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ORIGINAL RESEARCH
Compassionate Behavior of
Clinical Faculty: Associations
with Role Modelling and
Gender Specific Differences
ROSA BOGERD
MILOU E. W. M. SILKENS
BENJAMIN BOEREBACH
JOSÉ P. S. HENRIQUES
KIKI M. J. M. H. LOMBARTS
*Author affiliations can be found in the back matter of this article
ABSTRACT
Introduction: For future doctors, learning compassion skills is heavily dependent on female
and male faculty’s role modelling in practice. As such, more insight into the relationships
between faculty’s compassionate behavior, faculty gender and role modelling is needed.
Methods: In this cross-sectional survey, we analyzed 12416 resident evaluations of
2399 faculty members across 22 Dutch hospitals. The predictor variables were: observed
compassionate behavior, faculty gender (reference category: female), and an interaction
term between those two. Our outcome variables were: person, teacher and physician
role model. All variables, except for faculty gender, were scored on a 7-point Likert scale
ranging from 1 “totally disagree” to 7 “totally agree”.
Results: Female faculty scored slightly but significantly higher (M = 6.2, SD = 0.7) than male
faculty (M = 5.9, SD = 0.6) on observed compassionate behavior. Observed compassionate
behavior was significantly positively associated with being seen as a role model teacher
(b = 0.695; 95% CI = 0.623 – 0.767), physician (b = 0.657; 95% CI = 0.598 – 0.716) and
person (b = 0.714; 95% CI = 0.653 – 0.775). Male gender showed significant negative
associations with role model teacher (b = –0.847; 95% CI = –1.431 – –0.262), physician (b
= –0.630, 95% CI = –1.111 – –0.149) and person (b = –0.601, 95% CI = –1.099 – –0.103).
The interaction term showed positive significant associations with role model teacher (b
= 0.157, 95% CI = 0.061 – 0.767), physician (b = 0.116, 95% CI = 0.037 – 0.194) and
person (b = 0.102, 95% CI = 0.021 – 0.183).
Discussion: Dutch residents, in general, observed their faculty to be compassionate
towards patients and families and faculty’s observed compassionate behavior is related
to being seen as a role model. However, male faculty benefit more from demonstrating
compassion, as it has a greater positive influence on their perceived role model status
compared to female faculty.
CORRESPONDING AUTHOR:
Rosa Bogerd, MSc, MA
Amsterdam UMC, University
of Amsterdam, Department
of Medical Psychology,
Professional Performance &
Compassionate Care Research
group, Meibergdreef 9, 1105 AZ,
Amsterdam, The Netherlands
r.bogerd@amsterdamumc.nl
TO CITE THIS ARTICLE:
Bogerd R, Silkens MEWM,
Boerebach B, Henriques
JPS, Lombarts KMJMH.
Compassionate Behavior of
Clinical Faculty: Associations
with Role Modelling and
Gender Specific Differences.
Perspectives on Medical
Education. 2025; 14(1): 118–128.
DOI: https://doi.org/10.5334/
pme.1481
119Bogerd et al. Perspectives on Medical Education DOI: 10.5334/pme.1481
INTRODUCTION
In current times where healthcare systems are facing
huge patient demands and workforce shortages at
the same time, patients frequently experience a lack
of compassionate behavior from their healthcare
professionals [1–4]. This is worrisome, as compassion is a
crucial element of high quality patient care. Patients who
experience their care as compassionate are less anxious,
have lower stress and pain levels, and even report quicker
wound healing and other favorable clinical outcomes [5–7].
Perhaps even more disturbing, the absence of compassion
in patient care has been associated with an increased risk
of medical errors and physician burnout [7–9] and higher
healthcare spending in the long run [7, 10].
Faculty may express compassionate behavior through
both small and grand gestures in medical practice. Small
gestures include, for example, putting a hand on a patient’s
shoulder or verbally expressing one’s understanding of
the patient’s feelings, whereas visiting the patient more
often than usual is an example of a grand gesture [11, 12].
Caring for patients with compassion is not self-evident.
Some faculty show more compassion than others [13–15].
Research suggests that there are individual attributes,
experiences and characteristics that can be associated with
the variation in clinicians’ expressions of compassionate
behavior towards patients [15–17]. Gender may be such a
characteristic. Although female faculty are often expected
to be more compassionate, conforming to socially and
historically defined gender roles [18, 19], research on the
difference in compassionate behavior between male and
female faculty is not unanimous. A 2022 systematic review
by Pavlova and colleagues [17] found a comparable number
of studies favoring female faculty and studies showing no
effect for gender on compassionate behavior (respectively
20 versus 18 studies); only three studies found male faculty
to be more compassionate [17]. Two-thirds of the studies
included in the review used quantitative methods, but of
those, almost all were self-report studies. There is little
to no quantitative research on faculty’s compassionate
behavior as observed by residents. As the transfer of
compassion skills to future doctors is heavily dependent
on faculty’s (positive) role modelling in practice [16, 20–
22], understanding whether and to what extent residents
actually observe female and male faculty’s compassionate
behavior in practice is essential.
Role modelling is the overarching activity that
includes everything faculty do in their being and acting
as professionals [23, 24]. For residents a role model is
a supervisor whose skills and behaviors they desire to
emulate [25] which, in addition to formal curricula, makes
role modeling a powerful strategy to instill essential
professional competencies in young doctors [26]. Medical
education research commonly distinguishes three role
model typologies: teacher, physician and person role models
[23, 24]. Teacher role model qualities include, for example,
a student-centered approach and effective communication
and feedback. A physician role model is admired for their
medical knowledge and skills, sound clinical reasoning
and clear communication with patients and staff. Person
role models know how to maintain effective interpersonal
relationships, are enthusiastic and promote healing through
qualities such as compassion, honesty and integrity [24].
Residents mentioned compassion as an important attribute
for clinical and person models, but not for the teacher role
specifically [24, 27]. Additionally, previous work found male
role models to be generally described as more admirable
and more likely to be admired for their personalities than
for their professionalism [28]. Research on the relationship
between compassion and role modeling is scarce,
outdated and shows contradictory results [13, 20, 29, 30]
and the effect of gender on this relationship has not been
studied yet. Given that role modelling is crucial for instilling
compassion skills [16, 20–22], that some faculty fail to role
model compassion in practice [13, 14] and that it is largely
a matter of chance which role models residents encounter
during their training [31], more insight into the effect of
faculty gender on the relationship is needed.
This study aims to answer the following research
questions: 1) To what extent do residents observe faculty
showing compassionate behavior towards patients, and
are these perceptions equal for female and male faculty?
2) To what extent do faculty’s observed compassionate
behavior towards patients and faculty gender predict them
‘being seen as a role model’ by residents, and does this
differ for female and male faculty?
METHODS
STUDY DESIGN AND SETTING
In the Netherlands, the eight academic medical centers
provide residency training in collaboration with multiple
affiliated teaching hospitals. Within these hospitals,
residency training is the joint responsibility of the teaching
faculty group led by a program director. The duration of
residency training varies between specialties (three to six
years) [32]. As the quality of medical workplace training
ultimately determines the quality of patient care [21],
regular evaluation of faculty’s teaching qualities by their
residents is incorporated in medical training quality and
improvement cycles.
In the Netherlands, the System for Evaluation of Teaching
Qualities (SETQ) is a widely used and well researched
120Bogerd et al. Perspectives on Medical Education DOI: 10.5334/pme.1481
teaching evaluation tool [33–35]. With the latest
validated 31 item questionnaire, residents evaluate their
faculty’s qualities within six teaching domains: learning
climate, professional attitude towards residents, learner
centeredness, evaluation of residents, feedback to residents
and professional practice management. Apart from
these teaching domains, the SETQ includes two separate
items in which residents score faculty on: “adhering to
professional practice standards” and “demonstrating
compassion toward patients and their families” [33]. For a
full overview of the SETQ questionnaire see supplement I
‘SETQ Questionnaire’.
STUDY PARTICIPANTS AND DATA COLLECTION
To address our study aims, we gathered empirical data
between August 2020 and March 2023. Data were
collected using the SETQ questionnaire, via the online Perito
Professional Performance platform [36]. Residents from
programs of various specialties were included. We decided
to also include ‘junior doctors not in residency training’1
and fellows. The former because, although they are not
enrolled in postgraduate training, they have similar tasks
to residents and the latter because they are still in training
albeit as medical specialists. In this paper, residents refers
to all of those included in this study.
In the email invitation for the web-based SETQ
questionnaire residents were told to evaluate only those
faculty members whom they regularly work with and
whom they feel they can evaluate accurately. The email
further informed residents about the formative purpose
and use of the evaluations, as well as the purpose of the
research, and stressed that participation was anonymous
and voluntary.
MEASURES
Our outcome variables were the three types of role-
modelling, measured by the items “During my residency
training, this attending supervisor generally 1) is a role
model to me as a teacher/ supervisor, 2) is a role model to
me as a physician, 3) is a role model to me as a person”. The
main predictor in our study was ‘observed compassionate
behavior towards patients’. This variable was measured
using the item “During my residency training, this attending
supervisor generally demonstrates compassion towards
patients and their families”. Our second predictor variable
was gender (male/ female). Both our main predictor,
observed compassionate behavior towards patients, as well
as all three role-modelling items were scored on a 7-point
Likert scale: 1 = “totally disagree”, 2 = “disagree”, 3 =
“somewhat disagree”, 4 = “neutral”, 5 = “somewhat agree”,
6 = “agree”, 7 = “totally agree” or “not applicable” [37].
STATISTICAL ANALYSES
Since faculty were evaluated by multiple residents, we
aggregated and analyzed our data on the level of the
faculty member. Before aggregation, we removed 239
duplicate cases referring to residents who evaluated the
same faculty member twice or more at one moment in
time. We included only faculty whose SETQ scores were
based on at least 3 unique resident evaluations to assure
the reliability of the included scores [34].2 Furthermore,
when faculty had participated in multiple evaluation cycles
(e.g. in 2021 and in 2023), we included only the scores of
their most recent evaluation cycle. Finally, for the variable
“faculty gender”the options were male, female, and ‘other’.
While suboptimal from a research perspective, evaluations
used in medical training quality and improvement cycles
often offer limited gender options to protect privacy. In our
study, the ‘other’ option was set to missing because the
category was relatively small (8.4%) and could encompass
multiple meanings (e.g. a gender other than male or
female or the wish not to provide their gender).
The first aim of this study was to explore to what extent
residents perceive faculty to behave compassionately
towards their patients and to shed light on any gender-
related differences between faculty. To this end we
employed descriptive statistics and conducted an
independent samples t-test, using faculty gender as our
grouping variable.
Our second goal was to investigate to what extent
faculty’s compassionate behavior towards patients predicts
them being seen as a role model and whether and how this
differs for female and male faculty. For this purpose, we built
a multivariate general linear model (GLM). All assumptions
for a multivariate GLM were met.3 Within our model we used
multiple outcome variables (the three types of role models)
simultaneously with the same set of predictors (observed
compassionate behavior towards patients and faculty
gender (reference category = female)). We also entered an
interaction term (observed compassionate behavior*faculty
gender) in the model, as a third predictor. As the nature
of our study is fairly explorative, a significance level of α <
0.05 was used to interpret the various effects found. As a
sensitivity analysis, we additionally explored whether there
were any differences in the scores given by male versus
female residents on all our predictor and outcome variables.
We also checked whether the scores of female residents
were different for male and female faculty and vice versa.
All analyses were performed using SPSS Statistics V.28.
ETHICAL APPROVAL
The institutional ethical review board of the Amsterdam
UMC of the University of Amsterdam provided a waiver
121Bogerd et al. Perspectives on Medical Education DOI: 10.5334/pme.1481
declaring the Medical Research Involving Human Subjects
Act (WMO) did not apply to the current study (reference
number 2023.0844). This study complies with the EU GDPR
guidelines.
RESULTS
In total, 2399 faculty members representing 155
departments in 22 hospitals were scored based on 12416
resident evaluations, of mostly female residents (64.0%)
Most faculty were male (51.1%), non-surgical specialists
(38.8%) and worked in a university hospital (55.4%) The
median number of resident evaluations per supervisor was
4. (See Table 1 for participant characteristics).
On all included variables supervisors scored above a
mean of 5.6 on a 7-point Likert scale. Female (F) faculty
scored slightly but significantly higher than male (M) faculty
on observed compassionate behavior towards patients (F =
6.2 (SD = 0.6) versus M = 5.9 (SD = 0.7)) and on all types of
role modelling (teacher: F = 5.8 (SD = 0.8) versus M = 5.7 (SD
= 0.9), physician: F = 6.0 (SD = 0.7) versus M = 5.9 (SD = 0.8)
and person: F = 5.8 (SD = 0.7) versus M = 5.6 (SD = 0.8)).
The highest score found is female faculty’s mean score on
observed compassionate behavior (6.2, SD = 0.6) and the
lowest is male faculty’s mean score on person role model
(5.6, SD = 0.8). (See Table 2 for mean and median scores
and p values for the independent samples t-test). Based
on visual inspection of our data, resident gender did not
seem to affect these scores. (See supplement II ‘Sensitivity
analyses resident gender’.)
We found significant positive associations between
observed compassionate behavior from faculty towards
patients and them being seen as a role model teacher (b =
0.695; 95% CI = 0.623 – 0.767), physician (b = 0.657; 95%
CI = 0.598 – 0.716) and person (b = 0.714; 95% CI = 0.653
– 0.775). Our second predictor variable, faculty gender
(reference category = female) was significantly associated
with all three role model types: teacher (b = –0.847; 95%
CI = –1.431 – –0.262), physician (b = –0.630, 95% CI =
–1.111 – –0.149) and person (b = –0.601, 95% CI = –1.099
– –0.103). Finally, the interaction term between observed
compassionate behavior and faculty gender showed small
but significant associations with the teacher (b = 0.157,
95% CI = 0.061 – 0.767), the physician (b = 0.116, 95% CI =
0.037 – 0.194) and the person role model (b = 0.102, 95% CI
= 0.021 – 0.183). (Table 3). Visual inspection of descriptive
analyses revealed no indication of an effect of resident
gender (see supplement II ‘Sensitivity analyses resident
gender’). For a more detailed summary of the results of
our multivariate GLM see supplement IIII ‘Mutivariate GLM
summary’.
DISCUSSION
MAIN FINDINGS
This study quantitively explored how residents perceive their
faculty’s compassionate behaviors towards patients, and
whether these observed behaviors were associated with
being better role models. This is especially important as role
modelling is an important strategy to transfer compassion
related skills to residents. We found that Dutch residents,
in general, observed their faculty to be compassionate
DEMOGRAPHIC
CHARACTERISTICS
N FREQUENCY (%)
Number of residents
participated
2425
Gender (residents)
Male 783 32.3%
Female 1390 57.3%
Missing 252 10.4%
Number of resident evaluations 12416
Number of faculty evaluated 2399
Median number of evaluations
per faculty
4
Gender (faculty)
Male 1124 51.1%
Female 1077 44.9%
Missing 198 8.3%
Type of institute (faculty)
University hospital 1326 55.3%
General hospital 285 11.9%
Independent treatment
center
21 0.9%
Mental healthcare center 21 0.9%
Tertiary referral hospital 671 28.0%
Missings 75 3.1%
Specialty category (faculty)a
Non-surgical 932 38.8%
Surgical 753 31.4%
Supportive 395 16.5%
Non-medical 152 6.3%
Missings 167 7.0%
Table 1 Characteristics of study participants.
a For a detailed description of the specialty categories see
Supplement III ‘Categorization of specialty programs’.
122Bogerd et al. Perspectives on Medical Education DOI: 10.5334/pme.1481
towards patients (mean = 6.1 on a 7-point scale; SD =
0.6), and that female (F) faculty performed slightly but
significantly better than their male (M) peers (F = 6.2 (SD =
0.7) versus M = 5.9 (SD = 0.6)). Although these differences
may not be immediately apparent in practice, the results
of this study are consistent in showing female faculty
outperforming their male peers on all variables included,
with the largest difference between males and females
found on observed compassionate behavior. Additionally,
residents perceived the more compassionate supervisors as
better role model teachers, role model physicians and role
model persons. The interaction effect between observed
compassionate behavior and faculty gender indicated
that when male faculty showed compassion, this reflected
on them being seen as a role model more positively than
when female faculty demonstrated compassion. As far
as this study was able to detect, resident gender did not
affect these results.
EXPLANATION OF FINDINGS
The mean score of 6.1 for faculty’s observed compassionate
behaviors as measured in this study suggests that
residents in general perceive faculty to show compassion
towards patients and families. This score is comparable to
previously reported findings on compassionate behaviors
in the context of evaluating faculty’s clinical – instead of
teaching – performance [38]. When asked about faculty’s
patient-centeredness competencies, which included the
item “Shows compassion to patients”, residents rated their
faculty with an average of 4.43 on a 5-point Likert scale
[38]. Peer faculty and other healthcare professionals rated
faculty’s compassionate behavior slightly higher than
MAIN VARIABLES ALL FACULTY FEMALE FACULTY MALE FACULTY
MEAN
(sd)
MEDIAN (25–75
PERCENTILE)
MEAN
(sd)
MEDIAN (25–75
PERCENTILE)
MEAN (sd)MEDIAN (25–75
PERCENTILE)
INDEPENDENT
t-TEST
Observed
compassionate
behavior
6.1 (0.6) 6.2 (5.7–6.5) 6.2 (0.6) 6.3 (6.0–6.7) 5.9 (0.7) 6.0 (5.6–6.4) t = –9.6, p < 0.001
Teacher role model 5.7 (0.9) 5.9 (5.3–6.3) 5.8 (0.8) 6.0 (5.3–6.3) 5.7 (0.9) 5.8 (5.3–6.3) t = –2.5, p = 0.013
Physician role
model
5.9 (0.7) 6.0 (5.6–6.4) 6.0 (0.7) 6.0 (5.7–6.5) 5.9 (0.8) 6.0 (5.5–6.3) t = –3.4, p < 0.001
Person role model 5.7 (0.8) 5.8 (5.3–6.3) 5.8 (0.7) 6.0 (5.4–6.3) 5.6 (0.8) 5.8 (5.3–6.3) t = –5.4, p < 0.001
Table 2 Mean and median scores of resident ratings of observed compassionate behavior and role-modelling and t-test p value (α < 0.05).
B (SE) 95% CI
P
OBSERVED COMPASSIONATE BEHAVIOR
LL UL
Observed compassionate behavior on teacher role model 0.695 (0.037) 0.623 0.767 <0.001
Observed compassionate behavior on physician role model 0.657 (0.030) 0.598 0.716 <0.001
Observed compassionate behavior on person role model 0.714 (0.031) 0.653 0.775 <0.001
FACULTY GENDERa
Faculty gender on teacher role model –0.847 (0.298) –1.431 –0.262 0.005
Faculty gender on physician role model –0.630 (0.245) –1.111 –0.149 0.010
Faculty gender on person role model –0.601(0.254) –1.099 –0.103 0.018
OBSERVED COMPASSIONATE BEHAVIOR*FACULTY GENDER
Interaction on teacher role model 0.157 (0.049) 0.061 0.767 0.001
Interaction on physician role model 0.116 (0.040) 0.037 0.194 0.004
Interaction on person role model 0.102 (0.041) 0.021 0.183 0.014
Table 3 Unadjusted multivariate general linear model (GLM) predicting faculty being seen as a role model by residents according to their
gender and their observed compassionate behavior towards patients and families.
a The reference category for this variable was female.
123Bogerd et al. Perspectives on Medical Education DOI: 10.5334/pme.1481
residents did and provided scores between 4.45 and 4.55
on a 5-point Likert scale [38].
The average role modelling scores found in our study
ranged from 5.7 (person and teacher) to 5.9 (physician).
These scores are comparable to the findings in a 2012
SETQ study, which showed similar results on all three
types of role modelling – the physician role model type
also slightly outscoring the others [23]. The most recent
SETQ study, which was performed among US surgeons,
also reported scores comparable to our findings, although
the highest scores were found both on the physician and
the teacher role model type [39]. Notably, the many SETQ
studies performed amongst different specialties, in various
healthcare settings and contexts around the world, show
that overall, teaching faculty score well above a 3.5 on a
5-point Likert scale, and well above a 5.0 when a 7-point
scale is used on all items and teaching domains [33, 37,
39–41].
The found relationship between compassionate
behavior and role modelling in this study underscores
previous qualitative findings that compassionate behavior,
according to residents, is an important attribute of being
seen as a role model [24, 27]. As residents also observe
their faculty’s expressions of compassionate care in
practice, together these findings endorse the notion that
role modelling might indeed be a powerful strategy to
instill compassionate care skills in residents [42]. Previous
research, however, showed that residents’ perceptions
and ideas about what compassionate care entails may
differ from patients’ experiences with and expectations of
compassionate care. Based on interviews with residents
and patients, Debets et al. (2024) reported that “residents
often perceived that assessing patients’ compassion needs
comes down to the adage ‘do unto others as you would
have them do unto you’”, whereas patients also stressed
the importance of being asked about their specific needs
[12]. From this viewpoint, it is possible that the main, if not
only, strategy to convey compassionate care skills to the
next generation of physicians, overlooks crucial elements
of compassionate care. Consequently, explicitly educating
practicing faculty, residents and medical students about
the fundamentals of compassion becomes a necessary
additional step. This may be something to address in
medical curriculum reform processes as there is strong
evidence about the beneficial effects of compassion for
both patients and physicians [3, 5, 7, 16, 43–45].
Based on this quantitative study, it is unclear what exact
behavioral differences in compassionate behavior were
observed by residents. Other studies have highlighted
gender-specific practices suggesting that female
physicians display more patient-centered empathetic
communication and better psychosocial counselling [18,
46–48]. These practices resonate with historically female-
coded qualities, such as nurturing, expressiveness and
relationship building, all of which make up compassionate
behaviors [18, 19, 49]. Notably, in a previous SETQ study
we also found higher ratings for female physicians in the
more communicative teaching domains of giving residents
feedback and displaying professional attitudes to residents
[50]. Some might argue that given historical assumptions
in the medical field and Western society about female
physicians being expected to show compassion towards
patients, more so than male peers, the variations we
discovered in our study might actually be more pronounced
in reality. Thus, though residents might already anticipate
compassion from their female supervisors, our findings still
show a notable difference favoring women.
Lastly, in the interaction between observed
compassionate behavior and gender we found that showing
compassion reflects more positively on male supervisors
than on female supervisors, i.e. males expressing
compassion are rewarded by being seen as role models
more than their female peers displaying compassion.
Although the found effect was small and therefore perhaps
of limited relevance in practice, this finding aligns with the
general idea that male physicians are more admired for
showing humanistic behaviors because showing these
behaviors goes against previously mentioned gendered
expectations [18, 28]. In previous studies, using patient
evaluations, patient-centered behavior in male physicians
was associated with higher levels of greater overall
performance than in female physicians [47, 51].
IMPLICATIONS FOR CLINICAL EDUCATION,
RESEARCH AND POLICY
Our study findings show that residents do observe faculty’s
compassionate behavior towards patients in practice and
that this observed behavior is indeed associated with being
a better role model. The found association suggests that
using role modelling as a teaching strategy for compassion,
and maybe broader humanistic skills, might indeed
be effective. As the effect of observed compassionate
behavior is stronger for male physicians, and they are thus
‘rewarded’ more for being compassionate towards patients
than their female peers, this study contributes to the
growing understanding that the medical profession is not
gender-neutral [18, 19, 52, 53]. On the whole, this study
shows that compassion is being seen and appreciated by
residents and could therefore increase knowledge among
faculty about the impact of their behaviors towards
patients and families.
Which role models residents encounter during their
medical training is largely a matter of chance: faculty may
vary in how they express compassion towards patients
124Bogerd et al. Perspectives on Medical Education DOI: 10.5334/pme.1481
and families [54, 55] and experiences with negative role
models lacking humanistic behaviors have been reported
[13, 14, 31, 56]. Variation in staff groups, e.g. with regards
to gender, may therefore be a practical and potentially
beneficial strategy for transferring a range of compassion
skills to future doctors. In addition, future research could
be aimed at revealing and understanding differences in
expressing compassionate behavior between (female and
male) faculty in a qualitative way, for example by analyzing
the narrative feedback in teaching qualities assessments
[57] or by using observational methods. These insights
can be used to inform teacher training courses as well as
courses on compassion in the (post-graduate) medical
curriculum. Lastly, in line with previous empathy research
[58], it may be interesting to explore whether there are
differences in (observed) compassionate behavior across
faculty members from various medical specialties.
STRENGTHS AND LIMITATIONS
This study’s multicenter approach, which included
both academic and non-academic teaching hospitals,
ensures our sample’s validity of Dutch clinical teaching
faculty. The minimum number of 3 and median number
of 4 resident evaluations per faculty guarantee the
reliability of teaching faculty scores [59]. Also, we
included approximately one third of all Dutch medical
residents with a gender division resembling the one in
the population [60]. This strengthens us in our conviction
that the scores provided are representative of how Dutch
residents perceive their supervisors. When interpreting
the findings of our study, one should keep in mind the
cross sectional nature of this study. Based on previous
research [20], we hypothesized that showing compassion
towards patients was associated with being seen as a
role model in the eyes of residents. The associations
found in this study, however, may as well reflect a reverse
relationship between these variables. Furthermore, the
data of this study were partly gathered during the COVID
pandemic, which may have slightly colored our findings.
Lastly, although we are familiar with the possibility of a
halo effect in survey studies into people’s characteristics
[61], previous research reassures us that residents do
differentiate between faculty’s (positive) qualities using
the SETQ questionnaire [37, 62].
CONCLUSIONS
This study explored the relationship between faculty’s
observed compassionate behavior towards patients and
them being seen as role models by residents. The findings
of this study indicate that Dutch residents, in general,
observed their faculty to be compassionate towards
patients and families and that expressing compassion is
indeed related to being seen as a role model. The positive
effect of observed compassionate behavior on being seen as
a role model was stronger for male faculty than for female
faculty. This suggests that although showing compassion
towards patients reflects positively on all faculty in terms
of role modelling, residents admire male faculty more for
showing compassionate behaviors than female faculty.
As far as this study was able to detect, resident gender
did not affect our findings. The results of our study may
bring more awareness amongst teaching faculty of
the importance of showing compassion to patients in
training residents to become compassionate care givers.
Although role modelling compassionate behaviors can be
an effective teaching strategy, the importance and power
of compassion should also be made part of the formal
medical curriculum.
NOTES
1 In the Netherlands, medicine graduates often begin their careers
as “junior doctors not in training.” In this role, they perform
many of the same tasks as residents but are not enrolled in a
formal specialty training program. This period allows them to gain
valuable clinical experience and build a professional network,
which can help them to secure a spot in residency training later on.
2 In a previous confirmatory factor analysis study of the SETQ,
generalizability analysis showed that only two or three evaluations
per supervisor was enough for high reliability levels: “The
generalizability analysis, that was conducted to reveal if the trainee
evaluations, aggregated on supervisor level, had high α levels even if
just a few trainees completed an evaluation for a specific supervisor,
revealed that if only two or three trainees completed an evaluation,
α > .89 for all subscales.”
3 Although the assumption of the outcome variables being
continuous was not strictly met in our model, it is quite common
in the field of medical education to use a Multivariate GLM with
Likert scale variables as outcome measures. In this context, these
variables are typically interpreted as continuous scores.
ADDITIONAL FILES
The additional files for this article can be found as follows:
• Suppplement I. Evaluation of Teaching Qualities (Setq)
Questionnaire. DOI: https://doi.org/10.5334/pme.1481.
s1
• Supplement II. Sensitivity Analyses Resident Gender.
DOI: https://doi.org/10.5334/pme.1481.s2
• Supplement III. Categorization of Specialty Programs.
DOI: https://doi.org/10.5334/pme.1481.s3
• Supplement IIII. Multivariate Glm Summary. DOI:
https://doi.org/10.5334/pme.1481.s4
125Bogerd et al. Perspectives on Medical Education DOI: 10.5334/pme.1481
FUNDING INFORMATOIN
No specifc funding was received for this study.
COMPETING INTERESTS
The authors have no competing interests to declare.
AUTHOR AFFILIATIONS
Rosa Bogerd, MSc, MA orcid.org/0000-0002-9995-7536
PhD Candidate, Professional Performance and Compassionate
Care Research Group, Department of Medical Psychology,
Amsterdam UMC, the Netherlands; University of Amsterdam,
Amsterdam, the Netherlands; Quality of Care program,
Amsterdam Public Health Research Institute, Amsterdam, the
Netherlands
Milou E. W. M. Silkens, PhD orcid.org/0000-0001-8279-1341
Assistant professor, Erasmus School of Healthcare Policy &
Management, Erasmus University, Rotterdam, the Netherlands
Benjamin Boerebach, PhD orcid.org/0000-0002-5931-9783
Team lead, St. Antonius Hospital Emergency Medicine
Department, Nieuwegein, The Netherlands
José P. S. Henriques, MD, PhD orcid.org/0000-0002-8969-7929
Professor of Interventional Cardiology, Department of Cardiology,
Amsterdam UMC, Amsterdam, the Netherlands
Kiki M. J. M. H. Lombarts, PhD orcid.org/0000-0001-6167-0620
Professor Professional Performance, Professional Performance
and Compassionate Care Research Group, Department of
Medical Psychology, Amsterdam UMC, University of Amsterdam,
Amsterdam, the Netherlands
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128Bogerd et al. Perspectives on Medical Education DOI: 10.5334/pme.1481
TO CITE THIS ARTICLE:
Bogerd R, Silkens MEWM, Boerebach B, Henriques JPS, Lombarts KMJMH. Compassionate Behavior of Clinical Faculty: Associations with Role
Modelling and Gender Specific Differences. Perspectives on Medical Education. 2025; 14(1): 118–128. DOI: https://doi.org/10.5334/pme.1481
Submitted: 22 July 2024 Accepted: 20 February 2025 Published: 24 March 2025
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Perspectives on Medical Education is a peer-reviewed open access journal published by Ubiquity Press.
