Reports of the Decline of Empathy During Medical Education Are Greatly Exaggerated: A Reexamination of the Research

Abstract

Reexamination revealed that the evidence does not warrant the strong, disturbing conclusion that empathy declines during medical education. Results show a very weak decline in mean ratings, and even the weak decline is questionable because of the low and varying response rates. Moreover, the empathy instruments are self-reports, and it isn't clear what they measure-or whether what they measure is indicative of patients' perceptions and the effectiveness of patient care.

Empathy in Iranian medical students: Measurement model of the Jefferson Scale of Empathy

“…Furthermore, overreliance on computer-based diagnostic and therapeutic technology, emphasis of modern medical education on emotional detachment and clinical neutrality, and experiencing a demanding and hostile educational environment might also play a role in erosion of empathy in medical students ). However, a recent study has been criticized the finding and has suggested that the current evidence only shows a questionable and small decline in mean ratings of empathy (Colliver et al 2010). On the other hand, test developers have refuted the criticism by questioning the method used for comparisons in the review, which did not consider effect size of the differences (Hojat et al 2010).…”

Maintaining empathy in medical school: It is possible

“…Only recently have studies started questioning whether such a decline is of significant magnitude or "greatly exaggerated". (Colliver et al, 2010) While many studies have shown decreasing empathic behaviour of medical students, few have considered the impact of the curriculum and very few have offered solutions, particularly feasible solutions. (Feudtner et al, 1994;Wear, 2008;Krupat et al, 2009;Phillips 2009;Wear and Skillicorn 2009) In response, we concerned ourselves with investigating empathy across the entirety of our medical school students, while controlling for effects of age, gender, marital status, religious belief, cultural background, year of study (cohort), previous education and specific personal and professional development programs, in an attempt to identify their effect on the levels of empathy.…”

How do newly-qualified doctors perceive empathy in medical training and practice?

“…If empathic patient care does indeed decline during clinical training, then there is a strong case for augmenting postgraduate curricula so that foundation doctors can revisit the theory and apply their enhanced knowledge and skills in practice. Even if the case for ethical erosion is not well founded, as some author's claim [3], our pragmatic and interpretive investigation of FTs' written accounts suggests that trainees would value the opportunity to refine their empathic behaviors through effective educational interventions and positive role modeling.…”

“…There is some evidence, particularly from the USA, that medical students' empathy scores diminish upon entering clinical rotations and that empathy levels reduce during US internships [1,2]. Although the basis of such conclusions has been questioned in some quarters [3], there remain concerns that "ethical erosion" among health professionals may have a detrimental effect on patient care [4]. In the UK, publication of the report of the Mid Staffordshire NHS Foundation Trust Public Inquiry highlighted the consequences for patient care when a lack of staff empathy prevails within a clinical environment [5].…”