Erosion of empathy during medical training false perception: study

CHICAGO, Sept. 11 (Xinhua) -- A new study by social neuroscientists at the University of Chicago (UChicago) challenges the common perception that empathy declines during medical training.

The researchers point to the interaction of two facets of empathy: cognitive and affective. "Cognitive empathy is the ability to recognize and understand another person's experience, to communicate and confirm that understanding, and to act in an appropriate and helpful manner without necessarily sharing his or her emotions," said Jean Decety, and lead author of the new study. "Affective, or emotional, empathy is being attuned to someone else's emotions, feeling what he or she feels."

In the study, researchers resorted to a variety of subjective and objective measures to get a more complete understanding of the mechanisms that contribute to changes in empathetic capacity over the course of medical school.

Researchers designed a study that followed 129 medical students from Loyola University, Northwestern University and the University of Chicago during their first three years of medical school. At the beginning and end of each year, students completed a series of online surveys and behavioral tasks designed to objectively assess different components of empathy.

The first survey was the Jefferson Scale of Physician Empathy, one of the most common self-assessment questionnaires in the field and thought to primarily evaluate the cognitive aspects of empathy. "We sought to replicate the results of previous studies that used this self-report measure," said Decety. "We did, in fact, see declines in assessment scores over the course of student training, which is in line with other studies that used this method."

As the research team wanted to tease out how the individual components of empathy changed over time, they also administered the Questionnaire of Cognitive and Affective Empathy, which is designed to reliably distinguish between the two facets of empathy, based on the social cognitive neuroscience literature on empathy and its underlying brain mechanisms.

At each appointment, students were asked to complete a set of computerized tasks aimed at objectively evaluating their ability to recognize different mental and emotional states and sensitivity to the pain of others.

In contrast to the results of the Jefferson Scale questionnaire, student scores on the Questionnaire of Cognitive and Affective Empathy improved over time. Specifically, medical students showed both greater sensitivity to facial expressions of pain and progress in their ability to quickly and accurately recognize others' emotional states.

The study challenges the view of an overall decline of empathy during medical training. "We found that changes in empathy during medical training are not necessarily negative, the narrative appears to be much more complicated than we initially thought and illustrates how problematic it is to rely on a single, subjective measure to evaluate a complex psychological construct."

The facets of empathy that improved, including perspective-taking and understanding others' emotions, are thought to be most important to physician empathy-and the most susceptible to change through teaching. Given the importance of empathy in the clinical setting, characterizing and understanding changes in student empathy has important implications for future teaching interventions, the researchers hold.

The study has been published in Medical Education on Sept. 7.