How Do Distress and Well-being Relate to Medical Student Empathy? A Multicenter Study
- 2.7k Downloads
To determine whether lower levels of empathy among a sample of medical students in the United States are associated with personal and professional distress and to explore whether a high degree of personal well-being is associated with higher levels of empathy.
Multi-institutional, cross-sectional survey.
All medical schools in Minnesota (a private medical school, a traditional public university, and a public university with a focus in primary care).
A total of 1,098 medical students.
Validated instruments were used to measure empathy, distress (i.e., burnout and symptoms of depression), and well-being (high quality of life).
Medical student empathy scores were higher than normative samples of similarly aged individuals and were similar to other medical student samples. Domains of burnout inversely correlated with empathy (depersonalization with empathy independent of gender, all P < .02, and emotional exhaustion with emotive empathy for men, P = .009). Symptoms of depression inversely correlated with empathy for women (all P ≤ .01). In contrast, students’ sense of personal accomplishment demonstrated a positive correlation with empathy independent of gender (all P < .001). Similarly, achieving a high quality of life in specific domains correlated with higher empathy scores (P < .05). On multivariate analysis evaluating measures of distress and well-being simultaneously, both burnout (negative correlation) and well-being (positive correlation) independently correlated with student empathy scores.
Both distress and well-being are related to medical student empathy. Efforts to reduce student distress should be part of broader efforts to promote student well-being, which may enhance aspects of professionalism. Additional studies of student well-being and its potential influence on professionalism are needed.
Key wordsempathy well-being burnout professionalism quality of life competency undergraduate medical education
This study was funded through an Academic Primary Care Grant, provided by the division of Primary Care Internal Medicine, Mayo Clinic College of Medicine, and through a Professionalism Grant, provided by the Department of Medicine, Mayo Clinic College of Medicine. The sponsors had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; or preparation, review, or approval of the manuscript. The primary author had full access to all of the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis.
Potential Financial Conflicts of Interest
- 1.ACGME. ACGME Outcome Project. [cited 2006 August 18]; Available from: http://www.acgme.org/Outcome/
- 5.The Medical School Objectives Writing Group. Learning objectives for medical student education-guidelines for medical schools: report I of the Medical School Objectives Project. Acad Med 1999;74(1):13–8.Google Scholar
- 19.Melville A. Job satisfaction in general practice: implications for prescribing. Soc Sci Med [Med Psychol Med Sociol] 1980;14A(6):495–9.Google Scholar
- 31.Spilker B. Quality of life and pharmacoeconomics in clinical trials. New York: Lippincott-Raven; 1996.Google Scholar
- 36.Davis MH. A multidimensional approach to individual differences in empathy. Catalog of Selected Documents in Psychology 1980;10 MS. 2124: p 85.Google Scholar
- 37.Davis MH. Measuring individual differences in empathy: Evidence for a multidimensional approach. J Pers Soc Psychol 1983;44(1):113–126.Google Scholar
- 39.Maslach C. Maslach Burnout Inventory Manual. Palo Alto, CA: Consulting Psychologists Press; 1986.Google Scholar
- 43.Ware J, Kosinski M, Dewey J, Gandek B. How to score and interpret single-item health status measures: a manual for users of the SF-8 health survey. Lincoln, RI: QualityMetric Incorporated; 2001.Google Scholar
- 52.Leiter MP, Durup J. The discriminant validity of burnout and depression: a confirmatory factor analytic study. Anxiety Stress Coping 1994;7:357–73.Google Scholar
- 55.Jatoi A, Yamashita J, Sloan JA, Novotny PJ, Windschitl HE, Loprinzi CL. Does megestrol acetate down-regulate interleukin-6 in patients with cancer-associated anorexia and weight loss? A North Central Cancer Treatment Group investigation [see comment]. Support Care Cancer 2002;10(1):71–5.PubMedGoogle Scholar
- 64.Armitage P. Tests for linear trend in proportions and frequencies. Biometrics 1955;11:375–386.Google Scholar
- 71.Melville A. Job satisfaction in general practice: implications for prescribing. Soc Sci Med 1980;14A:495–499.Google Scholar
- 72.Firth-Cozens J. Emotional distress in junior house officers. Br Med J (Clin Res Ed) 1987;295(6597):533–6.Google Scholar
- 79.Campbell DA, Jr., Sonnad SS, Eckhauser FE, Campbell KK, Greenfield LJ. Burnout among American surgeons. Surgery 2001;130(4):696–702; discussion 702–5.Google Scholar
- 84.Stress and impairment during residency training: strategies for reduction, identification, and management. Resident Services Committee, Association of Program Directors in Internal Medicine. Ann Intern Med 1988;109(2):154–61.Google Scholar
- 92.Shanafelt TD. Finding meaning, balance, and personal satisfaction in the practice of oncology. J Support Oncol 2005;3(2):157–62, 164.Google Scholar
- 97.Mangus RS, Hawkins CE, Miller MJ. Tobacco and alcohol use among 1996 medical school graduates. JAMA 1998;280(13):1192–3, 1195.Google Scholar
- 110.Nightingale SD, Yarnold PR, Greenberg MS. Sympathy, empathy, and physician resource utilization. J Gen Intern Med 1991;6(5):420–3.Google Scholar