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Once is not enough
Enhancing and sustaining empathy in medical students. Hojat M et al. Medical Teacher 2013, 1-6, early online.
Reviewed by Lavjay Butani


What was the study question?
Can medical student empathy be enhanced and sustained using curricular interventions?

How was the study done?
At the Jefferson Medical College in Philadelphia, 248 second year students were randomized into 2 groups: the experimental group viewed brief movie clips of medical encounters followed by a group discussion emphasizing empathy, while the control group watched a medical documentary. Members of both groups completed the Jefferson Scale of Empathy (JSE) pre- and immediately post-session. Ten weeks later, half of the original experimental group participated in a presentation and discussion on the importance of empathy. The remainder of the experimental group and the entire control group watched a movie on racism followed by a group discussion. The JSE was again completed by both groups.

What were the results?
Baseline JSE scores were not statistically different between the groups. After phase 1 there was a small but significant increase in mean score in the experimental group but no change in the control group. After phase 2, the change in JSE scores was sustained only in the subset of the experimental group that received reinforcement on the importance of empathy. In the non-reinforced experimental group the mean JSE score declined back to the pretest score, while in the control group there was no change either from pre to post 1 or from post 1 to post 2.

What are the implications of these findings?
This study is a valuable addition to the growing literature that shows that empathy can be taught and learned, but that efforts to teach empathy need to be much more robust, sustained and continuously reinforced for learners to remain committed to upholding this professional value.

Editor's note: Here is another example of how reinforcement is needed for people to retain important content. And while this is true, we should probably be asking ourselves the bigger scarier question… why does our educational/practice system lead to decreased empathy in the first place, and how can we fix that problem? ( LL).

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