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

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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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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: Hojat, Mohammadreza
Mangione, Salvatore
Nasca, Thomas J
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
Social Sciences › Education › 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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An empirical study of decline in empathy in medical school

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