Teaching or Not Teaching Empathic Listening to Future Physicians? Historical Roots and Ongoing Challenges

Abstract

This commentary raises questions regarding empathy training as a core objective of foundational skills courses in most U.S. medical schools. While a number of educational activities focused on the cultivation of empathy have been introduced by medical educators, students spend very little time acquiring specific key communication competencies like listening. Medical school faculty have written about the importance of empathy, but have not availed themselves of the research that truly defines empathic listening, nor have they shifted their focus to exactly how these skills can be taught. In the absence of guidance about active listening as a therapeutic micro-skill, it is unlikely that physicians-in-training can consistently produce verbal responses that allow patients to feel that they are heard and understood. Thus, medical students may have communication deficiencies, including the inability to establish meaningful rapport with patients. The predicament is maintained because most physician faculty do not reach back to draw on prior models of interpersonal sensitivity training, nor do they cross disciplinary lines beyond medical school curricula to synthesize lessons from psychology and communication studies. This is problematic, because the development of meaningful relationships with patients has been demonstrated to improve outcomes.