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(de Velasco R)

Raul de Velasco interviewed by Edwin Rutsch

Empathy Training for Our Medical Students
by Raul de Velasco

"Types of Interventions that have been shown to enhance empathy:[1]

1. Patient Interview Training.
The most comprehensive method to do this, in my opinion, was  developed by Richard Frankel[2] He takes advantage of the patient interview to develop The Four Habits Method. According to him the third habit is to demonstrate empathy. He defines empathy quite similarly to the one used by Hoffman and Carl Rogers. He has developed a method for teaching and testing it.

2. Communication Skills Training.
is mostly about behavioral changes that both enhance the student's empathy and the perception by the patient of the student's empathy. Can be measured via different methods mainly through observation of behavior and self assessment.  It goes beyond patient interviewing. [3] [4]

3. Interpersonal skills training.
It emphasizes the teaching of empathic listening.[5]

4. Exposure to Literature, poetry, theatrical performances, films and the creative arts.
Several studies have shown improved in the affective part of empathy but not in the cognitive part. Use of the Humanities section in JAMA, On Being a Doctor in the Annals of Internal Medicine, Literature and Medicine, The journal
of Medical Humanities etc.etc… This, I think, should be started in Pre-Med but could be supplemented by vignettes in PBL or similar venues. [1]

5.Writing poetry, short stories, blogging, drama and reflective writing.
This seemed to increase the affective type of empathy, increasing scores in BEES not on ECRS.

6. Drama or how to act-in role.
showing students how to act as if you were really empathic. Improvement in empathy was not sustained. It may help to 'act' when we are exhausted and stressed out, it is fake or surface empathy instead of actual or deep empathy and may back fire. [2] [3]

7. Incorporate empathy and communication skills in PBL .
Found only one article from Turkey. [4]

8. Stress management, meditation skills and self-care [5]

9. Exposure to role models,
main problem is  shortage in the number of  appropriate role models among medical school faculty. Difficult to validate

10. Experiential learning interventions.
The students actual experiences of patients medical conditions as if they were patients. "


1. Samantha, A and others. Teaching Empathy to Medical Students: An Updated, Systematic Review. Academic Medicine, 88 (8)/ August 2013

2. Riess, H and others. Empathy Training for Resident Physicians: A Randomized Control Trial of a Neuroscience-Informed Curriculum. Journal General Internal Medicine 27 (10): 1280-6, 2012.

3. Neumann, M. and others. Analyzing the "nature" and "specific effectiveness" of clinical empathy: A Theretical overview…Patient Education and Counseling. 74 339-346, 2009.

4. Frankel, R and Stein. Getting the Most out of the Clinical Encounter: The Four Habits Model. The Permanent Journal/Fall 1999/Volume 3 No 3.

5. Bayne, H Training Medical Students in Empathic Communication. The journal for Specialists in Group Work, Vol 36. #4 December 2011, 316-329.

6. Shield, R Teaching communication and compassionate care skills…Medical Teacher 33:e408-e416. 2011.

7. Bruneau, T. Empathy and Listening: A Conceptual Review… International Journal of Listening, Taylor and Francis. 1-20, 1989.

8. Charon, R Narrative Medicine A Model for Empathy, Reflection, Profession, and Trust. JAMA , October 17, 2001- Volume 286, #15, page 1897

9. Finestone, H. Acting in medical practice The Lancet Vol344 Sept 17, 1994.

10. Teng Lim, B. "Being-in-role": A teaching innovation to enhance empathic communication skills in medical students. Medical Teacher 33, e663-e669, 2011.

11. Karaoglu, N. Looking for winds of change with a PBL scenario about communication and empathy. HealthMED. Volume 5/#3. 2011

12. Epstein, R. Mindful Practice JAMA Sept. 1, 1999–Vol 282, #9

Pedersen Empathy References

Methods Outline