Validation of the Toronto Empathy Questionnaire (TEQ) Among Medical Students in China: Analyses Using Three Psychometric Methods

Abstract

This study aimed to validate the simplified Chinese version of the Toronto Empathy Questionnaire (cTEQ) for use with the Chinese population. The original English version of the TEQ was translated into simplified Chinese based on international criteria. Psychometric analyses were performed based on three psychometric methods: classical test theory (CTT), item response theory (IRT), and Rasch model theory (RMT). Differential item functioning analysis was adopted to check possible item bias caused by responses from different subgroups based on sex and ethnicity. A total of 1296 medical students successfully completed the TEQ through an online survey; 75.2% of respondents were female and the average age was 19 years old. Forty students completed the questionnaire 2 weeks later to assess the test-retest reliability of the questionnaire. Confirmatory factor analysis supported a 3-factor structure of the cTEQ. The CTT analyses confirmed that the cTEQ has sound psychometric properties. However, IRT and RMT analyses suggested some items might need further modifications and revisions.

A validation study of the Korean version of the Toronto empathy questionnaire for the measurement of medical students’ empathy

“…Our findings support the assertion made by Kim and Han [ 19 ] of the possibility of a non-single factor model of the Korean TEQ. Our finding is also consistent with that of Xu and colleagues [ 18 ] that supported a 3-factor structure of the Chinese TEQ.…”

“…These findings seem to indicate the empathy levels of Korean premed students are similar with those of college students but are lower than those of medical students in other countries. Still, Korean medical students’ TEQ scores were slightly higher than those of Chinese medical students [ 18 ]. The lower TEQ scores of Chinese and Korean medical students likely pertain to cultural influences on empathy, which were mentioned earlier, as these two countries have similar cultural backgrounds.…”

“…The TEQ is devised to target general populations and represents empathy primarily as an emotional process [ 15 ]. Although the TEQ has been studied in medical students in international settings [ 16 – 18 ], its psychometric properties have seldom been investigated in non-English-speaking samples [ 18 ]. The Korean version of the TEQ was derived by translation and validated in a study of approximately 500 Korean undergraduates and graduate students by Kim and Han [ 19 ], but has not yet been validated in a population of Korean medical students.…”

Psychometric Analysis of the Czech Version of the Toronto Empathy Questionnaire

“…Its validity was supported via positive correlation with the Empathy Quotient [1] (r = 0.80), the Reading the Mind in the Eyes test [17] (r = 0.35) and via negative correlation with the Autism Quotient [18] (r = −0.30) [2]. To date, the TEQ as validated also in Turkey [19], China [3] or Korea [20].…”

“…From a more detailed view, it is thought that empathy has two facets. Emotional empathy reflects an emotional reaction (e.g., joy) to the feelings of others [2] while cognitive empathy is "cognitive and intellectual apprehension of another person's emotional state" [3].…”