Underlying construct of empathy, optimism, and burnout in medical students (original) (raw)
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Empathy, quality of life and occupational burnout among medical students
Research and Development in Medical Education
Background: Empathy, quality of life, and occupational burnout are essential factors in medical sciences that affect the physicians’ and patients’ communication. Therefore, the purpose of this study was to investigate the association of these three factors among medical students. Methods: This descriptive correlational study was conducted among medical internship students. Participants were selected by using simple random sampling. The Jefferson Empathy Questionnaire, the WHO Quality of Life Questionnaire, and the Maslach Burnout Questionnaire were used for data collection. Data were analyzed using t test, Kruskal-Wallis, analysis of variance (ANOVA), and Pearson’s correlation coefficient. Results: A total of 167 students completed the questionnaires. The association of empathy and occupational burnout (P=0.005, r=-0.414) and between the quality of life and occupational burnout (P=0.005, r=-0.446) were both significantly negative. Independent t test showed the mean score of occupati...
To better understand clinical empathy and what factors can undermine its experience and outcome in care-giving settings, a large-scale study was conducted with 7,584 board certified practicing physicians. Online validated instruments assessing different aspects of empathy, distress, burnout, altruistic behavior, emotional awareness, and well-being were used. Compassion satisfaction was strongly associated with empathic concern, perspective taking and altruism, while compassion fatigue (burnout and secondary traumatic stress) was more closely related to personal distress and alexithymia. Gender had a highly selective effect on empathic concern, with women displaying higher values, which led to a wide array of negative and devalued feelings. Years of experience did not influence dispositional measures per se after controlling for the effect of age and gender. Participants who experienced compassion fatigue with little to no compassion satisfaction showed the highest scores on personal distress and alexithymia as well as the strongest indicators of compassion fatigue. Physicians who have difficulty regulating their negative arousal and describing and identifying emotions seem to be more prone to emotional exhaustion, detachment, and a low sense of accomplishment. On the contrary, the ability to engage in self-other awareness and regulate one's emotions and the tendency to help others, seem to contribute to the sense of compassion that comes from assisting patients in clinical practice.
BMC Medical Education, 2021
Background Empathy is a well-established facet of clinical competency that research suggests is associated with enhanced medical student well-being. Since little is known about empathy and well-being before students enter medical school—during pre-medical education—the main goal of this study is to test a conceptual model of how clinical empathy is related to two indicators of well-being, depression, and burnout among pre-medical students. The theoretical model hypothesizes that three dimensions of clinical empathy—Perspective-Taking, Compassionate Care, and Standing in Patients’ Shoes— will be directly and negatively related to depression, as well as indirectly through its inverse relationship with three facets of burnout, Emotional Exhaustion, Poor Academic Efficacy, and Cynicism. Methods Using survey data from a sample of 132 pre-medical students at an American Midwestern university, this study employs structural equation modeling (SEM) to test the theoretical model of the relati...
Developing self-empathy in medical students and physicians to improve patient outcomes
MedEdPublish
The noble calling of medicine attracts men and women who want to help others, and who are well-aware that they will be faced, from their earliest days of training, with patients' illness, pain and suffering. Compassion, and what is also sometimes called empathy, is the basis for humanistic, patient-centered care. Today we are experiencing a crisis of burnout among medical students and compassion-fatigue among physicians, which results in emotional exhaustion, and depersonalization, leading to decreased compassion and empathy with diminished quality of care for patients. Studies have shown that a steep decline in empathy, as measured by the Jefferson Scale of Physician Empathy and other instruments, occurs with greatest frequency in the clinical experience years of medical students. What can ensue are feelings of depersonalization, emotional exhaustion and decreased effectiveness that can lead to depression, anxiety, and even an increased risk of suicide. To counter this alarming trend, the authors introduce the concept of self-empathy, which is new in the context of medical education. This is a way to develop empathy for others, thereby improving the well-being of medical students and practitioners, so that they can better care for their patients. It is critical that the study and practice of self-empathy be integrated into medical school curricula and in continuing education for physicians so that it becomes part of their day-today life.
Associations between Medical Student Empathy and Personality: A Multi-Institutional Study
Plos One, 2014
Background: More empathetic physicians are more likely to achieve higher patient satisfaction, adherence to treatments, and health outcomes. In the context of medical education, it is thus important to understand how personality might condition the empathetic development of medical students. Single institutional evidence shows associations between students' personality and empathy. This multi-institutional study aimed to assess such associations across institutions, looking for personality differences between students with high empathy and low empathy levels.
Empathy of medical students and personality: Evidence from the Five-Factor Model
Medical Teacher, 2012
The main aim of this study was to test hypothetical associations between personality dimensions and empathy scores in medical students. The Portuguese version of NEO-FFI was administered in order to characterize participants in terms of five personality traits: Neuroticism, Extraversion, Agreeableness, Openness to Experience, and Conscientiousness. Self-reported empathy measures were obtained with the Portuguese version of the Jefferson Scale of Physician Empathy (JSPE-spv), a Likert-type questionnaire specifically developed for administration in health sciences settings that measures domains, such as compassionate care and perspective taking. Correlation analysis, multivariate analysis of covariance, and logistic regression analysis were conducted. The results confirmed positive associations between agreeableness, openness to experience and empathy, and did not support our hypothesis of negative associations between neuroticism and empathy. It is suggested that that the personality of students should be taken into account in programs to enhance empathy in undergraduate medical education.
Association Between Empathy and Burnout Among Emergency Medicine Physicians
Journal of Clinical Medicine Research
Background: The association between physician self-reported empathy and burnout has been studied in the past with diverse findings. We aimed to determine the association between empathy and burnout among United States emergency medicine (EM) physicians using a novel combination of tools for validation. Methods: This was a prospective single-center observational study. Data were collected from EM physicians. From December 1, 2018 to January 31, 2019, we used the Jefferson scale of empathy (JSE) to assess physician empathy and the Copenhagen burnout inventory (CBI) to assess burnout. We divided EM physicians into different groups (residents in each year of training, junior/senior attendings). Empathy, burnout scores and their association were analyzed and compared among these groups. Results: A total of 33 attending physicians and 35 EM residents participated in this study. Median self-reported empathy scores were 113 (interquartile range (IQR): 105-117) in postgraduate year (PGY)-1, 112 (90-115) in PGY-2, 106 (93-118) in PGY-3 EM residents, 112 (105-116) in junior and 114 (101-125) in senior attending physicians. Overall burnout scores were 43 (33-50) in PGY-1, 51 (29-56) in PGY-2, 43 (42-53) in PGY-3 EM residents, 33 (24-47) in junior attending and 25 (22-53) in senior attending physicians separately. The Spearman correlation (ρ) was-0.11 and β-weight was-0.23 between empathy and patient-related burnout scores. Conclusion: Self-reported empathy declines over the course of EM residency training and improves after graduation. Overall high burnout occurs among EM residents and improves after graduation. Our analysis showed a weak negative correlation between self-reported empathy and patient-related burnout among EM physicians.
How Do Distress and Well-being Relate to Medical Student Empathy? A Multicenter Study
Journal of General Internal Medicine, 2007
Objective To determine whether lower levels of empathy among a sample of medical students in the United States are associated with personal and professional distress and to explore whether a high degree of personal well-being is associated with higher levels of empathy. Design Multi-institutional, cross-sectional survey. Setting All medical schools in Minnesota (a private medical school, a traditional public university, and a public university with a focus in primary care). Participants A total of 1,098 medical students. Measurements Validated instruments were used to measure empathy, distress (i.e., burnout and symptoms of depression), and well-being (high quality of life). Results Medical student empathy scores were higher than normative samples of similarly aged individuals and were similar to other medical student samples. Domains of burnout inversely correlated with empathy (depersonalization with empathy independent of gender, all P < .02, and emotional exhaustion with emotive empathy for men, P = .009). Symptoms of depression inversely correlated with empathy for women (all P ≤ .01). In contrast, students’ sense of personal accomplishment demonstrated a positive correlation with empathy independent of gender (all P < .001). Similarly, achieving a high quality of life in specific domains correlated with higher empathy scores (P < .05). On multivariate analysis evaluating measures of distress and well-being simultaneously, both burnout (negative correlation) and well-being (positive correlation) independently correlated with student empathy scores. Conclusions Both distress and well-being are related to medical student empathy. Efforts to reduce student distress should be part of broader efforts to promote student well-being, which may enhance aspects of professionalism. Additional studies of student well-being and its potential influence on professionalism are needed.
A Cross-sectional Measurement of Medical Student Empathy
Journal of General Internal Medicine, 2007
Empathy is important in the physician-patient relationship. Prior studies have suggested that physician empathy may decline with clinical training. To measure and examine student empathy across medical school years. 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. 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. 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 &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; .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 &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; .001). Females had higher JSPE-S scores than males (116.5 vs 112.1, P &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; .001). Age and debt did not affect empathy scores. 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.