Measurement of Empathy Among Japanese Medical Students: Psychometrics and Score Differences by Gender and Level of Medical Education

Center for Developing Medical and Health Care Education, Okayama University Medical School, Okayama, Japan.
Academic medicine: journal of the Association of American Medical Colleges (Impact Factor: 2.93). 10/2009; 84(9):1192-7. DOI: 10.1097/ACM.0b013e3181b180d4
Source: PubMed


To examine psychometric properties of a Japanese translation of the Jefferson Scale of Physician Empathy (JSPE), and to study differences in empathy scores between men and women, and students in different years of medical school.
The student version of the JSPE was translated into Japanese using back-translation procedures and administered to 400 Japanese students from all six years at the Okayama University Medical School. Item-total score correlations were calculated. Factor analysis was used to examine the underlying components of the Japanese version of the JSPE. Cronbach coefficient alpha was calculated to assess the internal consistency aspect of reliability of the instrument. Finally, empathy scores for men and women were compared using t test, and score differences by year of medical school were examined using analysis of variance.
Factor analysis confirmed the three components of "perspective taking," "compassionate care," and "ability to stand in patient's shoes," which had emerged in American and Mexican medical students. Item-total score correlations were all positive and statistically significant. Cronbach coefficient alpha was .80. Women outscored men, and empathy scores increased as students progressed through medical school in this cross-sectional study.
Findings provide support for the construct validity and reliability of the Japanese translated version of the JSPE for medical students. Cultural characteristics and educational differences in Japanese medical schools that influence empathic behaviors are described, and implications for cross-cultural study of empathy are discussed.

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    • "Respondents with a humanistic background reported a higher empathy level; this is true both for the medical specialty (person orientated vs technical orientated) and for the educational background prior to nursing or medical school (Hojat et al., 2002; Hojat, 2007). Empirical evidence is mixed upon the relationship between empathy and clinical experience; while some studies supported the idea that empathy is positively related to practice experience and students' progress in medical and healthcare professional schools (Kataoka et al., 2009; Ward et al., 2009; Roh et al., 2010), some others found that empathy tends to decrease with stressful clinical experiences (Hojat et al., 2009; McKenna et al., 2012; Ward et al., 2012), possibly supporting the idea that trainee distress may be a key element for empathy decline (Neumann et al., 2011). These discrepancies seem mainly linked to a few factors, such as cross-sectional designs, different lengths of observations, cultural differences between countries, and the differences concerning educational programs (Yu & Kirk, 2009; Kuo et al., 2012). "
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    ABSTRACT: This methodological study was conducted to test the psychometric properties of the Jefferson Scale of Empathy-Health Professional Student's version (JSE-HPS), in a convenience sample of 797 Italian nursing students and to describe their empathic engagement. Data were subjected to exploratory and confirmatory factor analysis, test-retest, correlation analysis, t-test, and analysis of variance method. Principal component factor extraction with Oblimin rotation on the first half of the sample was conducted. The analysis suggested a three-factor solution for 14 items: "compassionate care/emotional engagement," "perspective-taking," and "standing in the patient's shoes." Confirmatory factor analysis on the second half of the sample showed good fit indexes for the 14-item solution, indicated by the exploratory factor analysis, and the 20 item solution of the scale, with the exception of one item. Test-retest correlation was 0.50 (P < 0.001) for the overall scale. Results from group comparisons and correlations are also provided and discussed. The Italian version of the JSE-HPS is a psychometrically sound tool. The translated 20-item solution is also suitable to carry out cross-cultural comparisons. © 2015 Wiley Publishing Asia Pty Ltd.
    Nursing and Health Sciences 07/2015; DOI:10.1111/nhs.12221 · 1.04 Impact Factor
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    • "Boyle et al's above study observed higher mean empathy scores ranging from 107.34 to 111.55 in students studying nursing, midwifery, occupational therapy, physiotherapy and health science (Boyle et al., 2010). Similar studies of medical and nursing students have identified higher mean empathy scores of 118.5 (Chen, 2007), 117.71 (Sherman and Cramer, 2005), 104.3 (Kataoka, 2009) and 107.34 (McKenna, 2012). "
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    ABSTRACT: Abstract Introduction Empathetic behaviour is regarded as a positive trait amongst healthcare professionals and has been attributed to increased patient compliance, greater patient satisfaction, and greater diagnostic accuracy and reduced rates of clinical errors. Despite this, past studies have shown that healthcare students fail to recognise the importance of empathetic behaviour in patient care and display significant empathy decline throughout their studies. In particular, paramedic students have typically displayed lower rates of empathy when compared to their healthcare counterparts. The objective of this study is to assess both the level of empathy and changes in empathy in undergraduate paramedic students over a 3-year period at a single tertiary institution. Method A cross sectional study employing a convenience sample of first, second and third year undergraduate paramedic students at Monash University from 2008-2010. Student empathy scores where measured with the Jefferson Scale of Empathy – Health Profession Student version (JSE-HPS); a validated, self-reporting questionnaire. Results 552 students were enrolled in the study, of which 69% were females and 83% were aged under 25. The mean overall JSE-HPS score for the cohort was 108.60 (SD=12.50). Female students displayed significantly higher empathy scores of 110.27 (SD=11.62) compared to males at 105.36 (SD=13.57). There was also a significant difference (p=0.03) noted between the 2008 JSE-HPS score 106.32 (SD=14.02), when compared to the 2009 cohort, 110.18 (SD=12.91). There was no significant difference found in mean JSE-HPS scores across differing age groups. Conclusion Results from this study suggest that paramedic students display lower empathy than those reported by fellow healthcare students within the literature. Additionally, this study provides further evidence that females are typically more empathetic than their male counterparts in the same profession. The fact that empathy levels did not decline significantly throughout the course as expected defies current literature and is worthy of future investigation.
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    • "In addition, for years, a calm, unemotional, and less assertive attitude has been considered a virtue in Korea. Another reason for the lower empathy scores in the present study could be that the highschool students who want to attend medical school have to score high in mathematics and science subjects in the entrance examination, which is similar to Japan (Kataoka et al. 2009 "
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    ABSTRACT: Abstract Background: Previous studies on empathy in Korean medical students were conducted on small populations or with different scales of measurement, resulting in low representativeness and generalisability of the findings. Aim: To evaluate empathy in Korean medical students throughout the country and to make suggestions to improve empathy. Methods: The Jefferson Scale of Empathy (JSE) (Korean) was used, and the impact of sex, age, the medical school admission system, and grade of the respondents was investigated. Results: We analyzed 5343 questionnaires and found a mean empathy score of 105.9 ± 12.8. Females and post-baccalaureate students had higher scores as compared with their counterparts. There was a significant difference between the admission systems after controlling for gender. Students from higher grade levels had lower scores than those from the lower grade levels. Conclusions: The JSE score of Korean medical students was lower than that of students in Western countries. The difference of gender and medical school admission system should be considered, and capability to apply empathy to clinical practice should be focused upon in medical training.
    Medical Teacher 09/2014; DOI:10.3109/0142159X.2014.956058 · 1.68 Impact Factor
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