Multicultural personality traits of Chinese university students and their effects on the psychological adjustment in the aftermath of COVID-19 in Shanghai: a scale validation.

Objective: This study aims to explore Chinese university students' multicultural personalities and examine how they predict the psychological adjustment of students in Shanghai. In addition, the validation of Multicultural Personality Questionnaire Short Form (MPQ-SF) scale developed to assess the multicultural personality traits of individuals is also aimed in Chinese context. Data were collected after the psychological stresses from restrictions imposed by COVID-19 in China that influenced life adjustments for nearly three years. Method: A total of 1,099 university students participated in this multi-stage study. First, the Chinese version of MPQ-SF (MPQ-SF-C) was developed and validated. The impact of MPQ-SF-C dimensions was then tested through path analysis to establish the effects of Chinese university students' multicultural personality traits on their psychological adjustment using the Schwartz Outcome Scale (SOS-10). Results: The MPQ-SF-C yielded a five-factor solution which accounted for 60.14% of the common variance. The findings indicated that cultural empathy (ß = 0.23, p < 0.05), certainty seeking (ß = 0.13, p < 0.05), open-mindedness (ß = 0.48, p < 0.05), and emotional stability (ß = 0.24, p < 0.05) had significant influences on adjustment. Only flexibility was found to have a statistically insignificant impact on adjustment at this time in this context. MPQ-SF-C and SOS-10 scales represented very good psychometric properties in terms of their reliability and validity. Conclusion: The MPQ-SF-C shows good psychometric properties and appropriateness for evaluating multicultural personalities in Chinese contexts. The multicultural personality characteristics of university students using this scale well predicted their psychological adjustment.

Social cognition abilities in patients with primary and secondary chronic pain.

Previous evidence suggested that chronic pain is characterized by cognitive deficits, particularly in the social cognition domain. Recently, a new chronic pain classification has been proposed distinguishing chronic primary pain (CPP), in which pain is the primary cause of patients' disease, and chronic secondary pain (CSP), in which pain is secondary to an underlying illness. The present study aimed at investigating social cognition profiles in the two disorders. We included 38 CPP, 43 CSP patients, and 41 healthy controls (HC). Social cognition was assessed with the Ekman-60 faces test (Ekman-60F) and the Story-Based Empathy Task (SET), whereas global cognitive functioning was measured with the Montreal Cognitive Assessment (MoCA). Pain and mood symptoms, coping strategies, and alexithymia were also evaluated. Correlations among clinical pain-related measures, cognitive performance, and psychopathological features were investigated. Results suggested that CSP patients were impaired compared to CPP and HC in social cognition abilities, while CPP and HC performance was not statistically different. Pain intensity and illness duration did not correlate with cognitive performance or psychopathological measures. These findings confirmed the presence of social cognition deficits in chronic pain patients, suggesting for the first time that such impairment mainly affects CSP patients, but not CPP. We also highlighted the importance of measuring global cognitive functioning when targeting chronic pain disorders. Future research should further investigate the cognitive and psychopathological profile of CPP and CSP patients to clarify whether present findings can be generalized as disorder characteristics.

Social capital in the management of breast cancer in Lagos, Nigeria.

PURPOSE: Breast cancer is the most common cancer in women worldwide, necessitating substantial social support during diagnosis and treatment. This study examines the role of social capital in breast cancer management, focusing on the experiences of patients. OBJECTIVES: The objective of the study was to explore the role of social capital in breast cancer management among women living with breast cancer in Lagos, Nigeria. METHODS: Using a qualitative design, the study recruited 23 women with breast cancer receiving treatment at a teaching hospital in Lagos, Nigeria. Data were content analyzed to identify themes related to social capital. RESULTS: The study found that social capital, crucial for breast cancer patients' emotional and instrumental support, stems from various sources such as relatives, immediate family, spouses, places of worship, friends, and neighbors. Effective coping and management of the condition were facilitated through this support network. However, assistance from places of worship, friends, and neighbors was only accessible to those who openly acknowledged their health conditions and had established connections with these social groups. Relationships led to support only when there was a disclosure of the health condition. SIGNIFICANCE OF RESULTS: (1) This finding reinforces the importance of integrating social support mechanisms including family, friends, and community networks into breast cancer management programs. (2) The study identifies diverse sources of social capital, including relatives, family, spouses, places of worship, friends, and neighbors, stressing the need for tailored support networks. (3) Research reveals the link between health condition disclosure and support accessibility from groups like places of worship and friends, and it emphasizes creating stigma-free environments for patients to disclose health status comfortably. (4) The study highlights family involvement in breast cancer management as crucial for effective coping. Healthcare professionals should prioritize interventions strengthening family support systems. (5) Findings of stress community support for better breast cancer outcomes, advocating for initiatives like support groups and awareness campaigns to boost social capital and aid affected individuals. CONCLUSION: The study emphasizes the significance of involving family members in the breast cancer management process and highlights the need for support systems within families and communities to facilitate better outcomes for breast cancer patients.

The expression of empathy in human's closest relatives, bonobos and chimpanzees: current and future directions.

Empathy is a complex, multi-dimensional capacity that facilitates the sharing and understanding of others' emotions. As our closest living relatives, bonobos (Pan paniscus) and chimpanzees (P. troglodytes) provide an opportunity to explore the origins of hominin social cognition, including empathy. Despite certain assumptions that bonobos and chimpanzees may differ empathically, these species appear to overlap considerably in certain socio-emotional responses related to empathy. However, few studies have systematically tested for species variation in Pan empathic or socio-emotional tendencies. To address this, we synthesise the growing literature on Pan empathy to inform our understanding of the selection pressures that may underlie the evolution of hominin empathy, and its expression in our last common ancestor. As bonobos and chimpanzees show overlaps in their expression of complex socio-emotional phenomena such as empathy, we propose that group comparisons may be as or more meaningful than species comparisons when it comes to understanding the evolutionary pressures for such behaviour. Furthermore, key differences, such as how humans and Pan communicate, appear to distinguish how we experience empathy compared to our closest living relatives.

Disrupted cognitive and affective empathy network interactions in autistic children viewing social animation.

Empathy can be divided into two core components, cognitive empathy (CE) and affective empathy (AE), mediated by distinct neural networks. Deficient empathy is a central feature of autism spectrum conditions (ASC), but it is unclear if this deficit results from disruption solely within empathy networks or from disrupted functional integration between cognitive and affective empathy networks. To address this issue, we measured functional connectivity (FC) patterns both within and between empathy networks in autistic children (4-8 years, n = 31) and matched typically developing (TD) children (n = 26) using near-infrared spectroscopy during presentation of an animated story evoking CE and AE. Empathy and social communication ability were also assessed using the Empathy Quotient/Systemizing Quotient (EQ/SQ) and Social Responsiveness Scale (SRS), respectively. The results showed that the FC in the AE network of autistic children did not differ from the TD group across conditions; however, ASC group showed weaker FC in the CE network under the CE condition and weaker FC between networks when processing AE information, the latter of which was negatively correlated with EQ scores in ASC. The empathy defect in ASC may involve abnormal integration of CE and AE network activities under AE condition.

Age and parous-experience dependent changes in emotional contagion for positive infant sounds.

Introduction: Emotional contagion is achieved by inferring and emotionally resonating with other persons' feelings. It is unclear whether age-related changes in emotional contagion for infant sounds are modulated by the experience of childbirth or childcare. This study aims to evaluate changes in inference and emotional resonance for positive and negative infant sounds (laughter and crying) among women, based on age and parous experience. Methods: A total of 241 women (60 young nulliparous, 60 young parous, 60 old nulliparous, and 61 old parous) completed a web-based questionnaire. After listening to three types of infant sounds (laughter, cooing, and crying), participants responded with their valence for hearing infant sounds and estimated infant valence on an 11-point Likert scale. Results: The analysis for emotional resonance revealed that the correlation coefficient between self and estimated infant valences was greater in young parous and old nulliparous women than in young nulliparous women, in laughter and cooing sounds. However, correlation coefficients for crying did not differ among any of the four groups. Conclusion: The degree of emotional resonance for infant valence increased depending on age and parous-experience for positive infant sounds.

Could neurofeedback improve therapist-patient communication? Considering the potential for neuroscience informed examinations of the psychotherapeutic relationship.

Empathic communication between a patient and therapist is an essential component of psychotherapy. However, finding objective neural markers of the quality of the psychotherapeutic relationship have been elusive. Here we conceptualize how a neuroscience-informed approach involving real-time neurofeedback, facilitated via existing functional magnetic resonance imaging (fMRI) and electroencephalography (EEG) technologies, could provide objective information for facilitating therapeutic rapport. We propose several neurofeedback-assisted psychotherapy (NF-AP) approaches that could be studied as a way to optimize the experience of the individual patient and therapist across the spectrum of psychotherapeutic treatment. Finally, we consider how the possible strengths of these approaches are balanced by their current limitations and discuss the future prospects of NF-AP.

Cultivating physician empathy: a person-centered study based in self-determination theory.

While physician empathy is a vital ingredient in both physician wellness and quality of patient care, consensus on its origins, and how to cultivate it, is still lacking. The present study examines this issue in a new and innovative way, through the lens of self-determination theory. Using survey methodology, we collected data from N = 177 (44%) students at a Canadian medical school. We then used a person-centered approach (cluster analysis) to identify medical student profiles of self-determination (based on trait autonomy and perceived competence in learning) and how the learning environment impacted empathy for those in each profile. When the learning environment was more autonomy-supportive, students experienced higher satisfaction and lower frustration of their basic psychological needs in medical school, as well as greater empathy towards patients. The translation into increased empathy, however, was only evident among the students with higher self-determination at baseline. Results from this study suggest that autonomy-supportive learning environments will generally support medical students' psychological needs for optimal motivation and well-being, but whether or not they lead to empathy towards patients will depend on individual differences in self-determination. Findings and their implications are discussed in terms of developing theory-driven approaches to cultivating empathy in medical education.

Empathy bodyssence: temporal dynamics of sensorimotor and physiological responses and the subjective experience in synchrony with the other's suffering.

Background: Empathy is foundational in our intersubjective interactions, connecting with others across bodily, emotional, and cognitive dimensions. Previous evidence suggests that observing individuals in painful situations elicits whole bodily responses, unveiling the interdependence of the body and empathy. Although the role of the body has been extensively described, the temporal structure of bodily responses and its association with the comprehension of subjective experiences remain unclear. Objective: Building upon the enactive approach, our study introduces and examines "bodyssence," a neologism formed from "body" and "essence." Our primary goal is to analyze the temporal dynamics, physiological, and phenomenological elements in synchrony with the experiences of sportspersons suffering physical accidents. Methods: Using the empirical 5E approach, a refinement of Varela's neurophenomenological program, we integrated both objective third-person measurements (postural sway, electrodermal response, and heart rate) and first-person descriptions (phenomenological data). Thirty-five participants watched videos of sportspersons experiencing physical accidents during extreme sports practice, as well as neutral videos, while standing on a force platform and wearing electrodermal and heart electrodes. Subsequently, micro-phenomenological interviews were conducted. Results: Bodyssence is composed of three distinct temporal dynamics. Forefeel marks the commencement phase, encapsulating the body's pre-reflective consciousness as participants anticipate impending physical accidents involving extreme sportspersons, manifested through minimal postural movement and high heart rate. Fullfeel, capturing the zenith of empathetic engagement, is defined by profound negative emotions, and significant bodily and kinesthetic sensations, with this stage notably featuring an increase in postural movement alongside a reduction in heart rate. In the Reliefeel phase, participants report a decrease in emotional intensity, feeling a sense of relief, as their postural control starts to reach a state of equilibrium, and heart rate remaining low. Throughout these phases, the level of electrodermal activity consistently remains high. Conclusion: This study through an enactive approach elucidates the temporal attunement of bodily experience to the pain experienced by others. The integration of both first and third-person perspectives through an empirical 5E approach reveals the intricate nature of bodyssence, offering an innovative approach to understanding the dynamic nature of empathy.

I understand your pain but I do not feel it: lower affective empathy in response to others' social pain in narcissism.

Introduction: While the relationship between narcissism and empathy has been well-researched, studies have paid less attention to empathic accuracy, i.e., appreciating the precise strength of another person's emotions, and self-other distinction, in terms of the disparity between affective ratings for self and other in response to emotive stimuli. Furthermore, empathic responses may vary depending on whether the pain is physical or social. Methods: We investigated empathic accuracy, affective empathy, and the distinction between pain, emotion and intensity ratings for self and other, in high (n = 44) and low (n = 43) narcissism groups (HNG and LNG, respectively) selected from 611 students, in response to both types of pain. Participants watched six videos where targets expressed genuine experiences of physical and social pain, and rated the perceived affect and pain experienced by the person in the video and their own empathic emotional responses. Results and discussion: The HNG displayed lower affective empathy and empathic accuracy than the LNG for both pain types. Within the HNG there was higher empathic accuracy for social vs. physical pain, despite reduced affective empathy for social pain, in contrast to the LNG. In addition to this paradox, the HNG demonstrated greater differences between ratings for the self and for target others than the LNG, suggesting that narcissism is associated with higher self-other distinction in response to viewing other people describing social pain.

Lived experiences of healthcare. Putting the person in person centred care in the medical radiation sciences.

INTRODUCTION: Contemporary healthcare models recognise person-centred care (PCC) as a fundamental principle of quality, safe care. While substantial literature exists on PCC in healthcare generally, there is less evidence on how this relates to medical imaging and radiation therapy. Embedding patient-lived experiences of healthcare into healthcare education has promise in enhancing students' confidence in delivering PCC. Digital storytelling (DST) of patient-lived experiences can help improve reflection, understanding, critical thinking and empathy. METHODS: Authentic patient-lived experiences were extracted from students' clinical workbooks, transformed into first person vignettes and integrated into the curriculum. Students were invited to attend focus groups to explore the impact the activity had on the student. RESULTS: Thematic analysis identified three themes. (1) Enhancing PCC; (2) Mode of Delivery (Scaffolded Learning); and (3) Collaborative Learning. PCC was the strongest theme with students stating this is the first time they engaged in an activity focused on the psychosocial aspect of patient care. The majority of students indicated the mode of delivery was engaging and unique, whereby the vignettes were presented incrementally. Collaborative learning was identified by over half of the students where learning took place in a safe and supportive environment. CONCLUSION: This project explored students' perspectives of integrating patient-lived experiences into the curriculum via DST. Students who engaged with the activities felt better prepared to deliver quality safe PCC. IMPLICATIONS FOR PRACTICE: Providing healthcare students with opportunities to develop skills to deliver PCC before they enter the workforce can enhance their confidence in delivering effective PCC.

Implications of perceived empathy from spouses during pregnancy for health-related quality of life among pregnant women: a cross-sectional study in Anhui, China.

BACKGROUND: Empathy is a critical component of nursing care, impacting both nurses' and patients' outcomes. However, perceived empathy from spouses during pregnancy and its impact on health-related quality of life (HRQoL) are unclear. This study aimed to examine pregnant women's perceived empathy from their spouses and assess the relation of perceived empathy on HRQoL. METHODS: This cross-sectional study, performed in the obstetric clinics or wards of four well-known hospitals in Anhui Province, China, included 349 pregnant women in the second or third trimester; participants were recruited by convenience sampling and enrolled from October to December 2021. A general information questionnaire, the Interpersonal Reactivity Index (IRI), a purpose-designed empathy questionnaire and the Medical Outcomes Study 12-item Short-Form Health Survey (SF-12) were used to evaluate the pregnant women's general information, perceptions of empathy and HRQoL. Data were analysed using SPSS 22 at a threshold of P < 0.05. Descriptive analysis, Pearson correlation analysis, Student's t test, ANOVA, and multiple regression analysis were used for analysis. RESULTS: The pregnant women's total empathy, physical component summary (PCS) and mental component summary (MCS) scores were 41.6 ± 9.0, 41.6 ± 7.6, and 47.7 ± 9.1, respectively. Correlation analysis revealed that the purpose-designed empathy questionnaire items were significantly positively correlated with perspective taking and empathic concern but were not correlated with the personal distress dimension and were only partially correlated with the fantasy dimension. Maternal physical condition during pregnancy, planned pregnancy, and occupational stress were predictors of the PCS score (ß = 0.281, P < 0.01; ß = 0.132, P = 0.02; ß = -0.128, P = 0.02). The behavioural empathy item of our purpose-designed empathy questionnaire and empathic concern were important predictors of the MCS score (ß = 0.127, P = 0.02; ß = 0.158, P < 0.01), as well as other demographic and obstetric information, explaining 22.0% of the variance in MCS scores totally (F = 12.228, P < 0.01). CONCLUSIONS: Pregnant women perceived lower empathy from their spouses and reported lower HRQoL. Perceived empathy, particularly behavioural empathy, may significantly impact pregnant women's MCS scores but has no effect on their PCS scores. Strategies that foster perceived empathy from spouses among pregnant women are essential for facilitating healthy pregnancies and potentially improving maternal and child health.

The comparison of spiritual well-being and empathic tendencies in midwifery students: A cross-sectional study from Turkey.

This study aimed to investigate the relationship between spiritual well-being and empathic tendencies of midwifery students and the affecting factors. The sample of this descriptive-correlation type study, one of the descriptive research methods, included 237 midwifery students. The data were collected using the Descriptive Information Form, the Empathic Tendency Scale, and the Spiritual Well-Being Scale. Empathic tendency was higher among those who chose the midwifery department voluntarily, those who liked the department, those who felt that the department was suitable for them, those who participated in social and scientific activities, those who wanted to progress in the profession, those who wanted to work in the field and those who followed publications related to the field; Spiritual well-being was higher among those who felt that the department was suitable for them, those who participated in social and scientific activities, those who wanted to progress in the profession, those who participated in activities that provided the development of the profession, those who wanted to work in the field and those who followed publications related to the field. It was determined that the empathic tendencies and spiritual well-being of midwifery students were at a moderate level, and as a result of the comparison of Empathic Tendency Scale and Spiritual Well-being scale scores, there was a significant positive relationship between them.

Understanding the dark side of personality in sex offenders considering the level of sexual violence.

This study examined the relationship between the actual level of physical violence in sexual offenses and dark triad, empathic and impulsive personality traits of their perpetrators. Sixty-four male perpetrators of sexual offenses without any serious mental illness were included. A 5-point Likert-type coding system based on Violence Profile for Current Offense was applied to assess the severity of physical violence of each sexual offense. Personality traits of dark triad (psychopathy, Machiavellianism, narcissism), trait empathy and impulsiveness were also evaluated. Multivariate analyses indicated that non-stranger victim, secondary psychopathy, narcissism and empathy could significantly predict greater involvement of physical violence in a sexual offense. In addition, empathy was negatively correlated with all dark triad traits. Sexual violence should be conceptualized in the form of a continuum, and, considering such an approach, offenders with high secondary psychopathy and narcissism may show preference for sexual assaults that are more violent in nature.

Altered empathy processing in frontotemporal dementia A task-based fMRI study.

A lack of empathy, and particularly its affective components, is a core symptom of behavioural variant frontotemporal dementia (bvFTD). Visual exposure to images of a needle pricking a hand (pain condition) and Q-tips touching a hand (control condition) is an established functional magnetic resonance imaging (fMRI) paradigm used to investigate empathy for pain (EFP; pain condition minus control condition). EFP has been associated with increased blood oxygen level dependent (BOLD) signal in regions known to become atrophic in the early stages in bvFTD, including the anterior insula and the anterior cingulate. We therefore hypothesized that patients with bvFTD would display altered empathy processing in the EFP paradigm. Here we examined empathy processing using the EFP paradigm in 28 patients with bvFTD and 28 sex and age matched controls. Participants underwent structural MRI, task-based and resting-state fMRI. The Interpersonal Reactivity Index (IRI) was used as a measure of different facets of empathic function outside the scanner. The EFP paradigm was analysed at a whole brain level and using two regions-of-interest approaches, one based on a metanalysis of affective perceptual empathy versus cognitive evaluative empathy and one based on the controls activation pattern. In controls, EFP was linked to an expected increase of BOLD signal that displayed an overlap with the pattern of atrophy in the bvFTD patients (insula and anterior cingulate). Additional regions with increased signal were the supramarginal gyrus and the occipital cortex. These latter regions were the only ones that displayed increased BOLD signal in bvFTD patients. BOLD signal increase under the affective perceptual empathy but not the cognitive evaluative empathy region of interest was significantly greater in controls than in bvFTD patients. The controls rating on their empathic concern subscale of the IRI was significantly correlated with the BOLD signal in the EFP paradigm, as were an informants ratings of the patients empathic concern subscale. This correlation was not observed on other subscales of the IRI or when using the patient's self-ratings. Finally, controls and patients showed different connectivity patterns in empathy related networks during resting-state fMRI, mainly in nodes overlapping the ventral attention network. Our results indicate that reduced neural activity in regions typically affected by pathology in bvFTD is associated with reduced empathy processing, and a predictor of patients capacity to experience affective empathy.

The relationship between cerebral asymmetry and measures of psychopathy in a non-clinical sample is moderated by both empathic challenge and biological sex.

This study investigated the relationship between psychopathy, as assessed by the Levenson Self-Report Psychopathy (LSRP) scale, and cerebral laterality. EEG recordings from frontal cortex (L3 and L4) were taken during both resting conditions and while viewing a video of an emergency field amputation, used as an empathic challenge. The ratio of alpha power from the two recording site was taken as an index of relative activity in the two hemispheres. Eighty three students from the University subject pool were recruited as participants. Male participants had a significantly higher mean LSRP score than did female participants. While LSRP scores were unrelated to cerebral laterality under resting conditions, there was both a significant linear and quadratic negative relationship between LSRP scores and relative left-hemisphere alpha activity. As alpha activity has been reported to be inversely related to brain or mental activity, a negative relationship can be inferred between LSRP scores and right hemisphere neural activity. The female participants had a much stronger quadratic relationship than did the combined sample, while the male sample showed only weak, non-significant relationships. Our data suggest that the relationship between psychopathy and cerebral laterality may be sexually dimorphic.

Compassion buffers the association between trauma exposure and PTSD symptom severity: Findings of a cross-sectional study.

To advance intervention science dedicated to improve refugees' mental health, a better understanding of factors of risk and resilience involved in the etiology and maintenance of post-traumatic stress disorder (PTSD) is needed. In the present study, we tested whether empathy and compassion, two trainable aspects of social cognition related to health, would modulate risk for PTSD after war-related trauma. Fifty-six refugees and 42 migrants from Arabic-speaking countries reported on their trauma experiences, PTSD symptoms, and perceived trait empathy and compassion. They further completed the EmpaToM, a naturalistic computer task measuring behavioral empathy and compassion. Moderation analyses revealed that behavioral, but not self-reported compassion was a significant moderator of the trauma-PTSD link. Trauma was more strongly related to PTSD symptoms when individuals had low (ß =.59, t = 4.27, p <.001) as compared to high levels of behavioral compassion. Neither self-reported nor behavioral empathy moderated the trauma-PTSD link (ß =.24, t = 1.57, p =.120). Findings indicate that the ability to go beyond the sharing of others' suffering and generate the positive feeling of compassion may support resilience in the context of trauma and subsequent development of PTSD. Hence, compassion may be a suitable target for prevention and intervention approaches reducing PTSD symptoms after trauma.

How do Children with Intellectual Disabilities Empathize in Comparison to Typically Developing Children?

OBJECTIVES: Two studies were conducted to better understand how children with intellectual disabilities (ID) empathize with the feelings of others during social interactions. The first study tested hypotheses of developmental delay or difference regarding empathy in 79 children with ID by comparing them with typically developing (TD) children, matched for developmental age or chronological age. The second study examined specific aspects of empathy in 23 children with Down syndrome (DS), compared with 23 nonspecific ID children, matched for developmental age, and TD children, matched for developmental age or chronological age. METHOD: An empathy task was administered to the children while their parents completed the French versions of the Empathy Questionnaire and the Griffith Empathy Measure. RESULTS: The first study showed that ID children showed delayed empathy development but were perceived by their parents as deficient in cognitive empathy. The second study showed that DS children were perceived as being more attentive to the feelings of others than TD children and non-specific ID children, matched for developmental age, and as having affective empathy that was similar to that of TD children matched for chronological age. CONCLUSION: These studies have drawn attention to delays or differences in different dimensions of empathy in children with ID and DS, which need to be taken into account in interventions.

The effect of different patient-based learning models on student perceptions of empathy, engagement, knowledge, and learning experience.

BACKGROUND: Problem-based learning is used widely in pharmacy and medical programmes, incorporating realistic patient scenarios into regular teaching as a way of linking theory to practice. Routine case-based learning lessons ranges from real patient involvement, scripted patient scenarios, digital simulations (avatars) as well as through media such as Zoom. The existing literature has explored the extensive benefits of using patients in clinical education, but fewer studies have directly compared the efficacy of each model as learning tools. AIM: To compare student perceptions of patient-based learning models to elicit student empathy, increase engagement, improve knowledge, and enrich learning experience. METHODS: A questionnaire was distributed to second-year pharmacy students in Swansea University to gather their perceptions on the nine different patient-based learning models in their routine teaching (SUMS RESC 2023-0011). Students were asked to rank their experience of the models explicitly against each other, based on the four pillars of (1) eliciting student empathy, (2) increasing engagement, (3) improving knowledge and (4) enriching the learning experience. Students were also asked to rate the significance of realism (i.e. knowing the patient demographics/having a visual representation of the patient) to their experience. RESULTS: Altogether, 31 student rankings of the nine learning models were weighted (9 = highest rank; 1 = lowest ranked). The data showed clear preferences for real-patient involvement over fictional cases, especially for eliciting empathy. Interestingly, scripted scenarios were rated highly for both engagement and learning experience only when avatars were involved, which suggests a role of animated visual representation of the patient in facilitating these outcomes. CONCLUSION: Whilst it is useful to have multiple patient-based learning models, this study serves as a guide for educators in preparing case-based learning sessions for achieving the desired outcomes of any of the four pillars above.