Empathy in medical students: analysis as a function of the undergraduate period and sociodemographic profile

Pachêco, Carla Suzane Góes; Costa, Antônio Carlos Silva

doi:10.1590/1981-5271v46.3-2021043.ING

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Revista Brasileira de Educação Médica

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ORIGINAL ARTICLE • Rev. bras. educ. med. 46 (03) • 2022 • https://doi.org/10.1590/1981-5271v46.3-2021043.ING copy

Empathy in medical students: analysis as a function of the undergraduate period and sociodemographic profile

Authorship SCIMAGO INSTITUTIONS RANKINGS

Abstract:

Introduction:

Empathy, considered one of the most remarkable characteristics of great medical professionals, is the central element of the doctor-patient relationship and of person-centered care.

Objective:

To investigate how levels of empathy are manifested in medical students throughout their undergraduate course.

Method:

This is a quantitative, analytical, observational and cross-sectional study, carried out in a private higher education institution, located in the northeast of Brazil. The research was carried out by applying the Jefferson Scale of Empathy-Student version (JSE-S) and the correlation of the data obtained in the scale with the undergraduate school period and sociodemographic profile of the students, aiming to verify which correlations were significant for the expression of students’ empathy levels, as well as whether there is an erosion during training. Data collection took place between the months of October and November 2020. The study assessed 193 participants, including students attending the first year, an intermediate year and last year of the medical course. The sampling method used was by accessibility and convenience.

Results:

The global average score of the level of empathy in the group of all study participants (n = 193) was 123.56 ± 11.73. Whereas, by period, it was 124.78 ± 9.85 for first-year students, 124.00 ± 11.87 for intermediate-year students and 120.63 ± 13.57 for last-year students. There was no statistical difference between global scores or by psychometric factor when comparing the three studied groups. As for the correlation of JSE-S with the sociodemographic profile, the variables female gender and reason for choosing the course due to vocation were predictors of higher empathy scores.

Conclusion:

There was no evidence of empathy erosion regarding the levels of empathy among medical students throughout their undergraduate course, and female students and those who chose the course because they felt they had a vocation for Medicine showed significantly higher levels of empathy. More studies on this topic are essential, considering the importance of a balanced technical-scientific-humanistic posture to enable a medical practice of excellence.

Keywords:
Empathy; Students Medical; Education, Medical; Physician-Patient Relationship

		95% Confidence Interval
Factor	JSE-S items	JSE-S Average Score	Lower Limit	Upper Limit	Standard deviation	p-value
Compassionate Care (CC)	1,2,7,8,11,12,14,15,16,19,20	72.32	71.43	73.20	6.23	0.999
Capacity to put yourself in the patient’s shoes (CPPS)	3,6	9.49	9.09	9.89	2.83	0.178
Perspective Taking (PT)	4,5,9,10,13,17,18	41.76	40.92	42.60	5.91	0.687
Global Score	All (n = 193)	123.56	121.89	125.23	11.73	0.314

Variables	First-year students (n=55)		Intermediate cycle-students (n=100)		Last-year students (n=38)		Total (n=193)
	F	%	F	%	F	%	F	%
Age group (years)
<18	3	5.5	0	0	0	0	3	1.6
18-24	38	69.1	62	62	10	26.3	110	57
25-29	7	12.7	26	26	22	57.9	55	28.5
30-35	4	7.3	10	10	2	5.3	16	8.3
36-40	2	3.6	1	1	4	10.5	7	3.6
>40	1	1.8	1	1	0	0	2	1
Gender
Male	16	29.1	37	37	6	15.8	59	30.6
Female	39	70.9	63	63	32	84.2	134	69.4
Marital status
Married	6	10.9	7	7	4	10.5	17	8.8
Separated	0	0	1	1	0	0	1	0.5
Single	47	85.5	91	91	33	86.9	171	88.6
Stable relationship	2	3.6	0	0	1	2.6	3	1.6
Widowed	0	0	0	0	0	0	0	0
Other	0	0	1	1	0	0	1	0.5
Do you have children?
No	52	94.5	93	93	36	94.7	181	93.8
Yes	3	5.5	7	7	2	5.3	12	6.2
Religion
Catholic	30	54.6	63	63	21	55.2	114	59
Spiritist	5	9.1	6	6	3	7.9	14	7.3
Evangelical	7	12.7	10	10	4	10.5	21	10.9
None	11	20	20	20	8	21.1	39	20.2
Jehovah’s Witness	1	1.8	0	0	0	0	1	0.5
Other	1	1.8	1	1	2	5.3	4	2.1
Family Income (in minimum wages)
Up to 4	11	20	12	12	4	10.5	27	14
5-10	15	27.2	40	40	13	34.2	68	35.3
11-15	14	25.5	18	18	8	21.1	40	20.7
16-20	6	10.9	13	13	4	10.5	23	11.9
>20	9	16.4	17	17	9	23.7	35	18.1
Type of Housing
Student residence	1	1.8	0	0	0	0	1	0.5
Lives with parents	23	41.8	33	33	12	31.6	68	35.3
Rented Residence	6	10.9	18	18	7	18.4	31	16.1
Financed residence	3	5.5	3	3	1	2.6	7	3.6
Own residence	21	38.2	46	46	18	47.4	85	44
Other	1	1.8	0	0	0	0	1	0.5
Student loan
No	41	74.5	41	41	7	18.4	89	46.1
Yes	14	25.5	59	59	31	81.6	104	53.9
History of severe/chronic disease in the family
No	32	58.2	40	40	11	28.9	83	43
Yes	23	41.8	60	60	27	71.1	110	57
Do you have a disease or are exposed to any health condition that you consider to be impacting?
No	51	92.7	89	89	33	86.8	173	89.6
Yes	4	7.3	11	11	5	13.2	20	10.4
Father’s level of education
Higher Education	24	43.7	47	47	15	39.4	86	44.5
Postgraduate studies	13	23.6	20	20	6	15.8	39	20.2
Elementary school	5	9.1	8	8	2	5.3	15	7.8
Preschool	0	0	1	1	0	0	1	0.5
High school	13	23.6	23	23	13	34.2	49	25.4
Did not attend school	0	0	1	1	2	5.3	3	1.6
Other	0	0	0	0	0	0	0	0
Mother's level of education
Higher Education	23	41.8	40	40	18	47.4	81	42
Postgraduate studies	26	47.3	40	40	14	36.8	80	41.4
Elementary school	1	1.8	4	4	0	0	5	2.6
Preschool	0	0	0	0	0	0	0	0
High school	5	9.1	16	16	5	13.2	26	13.5
Did not attend school	0	0	0	0	1	2.6	1	0.5
Other	0	0	0	0	0	0	0	0
Do you have any paid activity
No	44	80	87	87	15	39.5	146	75.6
Yes	11	20	13	13	23	60.5	47	24.4
Reason for choosing the medical course
Social Contribution	19	34.5	29	29	8	21.1	56	29
Vocation	31	56.4	59	59	22	57.8	112	58
Labor market	3	5.5	6	6	5	13.2	14	7.3
Other people’s influence	1	1.8	3	3	1	2.6	5	2.6
Financial advantage	0	0	1	1	0	0	1	0.5
Other	1	1.8	2	2	2	5.3	5	2.6
In which area of medicine do you want to work?
Surgical area	22	40	21	21	6	15.8	49	25.4
Clinical area	15	27.3	46	46	26	68.4	87	45.1
I do not know	18	32.7	33	33	6	15.8	57	29.5

				95% Confidence Interval
Variables	Frequency	Percentage (%)	JSE-S Average Score	Lower Limit	Upper Limit	Standard deviation
Undergraduate school period
First-year students	55	28.5	124.78	122.12	127.44	9.85
Intermediate-year students	100	51.8	124.00	121.64	126.36	11.87
Last-year students	38	19.7	120.63	116.17	125.09	13.57
Age group (years)
<18	3	1.6	126.33	113.59	139.08	5.13
18-24	110	57.0	123.25	121.13	125.36	11.21
25-29	55	28.5	124.18	120.85	127.51	12.33
30-35	16	8.3	125.00	118.46	131.54	12.27
36-40	7	3.6	117.43	101.98	132.88	16.70
>40	2	1.0	129.50	34.20	224.80	10.61
Gender*
Female	134	69.4	124.69	122.78	126.60	11.18
Male	59	30.6	121.00	117.71	124.29	12.61
Family Income (in minimum wages)
Up to 4	27	14.0	125.15	120.42	129.88	11.95
5-10	68	35.2	123.84	120.66	127.02	13.14
11-15	40	20.7	122.30	118.58	126.02	11.62
16-20	23	11.9	122.70	118.78	126.61	9.06
>20	35	18.1	123.80	120.11	127.49	10.73
Reason for choosing the medical course**
Vocation	112	58.0	125.88	123.93	127.83	10.41
Social Contribution	56	29.0	122.45	119.77	125.12	9.99
Labor market	14	7.3	117.07	108.71	125.44	14.49
Other people’s influence	5	2.6	116.40	93.68	139.11	18.29
Personal wish	1	0.5	...	...	...	...
Vocation and Social Contribution and Labor market	1	0.5	...	...	...	...
I like it	1	0.5	...	...	...	...
Financial advantage	1	0.5	...	...	...	...
Social Contribution and Labor Market	1	0.5	...	...	...	...
Total	193	100	140

Reasons for choosing the medical course	p-value
Social contribution versus Vocation	0.328
Social contribution versus Labor market	0.597
Vocation versus Labor market	0.028*
Other people’s influence versus Vocation	0.346
Other people’s influence versus Social contribution	0.999
Other people’s influence versus Labor market	0.999

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[1] Chief Editor: Rosiane Viana Zuza Diniz. Associate editor: Pedro Tadao Hamamoto Filho.