Personal and Contextual Factors Related to Empathy in Medical Students
Despite the fact that research has emphasized the importance of empathy in the establishment of the physician-patient relationship (Norfolk, Birdi, & Walsh, 2007), little empirical research has been undertaken to identify and measure the factors related to the development of empathy among medical students. Several studies have suggested that the quality of the doctor-patient relationship not only influences the patient's perception and attitudes toward disease (Lerman et al., 1993), but also precipitates positive, measurable results, including quality of life and improved health outcomes (Baile & Aaron, 2005; Barrier, Li, & Jensen, 2003; Stewart, 1995; Traveline, Ruchinskas, & D'Alonzo, 2005; Teutsch, 2003).The present study explored both personal and contextual factors posited to influence levels of empathy in medical students. Personal factors included self-esteem, altruism, and personal experience with illness. Medical school year, chosen specialty, and participation in psycho-social curriculum were considered as contextual factors. The following hypotheses guided the study: H1 - Controlling for age, gender and race, those medical students with higher levels of self-esteem and altruism, and those who have had personal experience with chronic/serious illness, will have higher levels of measured empathy than those medical students who do not. H2 - Controlling for age, gender and race, those medical students who are in their first year of study, who have participated in psycho-social curricular electives, and who have selected either psychiatry, pediatrics, emergency, family or internal medicine as a specialty, will have higher levels of measured empathy than students in the second, third or fourth year, those students who have not participated in psycho-social curricular electives, and those who have selected either orthopedic surgery or anesthesiology as specialties.Four reliable and valid instruments measuring self-esteem, altruism, and dimensions of empathy constituted the majority of the questions in the online survey. Descriptive statistics were conducted to describe the sample. Reliability statistics were run on all scales using Cronbach's Alpha, and multiple regression analysis was employed to test the hypotheses.Significant findings indicate the following:1) Medical students with higher levels of self-esteem and altruism, and those who have had personal experience with chronic/serious illness, have higher levels of measured empathy.2) Students participating in the Mind/Body psycho-social curricular elective have greater levels of empathy than those not enrolled in this program.3) Students selecting the specialty category of Orthopedics/Anesthesiology have lowered measured levels of empathy than students in other specialties.4) Female students have greater empathy than male students.Implications for the study suggest that the social work profession is uniquely important in health care, as it considers the whole person as a self-determining individual influenced and influencing his or her environment (Reese & Raymer, 2004). In terms of education, with an understanding of the cognitive and affective dimensions of empathy gleaned through an exploration of both personal and contextual factors, social workers are in a unique position to shape curricular changes and to disseminate the information to students in medical school. Furthermore, an examination of the factors influencing empathy help to broaden existing knowledge for future research, while adding to the general area of expertise.
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