Empathy in medical students as related to academic performance, clinical competence and gender

TLDR

Empathy is a key element of a satisfactory doctor–patient relationship, and its measurement, development, and correlates are important objectives in medical education. The study aimed to test whether higher empathy scores predict higher clinical competence ratings and whether women score higher empathy than men. A 20‑item Jefferson Scale of Physician Empathy was administered to 371 third‑year medical students, and associations with clerkship competence ratings, gender, and objective exam scores were analyzed using t‑tests, ANOVA, chi‑square, and correlation coefficients. Higher empathy scores were linked to better clinical competence ratings and were higher in women, but empathy did not predict performance on objective exams, confirming both hypotheses and supporting further research on empathy’s educational and clinical correlates.

Abstract

Context Empathy is a major component of a satisfactory doctor–patient relationship and the cultivation of empathy is a learning objective proposed by the Association of American Medical Colleges (AAMC) for all American medical schools. Therefore, it is important to address the measurement of empathy, its development and its correlates in medical schools. Objectives We designed this study to test two hypotheses: firstly, that medical students with higher empathy scores would obtain higher ratings of clinical competence in core clinical clerkships; and secondly, that women would obtain higher empathy scores than men. Materials and subjects A 20-item empathy scale developed by the authors (Jefferson Scale of Physician Empathy) was completed by 371 third-year medical students (198 men, 173 women). Methods Associations between empathy scores and ratings of clinical competence in six core clerkships, gender, and performance on objective examinations were studied by using t-test, analysis of variance, chi-square and correlation coefficients. Results Both research hypotheses were confirmed. Empathy scores were associated with ratings of clinical competence and gender, but not with performance in objective examinations such as the Medical College Admission Test (MCAT), and Steps 1 and 2 of the US Medical Licensing Examinations (USMLE). Conclusions Empathy scores are associated with ratings of clinical competence and gender. The operational measure of empathy used in this study provides opportunities to further examine educational and clinical correlates of empathy, as well as stability and changes in empathy at different stages of undergraduate and graduate medical education.