Empathy in Iranian medical students: A preliminary psychometric analysis and differences by gender and year of medical school

Figures & data

Table

Practice points

The Persian version of JSPE is a psychometrically sound instrument to measure empathy among medical students. Cultural backgrounds and pedagogical practice may influence medical students’ attitudes towards empathy. Although previous studies and this study showed that women scored higher on the empathy scales than men, there is no evidence in the literature for gender differences in empathy in real-life settings. The cross-sectional nature of this study did not permit us to identify whether or not empathy changes during medical school. Further, longitudinal study designs are required to follow up cohorts to identify possible empathy changes. Ethnographic and phenomenological inquiry approaches are needed as a complement to the JSPE to explore the more subjective elements of empathy among medical students.

Table 1.  Factor pattern coefficients, mean and SD, and communalities (h²) for principal components extractions with Varimax rotation on the 20 items of the JSPE and Cronbach α values (n = 181).^a

No.	Item	Factor 1	Factor 2	Factor 3	Mean/SD	h^2
11	Patients’ illnesses can be cured only by medical or surgical treatment; therefore, physicians’ emotional ties with their patients do not have a significant influence in medical or surgical treatment^b	0.66	0.00	0.00	5.2/2.0	0.56
12	Asking patients about what is happening in their personal lives is not helpful in understanding their physical complaints^b	0.61	0.00	0.00	5.1/1.6	0.53
14	I believe that emotion has no place in the treatment of medical illness^b	0.60	0.00	0.00	6.0/1.3	0.54
10	Patients value a physician's understanding of their feelings which is therapeutic in its own right	0.55	0.00	0.00	5.9/1.5	0.56
8	Attentiveness to patients’ personal experiences does not influence treatment outcomes^b	0.53	0.00	0.00	5.5/1.4	0.40
7	Attention to patients’ emotions is not important in history taking^b	0.53	0.00	0.00	5.9/1.5	0.41
2	Patients feel better when their physicians understand their feelings	0.50	0.00	0.00	6.4/1.1	0.42
4	Understanding body language is as important as verbal communication in physician patient relationships	0.00	0.00	0.00	5.5/1.5	0.44
19	I do not enjoy reading non-medical literature or the arts^b	0.00	0.00	0.00	6./1.5	0.32
5	A physician's sense of humour contributes to a better clinical outcome	0.00	0.00	0.00	5.4/1.5	0.42
16	Physicians’ understanding of the emotional status of their patients, as well as that of their families is one important component of the physician–patient relationship	0.00	0.66	0.00	5.4/1.5	0.55
20	I believe that empathy is an important therapeutic factor in medical treatment	0.00	0.66	0.00	6.0/1.2	0.45
17	Physicians should try to think like their patients in order to render better care	0.00	0.64	0.00	4.1/1.7	0.50
13	Physicians should try to understand what is going on in their patients’ minds by paying attention to their non-verbal cues and body language	0.00	0.61	0.00	4.6/1.7	0.46
9	Physicians should try to stand in their patients’ shoes when providing care to them	0.00	0.57	0.00	4.4/1.7	0.44
15	Empathy is a therapeutic skill without which the physician's success is limited	0.00	0.55	0.00	5.3/1.7	0.41
3	It is difficult for a physician to view things from patients’ perspectives^b	0.00	0.00	0.76	4.3/1.7	0.61
6	Because people are different, it is difficult to see things from patients’ perspectives^b	0.00	0.00	0.55	4.3/1.6	0.42
1	Physicians’ understanding of their patients’ feelings and the feelings of their patients’ families does not influence medical or surgical treatment^b	0.00	0.00	0.49	5.1/2.0	0.44
18	Physicians should not allow themselves to be influenced by strong personal bonds between their patients and their family members^b	0.00	0.00	0.00	3.3/1.6	0.37
	Percentage of variance	15.6	14.1	8.3
	Cronbach's α values	0.73	0.71	0.51

Notes: The factor (component) labels are as follows: F1 compassionate care; F2 perspective taking; and F3 indicates AWPS.

^aThe factor pattern coefficients of 0.44 and below were replaced by 0s.

^bItems were reverse scored (strongly agree = 1, strongly disagree = 7).

Table 2.  Means and SD for JSPE components scores (n = 181)

Component	Mean	SD
Compassionate care	41.0	6.1
PT	30.0	6.1
AWPS	14.0	3.6

Table 3.  Correlation between subscales scores (n = 181)

Subscale	CC	PT	AWPS
CC		0.40**	0.18*
PT	0.40**		0.11
AWPS	0.18*	0.11

Note: *p ≤ 0.01; **p ≤ 0.005.

Table 4.  Comparison of results of previous studies using the JSPE from different countries

Country	Mean	SD
American^a	115.0	10.0
Mexican^b	110.4	14.1
Iran	105.1	12.9
Japan^c	104.3	13.1

Note: ^aHojat 2007; ^bAlcorta-Garza et al. (2005); Kataoka et al. (2009).

Table 5.  The background demographic of empathy mean scores (n = 181)

Demographic variables	No.	Mean/SD
Gender
Female	52	105.6/13.7
Male	127	103.7/11.0
Medical year
First	37	106.0/13.11
Second	35	102.0/13.8
Third	38	106.5/14.2
Fourth	35	105.2/11.8
Fifth	30	106.0/12.0

Table 6.  The background demographic of empathy mean components scores (n = 181)

	Compassionate care	PT	Walk in patient's shoes
Demographic variables	Mean/SD	Mean/SD	Mean/SD
Gender (No.)
Male (52)	5.8/0.72	4.8/0.90	4.1/1.1
Female (127)	5.9/0.93	5.0/1.0	4.3/1.0
Missing (2)
Medical school year (No.)
First (37)	5.9/0.80	5.0/1.1	4.4/0.96
Second (35)	5.6/1.0	4.9/0.81	4.0/1.1
Third (38)	5.9/0.93	5.0/1.2	4.6/1.0
Forth (35)	6.0/0.75	5.0/1.2	4.1/1.0
Fifth (30)	5.8/0.80	5.0/0.87	4.2/1/1
Missing (6)

Hojat M. Empathy in patient care: Antecedents, development, measurement, and outcomes. Springer, New York 2007

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Alcorta-Garza AJ, Gonzalez-Guerrero JF, Tavitas-Herrera SE, Rodrigues-Lara FJ, Hojat M. Validity of the Jefferson Scale of Physician Empathy among Mexican medical students. Salud Mental 2005; 28: 57–63

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