The Effect of Reflection Rounds on Medical Students’ Empathy

Background: A decline in empathy has been noted in medical students in medical education and training. This decline raises concerns because empathic physician-patient interactions positively impact health outcomes and patient satisfaction. We tested the hypothesis that Reflection Rounds would increase empathy scores of third-year medical students. Methods: Third-year students entering their Family and Community Medicine (FCM) clerkship completed the Jefferson Physician Scale of Empathy – Student Version (JPSE-S) at the onset of their clerkship; students at the Jefferson Campus site were assigned to the experimental group and students at Affiliate Sites were assigned to the control group. The experimental group attended four 1-hour Reflection Round sessions during the 6-week clerkship. These small group sessions were structured under the guidance of a clinician and a member of the pastoral care department, both of whom were trained to facilitate Reflection Rounds. The control group did not have Reflection Rounds. Both groups took JSE-S at the end of the clerkship. Results: At the start of the clerkship, there were no significant difference in empathy scores between the two groups. After the clerkship, there was a significant increase in student empathy scores among the students who experienced the Reflection Rounds improving from a mean score of 114.1 to 116.5, with a p-value of 0.04. There was no significant change in either direction among the students who did not participate in Reflection Rounds. When analyzed by gender, we found the change in empathy scores in the experimental group was statistically significant for women, but not for men. Discussion: These results indicate that Reflection Rounds help improve the empathy of medical students. Further evaluation with larger samples and with longitudinal analysis would be interesting to determine if the improvement in empathy acts differently by gender, and if the change is sustained over a longer period of time