnella; citation_volume=84; citation_issue=9; citation_publication_date=2009; citation_pages=1192-1197; citation_doi=10.1097/ACM.0b013e3181b180d4; citation_id=CR15

citation_journal_title=Academic Medicine; citation_title=Emotional and cognitive empathy in medical schools; citation_author=J Kliszcz, M Hebanowski, J Rembowski; citation_volume=73; citation_publication_date=1998; citation_pages=541; citation_doi=10.1097/00001888-199805000-00025; citation_id=CR38

citation_journal_title=Implementation Science; citation_title=Scoping studies: Advancing the methodology; citation_author=D Levac, H Colquhoun, KK O’Brien; citation_volume=5; citation_issue=1; citation_publication_date=2010; citation_pages=69; citation_doi=10.1186/1748-5908-5-69; citation_id=CR16

citation_journal_title=Medical Teacher; citation_title=How well do medical students rate and communicate clinical empathy?; citation_author=BT Lim, H Moriarty, M Huthwaite, L Gray, S Pullon, P Gallagher; citation_volume=35; citation_issue=2; citation_publication_date=2013; citation_pages=e946-e951; citation_doi=10.3109/0142159X.2012.715783; citation_id=CR17

citation_journal_title=Acta Médica Portuguesa; citation_title=Empathy in the doctor-patient relationship as viewed by first-year medical students: Data on validity and sensibility to change of the Jefferson measure in Portugal; citation_author=J Loureiro, M Gonçalves-Pereira, B Trancas, JM Caldas-de-Almeida, A Castro-Caldas; citation_volume=24; citation_publication_date=2011; citation_pages=431-442; citation_id=CR18

citation_journal_title=BMC Medical Education; citation_title=Empathy in senior year and first year medical students: A cross-sectional study; citation_author=E Magalhães, AP Salgueira, P Costa, MJ Costa; citation_volume=11; citation_issue=1; citation_publication_date=2011; citation_pages=52; citation_doi=10.1186/1472-6920-11-52; citation_id=CR19

Mays, N., Roberts, E., & Popay, J. (2001). Synthesising research evidence. In N. Fulop, P. Allen, A. Clarke, & N. Black (Eds.), Studying the organisation and delivery of health services: research methods (pp. 188–220.). London, UK: Routledge.

citation_journal_title=Investigación en Educación Médica; citation_title=Empatía según la escala de Jefferson en estudiantes de Medicina y Enfermería en Venezuela; citation_author=M Montilva, M García, A Torres, M Puertas, E Zapata; citation_volume=4; citation_issue=16; citation_publication_date=2015; citation_pages=223-228; citation_doi=10.1016/j.riem.2015.04.006; citation_id=CR20

citation_journal_title=Academic Medicine; citation_title=Is there hardening of the heart during medical school?; citation_author=BW Newton, L Barber, J Clardy, E Cleveland, P OʼSullivan; citation_volume=83; citation_issue=3; citation_publication_date=2008; citation_pages=244-249; citation_doi=10.1097/ACM.0b013e3181637837; citation_id=CR21

citation_journal_title=International Journal of Medical Education; citation_title=A study of empathy decline in students from five health disciplines during their first year of training; citation_author=P Nunes, S Williams, B Sa, K Stevenson; citation_volume=2; citation_publication_date=2011; citation_pages=12-17; citation_doi=10.5116/ijme.4d47.ddb0; citation_id=CR22

citation_journal_title=Patient Education and Counseling; citation_title=Empirical research on empathy in medicine—A critical review; citation_author=R Pedersen; citation_volume=76; citation_issue=3; citation_publication_date=2009; citation_pages=307-322; citation_doi=10.1016/j.pec.2009.06.012; citation_id=CR23

citation_journal_title=Research Synthesis Methods; citation_title=A scoping review of scoping reviews: Advancing the approach and enhancing the consistency; citation_author=MT Pham, A Rajić, JD Greig, JM Sargeant, A Papadopoulos, SA McEwen; citation_volume=5; citation_issue=4; citation_publication_date=2014; citation_pages=371-385; citation_doi=10.1002/jrsm.1123; citation_id=CR24

citation_journal_title=BMC Medical Education; citation_title=Stability of empathy among undergraduate medical students: A longitudinal study at one UK medical school; citation_author=TA Quince, RA Parker, DF Wood, JA Benson; citation_volume=11; citation_issue=1; citation_publication_date=2011; citation_pages=90; citation_doi=10.1186/1472-6920-11-90; citation_id=CR25

citation_journal_title=Medical Teacher; citation_title=Reconsidering the “decline” of medical student empathy as reported in studies using the Jefferson Scale of Physician Empathy-Student version (JSPE-S); citation_author=S Roff; citation_publication_date=2015; citation_id=CR26

citation_journal_title=Teaching and Learning in Medicine; citation_title=Evaluation of empathy among Korean medical students: A cross-sectional study using the Korean version of the Jefferson scale of physician empathy; citation_author=M-S Roh, B-J Hahm, DH Lee, DH Suh; citation_volume=22; citation_issue=3; citation_publication_date=2010; citation_pages=167-171; citation_doi=10.1080/10401334.2010.488191; citation_id=CR27

citation_journal_title=A scoping review. Medical Teacher; citation_title=Peer-coaching with health care professionals: What is the current status of the literature and what are the key components necessary in peer-coaching?; citation_author=H Schwellnus, H Carnahan; citation_volume=36; citation_issue=1; citation_publication_date=2014; citation_pages=38-46; citation_doi=10.3109/0142159X.2013.836269; citation_id=CR28

citation_journal_title=Medical Teacher; citation_title=Empathy in Iranian medical students: Measurement model of the Jefferson scale of empathy; citation_author=SV Shariat, M Habibi; citation_volume=35; citation_issue=1; citation_publication_date=2013; citation_pages=e913-e918; citation_doi=10.3109/0142159X.2012.714881; citation_id=CR29

citation_journal_title=Medical Journal Armed Forces India; citation_title=Cross sectional assessment of empathy among undergraduates from a medical college; citation_author=R Shashikumar, R Chaudhary, VSSR Ryali, PS Bhat, K Srivastava, J Prakash, D Basannar; citation_volume=70; citation_issue=2; citation_publication_date=2014; citation_pages=179-185; citation_doi=10.1016/j.mjafi.2014.02.005; citation_id=CR40

citation_journal_title=Educación Médica Superior; citation_title=Orientación empática en estudiantes de Medicina en una universidad de República Dominicana; citation_author=MG Silva, J Arboleda Castillo, VP Díaz Narváez; citation_volume=28; citation_issue=1; citation_publication_date=2014; citation_pages=74-83; citation_id=CR30

citation_journal_title=Advances in Health Sciences Education; citation_title=Development of a metacognitive effort construct of empathy during clinical training: A longitudinal study of the factor structure of the Jefferson scale of empathy; citation_author=RB Stansfield, A Schwartz, CL O’Brien, M Dekhtyar, L Dunham, M Quirk; citation_publication_date=2015; citation_id=CR31

citation_journal_title=Revista Brasileira de Educação Médica; citation_title=Avaliação da evolução da empatia em alunos do quarto ano da graduação em medicina da Unifesp em 2012; citation_author=L Thomazi, FG Moreira, MA Marco; citation_volume=38; citation_issue=1; citation_publication_date=2014; citation_pages=87-93; citation_doi=10.1590/S0100-55022014000100012; citation_id=CR32

citation_journal_title=Medical Teacher; citation_title=The emotional intelligence of medical students: An exploratory cross-sectional study; citation_author=M Todres, Z Tsimtsiou, A Stephenson, R Jones; citation_volume=32; citation_issue=1; citation_publication_date=2010; citation_pages=e42-e48; citation_doi=10.3109/01421590903199668; citation_id=CR41

citation_journal_title=Advances in Health Sciences Education: Theory and Practice; citation_title=Do empathy, perspective-taking, sense of power and personality differ across undergraduate education and are they inter-related?; citation_author=RL Toto, L Man, B Blatt, SJ Simmens, L Greenberg; citation_volume=20; citation_issue=1; citation_publication_date=2015; citation_pages=23-31; citation_doi=10.1007/s10459-014-9502-z; citation_id=CR33

citation_journal_title=BMC Medical Education; citation_title=Empathy in Chinese medical students: Psychometric characteristics and differences by gender and year of medical education; citation_author=D Wen, X Ma, H Li, Z Liu, B Xian, Y Liu; citation_volume=13; citation_issue=1; citation_publication_date=2013; citation_pages=130; citation_doi=10.1186/1472-6920-13-130; citation_id=CR34

citation_journal_title=International Journal of Medical Education; citation_title=An exploration of changes in cognitive and emotional empathy among medical students in the Caribbean; citation_author=FF Youssef, P Nunes, B Sa, S Williams; citation_volume=5; citation_publication_date=2014; citation_pages=185-192; citation_doi=10.5116/ijme.5412.e641; citation_id=CR35

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Springer Science and Business Media LLC

Tập 22 Số 5

1293-1313

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