Medicine › Psychiatry and Mental health

Empathy and Medical Education

Works Count: 69822

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This cluster of papers explores the topic of empathy in medicine, focusing on the decline of empathy in medical students and physicians, the factors influencing empathy, its impact on patient outcomes and satisfaction, and various training interventions aimed at cultivating and sustaining empathy in healthcare professionals. The papers also discuss the role of narrative medicine, arts-based interventions, and neuroscience in understanding and promoting empathy in clinical practice.

Keywords

Empathy; Medical Education; Physician; Narrative Medicine; Clinical Practice; Healthcare; Patient Satisfaction; Gender Differences; Neuroscience; Arts-based Interventions

A Textbook of Family Medicine

1990-07-15

Ian R. McWhinney , Tom P. Freeman

PART I: BASIC PRINCIPLES 1. The Origins of Family Madicine 2. Principles of Family Medicine 3. Illness in the Community 4. A Profile of Family Pratice 5. Philosophical and Scientific … PART I: BASIC PRINCIPLES 1. The Origins of Family Madicine 2. Principles of Family Medicine 3. Illness in the Community 4. A Profile of Family Pratice 5. Philosophical and Scientific Foundations of Family Medicine 6. Illness, Suffering, and Healing 7. Doctor-Patient Communication 8. Clinical Method 9. The Enhancement of Health and the Prevention of Disease 10. The Family in Health and Disease PART II: CLINICAL PROBLEMS 11. Acute Sore Throat 12. Headache 13. Fatigue 14. Hypertension 15. Diabetes PART III: THE PRACTICE OF FAMILY MEDICINE 16. Home Care 17. Consultation and Referral 19. The Health Profession 20. The Community Service Network 21. Alternative (Complementary) Medicine 22. Practice Management PART IV: EDUCATION AND RESEARCH 23. Continuing Self-Education 24. Research in Family Practice

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Narrative Medicine: Honoring the Stories of Illness

2007-01-16

Rita Charon

I: WHAT IS NARRATIVE MEDICINE 1. The source of Narrative Medicine 2. Bridging Health Care's Divides 3. Narrative Features of Medicine II: NARRATIVES OF ILLNESS 4. Telling One's Life 5. … I: WHAT IS NARRATIVE MEDICINE 1. The source of Narrative Medicine 2. Bridging Health Care's Divides 3. Narrative Features of Medicine II: NARRATIVES OF ILLNESS 4. Telling One's Life 5. The Patient, the Body, and the Self II: DEVELOPING NARRATIVE COMPETENCE 6. Close Reading 7. Attention, Represenation, and Affiliation 8. The Parallel Chart III: DIVIDENDS OF NARRATIVE MEDICINE 9. Bearing Witness 10. The Bioethics of Narrative Medicine 11. A Narrative Vision for Health Care

The feeling of what happens: body and emotion in the making of consciousness

2000-07-01

Antonio R. Damasio

The publication of this book is an event in the making. All over the world scientists, psychologists, and philosophers are waiting to read Antonio Damasio's new theory of the nature … The publication of this book is an event in the making. All over the world scientists, psychologists, and philosophers are waiting to read Antonio Damasio's new theory of the nature of consciousness and the construction of the self. A renowned and revered scientist and clinician, Damasio has spent decades following amnesiacs down hospital corridors, waiting for comatose patients to awaken, and devising ingenious research using PET scans to piece together the great puzzle of consciousness. In his bestselling Descartes' Error, Damasio revealed the critical importance of emotion in the making of reason. Building on this foundation, he now shows how consciousness is created. Consciousness is the feeling of what happens-our mind noticing the body's reaction to the world and responding to that experience. Without our bodies there can be no consciousness, which is at heart a mechanism for survival that engages body, emotion, and mind in the glorious spiral of human life. A hymn to the possibilities of human existence, a magnificent work of ingenious science, a gorgeously written book, The Feeling of What Happens is already being hailed as a classic.

The Doctor, His Patient, and the Illness

1957-08-01

B. Molics

Introduction. The General Problem. The Patients Offers and the Doctors Responses. Elimination by Appropriate Physical examination. Incidence and Evaluation of Neurotic Symptoms. Level of Diagnosis. The Collusion of Anonymity. The … Introduction. The General Problem. The Patients Offers and the Doctors Responses. Elimination by Appropriate Physical examination. Incidence and Evaluation of Neurotic Symptoms. Level of Diagnosis. The Collusion of Anonymity. The General Practitioner and His Consultants. The Perpetuation of the Teacher-Pupil Relationship. Advice and reassurance. How to Start. When to Stop. The Special Psychological Atmosphere of General Practice. The General Practitioner as Psychotherapist. A: Two Illustrative Cases. The general Practitioner as Psychotherapist B: The Difficult Case. The Apostolic Function-I. The Apostolic Function-II. The Doctor and his Patient. The Patient and his Illness. General Practitioner Psychotherapy. Summary and Future outlook.

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Measuring individual differences in empathy: Evidence for a multidimensional approach.

1983-01-01

Mark H. Davis

To facilitate a multidimensional approach to empathy the Interpersonal Reactivity Index (IRI) includes 4 subscales: Perspective-Taking (PT) Fantasy (FS) Empathic Concern (EC) and Personal Distress (PD). The aim of the … To facilitate a multidimensional approach to empathy the Interpersonal Reactivity Index (IRI) includes 4 subscales: Perspective-Taking (PT) Fantasy (FS) Empathic Concern (EC) and Personal Distress (PD). The aim of the present study was to establish the convergent and discriminant validity of these 4 subscales. Hypothesized relationships among the IRI subscales between the subscales and measures of other psychological constructs (social functioning self-esteem emotionality and sensitivity to others) and between the subscales and extant empathy measures were examined. Study subjects included 677 male and 667 female students enrolled in undergraduate psychology classes at the University of Texas. The IRI scales not only exhibited the predicted relationships among themselves but also were related in the expected manner to other measures. Higher PT scores were consistently associated with better social functioning and higher self-esteem; in contrast Fantasy scores were unrelated to these 2 characteristics. High EC scores were positively associated with shyness and anxiety but negatively linked to egotism. The most substantial relationships in the study involved the PD scale. PD scores were strongly linked with low self-esteem and poor interpersonal functioning as well as a constellation of vulnerability uncertainty and fearfulness. These findings support a multidimensional approach to empathy by providing evidence that the 4 qualities tapped by the IRI are indeed separate constructs each related in specific ways to other psychological measures.

Clinical Empathy as Emotional Labor in the Patient-Physician Relationship

2005-03-01

Eric B. Larson

Empathy should characterize all health care professions. Despite advancement in medical technology, the healing relationship between physicians and patients remains essential to quality care. We propose that physicians consider empathy … Empathy should characterize all health care professions. Despite advancement in medical technology, the healing relationship between physicians and patients remains essential to quality care. We propose that physicians consider empathy as emotional labor (ie, management of experienced and displayed emotions to present a certain image). Since the publication of Hochschild's The Managed Heart in 1983, researchers in management and organization behavior have been studying emotional labor by service workers, such as flight attendants and bill collectors. In this article, we focus on physicians as professionals who are expected to be empathic caregivers. They engage in such emotional labor through deep acting (ie, generating empathy-consistent emotional and cognitive reactions before and during empathic interactions with the patient, similar to the method-acting tradition used by some stage and screen actors), surface acting (ie, forging empathic behaviors toward the patient, absent of consistent emotional and cognitive reactions), or both. Although deep acting is preferred, physicians may rely on surface acting when immediate emotional and cognitive understanding of patients is impossible. Overall, we contend that physicians are more effective healers--and enjoy more professional satisfaction--when they engage in the process of empathy. We urge physicians first to recognize that their work has an element of emotional labor and, second, to consciously practice deep and surface acting to empathize with their patients. Medical students and residents can benefit from long-term regular training that includes conscious efforts to develop their empathic abilities. This will be valuable for both physicians and patients facing the increasingly fragmented and technological world of modern medicine.

Harrison's Principles of Internal Medicine

1984-02-10

John J. Massarelli

The first modern textbook of internal medicine was Osler'sThe Principles and Practice of Medicine, published in 1892. This was made possible by the development of bacteriology in the last third … The first modern textbook of internal medicine was Osler'sThe Principles and Practice of Medicine, published in 1892. This was made possible by the development of bacteriology in the last third of the 19th century, and the consequent assignment of specific causes to the illnesses most patients were initially seen with in those days. For the first time it was practical to have a nosography based on etiology. Osler's breadth of knowledge, clinical orientation, and mastery of English prose made the book a tremendous success. New editions appeared every two or three years. In 1927, an entirely new textbook of medicine came out, edited by Dr Russell Cecil, but written by 130 contributors. It soon replacedOsler(by then edited by McCrae) as the standard American medical text. Cecil retained Osler's format, with discrete descriptions of "disease entities" grouped by etiology or by systems affected. In 1950, another textbook was

The relation of empathy to prosocial and related behaviors.

1987-01-01

Nancy Eisenberg , Paul A. Miller

In a prior review involving a meta-analysis (Underwood & Moore, 1982), no relation between affective empathy and prosocial behavior was found. In this article, the literature relevant to this issue … In a prior review involving a meta-analysis (Underwood & Moore, 1982), no relation between affective empathy and prosocial behavior was found. In this article, the literature relevant to this issue is reexamined. The studies were organized according to the method used to assess empathy. When appropriate, meta-analyses were computed. In contrast to the earlier review, low to moderate positive relations generally were found between empathy and both prosocial behavior and cooperative/socially competent behavior. The method of assessing empathy did influence the strength of the relations; picture/story measures of empathy were not associated with prosocial behavior, whereas nearly all other measures were. Several possible explanations for the pattern of findings are discussed, as are the implications of the findings.

The Jefferson Scale of Physician Empathy: Development and Preliminary Psychometric Data

2001-04-01

Mohammadreza Hojat , Salvatore Mangione , Thomas J. Nasca +5 more

The present study was designed to develop a brief instrument to measure empathy in health care providers in patient care situations. Three groups participated in the study: Group 1 consisted … The present study was designed to develop a brief instrument to measure empathy in health care providers in patient care situations. Three groups participated in the study: Group 1 consisted of 55 physicians, Group 2 was 41 internal medicine residents, and Group 3 was composed of 193 third-year medical students. A 90-item preliminary version of the Empathy scale was developed based on a review of the literature and distributed to Group 1 for feedback. After pilot testing, a revised and shortened 45-item version of the instrument was distributed to Groups 2 and 3. A final version of the Jefferson Scale of Physician Empathy containing 20 items based on statistical analyses was constructed. Psychometric findings provided support for the construct validity, criterion-related validity (convergent and discriminant), and internal consistency reliability (coefficient alpha) of the scale scores.

Age norms for impulsiveness, venturesomeness and empathy in adults

1985-01-01

Sybil B. G. Eysenck , Paul R. Pearson , G. Easting +1 more

The Illness Narratives: Suffering, Healing and the Human Condition

1988-11-01

Andrew E. Slaby

The Illness Narratives: Suffering, Healing, and the Human Condition

1988-12-01

Armando R. Favazza

Perceiving Affective Content in Ambiguous Visual Stimuli: A Component of Emotional Intelligence

1990-06-01

John D. Mayer , Maria DiPaolo , Peter Salovey

Emotional intelligence involves the accurate appraisal and expression of emotions in oneself and others and the regulation of emotion in a way that enhances living. One aspect of emotional intelligence … Emotional intelligence involves the accurate appraisal and expression of emotions in oneself and others and the regulation of emotion in a way that enhances living. One aspect of emotional intelligence is the ability to recognize the consensually agreed upon emotional qualities of objects in the environment. One hundred thirty-nine adults viewed 18 reproductions of faces, color swatches, and abstract designs and rated the emotional content of these visual stimuli. Three scores were extracted, including consensual accuracy, amount, and range of emotion perceived. These scores were compared with other aspects of emotional intelligence such as empathy and related to constructs such as alexithymia and neuroticism. A general ability to perceive consensual emotional content in visual stimuli was found, and it was most strongly associated with the ability to respond empathically to others.

Development and validation of the Basic Empathy Scale

2005-09-29

Darrick Jolliffe , David P. Farrington

Illness narratives: fact or fiction?

2001-05-01

Mike Bury

There is currently considerable renewed interest in narrative analysis in the humanities, social sciences and medicine. Illness narratives, particularly those of patients or lay people, are a particular focus in … There is currently considerable renewed interest in narrative analysis in the humanities, social sciences and medicine. Illness narratives, particularly those of patients or lay people, are a particular focus in health related settings. This paper discusses the background to this interest, especially its roots in critiques of medical dominance and distinctions between disease and illness, drawn by sociologists and anthropologists in the 1970s. The current emphasis on patient or personal narratives can also be seen to stem from changes in morbidity patterns, the expansion of information about disease and illness, and in public debates about the effectiveness of medicine. The paper then goes on to outline a framework for analysing illness narratives. This involves exploring three types of narrative form: ‘contingent narratives’ which address beliefs about the origins of disease, the proximate causes of an illness episode, and the immediate effects of illness on everyday life; ‘moral narratives’ that provide accounts of (and help to constitute) changes between the person, the illness and social identity, and which help to (re) establish the moral status of the individual or help maintain social distance; and ‘core narratives’ that reveal connections between the lay person’s experiences and deeper cultural levels of meaning attached to suffering and illness. Here, distinctions are drawn between such sub forms as heroic, tragic, ironic and comic, and regressive/progressive narratives. Finally, the paper discusses some of the methodological issues raised by narrative analysis. Given the complex character of illness narratives, their social and psychological functions, together with the motivational issues to which they relate, it is suggested that they constitute a major challenge for sociological analysis. From this viewpoint current claims about narrative analysis in medicine need to be treated with caution.

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The Wounded Storyteller: Body Illness, and Ethics

1996-01-01

Arthur W. Frank

Is there a core neural network in empathy? An fMRI based quantitative meta-analysis

2010-10-26

Yan Fan , Niall W. Duncan , Moritz de Greck +1 more

Changes in Dispositional Empathy in American College Students Over Time: A Meta-Analysis

2010-08-05

Sara Konrath , Edward H. O’Brien , Courtney Hsing

The current study examines changes over time in a commonly used measure of dispositional empathy. A cross-temporal meta-analysis was conducted on 72 samples of American college students who completed at … The current study examines changes over time in a commonly used measure of dispositional empathy. A cross-temporal meta-analysis was conducted on 72 samples of American college students who completed at least one of the four subscales (Empathic Concern, Perspective Taking, Fantasy, and Personal Distress) of the Interpersonal Reactivity Index (IRI) between 1979 and 2009 (total N = 13,737). Overall, the authors found changes in the most prototypically empathic subscales of the IRI: Empathic Concern was most sharply dropping, followed by Perspective Taking. The IRI Fantasy and Personal Distress subscales exhibited no changes over time. Additional analyses found that the declines in Perspective Taking and Empathic Concern are relatively recent phenomena and are most pronounced in samples from after 2000.

Physician Empathy: Definition, Components, Measurement, and Relationship to Gender and Specialty

2002-08-30

Mohammadreza Hojat , Joseph S. Gonnella , Thomas J. Nasca +3 more

There is a dearth of empirical research on physician empathy despite its mediating role in patient-physician relationships and clinical outcomes. This study was designed to investigate the components of physician … There is a dearth of empirical research on physician empathy despite its mediating role in patient-physician relationships and clinical outcomes. This study was designed to investigate the components of physician empathy, its measurement properties, and group differences in empathy scores.A revised version of the Jefferson Scale of Physician Empathy (with 20 Likert-type items) was mailed to 1,007 physicians affiliated with the Jefferson Health System in the greater Philadelphia region; 704 (70%) responded. Construct validity, reliability of the empathy scale, and the differences on mean empathy scores by physicians' gender and specialty were examined.Three meaningful factors emerged (perspective taking, compassionate care, and standing in the patient's shoes) to provide support for the construct validity of the empathy scale that was also found to be internally consistent with relatively stable scores over time. Women scored higher than men to a degree that was nearly significant. With control for gender, psychiatrists scored a mean empathy rating that was significantly higher than that of physicians specializing in anesthesiology, orthopedic surgery, neurosurgery, radiology, cardiovascular surgery, obstetrics and gynecology, and general surgery. No significant difference was observed on empathy scores among physicians specializing in psychiatry, internal medicine, pediatrics, emergency medicine, and family medicine.Empathy is a multidimensional concept that varies among physicians and can be measured with a psychometrically sound tool. Implications for specialty selection and career counseling are discussed.

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An empirical study of decline in empathy in medical school

2004-08-24

Mohammadreza Hojat , Salvatore Mangione , Thomas J. Nasca +4 more

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 … 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.To examine changes in empathy among medical students as they progress through medical school.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.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.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.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.

Biomedicalization: Technoscientific Transformations of Health, Illness, and U.S. Biomedicine

2003-04-01

Adele E. Clarke , Laura Mamo , Jennifer R. Fishman +2 more

The first social transformation of American medicine institutionally established medicine by the end of World War II. In the next decades, medicalization-the expansion of medical jurisdiction, authority, and practices into … The first social transformation of American medicine institutionally established medicine by the end of World War II. In the next decades, medicalization-the expansion of medical jurisdiction, authority, and practices into new realms-became widespread. Since about 1985, dramatic changes in both the organization and practices of contemporary biomedicine, implemented largely through the integration of technoscientific innovations, have been coalescing into what the authors call biomedicalization, a second transformation of American medicine. Biomedicalization describes the increasingly complex, multisited, multidirectional processes of medicalization, both extended and reconstituted through the new social forms of highly technoscientific biomedicine. The historical shift from medicalization to biomedicalization is one from control over biomedical phenomena to transformations of them. Five key interactive processes both engender biomedicalization and are produced through it: (1) the political economic reconstitution of the vast sector of biomedicine; (2) the focus on health itself and the elaboration of risk and surveillance biomedicines; (3) the increasingly technological and scientific nature of biomedicine; (4) transformations in how biomedical knowledges are produced, distributed, and consumed, and in medical information management; and (5) transformations of bodies to include new properties and the production of new individual and collective technoscientific identities.

Empathy for Pain Involves the Affective but not Sensory Components of Pain

2004-02-19

Tania Singer , Ben Seymour , John P. O’Doherty +3 more

Our ability to have an experience of another's pain is characteristic of empathy. Using functional imaging, we assessed brain activity while volunteers experienced a painful stimulus and compared it to … Our ability to have an experience of another's pain is characteristic of empathy. Using functional imaging, we assessed brain activity while volunteers experienced a painful stimulus and compared it to that elicited when they observed a signal indicating that their loved one--present in the same room--was receiving a similar pain stimulus. Bilateral anterior insula (AI), rostral anterior cingulate cortex (ACC), brainstem, and cerebellum were activated when subjects received pain and also by a signal that a loved one experienced pain. AI and ACC activation correlated with individual empathy scores. Activity in the posterior insula/secondary somatosensory cortex, the sensorimotor cortex (SI/MI), and the caudal ACC was specific to receiving pain. Thus, a neural response in AI and rostral ACC, activated in common for "self" and "other" conditions, suggests that the neural substrate for empathic experience does not involve the entire "pain matrix." We conclude that only that part of the pain network associated with its affective qualities, but not its sensory qualities, mediates empathy.

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Influence of context effects on health outcomes: a systematic review

2001-03-01

Zelda Di Blasi , Elaine F. Harkness , Edzard Ernst +2 more

The QCAE: A Questionnaire of Cognitive and Affective Empathy

2010-12-23

Renate Reniers , Rhiannon Corcoran , Richard Drake +2 more

Abstract Empathy has been inconsistently defined and inadequately measured. This research aimed to produce a new and rigorously developed questionnaire. Exploratory (n 1= 640) and confirmatory (n 2= 318) factor … Abstract Empathy has been inconsistently defined and inadequately measured. This research aimed to produce a new and rigorously developed questionnaire. Exploratory (n 1= 640) and confirmatory (n 2= 318) factor analyses were employed to develop the Questionnaire of Cognitive and Affective Empathy (QCAE). Principal components analysis revealed 5 factors (31 items). Confirmatory factor analysis confirmed this structure in an independent sample. The hypothesized 2-factor structure (cognitive and affective empathy) was tested and provided the best and most parsimonious fit to the data. Gender differences, convergent validity, and construct validity were examined. The QCAE is a valid tool for assessing cognitive and affective empathy. Notes 1To solve the problem of a negative error variance in the second order model, the residual error variance of the peripheral responsivity factor was constrained to zero.

The consultation and relational empathy (CARE) measure: development and preliminary validation and reliability of an empathy-based consultation process measure

2004-10-01

Stewart W Mercer

Background. Empathy is a key aspect of the clinical encounter but there is a lack of patient-assessed measures suitable for general clinical settings. Objectives. Our aim was to develop a … Background. Empathy is a key aspect of the clinical encounter but there is a lack of patient-assessed measures suitable for general clinical settings. Objectives. Our aim was to develop a consultation process measure based on a broad definition of empathy, which is meaningful to patients irrespective of their socio-economic background. Methods. Qualitative and quantitative approaches were used to develop and validate the new measure, which we have called the consultation and relational empathy (CARE) measure. Concurrent validity was assessed by correlational analysis against other validated measures in a series of three pilot studies in general practice (in areas of high or low socio-economic deprivation). Face and content validity was investigated by 43 interviews with patients from both types of areas, and by feedback from GPs and expert researchers in the field. Results. The initial version of the new measure (pilot 1; high deprivation practice) correlated strongly (r = 0.85) with the Reynolds empathy measure (RES) and the Barrett-Lennard empathy subscale (BLESS) (r = 0.63), but had a highly skewed distribution (skew −1.879, kurtosis 3.563). Statistical analysis, and feedback from the 20 patients interviewed, the GPs and the expert researchers, led to a number of modifications. The revised, second version of the CARE measure, tested in an area of low deprivation (pilot 2) also correlated strongly with the established empathy measures (r = 0.84 versus RES and r = 0.77 versus BLESS) but had a less skewed distribution (skew −0.634, kurtosis −0.067). Internal reliability of the revised version was high (Cronbach's alpha 0.92). Patient feedback at interview (n = 13) led to only minor modification. The final version of the CARE measure, tested in pilot 3 (high deprivation practice) confirmed the validation with the other empathy measures (r = 0.85 versus RES and r = 0.84 versus BLESS) and the face validity (feedback from 10 patients). Conclusions. These preliminary results support the validity and reliability of the CARE measure as a tool for measuring patients' perceptions of relational empathy in the consultation.

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Distress and Empathy: Two Qualitatively Distinct Vicarious Emotions with Different Motivational Consequences

1987-03-01

C. Daniel Batson , Jim Fultz , Patricia A. Schoenrade

ABSTRACT The construct of empathy may be located conceptually at several different points in the network of interpersonal cognition and emotion We discuss one specific form of emotional empathy—other‐focused feelings … ABSTRACT The construct of empathy may be located conceptually at several different points in the network of interpersonal cognition and emotion We discuss one specific form of emotional empathy—other‐focused feelings evoked by perceiving another person in need First, evidence is reviewed suggesting that there are at least two distinct types of congruent emotional responses to perceiving another in need feelings of personal distress (e g, alarmed, upset, worried, disturbed, distressed, troubled, etc) and feelings of empathy (e g, sympathetic, moved, compassionate, tender, warm, softhearted, etc) Next, evidence is reviewed suggesting that these two emotional responses have different motivational consequences Personal distress seems to evoke egoistic motivation to reduce one's own aversive arousal, as a traditional Hullian tension‐reduction model would propose Empathy does not The motivation evoked by empathy may instead be altruistic, for the ultimate goal seems to be reduction of the other's need, not reduction of one's own aversive arousal Overall, the recent empirical evidence appears to support the more differentiated view of emotion and motivation proposed long ago by McDougall, not the unitary view proposed by Hull and his followers

Narrative Medicine

2001-10-17

Rita Charon

The effective practice of medicine requires narrative competence, that is, the ability to acknowledge, absorb, interpret, and act on the stories and plights of others. Medicine practiced with narrative competence, … The effective practice of medicine requires narrative competence, that is, the ability to acknowledge, absorb, interpret, and act on the stories and plights of others. Medicine practiced with narrative competence, called narrative medicine, is proposed as a model for humane and effective medical practice. Adopting methods such as close reading of literature and reflective writing allows narrative medicine to examine and illuminate 4 of medicine's central narrative situations: physician and patient, physician and self, physician and colleagues, and physicians and society. With narrative competence, physicians can reach and join their patients in illness, recognize their own personal journeys through medicine, acknowledge kinship with and duties toward other health care professionals, and inaugurate consequential discourse with the public about health care. By bridging the divides that separate physicians from patients, themselves, colleagues, and society, narrative medicine offers fresh opportunities for respectful, empathic, and nourishing medical care.

Physiciansʼ Empathy and Clinical Outcomes for Diabetic Patients

2011-01-20

Mohammadreza Hojat , Daniel Z. Louis , Fred W. Markham +3 more

To test the hypothesis that physicians' empathy is associated with positive clinical outcomes for diabetic patients.A correlational study design was used in a university-affiliated outpatient setting. Participants were 891 diabetic … To test the hypothesis that physicians' empathy is associated with positive clinical outcomes for diabetic patients.A correlational study design was used in a university-affiliated outpatient setting. Participants were 891 diabetic patients, treated between July 2006 and June 2009, by 29 family physicians. Results of the most recent hemoglobin A1c and LDL-C tests were extracted from the patients' electronic records. The results of hemoglobin A1c tests were categorized into good control (<7.0%) and poor control (>9.0%). Similarly, the results of the LDL-C tests were grouped into good control (<100) and poor control (>130). The physicians, who completed the Jefferson Scale of Empathy in 2009, were grouped into high, moderate, and low empathy scorers. Associations between physicians' level of empathy scores and patient outcomes were examined.Patients of physicians with high empathy scores were significantly more likely to have good control of hemoglobin A1c (56%) than were patients of physicians with low empathy scores (40%, P < .001). Similarly, the proportion of patients with good LDL-C control was significantly higher for physicians with high empathy scores (59%) than physicians with low scores (44%, P < .001). Logistic regression analyses indicated that physicians' empathy had a unique contribution to the prediction of optimal clinical outcomes after controlling for physicians' and patients' gender and age, and patients' health insurance.The hypothesis of a positive relationship between physicians' empathy and patients' clinical outcomes was confirmed, suggesting that physicians' empathy is an important factor associated with clinical competence and patient outcomes.

The role of pictures in improving health communication: A review of research on attention, comprehension, recall, and adherence

2005-08-26

Peter S. Houts , Cecilia C. Doak , Leonard G. Doak +1 more

Effectiveness of empathy in general practice: a systematic review

2012-12-31

Frans Derksen , Jozien M. Bensing , Antoine L. M. Lagro-Janssen

Empathy as a characteristic of patient-physician communication in both general practice and clinical care is considered to be the backbone of the patient-physician relationship. Although the value of empathy is … Empathy as a characteristic of patient-physician communication in both general practice and clinical care is considered to be the backbone of the patient-physician relationship. Although the value of empathy is seldom debated, its effectiveness is little discussed in general practice. This literature review explores the effectiveness of empathy in general practice. Effects that are discussed are: patient satisfaction and adherence, feelings of anxiety and stress, patient enablement, diagnostics related to information exchange, and clinical outcomes.To review the existing literature concerning all studies published in the last 15 years on the effectiveness of physician empathy in general practice.Systematic literature search.Searches of PubMed, EMBASE, and PsychINFO databases were undertaken, with citation searches of key studies and papers. Original studies published in English between July 1995 and July 2011, containing empirical data about patient experience of GPs' empathy, were included. Qualitative assessment was applied using Giacomini and Cook's criteria.After screening the literature using specified selection criteria, 964 original studies were selected; of these, seven were included in this review after applying quality assessment. There is a good correlation between physician empathy and patient satisfaction and a direct positive relationship with strengthening patient enablement. Empathy lowers patients' anxiety and distress and delivers significantly better clinical outcomes.Although only a small number of studies could be used in this search, the general outcome seems to be that empathy in the patient-physician communication in general practice is of unquestionable importance.

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The Toronto Empathy Questionnaire: Scale Development and Initial Validation of a Factor-Analytic Solution to Multiple Empathy Measures

2008-12-12

R. Nathan Spreng , Margaret C. McKinnon , Raymond A. Mar +1 more

To formulate a parsimonious tool to assess empathy, we used factor analysis on a combination of self-report measures to examine consensus and developed a brief self-report measure of this common … To formulate a parsimonious tool to assess empathy, we used factor analysis on a combination of self-report measures to examine consensus and developed a brief self-report measure of this common factor. The Toronto Empathy Questionnaire (TEQ) represents empathy as a primarily emotional process. In 3 studies, the TEQ demonstrated strong convergent validity, correlating positively with behavioral measures of social decoding, self-report measures of empathy, and negatively with a measure of Autism symptomatology. Moreover, it exhibited good internal consistency and high test–retest reliability. The TEQ is a brief, reliable, and valid instrument for the assessment of empathy.

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The Need for a New Medical Model: A Challenge for Biomedicine

1977-04-08

George L. Engel

The dominant model of disease today is biomedical, and it leaves no room within its framework for the social, psychological, and behavioral dimensions of illness. A biopsychosocial model is proposed … The dominant model of disease today is biomedical, and it leaves no room within its framework for the social, psychological, and behavioral dimensions of illness. A biopsychosocial model is proposed that provides a blueprint for research, a framework for teaching, and a design for action in the real world of health care.

The Devil is in the Third Year: A Longitudinal Study of Erosion of Empathy in Medical School

2009-08-22

Mohammadreza Hojat , Michael J. Vergare , Kaye Maxwell +5 more

This longitudinal study was designed to examine changes in medical students' empathy during medical school and to determine when the most significant changes occur.Four hundred fifty-six students who entered Jefferson … This longitudinal study was designed to examine changes in medical students' empathy during medical school and to determine when the most significant changes occur.Four hundred fifty-six students who entered Jefferson Medical College in 2002 (n = 227) and 2004 (n = 229) completed the Jefferson Scale of Physician Empathy at five different times: at entry into medical school on orientation day and subsequently at the end of each academic year. Statistical analyses were performed for the entire cohort, as well as for the "matched" cohort (participants who identified themselves at all five test administrations) and the "unmatched" cohort (participants who did not identify themselves in all five test administrations).Statistical analyses showed that empathy scores did not change significantly during the first two years of medical school. However, a significant decline in empathy scores was observed at the end of the third year which persisted until graduation. Findings were similar for the matched cohort (n = 121) and for the rest of the sample (unmatched cohort, n = 335). Patterns of decline in empathy scores were similar for men and women and across specialties.It is concluded that a significant decline in empathy occurs during the third year of medical school. It is ironic that the erosion of empathy occurs during a time when the curriculum is shifting toward patient-care activities; this is when empathy is most essential. Implications for retaining and enhancing empathy are discussed.

Evaluating the contribution of interpretative phenomenological analysis

2010-10-06

Jonathan A. Smith

Abstract This paper presents the results of a review of studies employing interpretative phenomenological analysis (IPA) obtained from three of the major databases: web of science, medline and psychinfo. Between … Abstract This paper presents the results of a review of studies employing interpretative phenomenological analysis (IPA) obtained from three of the major databases: web of science, medline and psychinfo. Between 1996 and 2008, 293 papers presenting empirical IPA studies were published. Trends over time are presented. This is followed by a categorisation of the content area of that corpus. The biggest specific area of research within IPA is illness experience, it forming the subject of nearly a quarter of the corpus. The paper then describes a guide for evaluating IPA research which is used to assess the illness experience papers. Detailed summaries are provided of the papers rated as good. These summaries describe the substantive findings as well as the markers of high quality. The paper finishes with a summary of core features of high-quality IPA work.

Empathy Decline and Its Reasons: A Systematic Review of Studies With Medical Students and Residents

2011-06-11

Melanie Neumann , Friedrich Edelhäuser , Diethard Tauschel +5 more

Empathy is a key element of patient-physician communication; it is relevant to and positively influences patients' health. The authors systematically reviewed the literature to investigate changes in trainee empathy and … Empathy is a key element of patient-physician communication; it is relevant to and positively influences patients' health. The authors systematically reviewed the literature to investigate changes in trainee empathy and reasons for those changes during medical school and residency.The authors conducted a systematic search of studies concerning trainee empathy published from January 1990 to January 2010, using manual methods and the PubMed, EMBASE, and PsycINFO databases. They independently reviewed and selected quantitative and qualitative studies for inclusion. Intervention studies, those that evaluated psychometric properties of self-assessment tools, and those with a sample size <30 were excluded.Eighteen studies met the inclusion criteria: 11 on medical students and 7 on residents. Three longitudinal and six cross-sectional studies of medical students demonstrated a significant decrease in empathy during medical school; one cross-sectional study found a tendency toward a decrease, and another suggested stable scores. The five longitudinal and two cross-sectional studies of residents showed a decrease in empathy during residency. The studies pointed to the clinical practice phase of training and the distress produced by aspects of the "hidden," "formal," and "informal" curricula as main reasons for empathy decline.The results of the reviewed studies, especially those with longitudinal data, suggest that empathy decline during medical school and residency compromises striving toward professionalism and may threaten health care quality. Theory-based investigations of the factors that contribute to empathy decline among trainees and improvement of the validity of self-assessment methods are necessary for further research.

Body Images: Development, Deviance, and Change

1992-03-01

Norman B. Levy

Chronic illness as biographical disruption

1982-07-01

Michael Bury

The paper is based on semi-structured interviews with a series of rheumatoid arthritis patients. Chronic illness is conceptualised as a particular type of disruptive event. This disruption highlights the resources … The paper is based on semi-structured interviews with a series of rheumatoid arthritis patients. Chronic illness is conceptualised as a particular type of disruptive event. This disruption highlights the resources (cognitive and material) available to individuals, modes of explanation for pain and suffering, continuities and discontinuities between professional and lay thought, and sources of variation in experience.

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Empathy: A Review of the Concept

2014-12-01

Benjamin M. P. Cuff , Sarah Brown , Laura Taylor +1 more

The inconsistent definition of empathy has had a negative impact on both research and practice. The aim of this article is to review and critically appraise a range of definitions … The inconsistent definition of empathy has had a negative impact on both research and practice. The aim of this article is to review and critically appraise a range of definitions of empathy and, through considered analysis, to develop a new conceptualisation. From the examination of 43 discrete definitions, 8 themes relating to the nature of empathy emerged: “distinguishing empathy from other concepts”; “cognitive or affective?”; “congruent or incongruent?”; “subject to other stimuli?”; “self/other distinction or merging?”; “trait or state influences?”; “has a behavioural outcome?”; and “automatic or controlled?” The relevance and validity of each theme is assessed and a new conceptualisation of empathy is offered. The benefits of employing a more consistent and complete definition of empathy are discussed.

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The clinical application of the biopsychosocial model

1980-05-01

G.L. Engel

How physicians approach patients and the problems they present is much influenced by the conceptual models around which their knowledge is organized. In this paper the implications of the biopsychosocial … How physicians approach patients and the problems they present is much influenced by the conceptual models around which their knowledge is organized. In this paper the implications of the biopsychosocial model for the study and care of a patient with an acute myocardial infarction are presented and contrasted with approaches used by adherents of the more traditional biomedical model. A medical rather than psychiatric patient was selected to emphasize the unity of medicine and to help define the place of psychiatrists in the education of physicians of the future.

These Things Called Empathy: Eight Related but Distinct Phenomena

2009-03-20

C. Daniel Batson

This chapter addresses two questions that empathy is supposed to answer and relate them to eight distinct phenomena that have been called empathy. The first is how one can know … This chapter addresses two questions that empathy is supposed to answer and relate them to eight distinct phenomena that have been called empathy. The first is how one can know what another person is thinking and feeling and the second is what leads one person to respond with sensitivity and care to the suffering of another. The first phenomenon related to empathy is knowing someone else’s internal state, including his or her thoughts and feelings, also known as cognitive empathy. The second is adopting the posture or matching the neural responses of an observed other, or facial empathy. The third concept is coming to feel as another person feels while the fourth is intuiting or projecting oneself into another’s situation. The fifth concept, imagining how another is thinking and feeling, has been variously termed psychological empathy, projection, and perspective taking. The last three phenomenon have been described as “changing places in fancy,” projective empathy, decentering, personal distress, pity, compassion, sympathetic distress, or simply sympathy.

How phenomenology can help us learn from the experiences of others

2019-04-05

Brian E. Neubauer , Catherine Witkop , Lara Varpio

Introduction As a research methodology, phenomenology is uniquely positioned to help health professions education (HPE) scholars learn from the experiences of others. Phenomenology is a form of qualitative research that … Introduction As a research methodology, phenomenology is uniquely positioned to help health professions education (HPE) scholars learn from the experiences of others. Phenomenology is a form of qualitative research that focuses on the study of an individual’s lived experiences within the world. Although it is a powerful approach for inquiry, the nature of this methodology is often intimidating to HPE researchers. This article aims to explain phenomenology by reviewing the key philosophical and methodological differences between two of the major approaches to phenomenology: transcendental and hermeneutic. Understanding the ontological and epistemological assumptions underpinning these approaches is essential for successfully conducting phenomenological research. Purpose This review provides an introduction to phenomenology and demonstrates how it can be applied to HPE research. We illustrate the two main sub-types of phenomenology and detail their ontological, epistemological, and methodological differences. Conclusions Phenomenology is a powerful research strategy that is well suited for exploring challenging problems in HPE. By building a better understanding of the nature of phenomenology and working to ensure proper alignment between the specific research question and the researcher’s underlying philosophy, we hope to encourage HPE scholars to consider its utility when addressing their research questions.

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Measuring individual differences in empathy: Evidence for a multidimensional approach.

1983-01-01

Mark H. Davis

Background to Compassionate Healthcare

2025-06-27

| Cambridge University Press eBooks

WHAT CAN COVID TEACH US?

2025-06-24

Marcus Bussey | Anthem Press eBooks

The Growing Need for Breast Health Education

2025-06-24

Lois Johnson | The Clinical Teacher

Sağlık Bilimlerinde Bütüncül Perspektifler ve Klinik Süreçler

2025-06-24

Arzu Nurdaş , Canan Gürsoy , Buğra Varol +6 more | Özgür Yayınları eBooks

Sağlık bilimleri, moleküler düzeydeki mekanizmaların anlaşılmasından klinik kararlara uzanan karmaşık bir bilgi zincirini kapsamaktadır. Bu sürecin etkin, güvenilir ve yenilikçi bir şekilde işlemesi, temel bilimlerle klinik bilimler arasındaki yapıcı iş … Sağlık bilimleri, moleküler düzeydeki mekanizmaların anlaşılmasından klinik kararlara uzanan karmaşık bir bilgi zincirini kapsamaktadır. Bu sürecin etkin, güvenilir ve yenilikçi bir şekilde işlemesi, temel bilimlerle klinik bilimler arasındaki yapıcı iş birliğine bağlıdır. Sağlık Bilimlerinde Bütüncül Perspektifler ve Klinik Süreçler başlıklı bu eser, sağlık alanındaki bilgi üretimini disiplinler arası bir bağlamda ele alarak, özellikle temel bilimsel verilerin klinik uygulamalara entegrasyonuna odaklanmaktadır. Bu kitap temel bilim alanlarından elde edilen bulguların, tanı, tedavi ve izlem süreçlerindeki yansımalarını değerlendirmektedir. Klinik pratikteki sorunların, laboratuvar temelli yaklaşımlarla nasıl daha iyi anlaşılabileceğini ve çözümlenebileceğini tartışmak, bu çalışmanın temel hedeflerinden biridir. Hedef kitlemiz; lisansüstü öğrenciler, araştırmacılar ve temel bilim veya klinik alanda çalışan sağlık profesyonelleridir. Okuyucuların, disiplinler arası bilgi akışını daha iyi kavramaları ve bu bilgi birikimini klinik kararlara entegre edebilmeleri amaçlanmaktadır. Kitap aynı zamanda, translasyonel araştırmaların önemine ve laboratuvar bulgularının hasta yatak başına uzanan yolculuğuna dikkat çekmektedir. Bu kitap, temel bilimsel bilginin yalnızca akademik birikimle sınırlı kalmayıp, klinik pratiğe yön verdiği bir sağlık sistemi tasavvuruna katkı sunmayı hedeflemektedir. Bu yaklaşımın, daha bütüncül, daha etkili ve daha bilim temelli sağlık hizmetlerinin inşasında önemli bir rol oynayacağına inanıyoruz.

Patient Involvement and Rare Diseases in Italy: Narratives, Spirituality, and Legitimation in Healthcare

2025-06-23

Ilaria E. Lesmo | Medical Anthropology

Public representations of rare diseases often depict patients as neglected and isolated. In response, initiatives promoting patient involvement have emerged, with illness narratives considered as key tools. However, the relationship … Public representations of rare diseases often depict patients as neglected and isolated. In response, initiatives promoting patient involvement have emerged, with illness narratives considered as key tools. However, the relationship between narratives and involvement remains underexplored. Based on ethnographic research conducted in Piedmont (Italy), I explore the narratives of two patients, which are deeply entangled with spiritual and religious perspectives, and explore the forms of involvement that emerged within the clinical space. I suggest that, depending on how moral and structural conditions intertwine, patients may be differently legitimized: roles of "experts of experience" or "implicated actors" arose within the field.

Limitações e potencialidades na promoção do autocuidado na narrativa de médicos e estudantes de medicina

2025-06-23

Isabella Sassaki Ricca , Marta Luciane Fischer | Caderno Pedagógico

Partindo da definição do autocuidado como a capacidade individual de promover e manter a saúde, prevenir e lidar com doenças com ou sem o apoio de um profissional, questionou-se como … Partindo da definição do autocuidado como a capacidade individual de promover e manter a saúde, prevenir e lidar com doenças com ou sem o apoio de um profissional, questionou-se como o médico percebe e exerce o seu autocuidado. Objetivou-se testar a hipótese de que profissionais domiciliados em grandes centros, em pequenos centros e estudantes possuem diferentes perspectivas das limitações e potencialidades relacionadas ao autocuidado. A pesquisa apresenta-se como qualitativa, transversal, descritiva e exploratória realizada por meio de grupos focais virtuais. Os três grupos possuíam inicialmente a mesma valorização das diferentes dimensões do autocuidado beneficiando a realização profissional em detrimento do lazer, do convívio com amigos e autoestima. No geral, os participantes expressaram mais valores e potencialidades quando comparados com as fragilidades e crenças demonstrando a prevalência de balizadores éticos e de soluções para as limitações apresentadas. A Bioética acolhe as vulnerabilidades do médico, pois seus pressupostos reconhecem a situação, os riscos e a consciência do autocuidado como um compromisso ético. A compreensão de que o bem-estar físico depende da qualidade do ambiente e das relações sociais, a mobilização coletiva a conduzir a um contexto benéfico para todos os seres vivos constituintes da realidade desta e de futuras gerações.

The limits of critique: toward a hermeneutic of humility within the medical humanities

2025-06-23

Dominic Robin | Bioethics News

Much More Than Pretty Words: Poetry About the COVID-19 Vaccine Brings Healing and Community

2025-06-22

Nichole Egbert , David Hassler , Thomas Meier | Health Communication

In response to the uncertainty of the COVID-19 vaccine rollout, the Global Vaccine Poem (GVP) was conceived in 2021 as a way for people to experience social connection and express … In response to the uncertainty of the COVID-19 vaccine rollout, the Global Vaccine Poem (GVP) was conceived in 2021 as a way for people to experience social connection and express themselves through poetry. The GVP project is an online portal where anyone can contribute a stanza or entire poem to express how they were/are feeling or experiencing COVID-19 vaccine. As of 2024, over 2000 poems from all over the world and every U.S. state have been collected. The GVP has grown to be an archive, communicating people's lived experiences during the COVID-19 pandemic. The project also inspired a book of a subset of the contributed poems in 2022. In this essay, the GVP project is described through the EFECT model for poetry therapy to demonstrate how communication via artistic expression can be leveraged to provide therapeutic benefit and mark the significance of this global event.

Author Correction: Patient perceptions of empathy in physician and artificial intelligence chatbot responses to patient questions about cancer

2025-06-21

David Chen , Kabir Chauhan , Rod Parsa +7 more | npj Digital Medicine

Reflection on ‘acts of resistance: Exploring undergraduate medical students’ experiences with social spaces’

2025-06-21

Muhammad Abdur Rehman , Afrah Arshad | Medical Teacher

The Art of Sacred Listening: Divine Presence and Clinical Empathy in Contemporary Medical History Taking

2025-06-20

Julian Ungar-Sargon | Journal of Religion and Theology

Entrevista a la Dra. Virgina Aspe Armella

2025-06-20

Cecilia Sabido Sánchez Juárez | Conocimiento y Acción

Llegué a la biblioteca unos minutos antes. El cubículo que buscaba tiene un acceso un tanto laberíntico, propio de la historia de la construcción que la alberga. Cuando llegué al … Llegué a la biblioteca unos minutos antes. El cubículo que buscaba tiene un acceso un tanto laberíntico, propio de la historia de la construcción que la alberga. Cuando llegué al lugar, la Dra. Aspe estaba trabajando. Escribía rápido, con esa letra clara y amplia que conozco bien. Decidí esperar a que se cumpliera la hora exacta para no interrumpirla. Uno reconoce cuando la mente avanza y es un crimen interrumpir ese proceso. Cuando llegó la hora me asomé nuevamente y vi que estaba hablando por teléfono, pero quise hacerle saber que ya estaba ahí y ya me atreví a tocar la puerta. Pronto terminó su conversación y me hizo pasar. Tiene una mesa ligera y mientras me saludaba, despejó el espacio para que pudiéramos trabajar las dos. Ese gesto generoso que invita a colaborar, a construir juntas. Le mostré la grabadora que traje para el encuentro y que nos permitiría dialogar con libertad (pese a lo que diga Walter Benjamin). Hay algo intransferible en el encuentro, compuesto por el respeto y la cercanía.

Poetry, Illness, and Medicine

2025-06-20

| Cambridge University Press eBooks

Virtual Reality as a Tool for Empathy Training in Healthcare Education: A Protocol for a Systematic Review of Qualitative Studies

2025-06-20

Ravi Shankar , Fiona Devi , Qian Xu

Abstract Background Virtual reality (VR) technology has emerged as a promising tool for experiential learning in healthcare education, with particular interest in its potential to foster empathy by allowing learners … Abstract Background Virtual reality (VR) technology has emerged as a promising tool for experiential learning in healthcare education, with particular interest in its potential to foster empathy by allowing learners to embody the patient perspective. Empathy is crucial for therapeutic alliance, patient satisfaction, and health outcomes, yet research consistently documents its decline as students progress through medical training. The COVID-19 pandemic has accelerated the adoption of immersive technologies and highlighted the importance of humanistic care. However, the feasibility, acceptability, and impact of VR empathy interventions are not yet well established. Objectives This systematic review aims to comprehensively synthesize qualitative evidence on the use of VR for empathy training in healthcare education. The review seeks to understand the feasibility, acceptability, and perceived impact of VR empathy interventions from the first-hand perspectives of learners, educators, and VR developers. Specifically, it will explore how VR empathy interventions are designed and implemented, examine learner experiences and engagement factors, identify perceived impacts on empathy and related outcomes, investigate facilitators and barriers to curriculum integration, and synthesize stakeholder-identified implementation considerations and best practices. Methods and Analysis A comprehensive search will be conducted across nine electronic databases (PubMed, Web of Science, Embase, CINAHL, MEDLINE, The Cochrane Library, PsycINFO, ERIC, Scopus) from inception to June 2025, supplemented by gray literature sources. Empirical qualitative studies focusing on VR interventions to foster empathy among healthcare students and professionals will be included using the SPIDER framework for eligibility criteria. Two reviewers will independently screen studies, extract data using a standardized form, and appraise methodological quality using the Critical Appraisal Skills Programme (CASP) qualitative checklist. Thematic synthesis will be employed to analyze and interpret findings, moving beyond simple aggregation to generate new insights and hypotheses. The review will be conducted according to PRISMA and ENTREQ guidelines, with the protocol registered in PROSPERO (CRD42025637500). Discussion Understanding how to optimize VR empathy training in healthcare education is timely and significant given the persistent challenges in maintaining empathy throughout medical training and the accelerated adoption of digital technologies. This review will provide actionable insights to ensure the thoughtful development and implementation of VR as an empathy-fostering tool. By synthesizing granular insights into participant experiences across diverse educational contexts, the findings can inform evidence-based instructional design, professional development for educators, and institutional support for VR initiatives. The review will also identify current gaps and challenges to guide a strategic research agenda for maximizing the impact of this emerging educational technology in cultivating a healthcare workforce equipped with both technical skills and human capacities needed for person-centered care.

Does the level of realism of clinical simulators have an influence on empathy in Dentistry students?

2025-06-20

Begoña Bartolomé Villar , María Fernández-Borque , Ana de la Hoz Calvo +1 more | Educación Médica

Tensions in Patient and Family Partner Storytelling in Clinical Education: Navigating the Who, What and How of Knowing

2025-06-19

Qian Wu , Latika Nirula , Helen Sklarz +2 more | The Clinical Teacher

ABSTRACT Introduction Increasingly, patient and family partners (PFPs) are asked to tell their stories in clinical education. Recognizing that current inclusion practices may not meaningfully shift power relations among PFPs, … ABSTRACT Introduction Increasingly, patient and family partners (PFPs) are asked to tell their stories in clinical education. Recognizing that current inclusion practices may not meaningfully shift power relations among PFPs, clinical teachers and learners, we sought to understand how power influences PFP storytelling in clinical education, with a focus on the tensions that PFPs may experience related to the knowledge that they hold and their status as knowers. Methods We recruited 11 PFP volunteers from an academic hospital in Toronto, Canada, to share their personal healthcare story in response to a prompt, participate in a semistructured interview and complete an online demographic survey. We used reflexive thematic analysis to gain insights into knowledge‐related tensions that participants grappled with when creating their stories for clinical education. Results Our findings illustrate the tensions PFP storytellers experienced regarding their identities as knowers, their lived experience as valid knowledge and acceptable ways to share their knowledge in the contexts of clinical education. PFP storytellers had to negotiate their identities as knowers, seek an epistemic space for their lived experience and balance their personal emotions with social expectations of how one should or should not feel and express emotion. Conclusions We argue that meaningful, equitable and ethical inclusion of PFPs and their stories in clinical education requires renewed understandings of and approaches to the knowledge that PFPs hold and share in clinical education.

The active white coats: a costume studies approach to the performance of medicine in Life Matters (2019)

2025-06-19

Yixuan Gao | Studies in Theatre and Performance

… it’s also the way that you do it

2025-06-19

Simon Gay | Education for Primary Care

Mesmer and the Triad of Body, Mind and Spirit

2025-06-19

| Journal of Clinical Medical Research

Allow me, reader, a reflection before starting a consultation with my patient. Over the years, I have performed many surgeries. Procedures that require experience, given their complexity and postoperative recovery. … Allow me, reader, a reflection before starting a consultation with my patient. Over the years, I have performed many surgeries. Procedures that require experience, given their complexity and postoperative recovery. I have accompanied patients throughout their rehabilitation, which at times has extended due to everyone’s age and/or physiology. There have also been times when I’ve sensed the emergence of my patient’s mental state. Fears, anxieties and preoperative depression all impact the patient’s eventual recovery to some degree. Today, it’s no secret the importance we physicians place on the physical body, the mind and the spirit. A couple of centuries ago, this triad was merely a shadow of its full potential.

Role of Attitude, Ethics, and Communication Module in Assessing Communication Skills among 1st-year Indian Medical Students

2025-06-18

Surajit Kundu , Richa Gurudiwan , Samta Tiwari +1 more | Bengal Physician Journal

Virtual and Augmented Reality in Undergraduate Medical Education in Psychiatry: A Systematic Review

2025-06-18

Joanne Rodda , Hanna Mansi , Jacob Fernando‐Sayers +2 more | The Clinical Teacher

ABSTRACT Background Simulation is widely used in medical education in all specialties; in psychiatry, it usually relies on standardised patients played by actors. Virtual and augmented reality (VR and AR) … ABSTRACT Background Simulation is widely used in medical education in all specialties; in psychiatry, it usually relies on standardised patients played by actors. Virtual and augmented reality (VR and AR) have the potential to provide standardised and replicable clinical experiences for learners. Aims The aim of this study was to evaluate the available literature regarding the use of VR and AR simulation in undergraduate medical education in psychiatry. Methods The review was registered on PROSPERO (CRD42024527726) and followed PRISMA guidelines. Three electronic databases were searched using a pre‐designed search string for studies of VR and AR in undergraduate medical student psychiatry education. Primary studies of any design were included. Two authors independently screened all references and extracted data. Learning methods and outcome measures were reported according to Kirkpatrick's training evaluation model. Methodological quality was evaluated using standardised tools. Results Searches yielded 7550 references, of which 19 studies from nine different countries were included. Learner satisfaction was generally positive, particularly with higher fidelity simulations. Fewer studies investigated changes in knowledge and skills; some reported improvements, which were often self‐reported by students. Positive changes in learner attitudes, especially empathy and stigma reduction, were also reported. Most studies were based on single interventions. Conclusions VR and AR simulation may be a useful addition to undergraduate psychiatry curricular teaching. However, significant gaps remain, including lack of long‐term outcome data, limited evaluation of behavioural change and predominance of single‐exposure interventions. Further research of the broader inclusion of VR and AR into teaching programmes will help to establish their value.

Storytelling as a transformative tool: how narrative-based teaching reshapes clinical education outcomes in vocational nursing internships

2025-06-18

Xiao Le , Dengshan Peng , Jiahao Zhong +5 more | Frontiers in Medicine

Background Traditional clinical apprenticeships in Chinese vocational nursing education often inadequately address professional identity development. This study evaluates the effectiveness of narrative pedagogy in enhancing professional identity and clinical competencies … Background Traditional clinical apprenticeships in Chinese vocational nursing education often inadequately address professional identity development. This study evaluates the effectiveness of narrative pedagogy in enhancing professional identity and clinical competencies among vocational nursing interns. Objective To evaluate the impact of narrative teaching interventions on two primary outcomes: professional identity development and clinical competency acquisition among vocational nursing interns. Methods Using stratified cluster randomization, 82 clinical interns from a tertiary hospital were allocated to either: Observation group ( n = 42) received biweekly narrative teaching sessions incorporating storytelling, role-playing, reflective writing, and clinical application cycles. Control group ( n = 40) standard one-on-one apprenticeship training. Post-intervention evaluations utilized the Nurse Professional Identity Scale, the Nursing Intern Core Competency Scale, and a custom teaching evaluation form. Results The observation group significantly outperformed the control group in professional identity and core competency dimensions ( P &lt; 0.001), with notable improvements in personal traits and clinical skills. They also excelled in learning interest, teamwork, and clinical thinking ( P &lt; 0.05). Conclusion Narrative-based teaching enhances vocational nursing students’ professional identity, competencies, and internship quality, offering a valuable model for emotional and professional development.

Culturally responsive approaches to cultivate care and innovation among emerging public health leaders for ethical community engagement: perspectives informed through lived experience

2025-06-18

M. Hernandez , Ruth Murcia | Frontiers in Public Health

Traditional methods of public health research, practice, and education continue to overlook the value of multidisciplinary approaches to research, practice, and training in addressing health problems. Students who graduate from … Traditional methods of public health research, practice, and education continue to overlook the value of multidisciplinary approaches to research, practice, and training in addressing health problems. Students who graduate from public health programs gain insufficient exposure to other fields of study and lack the leadership skills to effectively navigate interprofessional teams. Generally, public health programs do not adequately prepare students to engage with scholars from other fields such as humanities, ethnic studies, gender studies, etc. whose dynamic perspectives have not traditionally been considered in public health frameworks. Students, thus, become professionals who are ill-equipped to apply transdisciplinary approaches that critically examine the complex landscape of social health determinants and evolving health crises. Moreover, emerging student leaders with intimate connections to communities of interest are forced to shed their identities to conform to public health “best practices.” We aim to strengthen leadership development in public health programs through innovative research methods and collaborative pedagogies. We critique the conceptualization of “interdisciplinarity” within the public health field, demonstrate the potential of innovative methods to responsibly engage with culturally diverse communities, and propose strategies to strengthen community-researcher collaboration to foster more robust leadership skills among public health scholars. Our recommendations integrate diverse tools and resources from other fields of study that will achieve more equitable health solutions.

Empathy in Adults with Acquired Brain Injury: a Systematic Review and Meta-Analysis

2025-06-18

Emily Clements , Kristin Naragon‐Gainey , Michael Weinborn +4 more | Neuropsychology Review

Abstract Empathy is the ability to recognise, share and understand others’ emotional states. Increasing evidence suggests that empathy may be impacted by acquired brain injury (ABI), with consequences for social … Abstract Empathy is the ability to recognise, share and understand others’ emotional states. Increasing evidence suggests that empathy may be impacted by acquired brain injury (ABI), with consequences for social and emotional functioning. However, the literature has been characterised by inconsistent findings and small sample sizes. To address these limitations, we provide the first meta-analytic review of empathy in adults with ABI. Specifically, the review aimed to quantify the degree of impairment in adults with ABI across four empathy-related domains: cognitive, affective, empathic concern (e.g. sympathy) and personal distress. We also sought to estimate the prevalence of deficits in each area and explore whether demographic and injury factors moderate impairment. A systematic search yielded 29 studies measuring self-reported empathy in adults with ABI versus healthy, matched peers. A series of random-effects meta-analyses revealed moderate deficits in cognitive empathy (Hedges’ g = − 0.68, 95% CI [− 0.87, − 0.50]) and affective empathy (Hedges’ g = − 0.43, 95% CI [− 0.65, − 0.21]), as well as small-to-moderate deficits in empathic concern (Hedges’ g = − 0.38, 95% CI [− 0.63, − 0.13]). No significant difference was found for personal distress. We estimated the proportion of ABI participants scoring equal to or more than 1 SD below the normative mean to be 15.3–35.0%, depending on the empathy subcomponent. Our results highlight that empathy deficits may play an important role in functional or emotional difficulties post-brain injury. This demonstrates the need for routine clinical assessment of empathy in survivors of brain injury and the need to develop interventions which target both cognitive and affective components.

Empathy in technologically mediated patient-provider communication: a phenomenological and postphenomenological exploration

2025-06-17

Elisabeth Assing Hvidt , Finn Olesen | Philosophy Ethics and Humanities in Medicine

This theoretical paper aims to explore empathy in the context of technologically mediated patient-provider communication, specifically within the context of video- and telehealth consultations. Over the past few decades, empathy … This theoretical paper aims to explore empathy in the context of technologically mediated patient-provider communication, specifically within the context of video- and telehealth consultations. Over the past few decades, empathy has been recognized as a vital component of high-quality patient care, often prioritizing the cognitive over the emotional dimensions of empathy. As healthcare increasingly embraces digital communication technologies, including video consultations, the dynamics of empathy in clinical encounters are altered. With this paper we explore the pertinent question: how do new digital communication modalities impact on empathy and its different dimensions? To address the above question, we move beyond clinical and applied empathy frameworks instead integrating insights from two related philosophical traditions. First, the classical phenomenological understanding of empathy (represented primarily by Edith Stein) as embodied intuition. Second, the postphenomenological philosophy of technology, represented by Don Ihde and not least inspired by Maurice Merleau-Ponty's phenomenology of embodiment. We apply these theoretical frameworks to empirical analyses of video consultations in general practice and telemedical encounters between chronic obstructive pulmonary disease (COPD) patients and specialist telenurses. Our analysis demonstrates that even though video consultations do not allow for the same level of "fine-tuned" body-mediated sensory input, a whole-body empathetic experience can nevertheless be established through (1) the audio-visual sensory impressions that are being mediated by the technology, (2) our whole-body interpretations of this information and (3) our shared experiences of a lifeworld that we actively orient ourselves towards. These experiences may lead to empathetic communication and helping actions that draw on both emotional, intuitive and cognitive dimensions in a holistic manner. Combining theoretical insights from phenomenology and postphenomenology with empirical telehealth analyses, we demonstrate how empathy is both reconfigured through technological mediation and sustained as an embodied, intersubjective practice. We thus conclude that empathetic care practices can be established in technologically mediated encounters through bodily intentionality where our bodies and minds are unified in understanding and connecting with other persons, even though we are not in the same physical space. We propose a theoretical bridge, connecting classical phenomenology and postphenomenology in the context of empathy in technologically mediated patient-provider communication. This bridge is grounded in Merleau-Ponty's conception of whole-body perception and the lifeworld whether through physical proximity or digital interaction.

Integrating patient-centered learning strengthens concept mastery, problem-solving, and patient awareness in undergraduate immunology

2025-06-16

Dawn W. Cleveland , Sarah Sletten | Frontiers in Education

Background Immunology is a complex subject that students and instructors often find challenging. Active learning (AL) strategies, particularly patient-centered learning (PCL) within a team-based learning (TBL) framework, may enhance student … Background Immunology is a complex subject that students and instructors often find challenging. Active learning (AL) strategies, particularly patient-centered learning (PCL) within a team-based learning (TBL) framework, may enhance student engagement and conceptual understanding while fostering clinical reasoning and empathy development. Methods This study examines the effectiveness of PCL case studies in an undergraduate immunology course at a public R1 university. Students engaged in multi-day case studies, analyzing patient histories, symptoms, diagnostic results, and treatment plans while integrating foundational immunology concepts. Data were collected through end-of-course evaluations, including a Likert-scale item (quantitative) and two open-ended questions (qualitative). Results Students reported high agreement (mean = 4.72, SD = 0.74) that PCL enhanced their understanding of immunology. Thematic analysis of open-ended responses revealed six key learning outcomes, including real-world application, critical thinking, preparation for medical careers, and patient connection. Additionally, students identified diagnostic reasoning, problem-solving, and teamwork as skills gained. However, empathy was not explicitly mentioned, suggesting a need for more structured reflection-based activities in undergraduate coursework. Conclusion PCL improves concept mastery, clinical reasoning, and diagnostic skills in undergraduate immunology education. However, while case studies introduced patient-centered elements, students did not self-report increased empathy. Future course designs should incorporate intentional scaffolding of empathy development, such as guided reflections and interprofessional discussions, to better integrate scientific knowledge with humanistic awareness.

Beyond the bunker: Pursuing my passion for patient experience

2025-06-14

Carmen Chan | Journal of medical imaging and radiation sciences

Learning end-of-life care: Outcome measures of a medical student humanities curriculum

2025-06-13

R. B. Jenkins , Erin Gentry Lamb | Medical Teacher

Purpose: Medical humanities education varies widely and lacks robust outcomes data, grounded partly in disagreement over the appropriateness of quantitative assessment for this topic. End-of-life education likewise lacks standardization, and … Purpose: Medical humanities education varies widely and lacks robust outcomes data, grounded partly in disagreement over the appropriateness of quantitative assessment for this topic. End-of-life education likewise lacks standardization, and learners consistently desire improvement. Methods: We created a humanities intervention to teach foundational end-of-life concepts then taught it electively to 42 preclinical second-year medical students (MS2s). All MS2s (n = 182) completed quantitative end-of-life skills assessments, including a novel standardized patient (SP) encounter. Post-encounter measures included the Revised Collett-Lester Fear of Death Scale (CL-FODS), PANAS-X emotional reactivity scales, and student and SP performance assessments; students also completed the CL-FODS longitudinally during the year and gave summative curricular preparedness feedback. Results: Intervention students reported higher death anxiety than controls when measured longitudinally, but lower death anxiety immediately after the SP encounter. SPs assessed intervention students performed worse on jargon use and respect for autonomy versus controls. At end-of-year, intervention students rated their curricular preparedness better than controls. All other measures including other performance skills and the PANAS-X showed no differences. Conclusions: Intervention students showed mixed results on death anxiety suggesting task-specific and cognitive more than affective benefits. These results suggest a need for further refinement of quantitative pedagogical evaluation of humanities curricula.