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Cited by 865Empathy and Medical EducationInnovations in Medical EducationHealthcare professionals’ stress and burnout

An empirical study of decline in empathy in medical school

Hojat, Mohammadreza, Mangione, Salvatore, Nasca, Thomas J, Rattner, Susan, Erdmann, James B, Gonnella, Joseph S, Magee, Mike·2004·Medical Education
DOI 10.1111/j.1365-2929.2004.01911.x
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Abstract

Context It has been reported that medical students become more cynical as they progress through medical school. This can lead to a decline in empathy. Empirical research to address this issue is scarce because the definition of empathy lacks clarity, and a tool to measure empathy specifically in medical students and doctors has been unavailable. Objective To examine changes in empathy among medical students as they progress through medical school. Materials and subjects A newly developed scale (Jefferson Scale of Physician Empathy [JSPE], with 20 Likert‐type items) was administered to 125 medical students at the beginning (pretest) and end (post‐test) of Year 3 of medical school. This scale was specifically developed for measuring empathy in patient care situations and has acceptable psychometric properties. Methods In this prospective longitudinal study, the changes in pretest/post‐test empathy scores were examined by using t ‐test for repeated measure design; the effect size estimates were also calculated. Results Statistically significant declines were observed in 5 items ( P < 0.01) and the total sores of the JSPE ( P < 0.05) between the 2 test administrations. Conclusions Although the decline in empathy was not clinically important for all of the statistically significant findings, the downward trend suggests that empathy could be amenable to change during medical school. Further research is needed to identify factors that contribute to changes in empathy and to examine whether targeted educational programmes can help to retain, reinforce and cultivate empathy among medical students for improving clinical outcomes.

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  • Empathy has been shown to decline over the course of medical training and the course of physicians' medical careers, suggesting that interventions to increase empathy might need to be repeated over time to be effective.

    “Unfortunately, empathy has been shown to decline over the course of medical training91–94 and the course of physicians’ medical careers,85 suggesting that interventions to increase empathy might need to be repeated over time to be effective.”

    From Reducing Racial Bias Among Health Care Providers: Lessons from Social-Cognitive Psychology (2007) · cites this paper as [94]

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Authors
Hojat, M., Mangione, S., Nasca, T. J., Rattner, S., Erdmann, J. B., Gonnella, J. S., & Magee, M.
Affiliations
  • Thomas Jefferson University (US)
  • Pfizer (United States) (US)
Corresponding author
Hojat, Mohammadreza
ORCID
Venue
Medical Education
Publisher
Wiley
Published
2004-08-24
Volume
38
Issue
9
Pages
934-941
ISSN
  • 0308-0110 (ISSN-L)
  • 1365-2923
DOI
10.1111/j.1365-2929.2004.01911.x
OpenAlex
W2102389247
Cited by
864
References
48
Citations by year
2026: 16 · 2025: 20 · 2024: 38 · 2023: 31 · 2022: 42 · 2021: 59 · 2020: 65 · 2019: 59 · 2018: 53 · 2017: 64 · 2016: 53 · 2015: 58 · 2014: 56 · 2013: 49 · 2012: 38
FWCI
6.89
Type
journal article
Language
en
Open access
closed
Licence
onlinelibrary.wiley.com/termsAndConditions#vor (vor)
Locations
  • Medical Education (publishedVersion)
  • PubMed (publishedVersion)
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
empathy, medical students, Jefferson Scale of Physician Empathy, empathy decline, psychometric validation, empathy education
MeSH terms
Clinical Competence, Education, Medical, Undergraduate, Educational Measurement, Empathy, Female, Humans, Longitudinal Studies, Male, Prospective Studies

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