Davis Glenn Elbert, Hartwig Walter Carl, McTighe Adam J
J Am Osteopath Assoc. 2017 Aug 1;117(8):503-509. doi: 10.7556/jaoa.2017.100.
Physician empathy influences rapport with patients and improves outcomes, but it is not well understood as an outcome of osteopathic medical education.
To determine how clerkship preceptors at Touro University College of Osteopathic Medicine-CA (TUCOM) in Vallejo define empathy and how they compare observed empathetic behavior of TUCOM students with that of other medical students.
Cross-sectional data were obtained from a survey of TUCOM clinical preceptors comparing TUCOM students with other medical students on 10 behaviors. Results were analyzed with a 2-tailed z test of proportional difference at the 95% confidence level.
Of 650 preceptors contacted, 177 responded and were included in the final analysis (27%). Survey item reliability was high (Cronbach α=0.96). A majority of preceptors (59% to 71%) considered TUCOM students "similar" to other medical students for each behavior. A majority of preceptors (107 [60%]) shared a definition of empathy with one another and with the National Board of Osteopathic Medical Examiners and the American Association of Colleges of Osteopathic Medicine. Approximately 39% of preceptors rated TUCOM students "better" or "advanced" for "displays of empathy" compared with approximately 30% of preceptors who rated students as better or advanced across all 10 behaviors. Preceptors who shared a definition of empathy rated TUCOM students as better or advanced at a significantly higher rate for "displays of empathy" (z=1.982, P<.05) compared with preceptors who did not share a definition (n=70). Osteopathic preceptors (n=67) rated TUCOM students significantly higher on "displays of empathy" (z=2.82, P<.05) and "clear and effective communication to patients, families and co-workers" (z=2.83, P<.01) than did allopathic preceptors. No significant differences were found based on number of years as a preceptor or on the combination of types of students the preceptor taught.
Most clinical preceptors shared a definition of empathy, and they were able to observe and rate displays of it in clerkship students. Preceptors rated TUCOM students more favorably than other students they taught for displays of empathy.
医生的同理心会影响与患者的关系并改善治疗效果，但作为整骨医学教育的一项成果，人们对此并未充分理解。
确定位于瓦列霍的图罗大学整骨医学院（TUCOM）的临床带教老师如何定义同理心，以及他们如何将TUCOM学生观察到的同理心行为与其他医学生的进行比较。
通过对TUCOM临床带教老师的一项调查获取横断面数据，比较TUCOM学生与其他医学生在10种行为方面的情况。结果采用95%置信水平的双尾z检验进行比例差异分析。
在联系的650名带教老师中，177人做出回应并纳入最终分析（27%）。调查项目的信度很高（克朗巴哈α系数=0.96）。大多数带教老师（59%至71%）认为TUCOM学生在每种行为上与其他医学生“相似”。大多数带教老师（107人[60%]）彼此之间以及与整骨医学国家考试委员会和美国整骨医学院协会对同理心有共同的定义。与在所有10种行为上认为学生表现更好或更出色的约30%的带教老师相比，约39%的带教老师认为TUCOM学生在“同理心表现”方面“更好”或“更出色”。与未对同理心有共同定义的带教老师（n=70）相比，对同理心有共同定义的带教老师认为TUCOM学生在“同理心表现”方面表现更好或更出色的比例显著更高（z=1.982，P<0.05）。整骨医学带教老师（n=67）认为TUCOM学生在“同理心表现”（z=2.82，P<0.05）以及“与患者、家属和同事进行清晰有效的沟通”（z=2.83，P<0.01）方面的表现明显优于对抗疗法带教老师。在带教年限或带教老师所教学生类型的组合方面未发现显著差异。
大多数临床带教老师对同理心有共同的定义，并且他们能够观察并评价见习学生的同理心表现。在同理心表现方面，带教老师对TUCOM学生的评价比对他们所教的其他学生更有利。
