Empathy can be divided into cognitive empathy (CE) and affective empathy (AE). CE is defined as the accurate understanding and appropriate response to others' thoughts whereas AE is defined as the accurate understanding and appropriate response to others' emotions. The overall purpose of this systematic review and meta-analysis is to assess the effectiveness of empathy interventions in physicians and physicians-in-training in increasing CE and AE. Specifically, we are interested in examining whether specific teaching methods and intervention designs may contribute to greater empathy intervention effectiveness for CE and AE outcomes.

Studies searched included randomized controlled trials conducted between 1971 to 2022 examining empathy interventions for medical students and physicians. Thirty-six studies, consisting of 3,833 participants, met the inclusion criteria. Data were analysed using random-effects pairwise meta-analysis.

Empathy interventions have moderate effect sizes on both CE [d = .50 (95% CI = .30, .70)] and AE [d = .46 (95% CI = .30, .62)]. Heterogeneity of effects was evident for both analyses. The effectiveness of interventions on AE was moderated by measurement type. Intervention effectiveness was not significantly moderated by other intervention and study characteristics for either type of empathy.

There is evidence of key differences, and similarities, in how CE and AE is taught to medical students and professionals; however, the small number and high level of heterogeneity in studies makes this difficult to confirm. Research in this field will benefit from investigators standardizing teaching and research methods across studies.

[26 May 2025]: This article was published in Early View in error. The article is under embargo and will republish in December 2025.

Empathy is a key factor in the medical field as it strengthens doctor-patient relationships, enhances communication, and leads to improved patient outcomes. This study aims to investigate the empathy levels of medical students, providing insights into the factors that influence these levels and using advanced analytical methods for accurate predictions.

The study was conducted with 322 medical students from a public university in Turkey. A relational screening model was applied, using a "Personal Information Form" and an "Empathy Scale" to gather data. CHAID analysis was employed to identify the key predictors influencing empathy levels, whereas machine learning algorithms were utilized to classify and predict individuals' empathy levels.

The analysis revealed that 41.3% of students displayed high empathy, 44.7% moderate empathy, and 14.0% low empathy. Factors such as parental education, maternal occupation, and gender were significant in determining empathy levels, with gender being the most influential. The machine learning models achieved an 80.1% accuracy in predicting empathy levels.

The findings indicate that targeted educational and social interventions, especially those addressing gender differences, could improve empathy in medical students, potentially leading to better patient care.

Not applicable, as this study does not report results from a health care intervention involving human participants.

Medicine is inherently a humanistic profession. However, recent studies have emphasised the need for medical students to develop humane attitudes and behaviours. Breaking bad news is also one topic where a humanistic approach needs to be developed. The purpose of this study is to investigate the effects and differences between drama and the standardised patient (SP) method in objective structured clinical examinations (OSCEs) on fostering a humanistic approach in breaking bad news. This is a comparative case study, a qualitative research method, encompassing content analyses of observer notes and transcripts of audio recordings from debriefing sessions. The study includes fifth-year medical students from Karadeniz Technical University Faculty of Medicine, with 20 volunteer students participating as the sample. The listed students, those with odd numbers, were assigned to the SP-based OSCE group, while those with even numbers were assigned to the drama-based OSCE group. Data was analysed using Creswell's content analysis approach. A total of 20 students participated in the study, with half evaluated through SP-based OSCEs and the other half through drama-based OSCEs. A comparative analysis of drama-based and SP-based OSCE debriefings revealed unique strengths and challenges. Drama-based OSCEs fostered empathy, emotional engagement and reflective practice, aiding students in managing emotions. SP-based OSCEs enhanced structured communication but sometimes led to emotional desensitisation and performative empathy. Overall, the drama method proved to be a more humanistic approach effective in nurturing natural empathy and supportive communication, particularly in breaking bad news. This study highlights the strengths of drama-based OSCEs in fostering empathy and emotional engagement while maintaining structured communication frameworks. By directly comparing drama and SP methods, our findings underscore the potential of drama-based approaches to enhance humanistic medical education and patient communication. Integrating the complementary strengths of both methods into medical training can better prepare students for compassionate, effective patient interactions, addressing both emotional and technical aspects of clinical care.

Medical students frequently grapple with challenges during their studies, including emotional impacts, career socialization, psychiatric comorbidities, and burnout syndrome. Burnout syndrome profoundly influences mental and physical health, impacting patient care. Within this complex landscape, elevated stress levels specifically manifest in increased cynicism, reduced idealism, and other mental health issues. The simultaneous decline of empathy during medical education adds a layer of complexity. Understanding these dynamics and the potential protective factors is crucial for addressing students' well-being and optimizing curriculum development.

The present study comprised third-year and fifth-year Hungarian medical students from the University of Pécs in a partially cross-sectional, partially longitudinal investigation conducted at two time points (2018/19: 124 third-years; 127 fifth-years; 2020/21: 82 third-years; 37 fifth-years). All medical students were sampled in the given year of the selected semester (third-year students at the first timepoint were asked once again as fifth-year students at the second timepoint). In addition to descriptive statistics, structural equation modelling was used to assess the impact of time, role model, perceived stress, empathy, and burnout on medical students.

The analysis indicated that there was a significant increase in cynicism during the institutional socialization of medical students. While there was only partial support for the reduction in the perception of patient-centered role models during institutional socialization, the findings indicated that the perception of patient-centered role models and empathy acted as protective factors mitigating cynicism. Unexpectedly, the analysis found an increase in stress and cynicism over time, possibly influenced by factors such as the COVID-19 pandemic.

The study's findings indicate a rise in cynicism among medical students over time that could threaten future doctor-patient relationships. The findings emphasize the protective role of empathy and patient-centered role models, emphasizing the need for humanistic integration in medical education.

Training in spirituality and spiritual care is limited in medical education. A potentially novel approach for addressing these gaps in medical training is an immersive, experiential internship focused on patient spirituality and spiritual care based on pedagogical approaches adapted from clinical pastoral education (CPE).

Mixed method analyses were undertaken of participants pre- and post-program surveys and comments to assess the first five years of the six-week Spirituality And Health Summer Internship Program, modeled on a unit of CPE, for first-year medical students.

On a 5-point Likert scale (1 = poor/strongly disagree, 5 = excellent/strongly agree) participants rated the educational value (4.7, standard deviation [SD] = 0.3) and overall quality (4.4, SD = 0.35) of the internship highly and strongly endorsed they would recommend the internship to peers (4.48, SD = 0.36). Participants strongly valued (4.58, SD = 0.35) the opportunity to visit and have conversations with patients as a core activity of the internship. Following the internship, participants reported significant (p = 0.013 to p < 0.0001) increases in their (1) awareness of how spirituality influences their lives, (2) knowledge of the potential impact of spirituality on the patient experience, and (3) knowledge of the role of spirituality in the lives of health care providers. Significant increases were also noted in participants' comfort in (1) talking to patients, (2) talking about spirituality, and (3) talking to patients about spirituality.

A medical student summer internship focused on patient spirituality and spiritual care modeled after CPE provides a level of immersion in this content not obtainable in typical medical school curricula.

Empathy plays a pivotal role in healthcare professions, influencing patient satisfaction and treatment outcomes. Understanding the determinants of empathy in medical students is essential. However, findings from previous studies have been inconsistent. We hypothesized that part of this variability may be attributed to the influence of the geo-sociocultural context. In this study, we aimed to compare the longitudinal determinants of empathy in four cohorts of medical students from two distinct geo-sociocultural backgrounds.

This study included 199 medical students from Porto Alegre, Brazil and Geneva, Switzerland who were in their 1 st and 4 th years of training and agreed to participate on both occasions. The outcome variable was empathy scores (total and subdimensions) assessed through the Jefferson Scale of Empathy for Medical Students (JSE-S). Independent variables included gender, personality, motives for studying medicine, specialty preferences, and the level of motivation for medical studies. Multivariate regression analyses were conducted to investigate the associations between independent variables and empathy at each site in years 1 and 4.

In year 1, the personality trait openness to experience was associated with higher empathy (total score) in both Porto Alegre (b = 0.503, p ≤ 0.01) and Geneva (b = 0.592, p ≤ 0.001), with this association persisting over time. However, the relationships between empathy and the other independent variables varied significantly depending on the site.

The determinants of empathy were significantly modulated by the geo-sociocultural context. The personality trait openness to experience was the only consistent determinant of empathy across both sites over time. Associations between empathy and gender, motives for studying medicine, and specialty preferences were site specific. Our findings underscore the importance of considering students' backgrounds when assessing empathy teaching and learning.

The field of mental well-being interventions includes numerous studies of smartphone app-based programs, but there is a research-to-retail gap where many studies pertain to apps that are not publicly available, not used as standalone programs, or not tested in the general population, and many publicly available apps (or their proprietary in-app measures) have yet to be submitted to empirical testing. Furthermore, few well-being apps offer multicomponent interventions, despite such interventions having demonstrated efficacy outside the smartphone context. In response to these openings in the literature and marketplace, we have developed ReNeuWell, an iPhone app designed to measure the user's mental well-being (via the validated Composure, Own-worth, Mastery, Positivity, Achievement and Satisfaction for Well-being (COMPAS-W) scale) and improve their well-being via a personalised, multicomponent program of activities informed by the peer-reviewed evidence base. This article describes the protocol for the preregistered randomised controlled trial (RCT) of ReNeuWell, to test the app in adult participants from the general population of Apple App Store users. It is hypothesised that ReNeuWell users will experience significant increases in mental well-being and decreases in mental distress over the 6-12-week trial period, relative to users of an active control version of the app.

The RCT will recruit participants from Apple Store users who choose to download ReNeuWell in the normal course of browsing the marketplace. Following consent, the app will randomly allocate participants to receive either the full version of the app or the active control version. The full version assesses the user's well-being via the validated COMPAS-W scale, provides feedback on their well-being across six dimensions and creates a personalised schedule of daily positive psychology activities designed to enhance well-being along each dimension. Participants will be instructed to use the app for at least 10 min (at least one activity) per day for the first 6 weeks, and as they wish for the following 6 weeks. Trial outcomes will be measured via in-app surveys administered in weeks 1, 6 and 12. Data collection will begin when the app is officially launched on the Apple Store. Data will be analysed using linear mixed models to estimate condition-by-time interaction effects on the primary and secondary outcomes, and to assess whether any such effects are themselves moderated by other key variables.

This protocol has been approved by the Human Research Ethics Committee of the University of New South Wales (reference number: HC210302). Trial outcomes will be published in accordance with the preregistered protocol described here, both in the peer-reviewed literature and on the registry website.

This protocol was preregistered with the Australian New Zealand Clinical Trials Registry (registration approved on 4 August 2021; trial ID number: ACTRN12621001014842p).

Virtue-based ethics prioritizes phronesis (practical wisdom) because, as rules have become less action-guiding, good judgment (phronesis) becomes more necessary as a guiding meta-virtue. The view of phronesis that MacIntyre proposed in After Virtue (hereafter, AV phronesis) has been applied in medical ethics despite his substantial deviations from his source (Aristotle) in After Virtue. In this paper, we clarify the differences between the neo-Aristotelian and AV phronesis views and argue for a neo-Aristotelian phronesis with four functions (constitutive, adjudicative, emotion regulative, and blueprint). In referring to neo-Aristotelians, we refer to the recent scholars that who hark back strongly to Aristotle and have amended some of Aristotle's less palatable views by adding insights from current empirical science to the domains that he left vague. Then we discuss how AV phronesis and neo-Aristotelian phronesis differ, focusing on the distinction between technical (i.e., alterable means toward patient health such as medication choices) and phronetic (i.e., actions that are inseparable from patient health) actions in medicine. This distinction is understated in AV phronesis, but central to neo-Aristotelian phronesis. Accordingly, the neo-Aristotelian approach makes an important and unique contribution to physician ethical development.

The purpose of this study is to assess changes in empathy throughout a Doctor of Pharmacy (PharmD) program using a self-assessment tool and assessment by standardized patients (SPs).

This study was conducted over the course of a three-year, accelerated PharmD curriculum. Students participated in a series of educational interventions focused on empathy development within the didactic curriculum. Within the experiential curriculum, students applied empathy skills and participated in interprofessional workshops during their experiential rotations. Self and SP assessed empathy was measured at baseline and upon conclusion of the study.

PharmD students' self-rated empathy did not meaningfully change over the three-year period while SP-rated empathy increased.

Students were able to demonstrate empathetic behaviors as perceived by the SPs, even though they did not change their self-ratings from baseline. This difference may be due to students' ability to demonstrate empathetic behaviors without feeling higher levels of empathy or a decline in empathy due to burnout.

To examine the relationship between cancer patients' perceptions and oncology nurses' self-assessments of communication skills and empathy, and investigate the influence of patients' factors on these perceptions.

This cross-sectional study used a paired sampling approach (1:2 ratio) with 168 oncology nurses and 336 cancer patients. It assessed patients' perceptions and nurses' self-assessments of nurse-expressed communication and empathy. The study examined the relationship with patients' demographic (age, gender, education level, occupational status, and marital status), clinical (length of hospital stay and physical functional status), and psychosocial factors (religious beliefs and presence of family caregiver).

Patients reported moderate levels of communication (Mean [M] = 54.73, Standard deviation [SD] = 8.97) and empathy (M = 21.94, SD = 6.93). No significant correlation was found between patients' and nurses' perceptions of communication (r = -.041, p = .362) and empathy (r = -.014, p = .419). Lower patient-perceived communication and empathy were associated with higher education level, poor physical functional status, longer hospital stays (>15 days), being unmarried, and absence of family caregivers (only in communication perception) (all p < .05).

Cancer patients' and oncology nurses' perceptions of communication and empathy were not significantly correlated. Length of hospital stay, physical functional status, marital status, presence of family caregivers, and education level significantly influenced patients' perceptions. Future interventions should focus on vulnerable groups and adapting to patients' changing needs during extended hospital stays.

This article considers the ways in which empathy for patients and related solidarity with communities may be trained out of medical students during medical school. The article focuses especially on the pre-clinical years of medical school, those that begin with orientation and initiation events such as the White Coat Ceremony. The ethnographic data for the article come from field notes and recordings from my own medical training as well as hundreds of hours of observant participation and interviews with medical students over the past several years. Exploring the framework of language socialization, I argue that learning the verbal, textual and bodily language of medical practice contributes to the increasing experience of separation between physicians and patients. Further considering the ethnographic data, I argue that we also learn a form of empathy limited to performance that short circuits clinical care and the possibility for solidarity for health equity. The article concludes with implications for medical education and the medical social sciences and humanities.

Empathy is a crucial skill that enhances the quality of patient care, reduces burnout among healthcare professionals, and fosters professionalism in medical students. Clinical practice and standardized patient-based education provide opportunities to enhance empathy, but a lack of consistency and reproducibility as well as significant dependency on resources are impediments. The COVID-19 pandemic has further restricted these opportunities, highlighting the need for alternative approaches. Virtual patients through standardized scenarios ensure consistency and reproducibility while offering safe, flexible, and repetitive learning opportunities unconstrained by time or location. Empathy education using virtual patients could serve as a temporary alternative during the COVID-19 pandemic and address the limitations of traditional face-to-face learning methods. This review aims to comprehensively map existing literature on the use of virtual patients in empathy education and identify research gaps.

This scoping review will follow the Joanna Briggs Institute's guidelines and be reported according to PRISMA-P. The search strategy includes a comprehensive search across databases such as PubMed (MEDLINE), CINAHL, Web of Science, Scopus, ERIC, Google, Google Scholar, and Semantic Scholar, covering both published and gray literature without language restrictions. Both quantitative and qualitative studies will be included. Two independent researchers will screen all titles/abstracts and full texts for eligibility. Data will be extracted to summarize definitions of empathy, characteristics of virtual patient scenarios, and methods for measuring their impact on empathy development. Results will be presented in narrative and tabular formats to highlight key findings and research gaps.

As this review analyzes existing literature, ethical approval is not required. Findings will be actively disseminated through academic conferences and peer-reviewed publications, providing educators and researchers with valuable insights into the potential of virtual patients to enhance empathy in medical education. This study goes beyond the mere synthesis of academic knowledge by contributing to the advancement of medical education and clinical practice by clarifying virtual patient scenario design and evaluation methods in empathy education. The findings provide a critical foundation for our ongoing development of a medical education platform aimed at enhancing empathy through the use of virtual patients.

Traditional empathy teaching methods fall short in addressing the heightened empathy demands of in-service postgraduate nurses. Art-based approaches offer potential solutions.

We adopted a mixed method study with a quasi-experimental design. Two groups of in-service postgraduate nurses participated in narrative (n = 14) and visual (n = 13) arts interventions. Participants underwent four 45-minute sessions, including theory lectures and art-based interventions. Pre- and postcourse questionnaires assessed empathy and psychological capital.

The narrative arts group showed increased resilience (t = -2.775, p = .016) and secondary traumatic stress (t = -2.320, p = .037) postcourse. The visual arts group showed enhanced compassion satisfaction (t = -3.431, p = .005). Qualitative analysis identified two themes: empathy among participants and the benefits and challenges of the curriculum.

Incorporating both narrative and visual arts into nursing education could enhance empathy and well-being. Narrative arts enhanced resilience but increased secondary traumatic stress. Visual arts improved compassion satisfaction and offered a calming experience. [J Contin Educ Nurs. 2025;56(2):78-84.].

Empathy is an important construct in patient-physician relationships, particularly critical in family physicians' daily practice. We aimed to understand how empathy has been conceived and integrated into family medicine postgraduate training.

Medline, PsyINFO, and Embase were searched in this systematic mixed studies systematic review. Two independent reviewers screened abstracts and full texts. Disagreements were solved through research team consensus-based discussion. Included studies were synthesized thematically.

A total of 18 studies were included. Four themes were identified. (1) Empathy definition. Included studies stressed the cognitive component of empathy, paired either with a behavioural or an affective response. (2) Empathy modifiers. Starting residency right after medical school, having a role model, having high empathy levels before residency, having children, being married, and being exposed to patient involvement in education were found to have a positive impact on empathy. (3) Empathy-burnout relationship. Whereas greater burnout was related to lower empathy levels, excess empathy seems to favour burnout through 'compassion fatigue.' (4) Educational programs for empathy development. Five programs were identified: a communication workshop, a patient-led program, a mindfulness program, a family-oriented intervention, and an arts-based program.

Studies mostly measured the cognitive component of empathy. The moral component of empathy was underrepresented in the conceptualization of empathy and the development of educational interventions. Conflicting evidence exists regarding the decline of empathy levels during the family medicine residency. Longitudinal designs should be privileged when exploring the evolution of empathy levels across the continuum of medical education.

This study investigates the differences between in-person versus virtual format of an advanced communication skills OSCE through thematic analyses of post-OSCE debrief transcripts.

Two cohorts of senior medical students participated in either a 2019 in-person or 2021 virtual advanced communication skills OSCE. Students were grouped in triads and rotated through three of five possible cases. Afterwards, students participated in a faculty-led debrief (in-person in 2019, virtual in 2021). Inductive thematic analysis was used to compare the themes and the ratio of comments related to the themes were compared between the virtual and in-person OSCEs.

Thematic analyses for both in-person and virtual OSCEs identified the same four major themes (Case Review, Emotional Response, Feedback, and Reflection) and 11 subthemes. However, the ratio of comments related to Case Review was lower in the virtual OSCE compared to in-person (P < .0001). Analysis of subthemes within Case Review revealed the percentage of comments was higher for Content and lower for Challenges in the virtual OSCE compared to in-person (both P < .0001). There were no differences in the ratios of comments related to Emotional Response, Feedback, and Reflection, or their subthemes.

A virtual advanced communications skills OSCE for medical students showed identical qualitative themes to that from a prior in-person OSCE. However, students in the virtual OSCE focused more on matter-of-fact discussions about case content and less about the challenges they experienced. The findings suggest that some medical students may struggle with experiential learning in the virtual format, and have difficulty accessing or practicing their reflective observation skills based on Kolb's learning theory. Differences may be attributable to the additional cognitive load in the virtual setting, inadequate structural safeguards, and/or other limitations of virtual communication.

Nurses are key communication partners for patients with aphasia. Nurses' skills are vital for improving the patients' environment and nursing performance. This study develops and evaluates the effectiveness of a communication training program for nurses who care for patients with aphasia.

A program was developed based on the Intervention Mapping Protocol. Then, a simulation using a standardized patient with aphasia and surveys were conducted. Program effectiveness was evaluated using a quasi-experimental framework with a non-equivalent control group and pretest-posttest non-synchronized design.

The two groups exhibited statistical significant differences in health communication competence, knowledge of aphasia, patient advocacy, clinical decision-making, and compassionate competence.

This study developed communication training for nurses who care for patients with aphasia. The effectiveness test showed that this training affected nurses' knowledge, attitude, and skills. Clearly, communication education for nurses is important to provide comprehensive care for patients with aphasia and can enhance nursing.

Given the critical role of health professionals in societal health, the development of robust and effective selection methods is of fundamental concern for educational institutions within the field of health sciences education. Conventionally, admission competencies have been determined by institutional authorities. Developing institution-specific competency criteria enables an admission process that is mission- and value-aware, evidence-based, and strategically adaptable. However, few schools have established their admission competency criteria, although the majority possess their own models of graduation competencies. This study reports the process of developing and validating an institution-specific admission competency model that addresses the need for evidence-based and mission-aligned selection processes that are distinct from standardized models.

This study was conducted in two phases, using both qualitative and quantitative analyses. Phase I involved constructing an admission competency model through a qualitative approach facilitated by workshops with 17 faculty members and 92 first-year pre-doctoral students of a dental school. Through constant comparative analysis, this phase focused on the extraction and refinement of competencies for entering dental students. In Phase II, a questionnaire developed from the workshops asked respondents to rate the importance of 47 attributes across 10 constructs on a 5-point Likert scale. A total of 301 individuals participated in the survey. Exploratory Factor Analysis (EFA) identified the factor structure, and Confirmatory Factor Analysis (CFA) examined construct validity and assessed the model fit with the data.

The EFA of the 47 attributes identified 10 factors, and the CFA results indicated a good-to-acceptable level of fit for the ten-factor model. Aligned with the American Association of Medical Colleges Premed competencies, this study identified unique attributes specific to the institution, such as confidence, leadership, and entrepreneurship. These findings highlight the importance of developing tailored competencies reflecting the unique needs of institutions and their fields.

This study demonstrates the feasibility and value of creating institution-specific admission competency models, offering a methodology that aligns with evidence-based mission-driven selection processes. The distinct competencies identified emphasize the need for educational institutions to consider unique institutional and field-specific requirements and move beyond standardized models to enhance the selection of medical students.

To examine whether medical student empathy changes throughout the five years of a UK medical school.

Students completed an online version of the Jefferson Scale of Empathy (JSE-S) during the 2022-2023 academic year. Comparisons of empathy scores were made using analysis of variance (ANOVA), and independent t-tests.

Empathy scores varied across different years of medical school (P ≤ 0.001), with a small drop in empathy between the pre-clinical and clinical phases of medical school (Mean difference = 1.82, P = 0.025). Male students scored lower than female students and there was no statistically significant difference between the mean empathy score and speciality interest.

Students' empathy appeared declined slightly as they progressed through medical school. As a crucial component of good clinical care, interventions in medical education to enhance empathy should be prioritised.

This is the first time following the COVID-19 pandemic that medical student empathy was measured across all five years of a medical school. Unlike many previous related studies, we identified the point at which empathy appears to decline, providing guidance for educators who can target empathy enhancing interventions where they are most needed.

Empathy plays an important role in the interaction and communication with patients. Physicians' empathy has various positive patients' and physicians' outcomes. Despite the inclusion of empathy in medical curricula and the relevance of empathy in general and physicians' concept of it to medical care, there is no common definition of empathy in the clinical context: definitions tend to be abstract and we do not know enough about medical students' conceptualization of clinical empathy. A clear and consensual definition of empathy is needed to be able to teach and measure empathy adequately. We aimed to explore German medical students' views and understanding of (clinical) empathy.

We interviewed 24 students from the second half of the 3rd year and in their final clinical year (six female and male students in each subgroup) using a semi-structured interview guide. Interviews were digitally recorded and transcribed verbatim. We analysed the transcripts using thematic synthesis (Braun & Clarke).

We found three overarching themes: (1) empathy means perceiving and understanding patients' needs and acting accordingly, (2) empathy as an interpersonal, intangible construct and (3) taking time for patients. Showing interests, impartiality and openness towards the patients as well as the need to take patients seriously, treating them with respect, having a holistic view on patients and generate some kind of closeness with patients are subthemes of the first overarching theme.

Although it is often stated that the various existing definitions of empathy are abstract or far from practice, German medical students seem to have a good idea how to define empathy. Their definition resembles definitions known from the literature and used in education. Further research is needed to compare concepts of empathy of medical students from different countries and cultural backgrounds to inform research and teaching. It would also be interesting to investigate how concepts of empathy change over the course of study and affect perceptions of empathy in third party assessments.

Listening to stories of sickness lies at the heart of the patient-doctor relationship. Storytelling serves as a powerful learning tool fostering empathy, attentive listening, clinical curiosity and reflection, key elements of narrative competence. The patient's story, their history, forms the fundamental core of diagnosis, and their emotions are central to crafting appropriate treatment plans that address their true concerns. This study reviews the benefits of storytelling as a learning tool, particularly in enhancing empathy, attentive listening, clinical curiosity and reflection within medical education. It also describes a practical workshop that demonstrates how storytelling can be utilised to inspire students to develop narrative competence in a supportive learning environment. Since the stories draw on participants' clinical experience, in both primary and secondary care, the article aims to engage clinicians involved in medical education and the teaching of communication skills.

The authors sought to explore how a curriculum that uses a patient experience simulation followed by reflection can lead to clinical empathy in learners and whether this experience leads to behavioral change. Further, in response to critiques of common pragmatic approaches to clinical empathy teaching in which empathy is operationalized and taught through formal trainings and checklists, the study aimed to contribute insights regarding how clinical empathy may best be taught to health profession students.

Twenty-six senior medical students participated in an in situ patient experience simulation during a 4-month period in 2021-2022 in an academic emergency department. The simulation was followed by a written reflection and a structured debrief. A thematic analysis was performed on transcripts of the group debriefs.

In the group debriefs, learners described several empathetic behavioral changes they made after this intervention. First, learners discussed performing more small acts of kindness to improve patient care and humanize the patient experience. Second, learners discussed seeking to improve their communication through acknowledgment and validation of the patient experience. Finally, learners described actions to keep patients informed through frequent check-ins and setting expectations on time.

The findings suggest that empathy may not be simply transactional for health profession students and that an understanding of the patient experience leads to actions that improve the patient experience and alleviate suffering.

The aim of this study was to investigate the hypothesis that following a breast cancer patient for a day would enhance empathy in medical students.

This was a theory-testing case study of 4th year medical students completing a one week clinical attachment in breast disease in a UK University teaching hospital, in which half were assigned to an intervention of 'Follow a Patient' for a day, and the other half were controls. Reflective writing produced by the students at the end of the week was analysed using grounded theory and thematic analysis. The results were then unblinded to explore possible differences between the two groups of students.

Thematic analysis of 52 student reflections identified 14 open codes which grouped into five global themes, one of which was 'Demonstrates Empathy'. A total of 20 students demonstrated empathy in their writing, 15/27 from the study group and 5/25 from the control group, a difference that was significantly different p < .01.

This 'Follow a Patient' strategy is a useful model to include within an undergraduate curriculum to enhance medical student empathy.

Coronavirus disease (COVID)-19 had an impact on medical graduation, causing weaknesses arising from social isolation and remote emergency teaching, with an emphasis on deficits in the development of non-technical skills (soft skills). In this context, the interaction between a group of medical students and adolescents who develop activities at the Center for Learning and Mobilization for Citizenship in Campinas/SP, Brazil, was evaluated about the development of soft skills during the COVID-19 pandemic. The observational study was carried out using an electronic questionnaire based on a Likert scale on the feelings of undergraduate medical students regarding participation in project activities in the context of the development of social skills. The study demonstrated an important positive impact of student participation in a socio-educational project for the development of soft skills, emphasizing the ability to deal with adverse situations, decision-making, and the ability to deal with the fear of not corresponding. However, the existence of limitations and difficulties in the development of non-technical skills by students was revealed, further reinforced by the challenges brought by the COVID-19 pandemic. In this aspect, the study demonstrated participation in a voluntary social project as an important strategy to improve the teaching of these skills.

Empathy is essential to medical practice, and efforts to cultivate it often include incorporating liberal arts into medical curricula to promote it. However, the association between empathy and engagement in artistic practice beyond the medical curricula remains unclear. This study aims to assess the association between medical students´ empathy and their engagement in artistic activities.

Students enrolled at 11 Portuguese medical schools were invited to participate in an online survey. The survey included questions about their artistic practice, and the Interpersonal Reactivity Index (IRI) to measure empathy.

A total of 450 medical students completed the survey. 158 students (35%) were actively engaged in the arts, 118 of which practiced music (75%). Participants involved in artistic activities demonstrated significantly higher scores in the Fantasy subscale compared to their peers. Participants engaged in multiple artistic activities scored significantly higher in overall IRI, as well as in Empathic Concern and Fantasy subscales, compared to those practicing only one artistic activity. Participants who began their artistic practice earlier tended to achieve higher scores in overall IRI and on the Empathic Concern subscale.

The present study highlights a significant positive association between artistic practice and empathy levels among medical students. Further research is recommended to clarify this association, potentially informing revisions to medical school curricula.

Women medical students experience unique stressors and challenges during medical school related to inherent structural androcentric norms. Through a longitudinal qualitative study of 17 women medical students in their first two years of medical school, we sought to investigate how they navigated their medical school experience. We used a critical lens and narrative inquiry to understand their experiences within the powerful and marginalizing culture of medical school. Our participants identified two essential support groups: those relationships made within, and those sustained outside, medical school. These findings invoked a kinship framework-one where women medical students have a network of chosen kin who provide essential support for them during their first 2 years. The participants' chosen kin within medical school provided support through recognition of one another, belonging by not belonging, being encouraged to reach out, and creating long-term relationships. The chosen kin outside medical school provided support by reminding the student who they are and creating stability. Integrating models of kinship into medical school as practiced by women medical students may have immense value in providing essential supports for medical students, preventing burnout, and changing the culture of care for future physicians that would align recognition and practice of self-care with patient care.

Empathy is crucial for patient health. The Balint group is a commonly used method for empathy training. However, the impact of Balint groups on empathy remains unclear. This systematic review and meta-analysis of randomized controlled trials (RCTs) aims to assess the impact of Balint groups on empathy training among medical and nursing students, as well as doctors and nurses.

This review involved searching multiple databases for relevant articles. Rigorous eligibility criteria were applied during the screening of titles and abstracts, and during the selection of records. Following a full-text eligibility evaluation, two reviewers independently extracted data from the final selection of studies, and a meta-analysis was conducted. The standardized mean difference (SMD) was calculated to assess the systematic outcomes.

A total of 11 studies were included in this systematic review and meta-analysis. Participants in Balint groups demonstrated a significant increase in empathy than those in the control group (SMD = 1.46, 95% confidence interval [CI] 0.86-2.06; p < 0.001). Studies conducted in China (SMD = 2.13, 95% CI 1.27-2.99; p < 0.001) revealed a greater impact of Balint groups on empathy than those conducted in France (SMD = 0.24, 95% CI 0.12-0.37; p < 0.001). The impact of Balint groups was significantly greater among physicians (SMD = 2.50, 95% CI 1.79-3.21; p < 0.001) and nurses (SMD = 2.88, 95% CI 1.34-4.43; p < 0.001) compared to medical students (SMD = 0.71, 95% CI = 0.35-1.06; p < 0.001). Participants who attended ten or more sessions (SMD = 2.37, 95% CI 1.35-3.39; p < 0.001) demonstrated better outcomes compared to those who attended fewer than ten sessions (SMD = 0.79, 95% CI 0.30-1.29; p < 0.01).

Balint groups are effective for empathy training among doctors, nurses, and medical students. Future research should incorporate patient-led measurements to evaluate empathy and ascertain the long-term impact of Balint groups on empathy training.

PROSPERO registration number CRD42023488247.

Empathy is an important aspect of therapeutic relationships in health and social care settings. Health educators can foster empathy development in learners through creative writing activities. Drawing on the humanities, specifically poetry, this paper offers strategies for educators to support empathy development in learners, with a focus on service user poetry and associated creative writing activities. We discuss how poetry can enable alternative perspectives about care to emerge thereby challenging previously held assumptions about mental and physical states. Using poetry can enable a rehearsal of empathy by bringing experiences to the learner in a safe and facilitated environment. Through creative writing activities, we believe that students can learn to better understand and empathise with others, as well as explore their own feelings and experiences related to caregiving, to support self-care.

Despite the necessary focus on clinical skills and knowledge during the tertiary education of healthcare professionals, the literature highlights the importance of developing psycho-social competencies. Empathy, a cognitive-behavioral attribute linked to various benefits for patients and healthcare professionals, is one such competency. Pedagogical approaches to successfully develop empathy in tertiary healthcare students are available. However, these approaches are often integrated piecemeal throughout the tertiary education journey. Research on a more empathy-focused curriculum is scarce. This manuscript describes the design of a study that aims to examine the effects of a more empathy-focused curriculum on empathy in tertiary healthcare profession students in Singapore. Freshmen dentistry, medicine, nursing, and pharmacy students enrolled in a novel curriculum with a strong empathy focus will be recruited for the study and followed for the program's extent. Mixed-methods data collection at various time points will be conducted. Quantitative data will be collected on cognitive-behavioral empathy, intentions to provide empathic care, and engagement in courses of the curriculum. Qualitative data on perceptions of patient care and empathy in relation to relevant courses of the curriculum will be collected to provide context for quantitative findings. Ethics approval was granted by the Departmental Ethics Review Committee of the Saw Swee Hock School of Public Health, National University of Singapore (Ethics ID: SSHSPH-214).

Empathy stands as a cornerstone of humanistic qualities and is essential in healthcare for understanding and alleviating emotional suffering. Despite its necessity, formal empathy training remains elusive in postgraduate medical education across the globe, contributing to decline of humanistic practice among trainees. This study aims to assess and establish the need for empathy training by evaluating the perspectives of postgraduate trainees and faculty.

The study was conducted in a medical college of western India in 2023. Three online validated questionnaires were used to assess empathy-related perceptions among faculty and postgraduate trainees across various specialties. The questionnaires focused on demographic data, importance of empathy in patient care, empathy training, perceived levels of empathy, reasons for shortfalls in empathetic behavior and recommendations for nurturing empathy. Data were analyzed quantitatively and thematically.

A total of 150 and 127 responses were gathered and analyzed from faculty and trainees, respectively. Excessive workload, lack of formal training, and technology-dependent fast paced lifestyle were attributed for lack of empathy in clinical care. All the faculty agreed that empathy training is essential and majority (67%) believed that lack of empathetic behavior led to dissatisfaction among patients and caregivers.

Empathetic communication and behaviors are fundamental competencies for health-care professionals. There is need for a structured training for empathy in postgraduate medical curriculum.

Communication skills (CSs) and evidence-based practice (EBP) are key foundations for offering personalized and quality nursing care. CS that results in open communication is fundamental for applying EBP.

The objective of the study was to assess the relationship between the acquisition of EBP competencies and learning CS after taking an EBP course in the nursing degree.

Pre-test-post-test quasi-experimental study without a control group. The study population comprised fourth-year undergraduate nursing students. Before and after an EBP course, students completed a questionnaire on CS competence (HP-CSS) and EBP competence (EBP-COQ). The EBP course lasts for 15 weeks, with 150 h of work for the student. Out of these 150 h, 60 are conducted in person, while the remaining 90 h are for independent or group work, utilizing the flipped classroom methodology. Bivariate, correlational, pairwise Student's t-test, and linear regression multivariate analyses were performed.

The sample was composed of 153 students. After completing the EBP course, there was a statistically significant improvement in informative communication (p = 0.046) and assertiveness (p = 0.018). However, there were no observed changes in empathy, respect, and the total score of the CS competence. The results from the multivariate analysis showed that the dimensions of attitude towards EBP and EBP knowledge had a positive relation to three of the four dimensions of the CS and overall competence. Regarding the students' variables and characteristics, admission through special programs for athletes and older students (p < 0.001) and being female (p = 0.004) were positively statistically associated with empathy.

EBP training positively affects the development of CS in nursing students, as shown by significant improvements in the total scores of the CS and the dimensions of informative communication and assertiveness after the intervention. This study demonstrates the initial applicability and usefulness of an EBP training program for the development of CS in nursing students.

Empathy is an essential core competency for future doctors. Unfortunately, the medical curriculum is infamously known to burn out aspiring doctors, which may potentially lead to a decline in empathy among medical students. This research was planned to understand the evolution of empathic approaches among students across the curriculum using the Interpersonal reactivity index (IRI) as a benchmark at the Royal College of Surgeons in Ireland - Medical University of Bahrain (RCSI-MUB) and University of Sharjah (UoS).

We adopted a cross-sectional design and administered an online survey to the medical students of RCSI-MUB and UoS using a modified version of the IRI along with its three subscales of empathic concern (EC), perspective taking (PT), and personal distress (PD). To identify intra- and inter-institutional variations in empathy scores, the Analysis of Variance (ANOVA) was performed separately for each institution and with both institutions combined. A two-way ANOVA was conducted for the comparison between years and institutions. For the subscale analysis of EC, PT, and PD, we used one-way ANOVA for significant differences between years at both institutions. For the gender-effect analysis, t-test was performed to examine the differences in total IRI scores at both institutions combined and at each institution separately. Additionally, an Analysis of Covariance (ANCOVA) was done to identify the influence of gender on empathy scores.

A total of 140 students from both institutions participated in this study. We found a fluctuating pattern of empathy scores without a clear trend across the years. The sub-scales of EC, PD, and PT across academic years at both institutions showed significant differences within the EC at RCSI-MUB (p = 0.003). No significant differences were identified across other years from both institutions. There were significant differences between empathy scores from RCSI-MUB and UoS for EC (p = 0.011). Additionally, a pronounced interaction effect between year and institution was observed for PT (p = 0.032). The gender-wise analysis showed that female students had higher empathy scores than males (p = 0.004). The ANCOVA for IRI score results revealed a p-value of 0.023, indicating that gender plays a crucial role in empathy levels among medical students. The ANCOVA results revealed a p-value of 0.022 in the EC subscale.

Our study unveiled intricate patterns in empathy development among medical students across years and genders at RCSI-MUB and UoS. These congruences and dissimilarities in empathy scores signal a subjective understanding of empathy by medical students. The disparities in understanding may encourage medical educators to embed empathy in standard medical curricula for better healthcare outcomes.

The first experience of medical students in the dissecting room (DR) likely influences professional identity formation (PIF). Sparse data exist exploring how exposure to the DR and body donors without undertaking dissection influences PIF, or how culture may influence this experience. This qualitative study explored students' first, non-dissection DR experience to determine how this contributes to PIF, including the impact of culture through a Pasifika-student lens. It also explored student perspectives on what learning opportunities are unique to this experience. Medical students with no prior DR experience were recruited and then interviewed after initial engagement with the DR and body donors. Questions included participant experiences, cultural perspectives, and how the DR differed from other teaching experiences. Interviews were recorded, transcribed, and analyzed thematically. Twenty students were interviewed (mean age 22 years, 12 females; 8 Pasifika) resulting in 520 min of audio recording (mean 26 min). Four primary themes were identified: professional identity formation, educational elements, death and spirituality, and cultural perspectives. Three subthemes including student experiences, behaviors, and environment were developed within each theme. Findings indicate development of PIF likely occurs from a single engagement with body donors without undertaking dissection, including recognition of professional role. Culture can play an important role for students, with several Pasifika students viewing the DR as a "cultural purgatory". Unique learning experiences are identified, such as cultural awareness around behaviors with the dead. The experience is an educational "threshold concept" where students likely undergo substantial developments in PIF, and educational initiatives to support students are outlined.

To assess the Consultation And Relational Empathy (CARE) measure as a tool for examiners to assess medical students' empathy during Objective and Structured Clinical Examinations (OSCEs), as the best tool for assessing empathy during OSCEs remains unknown.

We first assessed the psychometric properties of the CARE measure, completed simultaneously by examiners and standardized patients (SP, either teachers - SPteacher - or civil society members - SPcivil society), for each student, at the end of an OSCE station. We then assessed the qualitative/quantitative agreement between examiners and SP.

We included 129 students, distributed in eight groups, four groups for each SP type. The CARE measure showed satisfactory psychometric properties in the context of the study but moderate, and even poor inter-rater reliability for some items. Considering paired observations, examiners scored lower than SPs (p < 0.001) regardless of the SP type. However, the difference in score was greater when the SP was a SPteacher rather than a SPcivil society (p < 0.01).

Despite acceptable psychometric properties, inter-rater reliability of the CARE measure between examiners and SP was unsatisfactory. The choice of examiner as well as the type of SP seems critical to ensure a fair measure of empathy during OSCEs.

Empathy is fundamental to the provision of efficacious patient-centered health care. Currently, there is no comprehensive synthesis of peer-reviewed empirical research related to empathy in the nutrition and dietetics profession. Understanding empathy in the context of nutrition and dietetics care may lead to improved teaching practices that support nutrition and dietetics students and practitioners to provide high-quality, empathic, patient-centered care.

This scoping review aimed to understand the approaches through which empathy is conceptualized, measured, and taught in the field of nutrition and dietetics.

Using the Preferred Reporting Items for Systematic reviews and Meta-Analyses-Scoping Reviews Statement and Checklist, a scoping review process was undertaken. Five databases were searched in February 2023: Cumulative Index to Nursing and Allied Health, Embase, Medline, PsycInfo, and Scopus, with no date limits. Eligible studies were English language-based, peer-reviewed, empirical research exploring or measuring empathy as an outcome in primary data stratified to nutrition and dietetics. Extracted qualitative data were synthesized and analyzed thematically with an inductive, interpretivist approach applied to conceptualize the interrelationship between empathy and dietetic practice. Quantitative data were extracted and summarized in a table.

Twenty-six studies were included in the scoping review. Analysis identified 2 overarching themes underpinning the current literature on empathy in nutrition and dietetics that described empathy as a key skill in the application of patient-centered care, which was supported by approaches to lifelong cultivation of empathy in the nutrition and dietetics profession. A range of tools has measured empathy in nutrition and dietetics students and practitioners with no clear consensus in findings across studies.

This review identified the extent and nature of empathy within nutrition and dietetics, from both practitioner and patient perspectives, and the vast array of approaches used to teach and quantify empathy in students and practitioners. Insights from this review inform the need for future studies. The results of this review suggest that future research include exploring implications of empathic dietetics care on patient outcomes and identification of best practice, evidence-based curricula and strategies to support sustainable cultivation and maintenance of empathic care across the career span of nutrition and dietetics practitioners.

The integration of shared decision-making (SDM) into undergraduate oncology education represents a critical evolution in medical pedagogy, reflecting the growing complexity and patient-centric focus of contemporary healthcare. This paper introduces a comprehensive pedagogical framework designed to embed SDM within the undergraduate medical curriculum, particularly in oncology, where the multiplicity of treatment options and their profound impact on patient life underscore the necessity of this approach. Grounded in a systematic literature review and aligned with established educational theories, this framework proposes twelve strategic approaches to cultivate future physicians proficient in both clinical acumen and patient-collaborative decision-making. The framework emphasizes real-world clinical experience, role-playing, case studies, and decision aids to deepen students' understanding of SDM. It advocates for the development of communication skills, ethical deliberation, and cultural competence, recognizing the multifaceted nature of patient care. The inclusion of patient narratives and evidence-based decision-making further enriches the curriculum, offering a holistic view of patient care. Additionally, the integration of digital tools within the SDM process acknowledges the evolving technological landscape in healthcare. The paper also addresses challenges in implementing this framework, such as curricular constraints and the need for educator training. It underscores the importance of continual evaluation and adaptation of these strategies to the dynamic field of medical education and practice. Overall, this comprehensive approach aims not only to enhance the quality of oncological care but also to prepare medical students for the complexities of modern medicine, where patient involvement in decision-making is both a necessity and an expectation.

Compersion is a positive emotion experienced in relation to one's partner's relationship(s) with other partner(s). Experiencing it is highly desired in communities practicing consensual non-monogamy (CNM), especially polyamory. This article presents the results of a study on compersion on Polish CNM individuals. The main goal of the study was to adapt to the Polish-speaking population the COMPERSe (Classifying Our Metamour/Partner Emotional Response Scale; Flicker et al., 2021), the first standardized quantitative scale designed to measure compersion. The analyses were performed on data obtained from 211 individuals in CNM relationships and on a comparative group of 169 people in monogamous relationships. The results of the confirmatory factor analyses suggested that the three-factor model of the original COMPERSe version did not fit well, leading to further revisions that resulted in a 7-item, two-factor solution with excellent fit, excellent internal consistency, strong divergent and convergent validity, and excellent test-retest stability. The CNM individuals were found to have higher scores on compersion and cognitive empathy and were also less jealous than the monogamous participants. Furthermore, polyamorous individuals experienced more compersion and less aversion to partner's autonomy than people in open relationships. It was also revealed that compersion indirectly predicted relationship satisfaction by decreasing jealousy and that compersion was, in turn, predicted by cognitive empathy. However, when polyamorous and open relationships were analyzed separately, compersion predicted relationship satisfaction directly, but only in polyamorous relationships; meanwhile, in open relationships, satisfaction was directly predicted by cognitive empathy.

Empathy in medical students is receiving increasing attention as it is fundamental to build and develop a functional patient-physician relationship. When looking at its determinants, demographic and academic factors seem to concur in shaping empathy in this population. Although data show strong gender differences and changes in empathy throughout medical school, it is not clear the direction of these changes and whether gender and curriculum features modulate them. This longitudinal study examined changes in empathy and explored gender differences throughout the medical school. Four consecutive cohorts of Italian medical students (N = 336) completed the Jefferson Scale of Empathy - Student (JSE-S) and the Interpersonal Reactivity Index (IRI) in their second year of study (before any clinical clerkship and communication skills courses) and fifth year of study (after a 2-year clinical clerkship and communication skills courses). Analysis of variance for repeated-measures revealed that, beyond the effect of gender, JSE-S total score and IRI Perspective Taking increased, whereas IRI Personal Distress and IRI Fantasy significantly decreased throughout medical school. No significant change in IRI Empathic Concern emerged over time. Student's t-tests showed that female students displayed significantly higher mean scores than their male counterparts for all empathy measures in both their second and fifth years of medical training. The findings suggest that the medical curriculum affects self-reported empathy dimensions among undergraduate medical students. Further research is needed to deepen the understanding of the educational factors that promote the changes in empathy levels during medical training.

Empathy is critical within medicine and improves patient outcomes and satisfaction. Empathy declines during the clerkship years due to the hidden curriculum, where students observe emotional distancing and desensitization by providers. Studies show arts curricula can preserve empathy but are limited by sample bias and preclerkship occurrence. We implemented and evaluated a brief pediatric clerkship arts curriculum to improve empathic behaviors.

We created two 1-hour required small-group sessions for pediatric clerkship medical students. The first session paired arts observation techniques with various paintings. The students then applied these techniques to video-based simulated patient interactions in the second session. We used the Toronto Empathy Questionnaire (TEQ) and an empathy behavior checklist (EBC) as pre/post assessments to gauge self-reported empathy and empathetic behaviors. We compared responses of learners who attended the sessions (curriculum group) to learners unable to attend (control group).

Thirty-four students participated in the curriculum; 19 were in the control group. Neither the control nor the curriculum group had a significant change in pre/post TEQ scores. Students with pre-TEQ scores less than 45 who participated in the curriculum had significant improvement in post-TEQ scores compared to their control group counterparts (p = .02). On the EBC, there was a significant difference between the curriculum and control groups for those who explored more about the child/family's experience (p < .05).

Our work suggests that a brief clerkship arts curriculum is useful for improving self-reported empathy ratings and empathetic skills, particularly for students identified as having below-average empathy.

To identify, critically appraise and synthesise evidence of the use and effectiveness of the arts for enhancing pre-registration/prelicensure healthcare students' empathy skills.

A systematic review of mixed methods literature.

A search of six electronic databases was conducted.

Articles describing English language, peer-reviewed, primary research studies reporting empathy as an outcome of an arts-based intervention with pre-registration/prelicensure healthcare students (years 1-7) and published between 2000 and 2024 were eligible for inclusion. The JBI Manual for Evidence Synthesis guided the review and a convergent segregated methodology was used to synthesise the results. Methodological rigour of included studies was examined using the Mixed Methods Appraisal Tool.

Twenty studies from 12 countries described the use of the arts to develop empathy, with visual arts being the most common approach (n = 8). Other modalities included film, drama, digital stories, literature, creative writing, music, poetry, photography and dance. Studies included nursing, medicine and dental, pharmacy and/or health sciences students. Ten studies used quantitative methods, three qualitative, and seven used mixed methods designs. Of the studies that presented pre-post outcome measures, nine reported significant gains in empathy scores at post-test and two reported non-significant gains in empathy. In eight studies, empathy scores demonstrated a significant intervention effect with effect sizes ranging from moderate (d = 0.52) to large (d = 1.19). Findings from qualitative studies revealed that arts pedagogies support students to better understand the perspectives of people with a lived experience of suffering but that these approaches are sometimes perceived negatively by students.

Arts interventions generally have a positive effect on healthcare students' empathy levels and enable a nuanced conceptual understanding of empathy. Arts modalities used as a stimulus for active learning and supported with facilitated group-based discussion and/or reflection, tend to be most effective.

Though medical education podcasts are fast gaining popularity, they are overwhelmingly focused on teaching the medical expert role of physicians. We explored how medical learners and educators engaged with and learned from an empathy and communication-focused podcast and sought their recommendations for integrating the podcast into medical curricula.

Six virtual, semi-structured focus groups were conducted with educators and learners within a large urban hospital and university setting. Participants were asked to listen to pre-selected episodes of the About Empathy podcast in advance. Thematic analysis was used to explore experiences and perceptions of empathy teaching and learning.

There were 24 participants. We identified six themes related to the podcast and empathy learning: (1) forging connection through stories, (2) creating space to reflect on empathy, (3) shifting perspectives and biases, (4) feeling validated and enabling self-compassion, (5) gaining knowledge and building skills through empathetic communication, and (6) translating new knowledge and skills into practice. Participants highlighted that the podcast's portability and asynchronous nature allowed them to be more fully present, reflective, and intentional in their learning.

The About Empathy podcast was experienced as a flexible, just-in-time tool that promoted self-agency over one's learning, reflective practice, and knowledge and skill acquisition, particularly with respect to empathic communication. Benefits of asynchronous e-learning tools such as podcasts support a shift to a blended learning model. Challenges finding a curricular home for this empathy-focused podcast require further consideration.

Empathy with patients improves clinical outcomes. Although previous studies have shown no significant differences in empathy levels between physicians and nurses, investigations have not considered differences in cultural backgrounds and related factors of healthcare providers at the individual level.

This study compares empathy between physicians and nurses in Japan and identifies relevant factors that contribute to these differences.

A cross-sectional survey design was used in the study. The online survey was conducted using the Nikkei Medical Online website.

A total of 5441 physicians and 965 nurses in Japan who were registered as members of Nikkei Medical Online were included.

Empathy was measured by the Jefferson Scale of Empathy (JSE).

Cronbach's α was 0.89. The mean JSE score for Japanese physicians was significantly lower at 100.05 (SD = 15.75) than the mean score of 110.63 (SD = 12.25) for nurses (p<0.001). In related factors, higher age (increasing by one year) (+0.29; 95% CI 0.25 to 0.32; p<0.001), self-identified female gender (+5.45; 95% CI 4.40 to 6.49; p<0.001), having children (+1.20; 95% CI 0.30 to 2.10; p=0.009), and working at a hospital with 20-99 beds (+1.73; 95% CI 0.03 to 3.43; p=0.046) were significantly associated with higher scores, whereas those whose mother is a physician (-6.65; 95% CI -8.82 to -4.47; p<0.001) and father is a nurse (-9.53; 95% CI -16.54 to -2.52; p=0.008) or co-medical professional (-3.85; 95% CI -5.49 to -2.21; p<0.001) were significantly associated with lower scores.

Physicians had significantly lower scores on the JSE than nurses in Japan. Higher age, self-identified female gender, having children, working at a small hospital, having a mother who is a physician, and having a father who is a nurse or co-medical professional were factors associated with the level of empathy.

To investigate the effects of empathy training on psychological concerns and empathy in caregivers of older people.

A randomized, double-blind, crossover, clinical trial with follow-up was conducted online. Thirty paid and unpaid caregivers of older people from different regions of Brazil participated in an empathy training program. The caregivers answered a sociodemographic questionnaire and measures for the evaluation of empathy (affective and cognitive domains), burden, the impact of providing care as well as depressive symptoms and psychiatric symptoms before and immediately after training. Empathy and its domains were also assessed at three post-intervention follow-ups.

Empathy training diminished levels of psychological concerns. Moreover, an increase was found in levels of cognitive empathy 15, 30 and 60 days after the intervention.

Empathy training with a focus on cognitive empathy diminished psychological concerns in caregivers of older people and increased the levels of this ability over time. This intervention can be considered a coping strategy for negative impacts related to providing care.

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Physician empathy is at the heart of doctor-patient communication and significantly influences patient outcomes. However, the research on how physicians express their empathy and how physician empathy affects patient outcomes and doctor-patient communication has not been well summarized in the latest literature. Thus, we conducted a systematic review to synthesize existing studies on physician empathy and its value to patient outcomes and doctor-patient communication. The systematic review consisted of studies published in English peer-reviewed journals between January 2017 and October 2021. Following the PRISMA procedure, a total of 3055 articles were retrieved, and 11 articles were retained. The thematic analysis revealed three emergent themes: physicians' empathic expressions; patient outcomes (patient functional status, patient safety, and patient satisfaction); and empathy enhancing doctor-patient communication. This study highlighted the different ways empathy may be expressed by physicians and its positive effects on patient outcomes and doctor- patient communication. This study also suggested the under-researched areas that can be expanded in the future.

Empathy is considered the ability to understand or feel others emotions or experiences. As an important part of medical education, empathy can affect medical students in many ways. It is still lacking a comprehensive evaluation of the existing articles on empathy's impact on medical students, despite the existence of many articles on the topic.

To summarize the impact of empathy on medical students during medical education from four perspectives: mental health, academic performance, clinical competence, and specialty preference.

The search terms used for retrieval were "empathy", "medical student", "mental health", "depression", "anxiety", "burnout", "examinations", "academic performance", "clinical competence", "specialty preference" on PubMed, EBSCO, and Web of Science before January 2024. The search was carried out by two reviewers. Titles and abstracts were screened independently and reviewed based on inclusion/exclusion criteria. A consensus was drawn on which articles were included.

Our results indicated that high empathy was a positive factor for mental health, However, students with high affective empathy were more likely to suffer from depression, anxiety, and burnout. Empathy was found to be unrelated to academic performance, but positively correlated with clinical competence, particularly in terms of communication skills. Medical students with high levels of empathy tended to prefer people-oriented majors.

Medical students who score higher on the self-reported empathy scales often have better mental health, better communication skills, and tend to choose people-oriented specialties. But empathy is not related to academic performance. Additionally, the different dimensions of empathy have different impacts on medical students. It is necessary to design targeted courses and training for medical students to enhance their empathy.

Empathy is an essential competence of a person-centered approach, and a recognisable ability for providing physiotherapy quality healthcare. Empathetic communication enhances the improvement of patient outcomes and their experience of treatment.

The aim of the study was to present further insights considering facilitators and barriers of an empathetic communication between patients and physiotherapists.

A qualitative focus group study was designed according to COREQ guidance for qualitative studies. Two focus groups were conducted. The first group included six patients and two individuals from non-governmental organizations, whereas three physiotherapists, two academic physiotherapist personnel and two undergraduate physiotherapy students participated in the second group. Both groups were audio recorded, and all data was verbatim transcribed for coding thematic analysis.

9 themes were revealed regarding empathetic facilitators (qualities of good communication, relationship building, interprofessional collaborative practice, positive environment, love for the healthcare profession and professionalism), while 8 themes were revealed regarding barriers (challenging situations, working conditions, burn out, depreciation of empathetic communication, lack of training, lack of professionalism, lack of personal development and health professionals' own personal problems).

The enhancement of empathy can be accomplished in a trustworthy relationship between patient and clinicians where the development of proficient communication skills are prioritized. However, hindering factors associated with health professionals, patients and the health system should be surmounted.

339-ΣΕ8/10-1-2020.

Background Empathy is essential for effective doctor-patient communication. It enables doctors to understand patients' emotions and concerns, facilitating personalized care and support. Empathy can be cultivated through various methods and training programs. Objective The study aims to assess the effectiveness of a multimodal intervention involving interactive lectures, peer role-play, and guided reflection in enhancing empathy levels among second-year medical undergraduate students in India. Methods This study utilized a questionnaire-based, pre- and post-test interventional design. Seventy-nine second-year medical students were included after obtaining their informed consent. The students received the intervention through an interactive lecture on communication skills, role-play on selected case studies, and guided reflection. The empathy levels were assessed using the Toronto Empathy Questionnaire (TEQ) before and after the intervention. The Mann-Whitney U test was utilized to compare pre-test and post-test TEQ scores. A univariate analysis of variance was conducted to explore the relationship between demographic variables and post-test TEQ scores. Statistical significance was considered at p ≤ 0.05. Results The TEQ score improved significantly (p=0.009) after the intervention. The univariate analysis indicated that gender, style of education, and place of residence did not have a statistically significant impact on post-test scores. Conclusion The study demonstrates that a multimodal intervention significantly enhances the empathy level of medical students, highlighting the potential of focused interventions to reduce gender disparities in empathy levels. There were no significant differences in empathy scores based on gender, place of residence, or schooling, suggesting the intervention's benefits may apply to all medical students.