A cross-sectional measurement of medical student empathy
A cross-sectional measurement of medical student empathy
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DOI：
10.1007/s11606-007-0298-x
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发表时间：
2007-10-01
影响因子：
5.7
通讯作者：
Orlander, Jay
中科院分区：
文献类型：
--
作者：
Chen, Daniel;Lew, Robert;Orlander, Jay
背景：共情在医患关系中很重要。先前的研究表明，医生的同理心可能会随着临床训练而下降。目的：测量和检验医学院学生的同理心。设计和参与者：2006年波士顿大学医学院学生的横断面研究。新入学的学生和临近学年结束的每个班级都接受了调查。测量方法：杰弗逊医师共情-学生量表（JSPE-S），一份经过验证的20项自我管理问卷，总分从20到140。JSPE-S分数被控制为潜在的混杂因素，如性别、年龄、毕业时预期的金融债务和未来的职业兴趣。结果：658名学生参与了研究，占全校总人数的81.4%。医学院一年级学生共情得分最高（118.5），而四年级学生共情得分最低（106.6）。二年级和三年级的共情测量值不同（118.2 vs 112.7, P < 0.001），与第一年的临床培训相对应。从新生到一年级，共情似乎有所增加（115.5比118.5,P = 0.02）。选择以人为本的学生的共情得分高于选择技术导向的学生（114.6比111.4,P = .002）。女生比男生更倾向于选择以人为本的专业（51.5% vs 26.9%, P < 0.001）。JSPE-S评分女性高于男性（116.5比112.1,P < 0.001）。年龄和债务对同理心得分没有影响。结论：学生临床前年共情得分高于临床年。需要努力确定班级之间共情得分的差异是队列效应还是代表医学教育过程中发生的变化。未来的研究需要证实临床培训是否会对共情产生负面影响，如果是的话，是否可以设计干预措施来减轻这种影响。
BACKGROUND: Empathy is important in the physician-patient relationship. Prior studies have suggested that physician empathy may decline with clinical training. OBJECTIVE: To measure and examine student empathy across medical school years.DESIGN AND PARTICIPANTS: A cross-sectional study of students at Boston University School of Medicine in 2006. Incoming students plus each class near the end of the academic year were surveyed.MEASUREMENTS: The Jefferson Scale of Physician Empathy-Student Version (JSPE-S), a validated 20-item self-administered questionnaire with a total score ranging from 20 to 140. JSPE-S scores were controlled for potential confounders such as gender, age, anticipated financial debt upon graduation, and future career interest.RESULTS: 658 students participated in the study (81.4% of the school population). The first-year medical student class had the highest empathy scores (118.5), whereas the fourth-year class had the lowest empathy scores (106.6). Measured empathy differed between second- and third-year classes (118.2 vs 112.7, P < .001), corresponding to the first year of clinical training. Empathy appears to increase from the incoming to the first-year class (115.5 vs 118.5, P = .02). Students preferring people-oriented specialties had higher empathy scores than students preferring technology-oriented specialties (114.6 vs 111.4, P = .002). Female students were more likely than male students to choose people-oriented specialties (51.5 vs 26.9%, P < .001). Females had higher JSPE-S scores than males (116.5 vs 112.1, P < .001). Age and debt did not affect empathy scores.CONCLUSIONS: Empathy scores of students in the preclinical years were higher than in the clinical years. Efforts are needed to determine whether differences in empathy scores among the classes are cohort effects or represent changes occurring in the course of medical education. Future research is needed to confirm whether clinical training impacts empathy negatively, and, if so, whether interventions can be designed to mitigate this impact.