How clinician examiners compare with simulated patients in assessing medical student empathy in a clinical exam setting

Abstract

Background: Empathy is an important clinical attribute to be assessed during clinical examinations. While simulated patients (SPs) are well positioned to assess empathy in such settings, clinician-examiners are objective observers who are also experts in assessment. In this study, the assessments of student empathy from both examiners and SPs in clinical examinations were compared.

Methods: The 10-item CARE measure were used for the assessment of empathy in 158 medical students in the Family Medicine specialty clerkship clinical competency test. The ratings from examiners and SPs were analyzed together with genders of students, examiners and patients, and the examination results.

Results: SPs empathy ratings were higher than those from examiners across all ten items of CARE. A weak positive correlation was found between both ratings. Female SPs were more likely to give higher ratings, and examiners were more likely to give higher ratings to female students. SPs rating was moderately correlated with student examination score, while the correlation with examiners rating was strong.

Conclusion: Although the inter-rater reliability was weak between the empathy rating from simulated patients and examiners, the evaluation of empathy from the patient’s perspective was seen to be more authentic as they are in interaction with the students.

Disclosure statement

The authors report no declarations of interest.

Glossary

Consultation and Relational Empathy (CARE) Measure: The CARE Measure is a widely used 10-item instrument for measuring patients’ perceptions of relational empathy in a primary care consultation. It measures empathy in the context of the therapeutic relationship during a one-onone consultation between a clinician (doctor, nurse, allied health professional) and a patient.

Reference Mercer SW, Maxwell M, Heaney D, Watt GC. 2004. s development and preliminary validation and reliability of an empathy-based consultation process measure. Fam Pract. 21(6):699-705. It measures empathy in the context of the therapeutic relationship during a one-on-one consultation between a clinician and a patient.

Additional information

Notes on contributors

Julie Yun Chen

Dr Julie Chen, MD, FCFP, is an Associate Professor (Teaching) in the Department of Family Medicine and Primary Care and Bau Institute of Medical and Health Sciences Education at the University of Hong Kong.

Weng-Yee Chin

Dr Weng Chin, MBBS, MD, FRACGP, is an Assistant Professor in the Department of Family Medicine and Primary Care at the University of Hong Kong.

Joyce Pui Yan Tsang

Ms Joyce Tsang, BSc, MND, is a Senior Research Assistant in the Department of Family Medicine and Primary Care and Bau Institute of Medical and Health Sciences Education at the University of Hong Kong.