Empathy Training for Resident Physicians: A Randomized Controlled Trial of a Neuroscience-Informed Curriculum
- 3.3k Downloads
Physician empathy is an essential attribute of the patient–physician relationship and is associated with better outcomes, greater patient safety and fewer malpractice claims.
We tested whether an innovative empathy training protocol grounded in neuroscience could improve physician empathy as rated by patients.
Randomized controlled trial.
We randomly assigned residents and fellows from surgery, medicine, anesthesiology, psychiatry, ophthalmology, and orthopedics (N = 99, 52% female, mean age 30.6 ± 3.6) to receive standard post-graduate medical education or education augmented with three 60-minute empathy training modules.
Patient ratings of physician empathy were assessed within one-month pre-training and between 1–2 months post-training with the use of the Consultation and Relational Empathy (CARE) measure. Each physician was rated by multiple patients (pre-mean = 4.6 ± 3.1; post-mean 4.9 ± 2.5), who were blinded to physician randomization. The primary outcome was change score on the patient-rated CARE.
The empathy training group showed greater changes in patient-rated CARE scores than the control (difference 2.2; P = 0.04). Trained physicians also showed greater changes in knowledge of the neurobiology of empathy (difference 1.8; P < 0.001) and in ability to decode facial expressions of emotion (difference 1.9; P < 0.001).
A brief intervention grounded in the neurobiology of empathy significantly improved physician empathy as rated by patients, suggesting that the quality of care in medicine could be improved by integrating the neuroscience of empathy into medical education.
KEY WORDSempathy randomized controlled trial communication skills graduate medical education patient–physician relationship
Contributors: We thank Dr. Lidia Schapira for her helpful comments on the manuscript and Dr. Brian C. George for his assistance with study design and recruitment. We are grateful to Paul Ekman, PhD for permission to use the Ekman Test. We are also grateful to the residents and fellows who participated in this study, to the patients who provided ratings of physician empathy, and to the staff, program directors, and department chiefs of the participating specialties.
We are grateful to the following foundations for their generous support: The Arnold P. Gold Foundation, The David Judah Fund, The Josiah Macy, Jr. Foundation, and The Risk Management Foundation. The funding agencies played no role in the design and conduct of this study, including analysis and interpretation of data, and preparation, review, and approval of the manuscript.
This work has not been presented previously.
Conflict of Interest:
Helen Riess reports her role as Chief Technology Officer for Empathetics, LLC. This study was completed prior to formation of Empathetics, LLC. The other authors declare that they do not have a conflict of interest.
- 6.Medical School Objectives Project. Learning Objectives for Medical Education: Guidelines for Medical Schools. Association of American Medical Colleges, 1998.Google Scholar
- 7.Chaudhry HJ, Rhyne J, Cain FE, Young A, Crane M, Bush F. Maintenance of licensure: protecting the public, promoting quality health care. J Med Regul. 2010;96(1):1–8.Google Scholar
- 9.Halpern J. from detached concern to empathy: Humanizing medical practice. Paperbackth ed. New York: Oxford University Press; 2010.Google Scholar
- 17.Harris J. The evolutionary neurobiology, emergence and facilitation of empathy. In: Farrow TFD, Woodruff PWR, eds. Empathy in mental illness. Cambridge: Cambridge University Press; 2007:506.Google Scholar
- 29.Hammond DC. Hypnotic induction and suggestion: An introductory manual. 1st ed. Des Plaines, IL: The American Society of Clinical Hypnosis; 1988.Google Scholar
- 33.Ekman P. Emotions revealed: Recognizing faces and feelings to improve communication and emotional life. New York: Holt; 2004.Google Scholar
- 36.Cohen J. Statistical power analysis for the behavioral sciences. 2nd ed. Hillsdale, NJ: Lawrence Erlbaum Associates; 1988.Google Scholar
- 37.Hemmerdinger JM, Samuel DR Stoddart SDR, Lilford RJ. A systematic review of tests of empathy in medicine. BMC Med Educ. 2007;7(24).Google Scholar