An empirical study of decline in empathy in medical school
An empirical study of decline in empathy in medical school
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DOI：
10.1111/j.1365-2929.2004.01911.x
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发表时间：
2004-09-01
影响因子：
6
通讯作者：
Magee, M
中科院分区：
文献类型：
--
作者：
Hojat, M;Mangione, S;Magee, M
据报道，医科学生随着他们在医学院的进步变得越来越愤世嫉俗。这可能会导致同理心的下降。解决这一问题的实证研究很少，因为共情的定义缺乏清晰度，而且还没有专门衡量医学生和医生共情的工具。目的探讨医学生共情能力的变化。材料与被试采用新开发的杰弗逊医生共情量表（JSPE）对125名医学生在三年级开始（前测）和结束（后测）时进行问卷调查。这个量表是专门为在病人护理情况下测量同理心而开发的，具有可接受的心理测量特性。方法本前瞻性纵向研究采用重复测量设计的t检验检验前测/后测共情得分的变化；还计算了效应量估计。结果两组患者在5项评分及JSPE总疮数上均有显著差异（P < 0.01），差异有统计学意义（P < 0.05）。结论：虽然共情能力的下降在临床上并不重要，但这种下降趋势表明，在医学院期间，共情能力是可以改变的。需要进一步的研究来确定导致移情改变的因素，并检查有针对性的教育方案是否有助于保留、加强和培养医学生的移情，以改善临床结果。
CONTEXT It has been reported that medical students become more cynical as they progress through medical school. This can lead to a decline in empathy. Empirical research to address this issue is scarce because the definition of empathy lacks clarity, and a tool to measure empathy specifically in medical students and doctors has been unavailable.OBJECTIVE To examine changes in empathy among medical students as they progress through medical school.MATERIALS AND SUBJECTS A newly developed scale (Jefferson Scale of Physician Empathy [JSPE], with 20 Likert-type items) was administered to 125 medical students at the beginning (pretest) and end (post-test) of Year 3 of medical school. This scale was specifically developed for measuring empathy in patient care situations and has acceptable psychometric properties.METHODS In this prospective longitudinal study, the changes in pretest/post-test empathy scores were examined by using t-test for repeated measure design; the effect size estimates were also calculated.RESULTS Statistically significant declines were observed in 5 items (P < 0.01) and the total sores of the JSPE (P < 0.05) between the 2 test administrations.CONCLUSIONS Although the decline in empathy was not clinically important for all of the statistically significant findings, the downward trend suggests that empathy could be amenable to change during medical school. Further research is needed to identify factors that contribute to changes in empathy and to examine whether targeted educational programmes can help to retain, reinforce and cultivate empathy among medical students for improving clinical outcomes.