International Research Center for Medical Education, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
Center for Medical Education and Clinical Training, Shinshu University, Matsumoto, Japan.
Perspect Med Educ. 2018 Aug;7(4):264-271. doi: 10.1007/s40037-018-0431-z.
Medical and healthcare professionals' empathy for patients is crucially important for patient care. Some studies have suggested that a significant decline in empathy occurs during clinical training years in medical school as documented by self-assessed empathy scales. Moreover, a recent study provided qualitative evidence that communication skills training in an examination context, such as in an objective structured clinical examination, might stimulate perspective taking but inhibit the development of compassionate care. Therefore, the current study examined how perspective taking and compassionate care relate to medical students' willingness to show empathic behaviour and how these relations may change with communication skills training.
A total of 295 fourth-year Japanese medical students from three universities completed the Jefferson Empathy Scale and a newly developed set of items on willingness to show empathic behaviour twice after communication skills training, pertaining to post-training and retrospectively for pre-training.
The findings indicate that students' willingness to show empathic behaviour is much more correlated with perspective taking than with compassionate care. Qualitative descriptive analysis of open-ended question responses revealed a difficulty of feeling compassion despite showing empathic behaviour.
These findings shed light on the conceptual structure of empathy among medical students and generate a number of hypotheses for future intervention and longitudinal studies on the relation between communication skills training and empathy.
医学和医疗保健专业人员对患者的同理心对于患者护理至关重要。一些研究表明,自我评估同理心量表记录的医学院临床培训年期间同理心会显著下降。此外,最近的一项研究提供了定性证据,即在考试情境中进行沟通技巧培训,例如在客观结构化临床考试中,可能会激发换位思考,但会抑制同情关怀的发展。因此,本研究探讨了换位思考和同情关怀如何与医学生表现出同理心行为的意愿相关,以及这些关系如何随着沟通技巧培训而变化。
共有来自三所大学的 295 名四年级日本医学生在沟通技巧培训后两次完成了杰斐逊同理心量表和新开发的一套关于表现出同理心行为意愿的项目,分别是培训后和回顾性培训前。
研究结果表明,学生表现出同理心行为的意愿与换位思考的相关性远高于与同情关怀的相关性。对开放式问题回答的定性描述性分析显示,尽管表现出同理心行为,但仍难以产生同情心。
这些发现揭示了医学生同理心的概念结构,并为未来关于沟通技巧培训和同理心之间关系的干预和纵向研究提出了一些假设。