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医学生同理心的下降:是人性丧失还是有益的应对过程?

Decline of empathy among medical students: Dehumanization or useful coping process?

作者信息

Triffaux J-M, Tisseron S, Nasello J A

机构信息

Psychosomatic Medicine and Psychological Medicine, University Day Hospital "La Clé", Liège, Belgium; Department of Medical Psychology, University of Liège, CHU of Liège, Liège, Belgium.

University of Paris VII Denis-Diderot (CRPMS), Paris, France.

出版信息

Encephale. 2019 Feb;45(1):3-8. doi: 10.1016/j.encep.2018.05.003. Epub 2018 Jun 28.

Abstract

OBJECTIVES

Empathy is central in patient-physician interactions and understanding its development is decisive for education. However, scientific literatures report a striking decline of empathy among medical students during their study course. Firstly, we aimed to replicate this result on a Belgian population. Secondly, as well reported by literature, we expected higher empathy scores for women. Lastly, as central, we expected higher empathy levels for medical students than for "control" students (commercial students were used as a control group: social interactions without a curing aspect) at the beginning of their study course, suggesting that empathy drives students to select specific education fields.

METHODS

Through a cross-sectional design, we assessed students from medical and commercial educations at different years of study with the Basic Empathy Scale (N=1602). We compared: (1) empathy scores at different scholar levels for both populations; (2) scores between men and women; (3) empathy scores between medical and commercial students in their first year of study.

RESULTS

As expected, a significant empathy decline was displayed over time for medical students; women reported significant higher empathy scores than men; and, in their first year, medical students presented significant higher empathy scores than commercials.

CONCLUSIONS

Replicating the empathy decline on several student populations is crucial, especially by using different tools. This decline is a multi-factorial process that mainly reflects self-representation changes. The empathy gender bias is a strong effect observed in several empathy-linked phenomena. Finally, empathy is not only central but also drives students to select specific education fields.

摘要

目的

同理心在医患互动中至关重要,了解其发展过程对医学教育具有决定性意义。然而,科学文献报道称,医学生在学习过程中同理心显著下降。首先,我们旨在对比利时人群重复这一研究结果。其次,正如文献中所报道的那样,我们预计女性的同理心得分更高。最后,也是最重要的一点,我们预计在学习初期,医学生的同理心水平高于“对照”学生(以商科学生作为对照组:不涉及治疗方面的社会互动),这表明同理心促使学生选择特定的教育领域。

方法

通过横断面设计,我们使用基本同理心量表(N = 1602)对医学和商科不同年级的学生进行评估。我们比较了:(1)两类人群在不同学业水平时的同理心得分;(2)男性和女性之间的得分;(3)医学和商科学生在第一年学习时的同理心得分。

结果

正如预期的那样,医学生的同理心随着时间推移显著下降;女性报告的同理心得分显著高于男性;并且在第一年,医学生的同理心得分显著高于商科学生。

结论

在多个学生群体中重复同理心下降的研究结果至关重要,尤其是使用不同的工具。这种下降是一个多因素过程,主要反映了自我认知的变化。同理心的性别偏见是在几种与同理心相关的现象中观察到的一个显著影响因素。最后,同理心不仅至关重要,还促使学生选择特定的教育领域。

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