Stepien Kathy A, Baernstein Amy
University of Washington School of Medicine, Seattle, WA, USA.
J Gen Intern Med. 2006 May;21(5):524-30. doi: 10.1111/j.1525-1497.2006.00443.x.
Empathy in the medical setting is appreciation of the patient's emotions and expression of that awareness to the patient. Named as an essential learning objective by the American Association of Medical Colleges, empathy is believed to significantly influence patient satisfaction, adherence to medical recommendations, clinical outcomes, and professional satisfaction. The objective of this study was to identify effective strategies to enhance empathy in undergraduate medical students.
We searched PubMed for studies that address the effectiveness of strategies for teaching empathy to medical students. We identified 13 peer-reviewed, English language, qualitative and quantitative studies reporting primary data on interventions that aim to foster empathy in undergraduate medical students, using Medical Subject Heading terms education, medical, undergraduate or student, medical crossed with empathy.
These studies indicate that empathy may be amenable to positive change with a range of interventional strategies. Communication skill workshops addressing the behavioral dimension of empathy show greatest quantitative impact on participants. However, current studies are challenged by varying definitions of empathy, small sample sizes, lack of adequate control groups, and variation among existing empathy measurement instruments.
Given the methodological limitations of the available studies, and uncertainty about which dimensions of empathy should be addressed, larger studies using validated measurement tools are recommended.
医疗环境中的同理心是对患者情绪的理解以及向患者表达这种理解。美国医学院协会将同理心列为一项重要的学习目标，人们认为同理心会对患者满意度、对医疗建议的依从性、临床疗效以及职业满意度产生重大影响。本研究的目的是确定提高本科医学生同理心的有效策略。
我们在PubMed上搜索了探讨向医学生传授同理心策略有效性的研究。我们确定了13项经过同行评审的、英文的定性和定量研究，这些研究报告了旨在培养本科医学生同理心的干预措施的原始数据，使用医学主题词“教育”“医学”“本科”或“学生”，并与“同理心”交叉检索。
这些研究表明，通过一系列干预策略，同理心可能会发生积极变化。针对同理心行为维度的沟通技巧工作坊对参与者产生的量化影响最大。然而，目前的研究面临着同理心定义各异、样本量小、缺乏足够对照组以及现有同理心测量工具存在差异等挑战。
鉴于现有研究的方法学局限性，以及对于应解决同理心哪些维度存在不确定性，建议使用经过验证的测量工具开展更大规模的研究。
