Continuing Medical Education (CME): An exploration of method in teaching empathy to first year residents in a Singapore hospital

Knowledge and skills can be taught. What of character or personality – can desirable personality traits like empathy be taught? Studies show that there is a deterioration of medical students’ and residents’ self-perceived empathy during clinical training. The first stage of the study aimed to compare the levels of empathy of Post-Graduate Year 1 (PGY1) doctors in a public hospital pre- and post-teaching. In complement, we explored the empathy learning experience of doctors in an environment with their colleagues from all job groups present. Stage 1 - Initial small-scale data was gathered in a mixed method study with 21 PGY1s (using the Jefferson Scale of Physician Empathy (JSPE), whilst their patients were asked to fill the Jefferson Scale of Patient Perceived Physician Empathy (JSPPPE). Equal and randomised test and control groups were formed. The test group of PGY1s were asked to view a teaching video online, after which they filled a qualitative reflective feedback form. The survey exercise was repeated to obtain post-intervention empathy scores. Findings: a heightened awareness about the doctor-patient relationship in the PGY1s who viewed the video; PGY1s’ self-assessed empathy levels do not correlate with their patients’ assessments. In Stage 2, using the classroom as a laboratory for teaching empathy, we explored what actually occurs during the learning and post-learning (reflection, practice change) experiences for doctors and their colleagues. Data was collected from five focus group discussions. The teaching of empathy is necessary in sustaining empathetic care throughout doctors’ training and career. Although some patients may not want empathy, we need to explore ways of arousing awareness of self and others, of curiosity, of imagination, and to promote reflection in practice – these contribute to restoring hope in humanistic care. Leaders in medical education and clinical tutors should closely monitor the hidden curriculum (and other organizational and systemic challenges) as well as ensure physician wellbeing whilst enacting a curriculum change in order to incorporate the teaching of empathy to residents, their peers, and colleagues