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(Nasr Esfahani 2014)

DOI or Website Link:

Publication:  Medical Journal of the Islamic Republic of Iran,  Vol. 28:65.

Authors:   Mehdi Nasr Esfahani, Mojgan Behzadipour, Amirhossein Jalali Nadoushan,

Seyed Vahid Shariat

Date:   2014 (14 July)


Nasr Esfahani, M., Behzadipour, M., Jalali Nadoushan, A., & Shariat,  S.V. (2014). A pilot randomized controlled trial on the effectiveness of inclusion of a distant learning component into empathy training. Medical Journal of the Islamic Republic of Iran, 28(65).

Abstract:   (Cut and pasted)

 Background: Studies have shown a gradual decline in empathy of medical trainees with increasing years of education. Methods to augment empathy show some promise, but the most effective methods are both expensive and time consuming. To assess effectiveness of communication skills training program as a distant learning method in improving empathy.

 Methods: Fourteen first year residents of psychiatry were randomly allocated to either participate in a two day workshop on communications skills (attending group) or to watch the videotape of the first day and participate in the second day (distance learning group). Assessments included Jefferson Scale of Empathy (JSE) and objective assessment of empathy (OAE) during a simulated interview, before and 3 months after the training.

 Results: The empathy was significantly increased in the attending group as measured by OAE. The score of JSE also increased in the attending group but did not reach a significance level. No increase in empathy was seen in the distance learning group.

 Conclusion: Watching the videotape of the workshop is not effective in improving empathy of residents. More interactive methods should be sought if we plan to use distance learning methods in enhancement of empathy.

Topic Area:

Emotional engagement as well as cognitive understanding

Benefits for treatment outcome and patient satisfaction

  • Cut and pasted:

Our intervention included a training workshop of communication skills, which was taught by an experienced academic psychiatrist on two days with a one week interval. Each day of the workshop lasted 6 hours. First day of the workshop included a 2 hour lecture on basic communication skills and one role playing on “clinical setting and basic communication skills in therapeutic relationship”. The second day of the workshop included two different role plays on “getting information from patient” and “giving information to patient”. All of the role plays of the two day workshop were performed twice; first, with some mistakes and negative points in the performance of the “physician”, and then in a professionally correct manner. After the “flawed” performance, residents discussed the negative points with the instructor. Furthermore, each session ended with a group discussion on the topics of that session.

One group attended both days live. A second group viewed a videotape of the first day and read a text, but attended only the second day live (the distance learning group).

Target Group:  
14 first-year residents of psychiatry

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

All of the subjects completed JSE before and three months after the intervention. There was also an objective assessment (OAE) by the authors.

(What was the result?)

Three months after the training, mean JSE score increased by more than 2 units in the attending group, but this change was not significant, probably due to our small sample size.

The score of OAE significantly increased in the attending group, and showed no change in distance learning group.

This pilot study suggests that a two day communication skills workshop can be effective in improving empathy of the first year residents of psychiatry after three months. However, participating in one of the two days of this workshop and watching the videotape of the other day is not effective in improving empathy.

This is the first study on improvement of empathy with a distance learning component. There was an issue of noncompliance in the distance learning group - some did not do their homework!

Face to face interaction seems to be an essential component of empathy training, and finding an alternative for it in distance learning seems to be the major challenge.

Further research on adding distance learning components to empathy training could focus on other more interactive methods or some aspects of virtual reality to the program.

Posted By:  Dorothy Della Noce
(Any other relevant information)


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