Ngo Hazel L, Sokolovic Nina, Jenkins Jennifer M
Department of Applied Psychology and Human Development, University of Toronto, Toronto, Canada.
Med Educ Online. 2025 Dec;30(1):2501263. doi: 10.1080/10872981.2025.2501263. Epub 2025 May 6.
Empathy can be divided into cognitive empathy (CE) and affective empathy (AE). CE is defined as the accurate understanding and appropriate response to others' thoughts whereas AE is defined as the accurate understanding and appropriate response to others' emotions. The overall purpose of this systematic review and meta-analysis is to assess the effectiveness of empathy interventions in physicians and physicians-in-training in increasing CE and AE. Specifically, we are interested in examining whether specific teaching methods and intervention designs may contribute to greater empathy intervention effectiveness for CE and AE outcomes.
Studies searched included randomized controlled trials conducted between 1971 to 2022 examining empathy interventions for medical students and physicians. Thirty-six studies, consisting of 3,833 participants, met the inclusion criteria. Data were analysed using random-effects pairwise meta-analysis.
Empathy interventions have moderate effect sizes on both CE [ = .50 (95% CI = .30, .70)] and AE [ = .46 (95% CI = .30, .62)]. Heterogeneity of effects was evident for both analyses. The effectiveness of interventions on AE was moderated by measurement type. Intervention effectiveness was not significantly moderated by other intervention and study characteristics for either type of empathy.
There is evidence of key differences, and similarities, in how CE and AE is taught to medical students and professionals; however, the small number and high level of heterogeneity in studies makes this difficult to confirm. Research in this field will benefit from investigators standardizing teaching and research methods across studies.
同理心可分为认知同理心（CE）和情感同理心（AE）。认知同理心被定义为对他人想法的准确理解和恰当回应，而情感同理心则被定义为对他人情绪的准确理解和恰当回应。本系统评价和荟萃分析的总体目的是评估同理心干预对在职医生和实习医生增强认知同理心和情感同理心的有效性。具体而言，我们感兴趣的是研究特定的教学方法和干预设计是否可能有助于提高认知同理心和情感同理心干预的效果。
检索的研究包括1971年至2022年间进行的针对医学生和医生的同理心干预随机对照试验。36项研究，共3833名参与者，符合纳入标准。采用随机效应配对荟萃分析对数据进行分析。
同理心干预对认知同理心[效应量=0.50（95%置信区间=0.30，0.70）]和情感同理心[效应量=0.46（95%置信区间=0.30，0.62）]均有中等效应量。两项分析的效应异质性均很明显。干预对情感同理心的有效性受测量类型的调节。对于任何一种同理心类型，干预效果均未受到其他干预和研究特征的显著调节。
有证据表明，在向医学生和专业人员教授认知同理心和情感同理心的方式上存在关键差异和相似之处；然而，研究数量少且异质性高，使得这一点难以确定。该领域的研究将受益于研究人员对各项研究的教学和研究方法进行标准化。
