Empathy in the doctor-patient relationship as viewed by first-year medical students: data on validity and sensibility to change of the Jefferson Measure in Portugal

PMID:22849932Background and aims: Empathy is a key feature of the doctor-patient relationship. Severalstudies have shown a link between empathic relationships and clinical outcomes. However,reports of a decline in empathy over the course of undergraduate medical education andmedical practice have raised concern among medical educators. Our study focuses on theexploration of the temporal stability of attitudes towards empathy in first-year medicalstudents. We also aimed to characterise this sample regarding attitudes towards empathyand its associations with socio-demographic determinants, motives for entering Medicineand professional expectations. Finally, we wanted to contribute to the preliminary validationin Portugal of the Jefferson Scale of Physician Empathy, students' version (JSPE-S),following Hojat's definition of empathy as a predominantly cognitive concept.Methods: We selected a non-randomized sample of 81 first-year medical students, inLisbon. For the evaluation of the motives for choosing Medicine as a career, we adapteda questionnaire based on the items reported by Vaglum and associates. For self-reportassessment of attitudes towards empathy, we used a Portuguese translation of the JSPE--S. Finally, we analysed the evolution of empathy-related attitudes through a six-monthperiod that included Medical Psychology teaching (given that the curriculum would beexpected to raise empathy-driven attitudes and skills).Results: The JSPE-S total score increased from baseline to follow-up assessments(p=0.001). At the baseline, we found a negative correlation between the "status/security"motivation index and the JSPE-S "standing in patient shoes" component, while there wasa positive correlation between the "people oriented" motivation index and the JSPE-S"compassionate care" factor. Psychometric properties were acceptable for both the JSPE-Sand the motivation questionnaire.Discussion: In general, our findings support the idea that empathy can be learnt in medicalschools. This study also provides evidence for the validation of the JSPE-S and for theacceptability of an instrument assessing motivation for medical school, in Portugal. Albeitweak, the correlations between motivational factors and empathy components deservefurther exploration in research.publishersversionpublishe