Letters to the Editor
To the Editor:
In the August 2011 issue of Academic Medicine, Neumann et al1 systematically reviewed the literature to explore the reported potential causes for changes in the empathic capacity of medical students and residents during the course of their training. Varying theories or explanations were proposed. It is striking that, in none of the reported studies, parallel studies of the empathic capacity of the medical faculty were undertaken.
In a number of the studies reported, reference is made to the impact on trainees of the hidden curriculum, including an unsuitable learning environment and inadequate role models as factors influencing the decline in trainees' empathic capacity. These elements of the learning environment are greatly controlled and determined by the faculty. Could it be that the declines noted in student and resident empathy are caused by their emulating the behavior of the faculty? Studies are needed to assess faculty empathic levels as contrasted with those of trainees. Without such data, it is difficult or impossible to know if the trainees' decline in empathic capacity is a learning issue or an issue related to their modeling their interactions with patients on those of the faculty.
Sidney Weissman, MD
Professor of clinical psychiatry, Feinberg School of Medicine, Northwestern University, Chicago, Illinois; firstname.lastname@example.org.
1. Neumann M, Edelhäuser F, Tauschel D, et al.. Empathy decline and its reasons: A systematic review of studies with medical students and residents. Acad Med. 2011;86:996–1009.