Department of Brain and Cognitive Engineering, Korea University, 145 Anam-ro, Seongbuk-gu, Seoul, 02841, South Korea.
Department of Medical Education, Korea University College of Medicine, Seoul, South Korea.
Adv Health Sci Educ Theory Pract. 2021 Oct;26(4):1207-1227. doi: 10.1007/s10459-021-10045-y. Epub 2021 Apr 20.
There is growing concern about a potential decline in empathy among medical students over time. Despite the importance of empathy toward patients in medicine, it remains unclear the nature of the changes in empathy among medical students. Thus, we systematically investigated affective and cognitive empathy for patients among medical students using neuroscientific approach. Nineteen medical students who completed their fifth-year medical curriculum and 23 age- and sex-matched nonmedical students participated in a functional magnetic resonance imaging study. Inside a brain scanner, all participants read empathy-eliciting scenarios while adopting either the patient or doctor perspective. Brain activation and self-reported ratings during the experience of empathy were obtained. Behavioral results indicated that all participants reported greater emotional negativity and empathic concern in association with the patient perspective condition than with the doctor perspective condition. Functional brain imaging results indicated that neural activity in the posterior superior temporal region implicated in goal-relevant attention reorienting was overall increased under the patient perspective than the doctor perspective condition. Relative to nonmedical students, medical students showed decreased activity in the temporoparietal region implicated in mentalizing under the patient perspective versus doctor perspective condition. Notably, this same region showed increased activity under the doctor versus patient condition in medical students relative to nonmedical students. This study is among the first to investigate the neural mechanisms of empathy among medical students and the current findings point to the cognitive empathy system as the locus of the primary brain differences associated with empathy toward patients.
人们越来越担心医学生的同理心会随着时间的推移而下降。尽管同理心对于医学中的患者至关重要，但医学生同理心的变化性质仍不清楚。因此，我们使用神经科学方法系统地研究了医学生对患者的情感和认知同理心。19 名完成五年级医学课程的医学生和 23 名年龄和性别匹配的非医学生参加了一项功能磁共振成像研究。在大脑扫描仪内，所有参与者在采用患者或医生视角的情况下阅读引发同理心的情景。获得了在同理心体验过程中的大脑激活和自我报告评分。行为结果表明，与医生视角条件相比，所有参与者在患者视角条件下报告了更大的情绪消极性和同理心关注。功能脑成像结果表明，与医生视角条件相比，在患者视角条件下，与目标相关的注意力重新定向相关的后上颞区的神经活动总体增加。与非医学生相比，医学生在患者视角条件下的心理化相关的颞顶叶区域的活动减少，而在医生视角条件下则增加。值得注意的是，与非医学生相比，在医学生中，该区域在医生视角条件下相对于患者视角条件下的活动增加。这项研究是首批调查医学生同理心的神经机制的研究之一，目前的研究结果表明，认知同理心系统是与对患者的同理心相关的主要大脑差异的核心。
