Unit for Psycho-Oncology & Health Psychology, Department of Psychology and Behavioural Sciences, Aarhus University, Aarhus, Denmark.
Research and Development Department, Division of Mental Health Services, Akershus University Hospital, Sykehusveien 25, 1478, Nordbyhagen, Norway.
BMC Med Educ. 2024 Jun 7;24(1):640. doi: 10.1186/s12909-024-05625-6.
Burnout levels in medical students are higher than in other student groups. Empathy is an increasingly desired outcome of medical schools. Empathy is negatively associated with burnout in physicians. Our objective was to quantitatively review the available literature on associations between empathy and burnout in medical students, and to explore associations between specific empathy aspects (cognitive and affective) and burnout sub-dimensions (emotional exhaustion, depersonalization and personal accomplishment).
A comprehensive search of the literature published up until January 2024 was undertaken in the PubMed, EMBASE, CINAHL, The Cochrane Library, and PsycINFO databases. Two independent reviewers screened 498 records and quality-rated and extracted data from eligible studies. The effect size correlations (ESr) were pooled using a random-effects model and between-study variation explored with meta-regression. The review was preregistered with PROSPERO (#CRD42023467670) and reported following the PRISMA guidelines.
Twenty-one studies including a total of 27,129 medical students published between 2010 and 2023 were included. Overall, empathy and burnout were negatively and statistically significantly associated (ESr: -0.15, 95%CI [-0.21; -0.10], p < .001). When analyzing sub-dimensions, cognitive empathy was negatively associated with emotional exhaustion (ESr: -0.10, 95%CI [-0.17; -0.03], p = .006) and depersonalization (ESr: -0.15, 95%CI [-0.24; 0.05], p = .003), and positively associated with personal accomplishment (ESr: 0.21, 95%CI [0.12; 0.30], p < .001). Affective empathy was not statistically significantly associated with emotional exhaustion, depersonalization or personal accomplishment. Supplementary Bayesian analysis indicated the strongest evidence for the positive association between cognitive empathy and personal accomplishment. Response rate and gender moderated the relationship so that higher response rates and more male respondents strengthen the negative association between empathy and burnout.
Greater empathy, in particular cognitive empathy, is associated with lower burnout levels in medical students. This appears to be primarily driven by cognitive empathy's positive association with personal accomplishment.
#CRD42023467670.
医学生的倦怠水平高于其他学生群体。同理心是医学院越来越期望的结果。同理心与医生的倦怠呈负相关。我们的目的是定量回顾医学学生同理心与倦怠之间的现有文献，并探讨同理心的特定方面（认知和情感）与倦怠子维度（情绪衰竭、去人性化和个人成就感）之间的关系。
对截至 2024 年 1 月发表的文献进行全面检索，检索范围包括 PubMed、EMBASE、CINAHL、The Cochrane Library 和 PsycINFO 数据库。两名独立的审查员筛选了 498 条记录，并对合格研究进行了质量评估和数据提取。使用随机效应模型汇总效应大小相关系数（ESr），并通过元回归探索研究间的差异。该综述已在 PROSPERO（#CRD42023467670）上预先注册，并按照 PRISMA 指南进行报告。
共纳入 21 项研究，总计 27129 名医学生，研究发表于 2010 年至 2023 年期间。总体而言，同理心和倦怠呈负相关且具有统计学意义（ESr：-0.15，95%CI[-0.21；-0.10]，p<.001）。在分析子维度时，认知同理心与情绪衰竭（ESr：-0.10，95%CI[-0.17；-0.03]，p=.006）和去人性化（ESr：-0.15，95%CI[-0.24；0.05]，p=.003）呈负相关，与个人成就感（ESr：0.21，95%CI[0.12；0.30]，p<.001）呈正相关。情感同理心与情绪衰竭、去人性化或个人成就感无统计学显著关联。补充贝叶斯分析表明，认知同理心与个人成就感之间存在正相关的证据最强。回复率和性别调节了这种关系，即较高的回复率和更多的男性受访者会加强同理心与倦怠之间的负相关关系。
同理心较大，特别是认知同理心，与医学生的倦怠水平较低相关。这似乎主要是由于认知同理心与个人成就感的正相关关系所致。
#CRD42023467670。
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