Article

Level of Empathy among Medical Students in Kuwait University, Kuwait

Department of Community Medicine and Behavioural Sciences (Biostatistics), Faculty of Medicine, Kuwait University, Jabriya, Kuwait.
Medical Principles and Practice (Impact Factor: 1.34). 03/2013; 22(4). DOI: 10.1159/000348300
Source: PubMed

ABSTRACT

Objectives:
To evaluate the level of empathy among medical students in Kuwait University Medical School and its association with sociodemographic factors, stress levels and personality.

Subjects and methods:
A cross-sectional survey of 264 medical students was conducted in the Faculty of Medicine, Kuwait University. Empathy levels were measured using the Jefferson Scale, personality was assessed using the Zuckerman-Kuhlman Personality Scale and the Perceived Stress Scale was used to measure stress levels. Factors associated with empathy were evaluated using t test/ANOVA for categorical variables and correlation for continuous predictors.

Results:
Mean empathy score was 104.6 ± 16.3. Empathy scores were significantly associated with gender, year of study, mother's level of education, household income, satisfactory relationship with the mother and stress levels. Male medical students in their clinical years also had significantly lower empathy levels. However, factors such as grade point average, desired specialty, marital status of parents, father's educational level and relationship with father were not significantly (p > 0.05) associated with levels of empathy. Stress scores were significantly and positively associated with empathy (r = 0.13; p = 0.041).

Conclusion:
Medical students in Kuwait University had low empathy level and this may be a cause for concern; as such we suggest a possible inclusion of emphasis on empathy in the curriculum.

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    • "In consequence, the way in which the affective and cognitive components of empathy are integrated with one another should differ between individuals because not all social factors (among others) affect individuals or groups of individuals in the same manner [29]; in addition, because Faculties of Dentistry receive students with varying degrees of empathy, the necessity emerges to take up the task of shaping this attribute in all educational models. Considering that some authors claim that empathy can be learned in higher education (specifically, in the medical sciences [6] [29]-[31]; the empathic education of Dentistry students (and of all those whose future professions require empathy), is to some extent in the hands of universities [4]. "
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    ABSTRACT: Empathy is considered to be associated with better patient compliance, satisfaction, and clinical outcomes. The aim of the study is to measure and examine empathy among a sample of undergraduate medical students of Bangladesh. It was a cross-sectional study and all the medical students of first through fifth year enrolled at Chattagram Maa-O-Shishu Hospital Medical College during the study period of 2014 were surveyed. Participants anonymously completed the Jefferson Scale of Empathy Medical Student version translated into Bengali language, a valid and reliable 20-item self-administered questionnaire. Principal component factor analysis with varimax rotation and Cronbach’s alpha coefficient were calculated to check validity and reliability of the scale. ANOVA was used to examine the differences in empathy between gender, academic years, and specialty preferences. The mean empathy score was 110.41 ± 13.59. Cronbach’s alpha coefficient was 0.88. There were significant associations between gender and empathy scores. The level of empathy in medical students gradually increases after clinical training in medical college. A nonsignificant difference was found between empathy scores and specialty preferences. It is suggested that the medical curriculum in Bangladesh should include more extensive program to promote empathy and other humanistic values among the medical students.1. IntroductionEmpathy is the ability to understand and share the feelings of others [1]. It is the power of entering into others’ personality and imaginatively experiencing their emotional state. Hojat et al. define empathy as “a predominantly cognitive attribute that involves understanding of the patient’s experiences, concerns, and perspectives, and a capability to communicate this understanding. An intention to help by preventing and alleviating pain and suffering is an additional feature of empathy in the context of patient care” [2]. Empathy is essential in “physician-patient relationship” to produce a desire within physician to help the patient, to know what the patient is thinking or feeling, to provide best care to the patient, and to blur the line between physician and patient [3]. Empathy is important in development of interpersonal understanding which allows the patient to feel respected and validated [3]. It is the key element which can propel the physician toward altruistic action [4]. It helps the physician to be closer to patient, putting the benefit of other above those of self, even at some sacrifice to one self. Empathy is considered to be associated with improved health outcomes. A good physician-patient relationship is capable of creating better patient compliance, satisfaction, and clinical outcomes [5].There are various factors determining empathy, such as, age, gender, family background, culture, intelligence, emotional stability, and education [6, 7]. The study of empathy in patient care is important not only within a society but also among different cultures because of variations in medical education curriculum, cultural norms, and social learning.One of the major tasks in medical education is to maintain and increase empathy in medical students for patients. But various researches suggest that empathy in medical students decreases during the course of medical training [8–10]. Students experience medical training as stressful which might be injuring instead of fostering empathy. [11]. During this training, students also learn how to manage the stresses and anxiety of illness which may develop maladaptive responses that lead to a decline in their level of empathy [12]. Besides this, dependence on technology for diagnosis and limited interactions with patients may lead to a decrease in empathy among the medical students [13].Empathy is believed to be measurable and teachable. The Association of American Medical Colleges recommended that empathy should be integrated and assessed in medical education [2, 14]. Various research instruments, for example, Interpersonal Reactivity Index, Balanced Emotional Empathy Scale, and Jefferson Scale of Empathy (JSE), are available to measure empathy [11]. Among the self-reported instruments, JSE was used by various researchers to measure empathy specifically within the context of the physician-patient relationship [7, 15–20]. The validity and reliability of the JSE have been also reported [18, 21].Exercises and a more extensive program have been introduced formally in various medical curricula worldwide, to asses and promote empathy and other humanistic values among the medical students [12]. Such programs are still not well established in Bangladesh. The present study was designed to examine and measure empathy among a sample of undergraduate medical students of Bangladesh and also to compare the effects of gender, academic year, and specialty preferences on empathy.2. Method The study was cross-sectional in nature and carried out in Chattagram Maa-O-Shishu Hospital Medical College (CMOSHMC), Chittagong, Bangladesh, during the study period of 2014. The study was approved by the CMOSHMC Ethical Committee.2.1. ParticipantsAll medical students of first through fifth year enrolled at CMOSHMC during 2014 were eligible to participate in the study. Participants included 426 medical students from five academic years, in the first (), second (), third (), fourth (), and fifth year (). There were 291 female and 135 male students in the study population. The undergraduate medical curriculum in Bangladesh is a traditional five year medical school training with 1.5 years preclinical study, 2 years paraclinical study with limited patient contact, and 1.5 years clinical study.2.2. InstrumentsThe JSE has been adapted to several countries and languages [7, 15–18, 20]. It exists in three versions, HP-Version: for administration to physicians, S-Version: for administration to medical students, HPS-Version: for administration to students in other health professions like nursing, paramedical courses [2]. In this study, the Jefferson Scale of Empathy Medical Student version (JSE S-version) translated into Bengali language was used to measure medical students’ attitudes toward empathic physician-patient engagement in the contact of patient care. The JSE S-version was translated into Bengali language using a back translation procedure to ensure the accuracy of the translation [2, 7, 15–20, 22, 23]. At first, JSE S-version was translated from English into Bengali language by two bilingual researchers having a detailed understanding of the instrument. Later the translated Bengali version was sent to another three bilingual researchers who had not seen the original English version and were asked to translate Bengali version back into English. Then the original English version was compared with the back-translated English versions to see consistency and adaptations that were done in wording, where needed, to make the text consistent with Bengali culture without losing intended key concepts, and lastly a final Bengali version was produced. The JSE S-version includes 20 items each answered on a seven-point Likert scale. 10 positively worded items were linked to “perspective taking” and directly scored (1 = strongly disagree, 7 = strongly agree). 10 items were negatively worded and reversed scored (1 = strongly agree, 7 = strongly disagree) [13]. Eight of the ten negatively worded items were concerned with “compassionate care” and 2 items were linked to “standing in the patient’s shoes.” Scores ranged from 20 to 140. Higher values indicate a higher degree of empathy [11].Specialties were categorized into three groups like people-oriented, technology-oriented, and other specialties, as shown in Table 1 [2, 10, 23]. Students specified their career specialty intentions, in terms of possibility of entering each of the specialties.
    Full-text · Article · Apr 2014
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