University of Southern Denmark, Campusvej 55, 5230, Odense M, Denmark.
Research Unit of General Practice, Department of Public Health, University of Southern Denmark, J.B. Winsløws Vej 9A, 5000, Odense C, Denmark.
BMC Med Educ. 2020 Feb 17;20(1):52. doi: 10.1186/s12909-020-1964-5.
Empathy allows a physician to understand the patient's situation and feelings and respond appropriately. Consequently, empathy gives rise to better diagnostics and clinical outcomes. This systematic review investigates the level of empathy among medical students across the number of educational years and how this level relates to gender, specialty preferences, and nationality.
In accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA), the authors conducted a systematic search of studies published between February 2010 and March 2019 investigating the level of empathy among medical students. The databases PubMed, EMBASE, and PsycINFO were searched. Studies employing quantitative methodologies and published in English or Scandinavian language and examining medical students exclusively were included.
Thirty studies were included of which 24 had a cross-sectional and 6 a longitudinal study design. In 14 studies, significantly lower levels of empathy were reported by increase in the number of educational years. The remaining 16 studies identified both higher, mixed and unchanged levels. In 18 out of 27 studies it was reported that females had higher empathy scores than males. Only three out of nine studies found an association between empathy scores and specialty preferences. Nine out of 30 studies reported a propensity towards lower mean empathy scores in non-Western compared to Western countries.
The results revealed equivocal findings concerning how the empathy level among medical students develops among medical students across numbers of educational years and how empathy levels are associated with gender, specialty preferences, and nationality. Future research might benefit from focusing on how students' empathy is displayed in clinical settings, e.g. in clinical encounters with patients, peers and other health professionals.
同理心使医生能够理解患者的情况和感受，并做出适当的反应。因此，同理心可以带来更好的诊断和临床结果。本系统评价调查了医学生在整个教育年限内的同理心水平，以及这种水平如何与性别、专业偏好和国籍相关。
根据系统评价和荟萃分析的首选报告项目（PRISMA），作者对 2010 年 2 月至 2019 年 3 月期间发表的调查医学生同理心水平的研究进行了系统搜索。检索了 PubMed、EMBASE 和 PsycINFO 数据库。纳入了采用定量方法、用英语或斯堪的纳维亚语发表、仅研究医学生的研究。
共纳入 30 项研究，其中 24 项为横断面研究，6 项为纵向研究。在 14 项研究中，随着教育年限的增加，同理心水平显著降低。其余 16 项研究则发现同理心水平既有升高，也有混合和不变。在 27 项研究中的 18 项中，女性的同理心评分高于男性。在 9 项研究中的 3 项中发现同理心评分与专业偏好之间存在关联。在 30 项研究中的 9 项中报告称，与西方国家相比，非西方国家的医学生平均同理心评分较低。
研究结果表明，医学生的同理心水平在整个教育年限内的发展以及同理心水平与性别、专业偏好和国籍的相关性存在矛盾的发现。未来的研究可能受益于关注学生的同理心如何在临床环境中表现出来，例如在与患者、同行和其他卫生专业人员的临床接触中。
