How does medical education affect empathy and compassion in medical students? A meta-ethnography: BEME Guide No. 57

Abstract

Background: Empathy and compassion are important in healthcare delivery, and are necessary qualities in medical students.

Aims: To explore medical students', patients' and educators' perceptions of what affects empathy and the expression of compassion; and to address gaps in knowledge, attitudes and skills on how education affects empathy and the expression of compassion in medical students.

Methods: The seven steps by Noblit and Hare were used for this meta-ethnography. Databases were searched for studies in English, published from 2007 to 2017 with outcomes of empathy and compassion. Key themes and concepts were identified, and accounts from the studies were used to build interpretations.

Findings: Thirty-three qualitative studies were included and four main themes were derived: seeing the patient as a person; appreciating the elements of empathy and compassion; navigating in the training environment; and being guided by ideals. Interactions between the patient, the medical student and training environment which affect the development of empathy and compassion are illustrated in a conceptual model.

Conclusions: This meta-ethnography extends our understanding of how medical education affects the expression of empathy and compassion in medical students. The results provide important considerations for medical educators and faculty developers in further developing and improving medical curricula.

Disclosure statement

The authors report no conflicts of interest. The authors alone are responsible for the content and writing of this article.

Glossary

Empathy: Is considered as a process, involving the ability to understand the patient’s situation, perspective, and feelings and to communicate back that understanding, and to act on that understanding in a helpful (therapeutic) way (Mercer and Reynolds 2002).

Compassion: Is “built on the capacity to empathize – a form of cognitive and emotional perspective taking – but involves the additional step of wanting to alleviate suffering” (Fernando et al. 2016, p. 340).

Medical student: Persons involved in medical, undergraduate studies and engaged in initial medical training regardless of their qualifications on entry.

Education: Includes medical education curricula and activities medical students engage in, in a variety of learning environments that could include classroom, bedside teaching, homework, interactions with patients, etc.

Educators: Include medical teachers, faculty, and persons involved in teaching medical students, e.g. patients.

Additional information

Funding

NHG-HOMER Grant, NHG-HOMER FY16/B03.

Notes on contributors

Charmaine Krishnasamy

Charmaine Krishnasamy, BOT(Hons), PhD, is a Senior Research Analyst at HOMER, NHG Education, National Healthcare Group, Singapore.

Sik Yin Ong

Sik Yin Ong, BASc, MNutrDiet, is a Research Analyst at HOMER, NHG Education, National Healthcare Group, Singapore.

May Eng Loo

May Eng Loo, BSc(Hons), MA, is a Research Analyst at HOMER, NHG Education, National Healthcare Group, Singapore.

Jill Thistlethwaite

Jill Thistlethwaite, MBBS, PhD, MMEd, FRCGP, FRACGP, Medical Adviser, NPS MedicineWise, Sydney, NSW; Adjunct Professor, University of Technology Sydney, NSW, Australia.