A comparison of medical students' self-reported empathy with simulated patients' assessments of the students' empathy.

BACKGROUND: Empathy is necessary for communication between patients and physicians to achieve optimal clinical outcomes. AIM: To examine associations between Simulated Patients' (SPs) assessment of medical students' empathy and the students' self-reported empathy. METHODS: A total of 248 third-year medical students completed the Jefferson Scale of Physician Empathy (JSPE). SPs completed the Jefferson Scale of Patient Perceptions of Physician Empathy (JSPPPE), and a global rating of empathy in 10 objective clinical skills examination encounters during a comprehensive end of third-year clinical skills examination. RESULTS: High correlation was found between the scores on the JSPPPE and the global ratings of empathy completed by the SPs (r = 0.87, p < 0.01). A moderate but statistically significant correlation was observed between scores of the JSPE and the JSPPPE (r = 0.19, p < 0.05). Significant differences were observed on the JSPE and global ratings of empathy among top, middle and low scorers on the JSPPPE in the expected direction. CONCLUSIONS: While significant associations exist between students' self-reported scores on the JSPE and SPs' evaluations of students' empathy, the associations are not large enough to conclude that the two evaluations are redundant.

Medical students' self-reported empathy and simulated patients' assessments of student empathy: an analysis by gender and ethnicity.

PURPOSE: To examine the contribution of students' gender and ethnicity to assessments by simulated patients (SPs) of medical students' empathy, and to compare the results with students' self-assessments of their own empathy. METHOD: In 2008, the authors used three different tools to assess the empathy of 248 third-year medical students. Students completed the Jefferson Scale of Physician Empathy (JSPE), and SPs completed the Jefferson Scale of Patient Perceptions of Physician Empathy (JSPPPE) and a global rating of empathy (GRE) in 10 objective structured clinical examination (OSCE) encounters. RESULTS: Of the 248 students who completed an end-of-third-year OSCE, 176 (71%) also completed the JSPE. Results showed that women scored higher than men on all three measures of empathy. The authors detected no significant difference between white and Asian American students on their self-report JSPE scores. However, the SPs' assessments on the JSPPPE and on the GRE were significantly lower, indicating less empathy, for Asian American students. CONCLUSIONS: A tool for SPs to assess students' empathy during an OSCE could be helpful for unmasking some deficits in empathy in students during the third year of medical school. Because the authors found no significant differences on self-reported empathy, the differences they observed in the SPs' assessments of white and Asian American students were unexpected and need further exploration. These findings call for investigation into the reasons for such differences so that OSCEs and other examinations comply with the guidelines for fairness in educational and psychological testing as recommended by professional testing organizations.

Evaluation of the congruence between students' postencounter notes and standardized patients' checklists in a clinical skills examination.

BACKGROUND AND PURPOSE: Questions remain about the congruence between students' written notes and checklists as summaries of encounters. METHODS: Students examined standardized patients and summarized findings in postencounter notes. The patients completed checklists. A physician read the students' notes and completed parallel checklists to document the history and physical items performed. Rates of under- and overdocumentation were calculated. RESULTS: Students documented findings for 71% of items performed - an underdocumentation rate of 29%. Approximately 94% of their documented findings were consistent with what they had done. Their rate of overdocumentation was 6%, in which they documented findings inconsistent with the checklists. About half the students had no instances of overdocumentation. CONCLUSION: Students' rate of underdocumentation was comparable to experienced clinicians. Although their overdocumentation rate was low overall, it was high for a few students. Evaluation of the congruence between checklists and postencounter notes provides useful information and informs checklist development.