When patients teach students empathy: a systematic review of interventions for promoting medical student empathy

Abstract

Background: Despite growing emphasis on empathic care, numerous studies demonstrate diminishing empathy in medical students. Involving patient educators in medical curricula may be a solution. Therefore, we conducted a systematic review to evaluate patient-involved interventions that promote empathy among medical students. Method: A literature search of MEDLINE, Embase, PsycINFO, and ERIC databases was performed using the keywords “empathy,” “medical student,” and their synonyms. Results were independently screened in duplicate. Conflicts were resolved by group consensus. All English studies describing interventions that promote empathy in medical students engaging patient educators were included. Relevant data was extracted and summarized. Results: 1467 studies were screened. 14 studies were included, of which 10 were pilot studies. Studies included patient involved interventions such as storytelling (5/14), shadowing patients (3/14), recorded videos (3/14), or combinations of methods (3/14). Qualitative measurements of empathy included written feedback and group discussions. Quantitative measurements included validated scales measuring empathy. All studies demonstrated increase in empathy among medical students. Participants reported satisfaction with training and patients reported being proud of giving back by training future physicians. Conclusion: Interventions engaging patient educators were shown to have a positive impact on medical student empathy. Furthermore, patient-led education was shown to increase medical student understanding of subject and knowledge retention while empowering patients. Further implementation of patient-involved education is an important step forward in patient-partnered care and may identify additional advantages of patient engagement in medical education.

Clinical empathy as perceived by patients with chronic illness in Canada: a qualitative focus group study

“…Our participants agreed that clinical empathy should be an essential component of medical school training and suggested increasing patient involvement in medical education, a strategy that was shown to enhance student empathy and knowledge in a recent systematic review. 16 Our participants also suggested that admission of more students with personal illness experiences may foster better understanding of patients with chronic illness. 43 , 44 Currently, medical students with chronic illness and disability are frequently undersupported and excluded from medical training.…”

“…Patient partnerships are increasingly recognized as central to designing health care interventions, and already feature prominently in research design, health policy and medical education in other countries. 16 , 18 , 19 Studies examining patient experiences of clinical empathy have also been primarily restricted to specific illness contexts. 20 – 22 However, we hypothesize that patients’ experiences of clinical empathy are not unique to particular diagnoses and that it is these universal factors that are the most useful in informing undergraduate medical education, since they are relevant to all future clinicians.…”

“… 20 – 22 However, we hypothesize that patients’ experiences of clinical empathy are not unique to particular diagnoses and that it is these universal factors that are the most useful in informing undergraduate medical education, since they are relevant to all future clinicians. Furthermore, data on clinical empathy in biomedicine have largely been drawn from the United States and United Kingdom; 16 , 23 given that patient experiences are highly unique within each health care system, we aimed to develop findings specifically applicable to the Canadian health care system.…”

Cultivating physician empathy: a person-centered study based in self-determination theory

“…Examples of how to emphasize these motivational factors could be in tailoring curricula: formal (what to teach with empathy), informal (how to improve learning environments), and hidden (addressing factors that overwhelm students, such as workload) [ 2 , 31 ]. Our findings may also help guide interventions that cultivate medical student empathy through autonomy-supportive SDT principles – for instance, in workshops for medical teachers on how to support medical learners’ basic psychological needs [ 31 ], and sessions for medical students on how to support patient autonomy, coupled with patient feedback [ 43 ]. Regardless of whether a medical student is ‘high’ or ‘low’ in self-determination, we would do well to create psychological safety for them, foster their self-awareness, and help them recognize choices in when and how to be empathic with patients.…”

It’s hard to get better as a teacher when you’re on your own: consider instructional coaching

“…When patients teach students empathy: a systematic review of interventions for promoting medical student empathy by Boshra and team 22 studied existing patient-involved interventions to improve empathy among medical students. The authors found that patient-led education positively impacted medical student empathy and increased their understanding of the subject.…”