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A systematic review of tests of empathy in medicine
  • Joanne M Hemmerdinger,
  • Samuel DR Stoddart
  • Richard J Lilford
 25 July 2007

This page still needs to be processed,  The list of measurements needs to be incorporated into the 



Empathy is frequently cited as an important attribute in physicians and some groups have expressed a desire to measure empathy either at selection for medical school or during medical (or postgraduate) training. In order to do this, a reliable and valid test of empathy is required. The purpose of this systematic review is to determine the reliability and validity of existing tests for the assessment of medical empathy.


A systematic review of research papers relating to the reliability and validity of tests of empathy in medical students and doctors. Journal databases (Medline, EMBASE, and PsycINFO) were searched for English-language articles relating to the assessment of empathy and related constructs in applicants to medical school, medical students, and doctors.


From 1147 citations, we identified 50 relevant papers describing 36 different instruments of empathy measurement. As some papers assessed more than one instrument, there were 59 instrument assessments. 20 of these involved only medical students, 30 involved only practising clinicians, and three involved only medical school applicants. Four assessments involved both medical students and practising clinicians, and two studies involved both medical school applicants and students.

Eight instruments demonstrated evidence of reliability, internal consistency, and validity. Of these, six were self-rated measures, one was a patient-rated measure, and one was an observer-rated measure.


A number of empathy measures available have been psychometrically assessed for research use among medical students and practising medical doctors. No empathy measures were found with sufficient evidence of predictive validity for use as selection measures for medical school. However, measures with a sufficient evidential base to support their use as tools for investigating the role of empathy in medical training and clinical care are available.


Additional file 2: Empathy tests identified.  
A summary of the tests identified by the review, illustrating the presence or absence of evidence concerning reliability and validity. 

  •  ACGME- Accreditation Council for Graduate Medical Education
  • ARS- Affect Reading Scale
  • ATH- Attitudes towards Humanities
  • BEES- Balanced Emotional Empathy Scale
  • BEM - Burn’s Empathy Measure
  • BLRI- Barrett-Lennard Relationship Inventory
  • CACS- Coordination and Competence System
  • CARE- Consultation and Relational Empathy Measure
  • CMQ- Career Motivation Questionnaire
  • CSA IPS- Clinical Skills Assessment and Interpersonal Skills
  • DIRI- Davis’ Interpersonal Reactivity Index
  • DIRI (R) – Revised version of DIRI
  • ECCS- Empathic Communication Coding System
  • ECRS- Empathy Construct Rating Scale
  • ECRS ADAPTED- Empathy Construct Rating Scale (With half of the original version of 84 items)
  • EI- Emotional Intelligence
  • EIS – Emotional Intelligence Scale
  • EMP- Empathy Scale
  • ES- 10 Item Empathy Scale
  • ESM – Emotional Speech Measure
  • ET- Empathy Test
  • FHCS – Four Habits Coding Scheme
  • FY SCALE- Femininity Scale of the Personal Attributes Questionnaire
  • GE-PAQ- German Extended Personal Attributes Questionnaire
  • HRI- Helping Relationship Inventory
  • IPS- Interpersonal Skills Rating Scale
  • JSPE- Jefferson Scale of Physician Empathy
  • LCIAS – Liverpool Clinical Interaction Analysis Scheme
  • MAAS- Maastricht Anamnestic Scoring List- Global
  • MCI- Medical Communication Index
  • MCRS- Medical Condition Regard Scale
  • MCSDS- Marlowe Crowne Social Desirability Scale
  • MIPS- Medical Interaction Processing System
  • MPCC – Measure of Patient-Centred Communication
  • MSQ(M) – Maxwell-Sullivan Questionnaire (modified)
  • NACE – Narcissism, Aloofness, Confidence, Empathy scale
  • OSCE- Objective Structured Clinical Examination
  • QPP- Quality from the Patient’s Perspective Questionnaire
  • RES- Reynolds’ Empathy Scale
  • RIAS- Roter Interaction Analysis System
  • RSE- Rosenberg Self Esteem Scale
  • SOC-13- Sense of Coherence Scale
  • TFA- Tolerance for Ambiguity
  • TMMS- Trait Meta-Mood Scale.

Empathy tests with evidence concerning reliability, internal consistency, and validity 

  • Medical Condition Regard Scale (MCRS) 
  • Jefferson Scale of Physician Empathy (JSPE)
  • Davis’ Interpersonal Reactivity Index (DIRI) 
  • Empathy Test (ET) 
  • Empathy Construct Rating Scale (ECRS) 
  • Balanced Emotional Empathy Scale (BEES) 
  • Consultation and Relational Empathy (CARE)  
  • Four Habits Coding Scheme (FHCS) 


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