医学生同理心的标准化患者评估：多机构研究中的种族和性别影响。

Standardized patient assessment of medical student empathy: ethnicity and gender effects in a multi-institutional study.

机构信息

Dr. K. Berg is professor of medicine and codirector, University Clinical Skills and Simulation Center, Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, Pennsylvania. Dr. Blatt is professor of medicine and director, Clinical Learning and Simulation Skills Center, George Washington University School of Medicine, Washington, DC. Dr. Lopreiato is professor of pediatrics and associate dean for simulation education, Uniformed Services University of the Health Sciences, Bethesda, Maryland. Dr. Jung is assistant professor of emergency medicine and associate director, Simulation Center, Johns Hopkins University, Baltimore, Maryland. Ms. Schaeffer is a medical student, Tufts University, Boston, Massachusetts. Mr. Heil is a research assistant, University Clinical Skills and Simulation Center, Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, Pennsylvania. Ms. Owens is director, Clinical Skills and Simulation Center, Howard University, Washington, DC. Dr. Carter-Nolan is assistant dean for medical education, vice chair for education, and assistant professor, Department of Community and Family Medicine, Howard University, Washington, DC. Dr. D. Berg is G. Fritz Blechschmidt, MD, Professor of Clinical Skills and codirector, University Clinical Skills and Simulation Center, Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, Pennsylvania. Mr. Veloski is director, Medical Education Research, Center for Research in Medical Education and Health Care, Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, Pennsylvania. Ms. Darby is standardized patient educator, Uniform Services University of the Health Sciences, Bethesda, Maryland. Dr. Hojat is research professor of psychiatry and human behavior and director, Jefferson Longitudinal Study, Center for Research in Medical Education and Health Care, Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, Pennsylvania.

出版信息

Acad Med. 2015 Jan;90(1):105-11. doi: 10.1097/ACM.0000000000000529.

DOI:10.1097/ACM.0000000000000529

PMID:25558813

Abstract

PURPOSE

To examine, primarily, the effects of ethnicity and gender, which could introduce bias into scoring, on standardized patient (SP) assessments of medical students and, secondarily, to examine medical students' self-reported empathy for ethnicity and gender effects so as to compare self-perception with the perceptions of SPs.

METHOD

Participants were 577 students from four medical schools in 2012: 373 (65%) were white, 79 (14%) black/African American, and 125 (22%) Asian/Pacific Islander. These students were assessed by 84 SPs: 62 (74%) were white and 22 (26%) were black/African American. SPs completed the Jefferson Scale of Patient Perceptions of Physician Empathy (JSPPPE) and the Global Ratings of Empathy tool. Students completed the Jefferson Scale of Empathy and two Interpersonal Reactivity Index subscales. The investigators used 2,882 student-SP encounters in their analyses.

RESULTS

Analyses of SPs' assessments of students' empathy indicated significant interaction effects of gender and ethnicity. Female students, regardless of ethnicity, obtained significantly higher mean JSPPPE scores than men. Female black/African American, female white, and female Asian/Pacific Islander students scored significantly higher on the JSPPPE than their respective male counterparts. Male black/African American students obtained the lowest SP assessment scores of empathy regardless of SP ethnicity. Black/African American students obtained the highest mean scores on self-reported empathy.

CONCLUSIONS

The significant interaction effects of ethnicity and gender in clinical encounters, plus the inconsistencies observed between SPs' assessments of students' empathy and students' self-reported empathy, raise questions about possible ethnicity and gender biases in the SPs' assessments of medical students' clinical skills.

摘要

目的

主要考察种族和性别因素对标准化患者（SP）评估医学生的影响，这些因素可能会导致评分偏差，并考察医学生对种族和性别影响的自我同理心感知，以便将自我认知与 SP 的认知进行比较。

方法

参与者是 2012 年来自四所医学院的 577 名学生：373 名（65%）是白人，79 名（14%）是黑人/非裔美国人，125 名（22%）是亚裔/太平洋岛民。这些学生由 84 名 SP 评估：62 名（74%）是白人，22 名（26%）是黑人/非裔美国人。SP 完成了杰斐逊患者感知医生同理心量表（JSPPPE）和整体同理心评价工具。学生完成了杰斐逊同理心量表和两个人际反应指数子量表。研究人员在分析中使用了 2882 名学生-SP 接触的数据。

结果

对 SP 评估学生同理心的分析表明，性别和种族存在显著的交互效应。无论种族如何，女性学生的 JSPPPE 平均得分都显著高于男性。女性黑人/非裔美国人、女性白人、女性亚裔/太平洋岛民学生在 JSPPPE 上的得分均显著高于各自的男性对应者。无论 SP 的种族如何，男性黑人/非裔美国学生获得的同理心 SP 评估得分最低。黑人/非裔美国学生在自我报告的同理心方面获得的平均得分最高。