Department of Radiology, Clínica Universidad de Navarra, Pamplona, Spain; Department of Medical Education, Universidad de Navarra, Pamplona, Spain.
Department of Health Science, Medicine, Public University of Navarre, Pamplona, Spain.
Patient Educ Couns. 2024 Feb;119:108042. doi: 10.1016/j.pec.2023.108042. Epub 2023 Oct 31.
Medical education should enhance empathy. We examined, using self-assessment instruments and standardized patients (SPs), the impact on empathy, of a multi-year intervention (years 4-6 of medical training) that uses reflective learning approaches.
241 final-year medical students participated; 110 from the 2018 graduation class (non-intervention group) and 131 from the 2019 graduation class (intervention group). Participants completed two self-reported empathy questionnaires - the Jefferson Scale of Empathy-Students (JSE-S) and the Interpersonal Reactivity Index (IRI) - and a personality questionnaire, the NEO Five-Factor Inventory. Additionally, SPs in a simulated station assessed participants' empathy with two patient-reported instruments: the Consultation and Relational Empathy (CARE) scale and the Jefferson Scale of Patient Perceptions of Physician Empathy (JSPPPE).
Empathy scores were significantly higher in the intervention group compared to the non-intervention group when assessed by the SP (p < 0.001). No differences were found in self-reported questionnaires between the two groups.
A longitudinal, multi-year reflection-based intervention enhanced empathy amongst medical students as assessed by SPs, but not when assessed by student self-reported measures.
Multi-year reflective learning interventions during clinical training nurture empathy in medical students. Assessments completed by SPs or patients may enhance the evaluation of empathy.
医学教育应当增强同理心。我们使用自我评估工具和标准化患者（SP）来检验一种基于反思学习的多年干预（医学培训的第 4-6 年）对同理心的影响。
共有 241 名即将毕业的医学生参与了这项研究，其中 110 名来自 2018 届（非干预组），131 名来自 2019 届（干预组）。参与者完成了两份自我报告的同理心问卷——《医学生同理心量表》（JSE-S）和《人际反应指数》（IRI），以及一份人格问卷《大五人格量表》（NEO Five-Factor Inventory）。此外，SP 在模拟站使用两份患者报告的工具评估了参与者的同理心：《咨询和关系同理心量表》（CARE）和《医学生感知医生同理心量表》（JSPPPE）。
SP 评估时，干预组的同理心得分显著高于非干预组（p<0.001）。两组间自我报告问卷无差异。
纵向、多年的基于反思的干预增强了医学生的同理心，而学生自我报告的测量则没有差异。
临床培训期间的多年反思学习干预有助于培养医学生的同理心。由 SP 或患者完成的评估可能会增强同理心的评估。
