Centre for Medical Education, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.
Med Educ. 2019 Jul;53(7):655-665. doi: 10.1111/medu.13819. Epub 2019 Mar 19.
There is convincing evidence that physician empathy leads to better patient care. As a result, there has been considerable research interest in investigating how empathy changes during undergraduate medical studies. Early (generally North American) studies raised concerns that medical training causes a decline in empathy. More recent studies (conducted around the world) have begun to suggest that either a slight increase or decrease in empathy occurs during undergraduate medical training, which has led some to argue that empathy changes indiscriminately (with no discernible pattern). This paper explores whether there is evidence to suggest that empathy changes indiscriminately or with a discernible geo-sociocultural pattern during undergraduate medical training.
Literature that investigated change in empathy during undergraduate medical training was reviewed. Cross-sectional and longitudinal studies were tabulated separately according to their respective geographical locations. The tabulated results were analysed to investigate whether empathy changed similarly or differently within different geographical locations.
The studies reviewed indicate similar patterns of empathy change within approximate geo-sociocultural clusters. Whereas US studies predominantly show small but significant decreases in empathy, Far Eastern studies mostly show small but significant increases in empathy as undergraduates progress through the medical course.
These results suggest that change in empathy during undergraduate medical education is not as indiscriminate (patternless) as once thought. Additionally, these results support the notion that empathy is a locally construed global construct.
有确凿的证据表明,医生的同理心会带来更好的患者护理。因此,人们对研究同理心在本科医学学习期间如何变化产生了浓厚的兴趣。早期(通常是北美的)研究引起了人们的担忧,即医学培训导致同理心下降。最近的研究(在世界各地进行)开始表明,同理心在本科医学培训期间要么略有增加,要么略有下降,这导致一些人认为同理心变化是不分青红皂白的(没有明显的模式)。本文探讨了是否有证据表明同理心在本科医学培训期间发生了不分青红皂白的变化,还是具有明显的地理社会文化模式。
回顾了调查本科医学培训期间同理心变化的文献。根据地理位置,分别将横断面研究和纵向研究列成表格。分析列成表格的结果,以调查同理心在不同地理位置内是否以相似或不同的方式发生变化。
综述的研究表明,在近似的地理社会文化群内,同理心的变化模式相似。虽然美国的研究主要显示同理心有小但显著的下降,但远东的研究则显示,随着医学生在医学课程中取得进步,同理心大多有小但显著的增加。
这些结果表明,本科医学教育期间同理心的变化并不像以前认为的那样不分青红皂白(无模式)。此外,这些结果支持了同理心是一种本地构建的全球结构的观点。