Salvatore Mangione | Thomas Jefferson University (original) (raw)

Papers by Salvatore Mangione

Research paper thumbnail of In defense of the stethoscope and the bedside

American Journal of Medicine, 2000

Research paper thumbnail of Cardiac auscultatory skills of physicians-in-training: a comparison of three English-speaking countries

American Journal of Medicine, 2001

PURPOSE: Cardiac auscultation is suffering from a declining interest caused by competing diagnost... more PURPOSE: Cardiac auscultation is suffering from a declining interest caused by competing diagnostic technology and, possibly, inadequate teaching and testing of physicians-in-training. Because access to technology, traditional teaching practices, and methods of trainees' assessment vary among different countries, we speculated that trainees' proficiency in auscultation might also vary.

Research paper thumbnail of Pulmonary Auscultatory Skills During Training in Internal Medicine and Family Practice

We conducted a multicenter, cross-sectional assessment of pulmonary auscultatory skills among med... more We conducted a multicenter, cross-sectional assessment of pulmonary auscultatory skills among medical students and housestaff. Our study included 194 medical students, 18 pulmonary fellows, and 656 generalists-in-training from 17 internal medicine and 23 family practice programs in the Mid- Atlantic area of the United States. All participants listened to 10 pulmonary events recorded directly from patients, and answered by completing a multiple choice questionnaire. Proficiency scores were expressed as the percentage of respondents per year and type of training who correctly identified each event. In addition, we calculated a series of cumulative scores for sound recognition, disease identification, and basic knowledge of lung auscultation. Trainees' cumulative scores ranged from 0 to 85 for both internal medicine and family practice residents (median = 40). On average, internal medicine and family practice trainees recognized less than half of all respiratory events, with little improvement per year of training, and were not significantly better than medical students in their scores. Pulmonary fellows had the highest diagnostic and knowledge scores of all groups. These data indicate that there is very little difference in auscultatory proficiency between internal medicine and family practice trainees, and suggest the need for revisiting these time-honored skills during residency training.

Research paper thumbnail of Physical Diagnosis Skills of Physicians in Training: A Focused Assessment

Academic Emergency Medicine, 1995

Objective: To assess the proficiency of emergency medicine (EM) trainees in the recognition of ph... more Objective: To assess the proficiency of emergency medicine (EM) trainees in the recognition of physical findings pertinent to the care of the critically ill patient.Methods: Fourteen medical students, 63 internal medicine (IM) residents, and 47 EM residents from three university-affiliated programs in Philadelphia were tested. Proficiency in physical diagnosis was assessed by a multimedia questionnaire targeting findings useful in emergencies or related to diseases frequently encountered in the ED. Attitudes toward diagnosis not based on technology, teaching practices of physical examination during EM training, and self-motivated learning of physical diagnosis also were assessed for all the EM trainees.Results: With the exception of ophthalmology, the EM trainees were never significantly better than the senior students or the IM residents. They were less proficient than the IM residents in cardiology, and not significantly different from the IM residents in all other areas. For no organ system tested, however, did they achieve less than a 42.9% error rate (range: 42.9–72.3%, median = 54.8%). There was no significant improvement in proficiency over the three years of customary EM training. The EM residents who had received supervised teaching in physical diagnosis during training achieved a significantly higher cumulative score. The EM residents attributed great clinical importance to physical diagnosis and wished for more time devoted to its teaching.Conclusions: These data confirm the recently reported deficiencies of physical diagnosis skills among physicians in training. The results are particularly disturbing because they relate to EM trainees and concern skills useful in the ED. Physical diagnosis should gain more attention in both medical schools and residency programs.

Research paper thumbnail of Creation and assessment of a structured review course in physical diagnosis for medical residents

Journal of General Internal Medicine, 1994

Objective: To evaluate the effects of a course in physical diagnosis on the knowledge, skills, an... more Objective: To evaluate the effects of a course in physical diagnosis on the knowledge, skills, and attitudes of internal medicine trainees. Design: A controlled, prospective assignment of housestaff to a yearlong curricular program, linked to a set of pre- and posttests. House-officers who could not attend the teaching sessions functioned as control subjects. Setting: An internal medicine training program at an urban medical school. Subjects: 56 (86.1%) of 65 eligible internal medicine housestaff (postgraduate years 1 through 3) participated in the intervention and assessment. A comparison group of 14 senior medical students participated in the pretest. Intervention: 12 monthly lectures emphasizing skills useful in emergencies or validated by the literature. Measurements: The pre- and posttests included: 1) a multiple-choice questionnaire to assess knowledge; 2) professional standardized patients to assess selected skills; and 3) Likert-type questionnaires to assess self-motivated learning and attitude toward diagnosis not based on technology. Main results: The residents expressed interest in the program and on a six-point scale rated the usefulness of lectures and standardized patients as 3.5±1.3 and 4.3±1, respectively. For no system tested, however, did they achieve more than 55.2% correct answers (range: 24.2%–55.2%, median =41.04), and their performance did not differ from that of the fourth-year medical students. There was no significant difference in pre/posttest improvement between the control and intervention groups. Conclusions: These data confirm the deficiencies of physical diagnostic skills and knowledge among physicians in training. These deficiencies were not corrected by the classroom lecture series. Improvement in these skills may require a more intense experiential program made part of residency requirements.

Research paper thumbnail of Cardiac auscultatory skills of internal medicine and family practice trainees. A comparison of diagnostic proficiency

Jama-journal of The American Medical Association, 1997

Medical educators have had a growing sense that proficiency in physical diagnostic skills is wani... more Medical educators have had a growing sense that proficiency in physical diagnostic skills is waning, but few data have examined the question critically. To compare the cardiac auscultatory proficiency of medical students and physicians in training. A multicenter cross-sectional assessment of students and house staff. A total of 8 internal medicine and 23 family practice programs of the mid-Atlantic area. A total of 453 physicians in training and 88 medical students. All participants listened to 12 cardiac events directly recorded from patients, which they identified by completing a multiple-choice questionnaire. scores were expressed as the percentage of participants, for year and type of training, who correctly identified each event. Cumulative scores were expressed as the total number of events correctly recognized. An adjusted score was calculated whenever participants selected not only the correct finding but also findings that are acoustically similar and yet absent. Trainees' cumulative scores ranged between 0 and 7 for both internal medicine and family practice residents (median, 2.5 and 2.0, respectively). Internal medicine residents had the highest cumulative adjusted scores for the 6 extra sounds and for all 12 cardiac events tested (P=.01 and .02, respectively). On average, internal medicine and family practice residents recognized 20% of all cardiac events; the number of correct identifications improved little with year of training and was not significantly higher than the number identified by medical students. Both internal medicine and family practice trainees had a disturbingly low identification rate for 12 important and commonly encountered cardiac events. This study suggests a need to improve the teaching and assessment of cardiac auscultation during generalists' training, particularly with the advent of managed care and its search for more cost-effective uses of technology.

Research paper thumbnail of A comparison of computer-assisted instruction and small-group teaching of cardiac auscultation to medical students

Medical Education, 1991

Summary. Cardiac auscultation is suffering from declining interest, caused-by competing diagnosti... more Summary. Cardiac auscultation is suffering from declining interest, caused-by competing diagnostic technology and inadequate training of doctors. Computer-assisted instruction (CAI) supporting graphics and digitized sound could be ideally suited for teaching and sharpening this skill. To evaluate this premise we randomized 35 third-year medical students to 3 hours of seminar teaching plus the use of audiotapes (group 1), the self-use of a MacIntosh-based CAI (group 2), or both (group 3). All students took a pre- and post-test consisting of eight pre-recorded cardiac events and were also assessed for computer anxiety. Although there were no significant differences between pre- and post-tests for each group and among groups, group 1 had a 4.5% deterioration in its diagnostic score compared to the 7.2% and 3.2% improvements of groups 2 and 3 respectively. Group 2 used the CAI significantly more than group 3. We conclude that CAI is at least as effective as seminars in teaching cardiac auscultation to third-year medical students.

Research paper thumbnail of The teaching of cardiac auscultation during internal medicine and family medicine training???a nationwide comparison

Research paper thumbnail of The Jefferson Scale of Physician Empathy: Further Psychometric Data and Differences by Gender and Specialty at Item Level

Academic Medicine, 2002

Wolters Kluwer Health may email you for journal alerts and information, but is committed to maint... more Wolters Kluwer Health may email you for journal alerts and information, but is committed to maintaining your privacy and will not share your personal information without your express consent. For more information, please refer to our Privacy Policy. ... Skip Navigation Links Home > October ...

Research paper thumbnail of Empathy in medical students as related to academic performance, clinical competence and gender

Medical Education, 2002

Context Empathy is a major component of a satisfactory doctor-patient relationship and the cultiv... more Context Empathy is a major component of a satisfactory doctor-patient relationship and the cultivation of empathy is a learning objective proposed by the Association of American Medical Colleges (AAMC) for all American medical schools. Therefore, it is important to address the measurement of empathy, its development and its correlates in medical schools.

Research paper thumbnail of Physician empathy in medical education and practice: experience with the Jefferson scale of physician empathy

Seminars in Integrative Medicine, 2003

... measure physician empathy. Finally, we outline a research agenda on physician empathy that ho... more ... measure physician empathy. Finally, we outline a research agenda on physician empathy that hopefully can provide guidelines for future research on the topic. Conceptual views on empathy. ... Empathy and sympathy. Two important components ...

Research paper thumbnail of Empathy in Medical Education and Patient Care

Academic Medicine, 2001

... Hojat, Mohammadreza PhD; Mangione, Salvatore MD; Gonnella, Joseph S. MD; Nasca, Thomas MD; Ve... more ... Hojat, Mohammadreza PhD; Mangione, Salvatore MD; Gonnella, Joseph S. MD; Nasca, Thomas MD; Veloski, J. Jon MS; Kane, Gregory MD. ... Veloski is chief, Medical Education Division, and Dr. Kane is clinical associate profesor of medicine; all are at Jefferson Medical College ...

Research paper thumbnail of Empathy Scores in Medical School and Ratings of Empathic Behavior in Residency Training 3 Years Later

Journal of Social Psychology, 2005

The authors designed the present study to examine the association between individuals&amp... more The authors designed the present study to examine the association between individuals' scores on the Jefferson Scale of Physician Empathy (JSPE; M. Hojat, J. S. Gonnella, S. Mangione, T. J. Nasca, & M. Magee, 2003; M. Hojat, J. S. Gonnella, T. J. Nasca, S. Mangione, M. Vergare, & M. Magee, 2002; M. Hojat, S. Mangione, T. J. Nasca, M. J. M. Cohen, J. S. Gonnella, J. B. Erdmann, J. J. Veloski, & M. Magee, 2001), a self-report empathy scale, during medical school and ratings of their empathic behavior made by directors of their residency training programs 3 years later. Participants were 106 physicians. The authors examined the relationships between scores on the JSPE (with 20 Likert-type items) at the beginning of the students' 3rd year of medical school and ratings of their empathic behavior made by directors of their residency training programs. Top scorers on the JSPE in medical school, compared to Bottom scorers, obtained a significantly higher average rating of empathic behavior in residency 3 years later (p < .05, effect size = 0.50). The findings support the long-term predictive validity of the self-report empathy scale, JSPE, despite different methods of evaluations (self-report and supervisors' ratings) and despite a time interval between evaluations (3 years). Because empathy is relevant to prosocial and helping behavior, it is important for investigators to further enhance our understanding of its correlates and outcomes among health professionals.

Research paper thumbnail of The Jefferson Scale of Physician Empathy: Development and Preliminary Psychometric Data

Educational and Psychological Measurement, 2001

Abstract The present study was designed to develop a brief instrument to measure empathy in healt... more Abstract The present study was designed to develop a brief instrument to measure empathy in health care providers in patient care situations. Three groups participated in the study: Group 1 consisted of 55 physicians, Group 2 was 41 internal medicine residents, and ...

Research paper thumbnail of An empirical study of decline in empathy in medical school

Medical Education, 2004

CONTEXT It has been reported that medical students become more cynical as they progress through m... more 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.

Research paper thumbnail of Assessment of empathy in different years of internal medicine training

Medical Teacher, 2002

The operational measurement of physician empathy, as well as the question of whether empathy coul... more The operational measurement of physician empathy, as well as the question of whether empathy could change at different levels of medical education, is of interest to medical educators. To address this issue, 98 internal medicine residents from all 3 years of training were studied. The Jefferson Scale of Physician Empathy was administered, and residents' empathy scores correlated with ratings on humanistic attributes made by postgraduate program directors. No statistically significant differences in scores were found among residents of different training levels. Empathy scores remained also stable during internship (test-retest reliability = 0.72). Correlation between empathy and ratings on humanism was 0.17. Thus, the findings suggest that empathy is a relatively stable trait that is not easily amenable to change in residency training programs. The issue of whether targeted educational activities for the purpose of cultivating empathy can improve empathy scores awaits empirical scrutiny.

Research paper thumbnail of Comparisons of Nurses and Physicians on an Operational Measure of Empathy

Evaluation & The Health Professions, 2004

In view of many changes taking place in today&amp... more In view of many changes taking place in today's health care marketplace, the theme of empathy in health provider-patient relations needs to be revisited. It has been proposed that patients benefit when all members of the health care team provide empathic care. Despite the role of empathy in patient outcomes, empirical research on empathy among health professionals is scarce partly because of a lack of a psychometrically sound tool to measure it. In this study, we briefly describe the development and validation of the Jefferson Scale of Physician Empathy (JSPE), an instrument that was specifically developed to measure empathy among health professionals (20 Likert-type items). The purpose of this study was to compare nurses and physicians on their responses to the JSPE. Study participants were 56 female registered nurses and 42 female physicians in the Internal Medicine postgraduate medical education program at Thomas Jefferson University Hospital. The reliability coefficients (Chronbach's coefficient alpha) were 0.87 for the nurses and 0.89 for physicians. Results of t test showed no significant difference between nurses and physicians on total scores of the JSPE; however, multivariate analyses of variance indicated statistically significant differences between the two groups on 5 of 20 items of the JSPE. Findings suggest that the JSPE is a reliable research tool that can be used to assess empathy among health professionals including nurses.

Research paper thumbnail of In defense of the stethoscope and the bedside

American Journal of Medicine, 2000

Research paper thumbnail of Cardiac auscultatory skills of physicians-in-training: a comparison of three English-speaking countries

American Journal of Medicine, 2001

PURPOSE: Cardiac auscultation is suffering from a declining interest caused by competing diagnost... more PURPOSE: Cardiac auscultation is suffering from a declining interest caused by competing diagnostic technology and, possibly, inadequate teaching and testing of physicians-in-training. Because access to technology, traditional teaching practices, and methods of trainees' assessment vary among different countries, we speculated that trainees' proficiency in auscultation might also vary.

Research paper thumbnail of Pulmonary Auscultatory Skills During Training in Internal Medicine and Family Practice

We conducted a multicenter, cross-sectional assessment of pulmonary auscultatory skills among med... more We conducted a multicenter, cross-sectional assessment of pulmonary auscultatory skills among medical students and housestaff. Our study included 194 medical students, 18 pulmonary fellows, and 656 generalists-in-training from 17 internal medicine and 23 family practice programs in the Mid- Atlantic area of the United States. All participants listened to 10 pulmonary events recorded directly from patients, and answered by completing a multiple choice questionnaire. Proficiency scores were expressed as the percentage of respondents per year and type of training who correctly identified each event. In addition, we calculated a series of cumulative scores for sound recognition, disease identification, and basic knowledge of lung auscultation. Trainees' cumulative scores ranged from 0 to 85 for both internal medicine and family practice residents (median = 40). On average, internal medicine and family practice trainees recognized less than half of all respiratory events, with little improvement per year of training, and were not significantly better than medical students in their scores. Pulmonary fellows had the highest diagnostic and knowledge scores of all groups. These data indicate that there is very little difference in auscultatory proficiency between internal medicine and family practice trainees, and suggest the need for revisiting these time-honored skills during residency training.

Research paper thumbnail of Physical Diagnosis Skills of Physicians in Training: A Focused Assessment

Academic Emergency Medicine, 1995

Objective: To assess the proficiency of emergency medicine (EM) trainees in the recognition of ph... more Objective: To assess the proficiency of emergency medicine (EM) trainees in the recognition of physical findings pertinent to the care of the critically ill patient.Methods: Fourteen medical students, 63 internal medicine (IM) residents, and 47 EM residents from three university-affiliated programs in Philadelphia were tested. Proficiency in physical diagnosis was assessed by a multimedia questionnaire targeting findings useful in emergencies or related to diseases frequently encountered in the ED. Attitudes toward diagnosis not based on technology, teaching practices of physical examination during EM training, and self-motivated learning of physical diagnosis also were assessed for all the EM trainees.Results: With the exception of ophthalmology, the EM trainees were never significantly better than the senior students or the IM residents. They were less proficient than the IM residents in cardiology, and not significantly different from the IM residents in all other areas. For no organ system tested, however, did they achieve less than a 42.9% error rate (range: 42.9–72.3%, median = 54.8%). There was no significant improvement in proficiency over the three years of customary EM training. The EM residents who had received supervised teaching in physical diagnosis during training achieved a significantly higher cumulative score. The EM residents attributed great clinical importance to physical diagnosis and wished for more time devoted to its teaching.Conclusions: These data confirm the recently reported deficiencies of physical diagnosis skills among physicians in training. The results are particularly disturbing because they relate to EM trainees and concern skills useful in the ED. Physical diagnosis should gain more attention in both medical schools and residency programs.

Research paper thumbnail of Creation and assessment of a structured review course in physical diagnosis for medical residents

Journal of General Internal Medicine, 1994

Objective: To evaluate the effects of a course in physical diagnosis on the knowledge, skills, an... more Objective: To evaluate the effects of a course in physical diagnosis on the knowledge, skills, and attitudes of internal medicine trainees. Design: A controlled, prospective assignment of housestaff to a yearlong curricular program, linked to a set of pre- and posttests. House-officers who could not attend the teaching sessions functioned as control subjects. Setting: An internal medicine training program at an urban medical school. Subjects: 56 (86.1%) of 65 eligible internal medicine housestaff (postgraduate years 1 through 3) participated in the intervention and assessment. A comparison group of 14 senior medical students participated in the pretest. Intervention: 12 monthly lectures emphasizing skills useful in emergencies or validated by the literature. Measurements: The pre- and posttests included: 1) a multiple-choice questionnaire to assess knowledge; 2) professional standardized patients to assess selected skills; and 3) Likert-type questionnaires to assess self-motivated learning and attitude toward diagnosis not based on technology. Main results: The residents expressed interest in the program and on a six-point scale rated the usefulness of lectures and standardized patients as 3.5±1.3 and 4.3±1, respectively. For no system tested, however, did they achieve more than 55.2% correct answers (range: 24.2%–55.2%, median =41.04), and their performance did not differ from that of the fourth-year medical students. There was no significant difference in pre/posttest improvement between the control and intervention groups. Conclusions: These data confirm the deficiencies of physical diagnostic skills and knowledge among physicians in training. These deficiencies were not corrected by the classroom lecture series. Improvement in these skills may require a more intense experiential program made part of residency requirements.

Research paper thumbnail of Cardiac auscultatory skills of internal medicine and family practice trainees. A comparison of diagnostic proficiency

Jama-journal of The American Medical Association, 1997

Medical educators have had a growing sense that proficiency in physical diagnostic skills is wani... more Medical educators have had a growing sense that proficiency in physical diagnostic skills is waning, but few data have examined the question critically. To compare the cardiac auscultatory proficiency of medical students and physicians in training. A multicenter cross-sectional assessment of students and house staff. A total of 8 internal medicine and 23 family practice programs of the mid-Atlantic area. A total of 453 physicians in training and 88 medical students. All participants listened to 12 cardiac events directly recorded from patients, which they identified by completing a multiple-choice questionnaire. scores were expressed as the percentage of participants, for year and type of training, who correctly identified each event. Cumulative scores were expressed as the total number of events correctly recognized. An adjusted score was calculated whenever participants selected not only the correct finding but also findings that are acoustically similar and yet absent. Trainees' cumulative scores ranged between 0 and 7 for both internal medicine and family practice residents (median, 2.5 and 2.0, respectively). Internal medicine residents had the highest cumulative adjusted scores for the 6 extra sounds and for all 12 cardiac events tested (P=.01 and .02, respectively). On average, internal medicine and family practice residents recognized 20% of all cardiac events; the number of correct identifications improved little with year of training and was not significantly higher than the number identified by medical students. Both internal medicine and family practice trainees had a disturbingly low identification rate for 12 important and commonly encountered cardiac events. This study suggests a need to improve the teaching and assessment of cardiac auscultation during generalists' training, particularly with the advent of managed care and its search for more cost-effective uses of technology.

Research paper thumbnail of A comparison of computer-assisted instruction and small-group teaching of cardiac auscultation to medical students

Medical Education, 1991

Summary. Cardiac auscultation is suffering from declining interest, caused-by competing diagnosti... more Summary. Cardiac auscultation is suffering from declining interest, caused-by competing diagnostic technology and inadequate training of doctors. Computer-assisted instruction (CAI) supporting graphics and digitized sound could be ideally suited for teaching and sharpening this skill. To evaluate this premise we randomized 35 third-year medical students to 3 hours of seminar teaching plus the use of audiotapes (group 1), the self-use of a MacIntosh-based CAI (group 2), or both (group 3). All students took a pre- and post-test consisting of eight pre-recorded cardiac events and were also assessed for computer anxiety. Although there were no significant differences between pre- and post-tests for each group and among groups, group 1 had a 4.5% deterioration in its diagnostic score compared to the 7.2% and 3.2% improvements of groups 2 and 3 respectively. Group 2 used the CAI significantly more than group 3. We conclude that CAI is at least as effective as seminars in teaching cardiac auscultation to third-year medical students.

Research paper thumbnail of The teaching of cardiac auscultation during internal medicine and family medicine training???a nationwide comparison

Research paper thumbnail of The Jefferson Scale of Physician Empathy: Further Psychometric Data and Differences by Gender and Specialty at Item Level

Academic Medicine, 2002

Wolters Kluwer Health may email you for journal alerts and information, but is committed to maint... more Wolters Kluwer Health may email you for journal alerts and information, but is committed to maintaining your privacy and will not share your personal information without your express consent. For more information, please refer to our Privacy Policy. ... Skip Navigation Links Home > October ...

Research paper thumbnail of Empathy in medical students as related to academic performance, clinical competence and gender

Medical Education, 2002

Context Empathy is a major component of a satisfactory doctor-patient relationship and the cultiv... more Context Empathy is a major component of a satisfactory doctor-patient relationship and the cultivation of empathy is a learning objective proposed by the Association of American Medical Colleges (AAMC) for all American medical schools. Therefore, it is important to address the measurement of empathy, its development and its correlates in medical schools.

Research paper thumbnail of Physician empathy in medical education and practice: experience with the Jefferson scale of physician empathy

Seminars in Integrative Medicine, 2003

... measure physician empathy. Finally, we outline a research agenda on physician empathy that ho... more ... measure physician empathy. Finally, we outline a research agenda on physician empathy that hopefully can provide guidelines for future research on the topic. Conceptual views on empathy. ... Empathy and sympathy. Two important components ...

Research paper thumbnail of Empathy in Medical Education and Patient Care

Academic Medicine, 2001

... Hojat, Mohammadreza PhD; Mangione, Salvatore MD; Gonnella, Joseph S. MD; Nasca, Thomas MD; Ve... more ... Hojat, Mohammadreza PhD; Mangione, Salvatore MD; Gonnella, Joseph S. MD; Nasca, Thomas MD; Veloski, J. Jon MS; Kane, Gregory MD. ... Veloski is chief, Medical Education Division, and Dr. Kane is clinical associate profesor of medicine; all are at Jefferson Medical College ...

Research paper thumbnail of Empathy Scores in Medical School and Ratings of Empathic Behavior in Residency Training 3 Years Later

Journal of Social Psychology, 2005

The authors designed the present study to examine the association between individuals&amp... more The authors designed the present study to examine the association between individuals' scores on the Jefferson Scale of Physician Empathy (JSPE; M. Hojat, J. S. Gonnella, S. Mangione, T. J. Nasca, & M. Magee, 2003; M. Hojat, J. S. Gonnella, T. J. Nasca, S. Mangione, M. Vergare, & M. Magee, 2002; M. Hojat, S. Mangione, T. J. Nasca, M. J. M. Cohen, J. S. Gonnella, J. B. Erdmann, J. J. Veloski, & M. Magee, 2001), a self-report empathy scale, during medical school and ratings of their empathic behavior made by directors of their residency training programs 3 years later. Participants were 106 physicians. The authors examined the relationships between scores on the JSPE (with 20 Likert-type items) at the beginning of the students' 3rd year of medical school and ratings of their empathic behavior made by directors of their residency training programs. Top scorers on the JSPE in medical school, compared to Bottom scorers, obtained a significantly higher average rating of empathic behavior in residency 3 years later (p < .05, effect size = 0.50). The findings support the long-term predictive validity of the self-report empathy scale, JSPE, despite different methods of evaluations (self-report and supervisors' ratings) and despite a time interval between evaluations (3 years). Because empathy is relevant to prosocial and helping behavior, it is important for investigators to further enhance our understanding of its correlates and outcomes among health professionals.

Research paper thumbnail of The Jefferson Scale of Physician Empathy: Development and Preliminary Psychometric Data

Educational and Psychological Measurement, 2001

Abstract The present study was designed to develop a brief instrument to measure empathy in healt... more Abstract The present study was designed to develop a brief instrument to measure empathy in health care providers in patient care situations. Three groups participated in the study: Group 1 consisted of 55 physicians, Group 2 was 41 internal medicine residents, and ...

Research paper thumbnail of An empirical study of decline in empathy in medical school

Medical Education, 2004

CONTEXT It has been reported that medical students become more cynical as they progress through m... more 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.

Research paper thumbnail of Assessment of empathy in different years of internal medicine training

Medical Teacher, 2002

The operational measurement of physician empathy, as well as the question of whether empathy coul... more The operational measurement of physician empathy, as well as the question of whether empathy could change at different levels of medical education, is of interest to medical educators. To address this issue, 98 internal medicine residents from all 3 years of training were studied. The Jefferson Scale of Physician Empathy was administered, and residents' empathy scores correlated with ratings on humanistic attributes made by postgraduate program directors. No statistically significant differences in scores were found among residents of different training levels. Empathy scores remained also stable during internship (test-retest reliability = 0.72). Correlation between empathy and ratings on humanism was 0.17. Thus, the findings suggest that empathy is a relatively stable trait that is not easily amenable to change in residency training programs. The issue of whether targeted educational activities for the purpose of cultivating empathy can improve empathy scores awaits empirical scrutiny.

Research paper thumbnail of Comparisons of Nurses and Physicians on an Operational Measure of Empathy

Evaluation & The Health Professions, 2004

In view of many changes taking place in today&amp... more In view of many changes taking place in today's health care marketplace, the theme of empathy in health provider-patient relations needs to be revisited. It has been proposed that patients benefit when all members of the health care team provide empathic care. Despite the role of empathy in patient outcomes, empirical research on empathy among health professionals is scarce partly because of a lack of a psychometrically sound tool to measure it. In this study, we briefly describe the development and validation of the Jefferson Scale of Physician Empathy (JSPE), an instrument that was specifically developed to measure empathy among health professionals (20 Likert-type items). The purpose of this study was to compare nurses and physicians on their responses to the JSPE. Study participants were 56 female registered nurses and 42 female physicians in the Internal Medicine postgraduate medical education program at Thomas Jefferson University Hospital. The reliability coefficients (Chronbach's coefficient alpha) were 0.87 for the nurses and 0.89 for physicians. Results of t test showed no significant difference between nurses and physicians on total scores of the JSPE; however, multivariate analyses of variance indicated statistically significant differences between the two groups on 5 of 20 items of the JSPE. Findings suggest that the JSPE is a reliable research tool that can be used to assess empathy among health professionals including nurses.