学习环境作为医学生同理心的预测因素：一项来自中国12所医学院校的多中心横断面研究。

Learning environment as a predictor for medical students' empathy: a multicenter cross-sectional study from 12 medical schools in China.

作者信息

Huang Runzhi, Shi Jiaying, Liu Yifan, Xian Shuyuan, Zhang Wei, Yao Yuntao, Wu Xinru, Li Yuanan, Zhang Haoyu, Lu Bingnan, Zhou Jiajie, Zhou Yibin, Lin Min, Wang Xiaonan, Liu Xin, Wang Yue, Chen Wenfang, Zhang Chongyou, Du Erbin, Lin Qing, Huang Zongqiang, Chen Yu, Zhang Jie, Liu Jun, Chen Xihui, Pan Xiuwu, Cui Xingang, Ji Shizhao, Yin Huabin

机构信息

Department of Orthopedics, School of Medicine, Shanghai General Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, 100 Haining Road, Shanghai, China.

Department of Burn Surgery, the First Affiliated Hospital of Naval Medical University, Shanghai, People's Republic of China.

出版信息

BMC Psychol. 2025 Jan 3;13(1):5. doi: 10.1186/s40359-024-02174-x.

DOI:10.1186/s40359-024-02174-x

PMID:39754270

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11699764/

Abstract

BACKGROUND

Empathy of medical students is crucial, yet it tends to decline as students enter later academic years. Empathy appeared to be affected by the learning environment (LE), which could be a potential contributor. We conducted a cross-sectional study to investigate the association between LE and empathy.

METHOD

The study comprised overall 10,901 medical students from 12 Chinese medical schools. Jefferson Scale of Empathy (JSE) was utilized to assess empathy, while a 5-point question and the Johns Hopkins Learning Environment Scale were employed to evaluate LE. JSE scores were compared across LE levels using Pearson Chi-square, Welch's ANOVA, and univariable linear regression. After adjusting for covariates, multivariable linear and logistic regression were used to assess the independent connection between LE and empathy. Confounders were controlled by stratified subgroup analysis.

RESULTS

LE was significantly associated with medical students' empathy, as shown by the Pearson Chi-square test (p < 0.001) and Welch's ANOVA (p < 0.001). In multivariable logistic regression analysis, lower JSE scores were linked to common, bad, and terrible LE (OR = 2.226, 95% CI = [2.011, 2.465], p < 0.001; OR = 2.558, 95% CI = [1.745, 3.751], p < 0.001; OR = 1.889, 95% CI = [1.131, 3.153], p = 0.015), while excellent LE was associated with higher JSE scores (OR = 0.348, 95% CI = [0.312, 0.388], p < 0.001). Linear regression and stratified subgroup analysis confirmed logistic regression's findings.

CONCLUSION

LE was a significant predictor for empathy. Better LE was associated with higher empathy and worse LE was related to lower empathy. This inspired us to improve LE to enhance medical students' empathy.

摘要

背景

医学生的同理心至关重要，但随着学生进入更高年级，同理心往往会下降。同理心似乎受到学习环境（LE）的影响，这可能是一个潜在因素。我们进行了一项横断面研究，以调查学习环境与同理心之间的关联。

方法

该研究共纳入了来自12所中国医学院校的10901名医学生。使用杰斐逊同理心量表（JSE）评估同理心，同时采用一个5分问题和约翰霍普金斯学习环境量表来评估学习环境。使用Pearson卡方检验、Welch方差分析和单变量线性回归比较不同学习环境水平下的JSE得分。在调整协变量后，使用多变量线性和逻辑回归来评估学习环境与同理心之间的独立联系。通过分层亚组分析控制混杂因素。

结果

Pearson卡方检验（p < 0.001）和Welch方差分析（p < 0.001）表明，学习环境与医学生的同理心显著相关。在多变量逻辑回归分析中，较低的JSE得分与一般、较差和糟糕的学习环境相关（OR = 2.226，95% CI = [2.011, 2.465]，p < 0.001；OR = 2.558，95% CI = [1.745, 3.751]，p < 0.001；OR = 1.889，95% CI = [1.131, 3.153]，p = 0.015），而优秀的学习环境与较高的JSE得分相关（OR = 0.348，95% CI = [0.312, 0.388]，p < 0.001）。线性回归和分层亚组分析证实了逻辑回归的结果。