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The Impact of Simulated Medical Consultations on the Empathy Levels of Students at One Medical School

Schweller, Marcelo MD; Costa, Felipe Osorio MD; Antônio, Maria Ângela R.G.M. PhD; Amaral, Eliana M. PhD; de Carvalho-Filho, Marco Antonio PhD

doi: 10.1097/ACM.0000000000000175
Research Reports

Purpose To examine the impact of simulated medical consultations using standardized patients (SPs) on the empathy levels of fourth- and sixth-year students at the Unicamp medical school in Brazil.

Method Throughout 2011 and 2012, the authors conducted this study with two classes of fourth-year (n = 124) and two classes of sixth-year (n = 123) medical students. Students completed the medical student version of the Jefferson Scale of Physician Empathy before and after simulated medical consultations with SPs, followed by an in-depth debriefing dealing with the feelings of the patient about the disease, such as fear, guilt, anger, and abandonment; the feelings of the doctor towards the patient; and other topics as they arose.

Results The simulation activity increased the empathy scores of the fourth-year students (from 115.8 to 121.1, P < .001, effect size = 0.61) and of the sixth-year students (from 117.1 to 123.5, P < .001, effect size = 0.64).

Conclusions Although the study results were obtained via self-report—a limitation—they suggest that the effective simulation of medical consultations with SPs may improve medical students’ empathy levels. One unexpected result was that this activity, during the debriefing, became a forum for debating topics such as the doctor–patient relationship, the hidden curriculum, negative role models, and emotionally significant experiences of students in medical school. This kind of activity in itself may influence young doctors to become more empathetic and compassionate with their patients and foster a more meaningful way of practicing medicine.

Dr. Schweller is assistant professor, Department of Emergency Medicine, Faculty of Medical Sciences, State University of Campinas (Unicamp), Campinas, Brazil.

Dr. Costa is assistant professor, Department of Oncology, Faculty of Medical Sciences, State University of Campinas (Unicamp), Campinas, Brazil.

Dr. Antônio is professor of medicine, Department of Pediatrics, Faculty of Medical Sciences, State University of Campinas (Unicamp), Campinas, Brazil.

Dr. Amaral is professor of medicine, Department of Obstetrics and Gynecology, Faculty of Medical Sciences, State University of Campinas (Unicamp), Campinas, Brazil.

Dr. Carvalho-Filho is professor of medicine, Department of Emergency Medicine, Faculty of Medical Sciences, State University of Campinas (Unicamp), Campinas, Brazil.

Funding/Support: The authors received funding from the State of Sao Paulo Research Foundation and the National Counsel of Technological and Scientific Development.

Other disclosures: None reported.

Ethical approval: Granted by the research ethics committee on human beings from the Faculty of Medical Sciences of the State University of Campinas (Unicamp).

Previous presentations: The authors presented portions of this work at the Association for Medical Education in Europe (AMEE) Conference in Lyon, France, August 2012.

Correspondence should be addressed to Dr. Carvalho-Filho, Departamento de Clínica Médica, Faculdade de Ciências Médicas, Universidade Estadual de Campinas (Unicamp), Rua Tessália de Vieira Camargo, 126, Cidade Universitária Zeferino Vaz, Campinas–SP, CEP 13083-887, Brazil; telephone: (+5519) 9603-6684; e-mail: macarvalhofilho@gmail.com.

© 2014 by the Association of American Medical Colleges