Empathy: Lost or Found in Medical Education?

Sonal Singh, MD

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In This Article

The Decline of Empathy in Medical Training

Studies report that empathy declines among medical students[3] as well as residents.[4] Hojat and coworkers[3] examined changes in empathy in a class of third-year medical students. Using a validated questionnaire, the Jefferson Scale of Physician Empathy (JSPE), they demonstrated a small, but clinically significant reduction in total empathy score over the course of that year.[3] Similarly, Bellini and Shea[4] used a different measure of empathy, the Interpersonal Reactivity Index (IRI), of 60 residents at 6 time points during their internal medicine residency training. The IRI scores showed a decline in empathic concern that persisted through residency.[4]

There are several reasons for this decline in empathy. Current medical education emphasizes detachment and objective clinical neutrality,[5] and places greater emphasis on technologic rather than humanistic aspects of medicine.[6] A lack of role models, educational experiences, and the development of a sense of being part of a privileged group (elitism) are among the factors that may contribute to a decline in empathy during medical education.[6,7] Increased student and resident numbers at a time of shrinking resources, focus on research at the expense of teaching and learning, managed care, increased litigation, and defensive medicine may all affect the learning environment.[8]

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