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Cited by 547Empathy and Medical EducationInnovations in Medical EducationHealthcare professionals’ stress and burnout

A cross-sectional measurement of medical student empathy

Open access
Chen, Daniel, Lew, Robert, Hershman, Warren, Orlander, Jay·2007·Journal of General Internal Medicine
DOI 10.1007/s11606-007-0298-xPMC PMC2305857
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Abstract

Background Empathy is important in the physician-patient relationship. Prior studies have suggested that physician empathy may decline with clinical training. Objective To measure and examine student empathy across medical school years. Design and participants A cross-sectional study of students at Boston University School of Medicine in 2006. Incoming students plus each class near the end of the academic year were surveyed. Measurements The Jefferson Scale of Physician Empathy-Student Version (JSPE-S), a validated 20-item self-administered questionnaire with a total score ranging from 20 to 140. JSPE-S scores were controlled for potential confounders such as gender, age, anticipated financial debt upon graduation, and future career interest. Results 658 students participated in the study (81.4% of the school population). The first-year medical student class had the highest empathy scores (118.5), whereas the fourth-year class had the lowest empathy scores (106.6). Measured empathy differed between second- and third-year classes (118.2 vs 112.7, P < .001), corresponding to the first year of clinical training. Empathy appears to increase from the incoming to the first-year class (115.5 vs 118.5, P = .02). Students preferring people-oriented specialties had higher empathy scores than students preferring technology-oriented specialties (114.6 vs 111.4, P = .002). Female students were more likely than male students to choose people-oriented specialties (51.5 vs 26.9%, P < .001). Females had higher JSPE-S scores than males (116.5 vs 112.1, P < .001). Age and debt did not affect empathy scores. Conclusions Empathy scores of students in the preclinical years were higher than in the clinical years. Efforts are needed to determine whether differences in empathy scores among the classes are cohort effects or represent changes occurring in the course of medical education. Future research is needed to confirm whether clinical training impacts empathy negatively, and, if so, whether interventions can be designed to mitigate this impact.

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  • Studies of medical student empathy are limited by self-assessment, non-generalizable single-institution comparisons, and lack of measures reflecting actual patient encounters with practicing physicians.

    “Such studies of medical student empathy are limited in several important ways: they measure only the student's self-assessment of empathy; the comparisons involve students from single osteopathic and allopathic institutions that are not generalizable to the broader populations of osteopathic and allopathic medical students; and they do not provide measures of empathy that reflect actual patient En”

    From <b>Empathy in Medicine</b> Osteopathic and Allopathic Physician Interpersonal Manner, Empathy, and Communication Style and Clinical Status of Their Patients: A Pain Registry–Based Study (2019) · cites this paper as [5]

    The Discussion says the study used a self-reported empathy scale that does not measure behavior, and that it was conducted at one medical school. Its measurements therefore do not reflect actual patient encounters with practicing physicians. But the paper does not compare osteopathic and allopathic institutions, and it says its findings may generalize to schools with a similar structure; it does not support that specific non-generalizability claim. (LLM, conf=0.86)

    Experimental — accuracy not yet measured

  • Another study of self-reported empathy found a significant difference in favor of osteopathic medical students, but only among third-year students in comparison with an externally acquired control group.

    “Alternatively, another study of selfreported empathy found a significant difference in favor of osteopathic medical students, 4 but only among thirdyear students in comparison with an externally acquired control group.5”

    From <b>Empathy in Medicine</b> Osteopathic and Allopathic Physician Interpersonal Manner, Empathy, and Communication Style and Clinical Status of Their Patients: A Pain Registry–Based Study (2019) · cites this paper as [5]

    The Study Design and Results describe self-reported empathy scores for Boston University medical students, including third-year students, so the paper could supply an external comparison group. Neither those sections nor the Discussion report a comparison with osteopathic students or a significant difference favoring them only in the third year. The cited paper therefore supports the comparison data, not the comparative finding. (LLM, conf=0.82)

    Experimental — accuracy not yet measured

  • Comparative studies of empathy have focused on osteopathic and allopathic medical students.

    “Comparative studies of empathy have focused on osteopathic and allopathic medical students.”

    From <b>Empathy in Medicine</b> Osteopathic and Allopathic Physician Interpersonal Manner, Empathy, and Communication Style and Clinical Status of Their Patients: A Pain Registry–Based Study (2019) · cites this paper as [5]

    The Methods and Results describe a comparison of empathy across class years at one medical school, and the Discussion reviews other comparisons among medical students. No passage in our copy identifies comparative studies focused on osteopathic versus allopathic students; searches for those terms found none. (LLM, conf=0.72)

    Experimental — accuracy not yet measured

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1 of the 43 references couldn’t be matched to a known paper.

Research works printed but not linked: 1

  1. [4]4. Levinson W, Roter DL, Mullooly JP, Dull VT, Frankel RM. The relationship with malpractice claims among primary care physicians and surgeons. JAMA. 1997;277:553 -9.

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Authors
Chen, D., Lew, R., Hershman, W., & Orlander, J.
Affiliations
Boston University (US)
Corresponding author
Chen, Daniel
ORCID
Venue
Journal of General Internal Medicine
Publisher
Springer Science and Business Media LLC
Published
2007-07-26
Volume
22
Issue
10
Pages
1434-1438
ISSN
  • 0884-8734 (ISSN-L)
  • 1525-1497
DOI
10.1007/s11606-007-0298-x
PMC
PMC2305857
OpenAlex
W1974059841
Cited by
547
References
43
Citations by year
2026: 12 · 2025: 21 · 2024: 32 · 2023: 32 · 2022: 35 · 2021: 46 · 2020: 48 · 2019: 35 · 2018: 35 · 2017: 35 · 2016: 41 · 2015: 39 · 2014: 35 · 2013: 30 · 2012: 29
FWCI
5.25
Type
journal article
Language
en
Open access
Licence
www.springer.com/tdm (tdm)
Locations
  • Journal of General Internal Medicine (publishedVersion)
  • PubMed Central (publishedVersion)
  • PubMed (publishedVersion)
  • DigitalGeorgetown (Georgetown University Library) (submittedVersion)
Topics
  • Health Sciences › Medicine › Psychiatry and Mental health › Empathy and Medical Education
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Innovations in Medical Education
  • Health Sciences › Health Professions › General Health Professions › Healthcare professionals’ stress and burnout
Keywords
physician empathy, medical students, specialty choice, gender differences, physician-patient relationship
MeSH terms
Adult, Analysis of Variance, Attitude of Health Personnel, Cross-Sectional Studies, Education, Medical, Undergraduate, Empathy, Female, Humans, Male, Probability, Surveys and Questionnaires, Sex Factors, Students, Medical, Time Factors

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