A latent growth model suggests that empathy of medical students does not decline over time

Abstract

Empathy is a relevant attribute in the context of patient care. However, a decline in empathy throughout medical education has been reported in North-American medical schools, particularly, in the transition to clinical training. The present study aims to longitudinally model empathy during medical school at three time points: at the entrance, final of pre-clinical phase and at the beginning of clinical training. Data collected with the adaptation to Portuguese of the Jefferson Scale of Physician Empathy (student version) were analysed with latent growth modelling, conditioned by gender, openness and agreeableness. Empathy scores at all times were higher for females than for males, but only significantly at the end of the preclinical phase. The model showed a satisfactory fit level and the primary finding was that undergraduate medical student's empathy did not decline over time. Empathy scores were significantly and positively related with Openness to Experience and Agreeableness at admission, but the empathy rate of change across time was not significant. The stability of empathy revealed by a longitudinal methodology applied for the first time to empathy studying, contradicts previous results of decline and contributes to the understanding of the empathy development of medical students.

Reconsidering the ‘Decline’ of Dental Student Empathy within the Course in Latin America

“…Other authors published the data in this study. [18][19][20] The study population consisted of students belonging to the courses from the first to fifth year of the undergraduate degree program of Dentistry of eighteen Dental Faculties in six countries in Latin America (Dominican Republic, Costa Rica, Panama, Colombia, Argentina and Chile) (n total = 4407). [19][20][21] The Jefferson Scale of Physician Empathy (JSPE), the Spanish version for medical students (S), adapted and validated (for cultural form and content), specially for dental students in all the countries studied by criterion of judges, was applied to all students.…”

“…[19][20][21] The primary and original data from the empathy levels within the course of each university examined were analyzed by the Cronbach's alpha test (reliability by internal consistency); the sum of the primary data score, obtained using the scale previously mentioned, were initially analyzed by the Kolmogorov-Smirnov normality test (K-S) in both types and to the Homoscedasticity Levene test and the effect size was measured by the Hedges (g). [18][19][20][21][22] The means of academic years, from first to fifth, in each of the universities were obtained from the aforementioned works [18][19][20] and tested for polynomial regression to determine the type of curve an analysis of variance sequentially. In addition, the regression equation was estimated and the coefficient of determination (R 2 ), were adjusted and unadjusted, associated with the estimated curve …”

“…The scientific community studying empathy accepts the phenomenon of empathic erosion and, as described above, an important part of it indicates that the third year of the course is the turning point of the levels of empathy within the course and they begin to decrease in senior years. 2,5,[7][8][9]14 However, some studies have been published that contradict these results and show that this decline does not always occur, at least in absolute terms, [16][17][18] all of which can be inferred that the empathic decline (as quantitative expression of erosion) seems not to be a 'scientific fact'.…”

“…[16][17][18]39,40 The importance of the findings in this research is that it poses a dilemma of whether or not there exists empathic decline within the course, and need to determine and measure what are the root causes of this decline and, above all, respond to the finding that it occurs in some of the universities studied and not in others. Furthermore, we must explain why the empathic decline is not only evident in one turning 'point': the third academic year, but in different academic years with values of empathy, which grew in some cases and, in others declined.…”

Response to “are personality traits really weak/moderate predictors of empathy?”

“…We read with great interest the article by Magalhães et al (2012) in a recent issue of Medical Teacher that assessed empathy in medical students with the Jefferson Scale of Physician Empathy and found that personality traits are weak or moderate predictors of empathy.…”