Korean J Med Educ.  2016 Mar;28(1):67-78. 10.3946/kjme.2016.11.

Complex and novel determinants of empathy change in medical students

Affiliations
  • 1Dean's Office, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
  • 2Centre for Medical Education, Yong Loo Lin School of Medicine, National University of Singapore, Singapore. meddds@nus.edu.sg
  • 3Biostatistics Unit, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.

Abstract

PURPOSE
Physician empathy is a core attribute in medical professionals, giving better patient outcomes. Medical school is an opportune time for building empathetic foundations. This study explores empathy change and focuses on contributory factors.
METHODS
We conducted a cross-sectional study involving 881 students (63%) from Years 1 to 5 in a Singaporean medical school using the Jefferson Scale of Physician Empathy-Student version (JSPE-S) and a questionnaire investigating the relationship between reported and novel personal-social empathy determinants.
RESULTS
Empathy declined significantly between preclinical and clinical years. Female and medical specialty interest respondents had higher scores than their counterparts. Despite strong internal consistency, factor analysis suggested that the JSPE model is not a perfect fit. Year 1 students had highest Perspective Taking scores and Year 2 students had highest Compassionate Care scores. High workload and inappropriate learning environments were the most relevant stressors. Time spent with family, arts, and community service correlated with higher empathy scores, whilst time spent with significant others and individual leisure correlated with lower scores. Thematic analysis revealed that the most common self-reported determinants were exposure to activity (community service) or socialisation, personal and family-related event as well as environment (high work-load).
CONCLUSION
While the empathy construct in multicultural Singapore is congruent with a Western model, important differences remain. A more subtle understanding of the heterogeneity of the medical student experience is important. A greater breadth of determinants of empathy, such as engagement in arts-related activities should be considered.

Keyword

Empathy; Medical students; Personal-social empathy determinants

MeSH Terms

Art
Cross-Sectional Studies
*Education, Medical, Undergraduate
*Empathy
Factor Analysis, Statistical
Family
Female
Humans
Male
Medicine
*Physician-Patient Relations
Physicians
Self Report
Sex Factors
Singapore
Social Participation
*Students, Medical
Workload
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