Cognitive and behavioural empathy: are 4th and 6th medical students different?
摘要
Several authors have reported that medical students’ empathy declines over time as they start their clinical work. However, such observations, performed in cross-sectional or longitudinal studies, were mainly based on self-reports measuring cognitive/affective empathy. The aim of the study was to measure both the cognitive and affective dimensions of empathy as well as and behavioural empathy between fourth- and sixth-year medical students.
MethodsFourth- and sixth-year medical students at the Faculty of Medicine in Geneva were invited to partake to a videotaped formative objective structured clinical examination (OSCE) with standardized patients (SPs). They were asked to fill in the Cognitive and Affective Empathy Scale (QCAE) (31–124 scale) and Jefferson Scale of Empathy (JSE- Student version; 20–140 scale) measuring the cognitive/affective dimensions of empathy. Based on the videotapings, students’ verbal empathy was measured using the Verona Coding Definitions of Emotional Sequences (VR-CoDES-P). Nonverbal behaviour was assessed along five dimensions, using a 1–5 Likert scale. Differences of scores between fourth- and sixth-year medical students were analysed using analyses of variance (ANOVA).
Results26 fourth-year and 30 sixth-year medical students participated. Their mean scores on two different self-reported cognitive/affective empathy scales were similar (mean ± standard deviation: Jefferson: 114.65 ± 8.17 vs. 116.97 ± 8.56; p = 0.308) (QCAE: 91.46 ± 9.98 and 94.93 ± 9.64; p = 0.192). There is some evidence that fourth year medical students expressed more verbal empathy in response to patients’ cues and concerns than sixth year medical students (0.28 ± 0.19 vs. 0.18 ± 0.15; p = 0.028). There was no difference in nonverbal behaviour between the two groups of students (18.90 ± 2.33 vs. 18.80 ± 2.79; p = 0.92).
ConclusionsThere was no difference of scores in self-reported scales of cognitive/affective empathy between fourth and sixth-year medical students. Differences in behavioural empathy observed between fourth- and sixth- year medical students seemed to be due to changes in verbal empathy more than in nonverbal behaviour.