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(Batt-Rawden + 2013)*


  • DOI or Website Link:  http://dx.doi.org/10.1097/ACM.0b013e318299f3e3  
    Full Text  
    Publication:  Academic Medicine, 88, 1171–1177
    Authors:   
    • Batt-Rawden, S. A.,
    •  Chisolm, M. S., 
    • Anton, B., 
    • Flickinger, T. E.
    Date:    (2013).
    Affiliation(s):  
    Citation: 
    Batt-Rawden, S. A., Chisolm, M. S., Anton, B., & Flickinger, T. E. (2013). Teaching empathy to medical students: An updated, systematic reviewAcademic Medicine, 88, 1171–1177. http://dx.doi.org/10.1097/ACM.0b013e318299f3e3    

    Comments: 
    Reviewed in Meta-study (BATT-RAWDEN + 2013)*  (physicians/medical education)
    • Reviewed in  Meta-study  (KELM+ 2014)*  
    • (18 Evaluated) (healthcare) 

    Abstract:   

    PURPOSE:
    Some research shows that empathy declines during medical school. The authors conducted an updated, systematic review of the literature on empathy-enhancing educational interventions in undergraduate medical education.

    METHOD:
    The authors searched PubMed, EMBASE, PsycINFO, CINAHL, Scopus, and Web of Science (January 1, 2004 through March 19, 2012) using key words related to undergraduate medical education and empathy. They independently selected and reviewed all English-language articles that described an educational intervention designed to promote empathy in medical students, assessing the quality of the quantitative studies using the Medical Education Research Study Quality Instrument (MERSQI).

    RESULTS:
    The authors identified and reviewed the full texts of 18 articles (15 quantitative and 3 qualitative studies). Included interventions used one or more of the following-patient narrative and creative arts (n=7), writing (n=3), drama (n=1), communication skills training (n=4), problem-based learning (n=1), interprofessional skills training (n=1), patient interviews (n=4), experiential learning (n=2), and empathy-focused training (n=1). Fifteen articles reported significant increases in empathy. Mean effect size was 0.23. Mean MERSQI score was 10.13 (range 6.5-14).

    CONCLUSIONS:
    These findings suggest that educational interventions can be effective in maintaining and enhancing empathy in undergraduate medical students. In addition, they highlight the need for multicenter, randomized controlled trials, reporting long-term data to evaluate the longevity of intervention effects. Defining empathy remains problematic, and the authors call for conceptual clarity to aid future research.

    Quotes: (Any pithy quotes)


    Topic Area: (In which field / sector / perspective was this study conducted?)


    Definition(How was empathy defined?)


    Benefits(Were any benefits of empathy mentioned?)

    Criticisms  (Were any criticisms, negative effects or risks of empathy mentioned?)


    Methods(What were the methods used to train empathy?)
    • Patient narrative and creative arts interventions.
    • Writing interventions.
    • Drama interventions.
    • Communication skills training interventions.
    • Problem-based learning intervention.
    • Interpersonal skills training intervention.
    • Patient interview interventions.
    • Experiential learning interventions.
    • Empathy intervention.

    Target Group:  (Who participated in this study / training?)


    Measurements(About the assessment: How was the change in empathy measured before/after the intervention/method?) 

    "Of the 15 quantitative studies, 
    • 12 used validated outcome measures in various combinations. 
    • Nine studies employed self-report questionnaires—
    • 7 studies used the JSPE,9,13,14
    • 1 study used the Empathy Tendency Scale (ETS)51,52 and the Empathic Skill Scale (ESS),51,52and 
    • 1 study used the BEES16 and the ECRS.18
    • Two studies employed observed measures—1 used CARE19 from the point of view of first-person patient assessors, and another used the Staff–Patient Interaction Rating Scale (SPIR)53 from the point of view of third-person assessors. 
    • The remaining 4 studies used nonvalidated, self-report measures developed by the study investigators."

    Result: (What was the result?)


    Posted By:  
     

    Notes:  
    (Any other relevant information)


    * Papers Evaluated in Meta-Study:

    61. Bayne HB. Training medical students in empathic communication. J Spec Group Work. 2011;36:316–329

    * 63. Bombeke K, Van Roosbroeck S, De Winter B, et al. Medical students trained in communication skills show a decline in patient-centred attitudes: An observational study comparing two cohorts during clinical clerkships. Patient Educ Couns. 2011;84:310–318
    *  71. Bunn W, Terpstra J. Cultivating empathy for the mentally ill using simulated auditory hallucinations. Acad Psychiatry. 2009;33:457–460
    (DASGUPTA + 2004)
    *  56. DasGupta S, Charon R. Personal illness narratives: Using reflective writing to teach empathy. Acad Med. 2004;79:351–356

    *  64. Fernández-Olano C, Montoya-Fernández J, Salinas-Sánchez AS. Impact of clinical interview training on the empathy level of medical students and medical residents. Med Teach. 2008;30:322–324
    *  65. Karaoglu N, Seker M. Looking for winds of change with a PBL scenario about communication and empathy. Health Med. 2011;5:515–521
    Cited Here...

    (KOMMALAGE 2011)
    *   69. Kommalage M. Using videos to introduce clinical material: Effects on empathy. Med Educ. 2011;45:514–515
    *  59. Lim BT, Moriarty H, Huthwaite M. “Being-in-role”: A teaching innovation to enhance empathic communication skills in medical students. Med Teach. 2011;33:e663–e669
    (MULLEN + 2010)
    * 67. Mullen K, Nicolson M, Cotton P. Improving medical students’ attitudes towards the chronic sick: A role for social science research. BMC Med Educ. 2010;10:84
    *  54. Muszkat M, Yehuda AB, Moses S, Naparstek Y. Teaching empathy through poetry: A clinically based model. Med Educ. 2010;44:503
    Cited Here...

    *  58. Rosenthal S, Howard B, Schlussel YR, et al. Humanism at heart: Preserving empathy in third-year medical students. Acad Med. 2011;86:350–358

     (SHAPIRO + 2004)
    *  55. Shapiro J, Morrison E, Boker J. Teaching empathy to first year medical students: Evaluation of an elective literature and medicine course. Educ Health (Abingdon). 2004;17:73–84

    (SHAPIRO + 2006)
    *  57. Shapiro J, Rucker L, Boker J, Lie D. Point-of-view writing: A method for increasing medical students’ empathy, identification and expression of emotion, and insight. Educ Health (Abingdon). 2006;19:96–105

    (SHAPIRO +2009)
    70. Shapiro SM, Lancee WJ, Richards-Bentley CM. Evaluation of a communication skills program for first-year medical students at the University of Toronto. BMC Med Educ. 2009;9:11

    * 66. Tiuraniemi J, Läärä R, Kyrö T, Lindeman S. Medical and psychology students’ self-assessed communication skills: A pilot study. Patient Educ Couns. 2011;83:152–157

    *  60. Van Winkle LJ, Fjortoft N, Hojat M. Impact of a workshop about aging on the empathy scores of pharmacy and medical students. Am J Pharm Educ. 2012;76:9
    *  72. Varkey P, Chutka DS, Lesnick TG. The aging game: Improving medical students’ attitudes toward caring for the elderly. J Am Med Dir Assoc. 2006;7:224–229

    * 68. Yuen JK, Breckman R, Adelman RD, Capello CF, LoFaso V, Reid MC. Reflections of medical students on visiting chronically ill older patients in the home. J Am Geriatr Soc. 2006;54:1778–1783









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    *  54. Muszkat M, Yehuda AB, Moses S, Naparstek Y. Teaching empathy through poetry: A clinically based model. Med Educ. 2010;44:503
    *  55. Shapiro J, Morrison E, Boker J. Teaching empathy to first year medical students: Evaluation of an elective literature and medicine course. Educ Health (Abingdon). 2004;17:73–84


    (DASGUPTA + 2004)
    *  56. DasGupta S, Charon R. Personal illness narratives: Using reflective writing to teach empathy. Acad Med. 2004;79:351–356

    (SHAPIRO + 2006)
    *  57. Shapiro J, Rucker L, Boker J, Lie D. Point-of-view writing: A method for increasing medical students’ empathy, identification and expression of emotion, and insight. Educ Health (Abingdon). 2006;19:96–105


    (ROSENTHAL + 2011)
    *  58. Rosenthal S, Howard B, Schlussel YR, et al. Humanism at heart: Preserving empathy in third-year medical students. Acad Med. 2011;86:350–358
    *  59. Lim BT, Moriarty H, Huthwaite M. “Being-in-role”: A teaching innovation to enhance empathic communication skills in medical students. Med Teach. 2011;33:e663–e669
    *  60. Van Winkle LJ, Fjortoft N, Hojat M. Impact of a workshop about aging on the empathy scores of pharmacy and medical students. Am J Pharm Educ. 2012;76:9
    61. Bayne HB. Training medical students in empathic communication. J Spec Group Work. 2011;36:316–329
    62. Norfolk T, Birdi K, Walsh D. The role of empathy in establishing rapport in the consultation: A new model. Med Educ. 2007;41:690–697
    * 63. Bombeke K, Van Roosbroeck S, De Winter B, et al. Medical students trained in communication skills show a decline in patient-centred attitudes: An observational study comparing two cohorts during clinical clerkships. Patient Educ Couns. 2011;84:310–318


    (FERNANDEZ-OLANO 2008)
    *  64. Fernández-Olano C, Montoya-Fernández J, Salinas-Sánchez AS. Impact of clinical interview training on the empathy level of medical students and medical residents. Med Teach. 2008;30:322–324
    *  65. Karaoglu N, Seker M. Looking for winds of change with a PBL scenario about communication and empathy. Health Med. 2011;5:515–521

    * 66. Tiuraniemi J, Läärä R, Kyrö T, Lindeman S. Medical and psychology students’ self-assessed communication skills: A pilot study. Patient Educ Couns. 2011;83:152–157


    (MULLEN + 2010)
    * 67. Mullen K, Nicolson M, Cotton P. Improving medical students’ attitudes towards the chronic sick: A role for social science research. BMC Med Educ. 2010;10:84

    (YUEN + 2006) (Yuen + 2006) 
    * 68. Yuen JK, Breckman R, Adelman RD, Capello CF, LoFaso V, Reid MC. Reflections of medical students on visiting chronically ill older patients in the home. J Am Geriatr Soc. 2006;54:1778–1783


    (KOMMALAGE 2011)
    *   69. Kommalage M. Using videos to introduce clinical material: Effects on empathy. Med Educ. 2011;45:514–515

    (SHAPIRO +2009)
    70. Shapiro SM, Lancee WJ, Richards-Bentley CM. Evaluation of a communication skills program for first-year medical students at the University of Toronto. BMC Med Educ. 2009;9:11
    *  71. Bunn W, Terpstra J. Cultivating empathy for the mentally ill using simulated auditory hallucinations. Acad Psychiatry. 2009;33:457–460
    *  72. Varkey P, Chutka DS, Lesnick TG. The aging game: Improving medical students’ attitudes toward caring for the elderly. J Am Med Dir Assoc. 2006;7:224–229

    73. Schonfield J, Donner L. Student psychotherapists’ specialty choices and changes in their perceptions of self and patient. J Med Educ. 1972;47:645–651


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