Educating Physicians: Research Reports
Important correlations exist between patients' satisfaction and physicians' empathy, but medical students' empathy may decline during their undergraduate education. Our study measured “innate” (versus “role playing”) empathy using Mehrabian's Balanced Emotional Empathy Scale (BEES)1 to see whether empathy scores differed by year of training and whether there was a relationship between empathy scores and students' specialty choices.
At the beginning of the 1997 academic year at the University of Arkansas for Medical Sciences, students (M1 = 148, M2 = 130, M3 = 139, M4 = 131) voluntarily completed the BEES questionnaire, and indicated their sex and their likely career choices from a list of core (e.g., family medicine, pediatrics) and non-core (e.g., radiology, pathology) specialties. Descriptive statistics were calculated by class, sex, and specialty choice, and group comparisons were made using ANOVA and ANCOVA (p < 0.05).
There was no statistically significant difference among the classes' BEES scores (mean scores: M1 = 44.42; M2 = 42.92; M3 = 45.49; M4 = 40.31). Mean scores across all four years among women were fairly constant, but differed between M3 (40.42) and M4 (30.35) for men (p < 0.05). Students choosing core specialties had more empathy than those choosing non-core specialties (47.2 ± 26.5, 36.0 ± 27.2; F = 19.501, p = 0.001). Men were less likely to exhibit empathy variance by specialty choice than were women. After removing gender effects, students choosing non-core specialties had lower average empathy scores than did those choosing core specialties, a difference that significantly increased in M3 and M4 students.
Our findings show that medical students' empathy differed significantly for men between the M3 and M4 years. We also found that, regardless of their sex, students who indicated they would choose non-core specialties had lower empathy scores than did their counterparts. The reduction in innate empathy among subsets of students may imply a need to teach role-playing in order for students to appear empathetic. Our long-term goal is to follow cohorts of students through their medical education to study the relationship between specialty choice and empathy.
1. Mehrabian A. Manual of the Balanced Emotional Empathy Scale (BEES). 1996. (Available from Albert Mehrabian, 1130 Alta Mesa Road, Monterey, CA 93940).