Advertisement

Barriers to Empathy: The Medical School Culture

  • David Ian JeffreyEmail author
Chapter
First Online:

Abstract

This chapter addresses the hidden curriculum, the culture or ambience of the medical school.

This is a preview of subscription content, log in to check access.

References

  1. Ahrweiler, F., Neumann, M., Goldblatt, H., Hahn, E. G., & Scheffer, C. (2014). Determinants of physician empathy during medical education: Hypothetical conclusions from an exploratory qualitative survey of practicing physicians. BMC Medical Education, 14, 122–134.CrossRefGoogle Scholar
  2. Allen, D., Wainwright, M., Mount, B., & Hutchinson, T. (2008). The wounding path to becoming healers: Medical students’ apprenticeship experiences. Medical Teacher, 30, 260–264.CrossRefGoogle Scholar
  3. Antonovsky, A. (1996). The salutogenic model as a theory to guide health promotion. Health Promotion International, 11, 11–18.CrossRefGoogle Scholar
  4. Back, L. (2016). Academic Diary: Or Why Higher Education Still Matters. London: Goldsmiths.Google Scholar
  5. Baker, M., Wessely, S., & Openshaw, D. (2016). Not such friendly banter? GPs and psychiatrists against the systematic denigration of their specialties. British Journal of General Practise, 66, 508–509.CrossRefGoogle Scholar
  6. Bandini, J., Mitchell, C., Epstein-Peterson, Z. D., Amobi, A., Cahill, J., Peteet, J., et al. (2017). Student and faculty reflections of the hidden curriculum: How does the hidden curriculum shape students’ medical training and professionalization? American Journal of Hospice and Palliative Medicine, 34, 57–63.CrossRefGoogle Scholar
  7. Bauer, J. L. (2008). Slow medicine. The Journal of Alternative and Complementary Medicine, 14, 891–892.CrossRefGoogle Scholar
  8. Bayne, H. B. (2011). Training medical students in empathic communication. The Journal for Specialists in Group Work, 36, 316–329.CrossRefGoogle Scholar
  9. Benbassat, J. (2014). Changes in wellbeing and professional values among medical undergraduate students: A narrative review of the literature. Advances in Health Sciences Education, 19, 597–610.CrossRefGoogle Scholar
  10. Bleakley, A., & Bligh, J. (2009). Who can resist Foucault? Journal of Medicine and Philosophy, 34, 368–383.CrossRefGoogle Scholar
  11. Brandl, K., Schneid, S. D., Smith, S., Winegarden, B., Mandel, J., & Kelly, C. J. (2017). Small group activities within academic communities improve the connectedness of students and faculty. Medical Teacher, 39(8), 1–7.CrossRefGoogle Scholar
  12. Brazeau, C., Schroeder, R., Rovi, S., & Boyd, L. (2010). Relationships between medical student burnout, empathy, and professionalism climate. Academic Medicine, 85, 33–36.CrossRefGoogle Scholar
  13. Cacioppo, J. T., Hawkley, L. C., Norman, G. J., & Berntson, G. G. (2011). Social isolation. Annals of the New York Academy of Sciences, 1231, 17–22.CrossRefGoogle Scholar
  14. Chew-Graham, C. A., Rogers, A., & Yassin, N. (2003). ‘I wouldn’t want it on my CV or their records’: Medical students’ experiences of help-seeking for mental health problems. Medical Education, 37, 873–880.CrossRefGoogle Scholar
  15. Christakis, D., & Feudtner, C. (1997). Temporary matters: The ethical consequences of transient social relationships in medical training. JAMA, 278, 739–743.CrossRefGoogle Scholar
  16. Cooper, B. (2011). Empathy in Education: Engagement, Values and Achievement. London: Bloomsbury Publishing.Google Scholar
  17. Costa, P., Alves, R., Neto, I., Marvao, P., Portela, M., & Costa, M. J. (2014). Associations between medical student empathy and personality: A Multi-institutional study. PLoS ONE, 9, e89254–e89254.CrossRefGoogle Scholar
  18. Coulehan, J., & Williams, P. (2003). Conflicting professional values in medical education. Cambridge Quarterly of Healthcare Ethics, 12, 7–20.PubMedPubMedCentralGoogle Scholar
  19. Cutler, J., Harding, K., Mozian, S., Wright, L. L., Pica, A. G., Masters, S., et al. (2009). Discrediting the notion “working with ‘crazies’ will make you ‘crazy’”: Addressing stigma and enhancing empathy in medical student education. Advances in Health Sciences Education, 14, 487–502.CrossRefGoogle Scholar
  20. Dyrbye, L. N., Thomas, M. R., & Shanafelt, T. D. (2005). Medical student distress: Causes, consequences and proposed solutions. Mayo Clinic Proceedings, 80, 1613–1622.CrossRefGoogle Scholar
  21. Dyrbye, L. N., Thomas, M. R., Power, D. V., Durning, S., Moutier, C., Massie, F. S., et al. (2010). Burnout and serious thoughts of dropping out of medical school: A multi-institutional study. Academic Medicine, 85, 94–102.CrossRefGoogle Scholar
  22. Eikeland, H. L., Ornes, K., Finset, A., & Pedersen, R. (2014). The physician’s role and empathy—A qualitative study of third year medical students. BMC Medical Education, 14, 165–173.CrossRefGoogle Scholar
  23. Ekman, E., & Halpern, J. (2015). Professional distress and meaning in health care: Why professional empathy can help. Social Work in Health Care, 54, 633–650.CrossRefGoogle Scholar
  24. Epstein, R. M. (2014). Realizing Engel’s biopsychosocial vision: Resilience, compassion, and quality of care. The International Journal of Psychiatry in Medicine, 47, 275–287.CrossRefGoogle Scholar
  25. Firth-Cozens, J. (2001). Medical student stress. Medical Education, 35, 6–7.CrossRefGoogle Scholar
  26. Frost, H. D., & Regehr, G. (2013). “I am a doctor”: Negotiating the discourses of standardization and diversity in professional identity construction. Academic Medicine, 88, 1570–1577.CrossRefGoogle Scholar
  27. General Medical Council. (2009). Tomorrow’s Doctors: Outcomes and Standards for Undergraduate Medical Education. London: General Medical Council.Google Scholar
  28. General Medical Council. (2013). Doctors’ Use of Social Media. London: General Medical Council.Google Scholar
  29. Goldacre, M. J., Turner, G., & Lambert, T. W. (2004). Variation by medical school in career choices of UK graduates of 1999 and 2000. Medical Education, 38, 249–258.CrossRefGoogle Scholar
  30. Halpern, J. (2001). From Detached Concern to Empathy: Humanizing Medical Practice. Oxford: Oxford University Press.CrossRefGoogle Scholar
  31. Halpern, J. (2014). From idealized clinical empathy to empathic communication in medical care. Medicine, Health Care and Philosophy, 17, 301–311.CrossRefGoogle Scholar
  32. Hardy, C. (2017). Empathizing with patients: The role of interaction and narratives in providing better patient care. Medicine, Healthcare and Philosophy., 20, 237–248.CrossRefGoogle Scholar
  33. Harrison, R. L., & Westwood, M. J. (2009). Preventing vicarious traumatization of mental health therapists: Identifying protective practices. Psychotherapy: Theory, Research, Practice, Training, 46(2), 203–219.CrossRefGoogle Scholar
  34. Hinze, S. W. (1999). Gender and the body of medicine or at least some body parts: (Re) constructing the prestige hierarchy of medical specialties. The Sociological Quarterly, 40, 217–239.CrossRefGoogle Scholar
  35. Hojat, M., Zuckerman, M., Magee, M., Mangione, S., Nasca, T., Vergare, M., et al. (2005). Empathy in medical students as related to specialty interest, personality, and perceptions of mother and father. Personality and Individual Differences, 39, 1205–1215.CrossRefGoogle Scholar
  36. Jackson, V., Mack, J., Matsuyama, R., Lakoma, M. D., Sullivan, A. M., Arnold, R., et al. (2008). A qualitative study of oncologists’ approaches to end-of-life care. Journal of Palliative Medicine, 11, 893–906.CrossRefGoogle Scholar
  37. Janssen, A. L., & Macleod, R. D. (2010). What can people approaching death teach us about how to care? Patient Education and Counseling, 81, 251–256.CrossRefGoogle Scholar
  38. Jennings, M. (2009). Medical student burnout: Interdisciplinary exploration and analysis. Journal of Medical Humanities, 30, 253–269.CrossRefGoogle Scholar
  39. Kang, J., Djafari Marbini, H., Patel, P., Fawcett, N., & Leaver, L. (2015). Survey of medical students’ use of social media. The Clinical Teacher, 12, 373–377.CrossRefGoogle Scholar
  40. Karnieli-Miller, O., Vu, T. R., Frankel, R. M., Holtman, M. C., Clyman, S. G., Hui, S. L., et al. (2011). Which experiences in the hidden curriculum teach students about professionalism? Academic Medicine, 86, 369–377.CrossRefGoogle Scholar
  41. Kearney, M. K., Weininger, R. B., Vachon, M. L. S., Harrison, R. L., & Mount, B. M. (2009). Self-care of physicians caring for patients at the end of Life “being connected…. a key to survival”. JAMA, 301, 1155–1164.CrossRefGoogle Scholar
  42. Kerasidou, A., & Horn, R. (2016). Making space for empathy: Supporting doctors in the emotional labour of clinical care. BMC Medical Ethics, 17, 8–13.CrossRefGoogle Scholar
  43. Konrath, S. H., O’Brien, E. H., & Hsing, C. (2010). Changes in dispositional empathy in American college students over time: A meta-analysis. Personality and Social Psychology Review, 15, 180–198.CrossRefGoogle Scholar
  44. Kozéki, B., & Berghammer, R. (1992). The role of empathy in the motivational structure of school children. Personality and Individual Differences, 13, 191–203.CrossRefGoogle Scholar
  45. Langewitz, W., Denz, M., Keller, A., Kiss, A., Rütimann, S., & Wössmer, B. (2002). Spontaneous talking time at start of consultation in outpatient clinic: Cohort study. BMJ, 325, 682–683.CrossRefGoogle Scholar
  46. Lempp, H., & Seale, C. (2004). The hidden curriculum in undergraduate medical education: Qualitative study of medical students’ perceptions of teaching. BMJ, 329, 770–773.CrossRefGoogle Scholar
  47. Marcum, J. A. (2013). The role of empathy and wisdom in medical practice and pedagogy: Confronting the hidden curriculum. Journal of Biomedical Education, 2013, 1–8.CrossRefGoogle Scholar
  48. Marshall, G. R. E., & Hooker, C. (2016). Empathy and affect: What can empathied bodies do? Medical Humanities, 42, 128–134.CrossRefGoogle Scholar
  49. Marvel, M. K., Epstein, R. M., Flowers, K., & Beckman, H. B. (1999). Soliciting the patient’s agenda: Have we improved? JAMA, 281, 283–287.Google Scholar
  50. Mayes, C. (2009). Pastoral power and the confessing subject in patient-centred communication. Journal of Bioethical Inquiry, 6, 483–493.CrossRefGoogle Scholar
  51. Monrouxe, L. V., & Rees, C. E. (2012). “It’s just a clash of cultures”: Emotional talk within medical students’ narratives of professionalism dilemmas. Advances in Health Sciences Education, 17, 671–701.CrossRefGoogle Scholar
  52. Monrouxe, L. V., Rees, C. E., Endacott, R., & Ternan, E. (2014). ‘Even now it makes me angry’: Health care students’ professionalism dilemma narratives. Medical Education, 48, 502–517.CrossRefGoogle Scholar
  53. Neumann, M., Edelhaeuser, F., Tauschel, D., Fischer, M. R., Wirtz, M., Woopen, C., et al. (2011). Empathy decline and its reasons: A systematic review of studies with medical students and residents. Academic Medicine, 86, 996–1009.CrossRefGoogle Scholar
  54. Nogueira-Martins, M. C. F., Nogueira-Martins, L. A., & Turato, E. R. (2006). Medical students’ perceptions of their learning about the doctor–patient relationship: A qualitative study. Medical Education, 40, 322–328.CrossRefGoogle Scholar
  55. Ozbay, F., Johnson, D. C., Dimoulas, E., Morgan III, C., Charney, D., & Southwick, S. (2007). Social support and resilience to stress: From neurobiology to clinical practice. Psychiatry, 4(5), 35.Google Scholar
  56. Paro, H. M. S., Silveira, P. S. P., Perotta, B., Gannam, S., Enns, S. C., Giaxa, R. R. B., et al. (2014). Empathy among medical students: Is there a relation with quality of life and burnout? PloS One, 9, e94133–e94133.CrossRefGoogle Scholar
  57. Pickard, M., Bates, L., Dorian, M., Greig, H., & Saint, D. (2000). Alcohol and drug use in second-year medical students at the University of Leeds. Medical Education, 34, 148–150.CrossRefGoogle Scholar
  58. Ratanawongsa, N., Teherani, A., & Hauer, K. E. (2005). Third-year medical students’ experiences with dying patients during the internal medicine clerkship: A qualitative study of the informal curriculum. Academic Medicine, 80, 641–647.CrossRefGoogle Scholar
  59. Reblin, M., & Uchino, B. N. (2008). Social and emotional support and its implication for health. Current Opinion in Psychiatry, 21, 201–205.CrossRefGoogle Scholar
  60. Rees, C. E., & Monrouxe, L. V. (2011). “A morning since eight of just pure grill”: A multischool qualitative study of student abuse. Academic Medicine, 86, 1374–1382.CrossRefGoogle Scholar
  61. Rees, C. E., Monrouxe, L. V., & McDonald, L. A. (2013). Narrative, emotion and action: analysing ‘most memorable’ professionalism dilemmas. Medical Education, 47, 80–96.CrossRefGoogle Scholar
  62. Schweller, M., Ribeiro, D. L., Celeri, E. V., & de Carvalho-Filho, M. A. (2017). Nurturing virtues of the medical profession: Does it enhance medical students’ empathy? International Journal of Medical Education, 8, 262.CrossRefGoogle Scholar
  63. Shanafelt, T., West, C., Zhao, X. H., Novotny, P., Kolars, J., Habermann, T., et al. (2005). Relationship between increased personal well-being and enhanced empathy among internal medicine residents. Journal of General Internal Medicine, 20, 559–564.CrossRefGoogle Scholar
  64. Tavakol, S., Dennick, R., & Tavakol, M. (2012). Medical students’ understanding of empathy: A phenomenological study. Medical Education, 46, 306–316.CrossRefGoogle Scholar
  65. Thomas, M. R., Dyrbye, L. N., Huntington, J. L., Lawson, K., Novotny, P. J., Sloan, J. A., et al. (2007). How do distress and well-being relate to medical student empathy? A multicenter study. Journal of General Internal Medicine, 22, 177–183.CrossRefGoogle Scholar
  66. Timm, A. (2014). ‘It would not be tolerated in any other profession except medicine’: Survey reporting on undergraduates’ exposure to bullying and harassment in their first placement year. BMJ Open [Online], 4. Available http://dx.doi.org/10.1136/bmjopen-2014-005140. Accessed January 29, 2018.
  67. Twenge, J. M. (2013). The evidence for generation me and against generation we. Emerging Adulthood, 1, 11–16.CrossRefGoogle Scholar
  68. Verghese, A. (2008). Culture shock—Patient as icon, icon as patient. New England Journal of Medicine, 359, 2748–2751.CrossRefGoogle Scholar
  69. von Harscher, H., Desmarais, N., Dollinger, R., Grossman, S., & Aldana, S. (2018). The impact of empathy on burnout in medical students: New findings. Psychology, Health & Medicine, 23, 295–303.CrossRefGoogle Scholar
  70. Vossen, H. G., & Valkenburg, P. M. (2016). Do social media foster or curtail adolescents’ empathy? A longitudinal study. Computers in Human Behavior, 63, 118–124.CrossRefGoogle Scholar
  71. Wear, D., Zarconi, J., Kumagai, A., & Cole-Kelly, K. (2014). Slow medical education. Academic Medicine, 90, 289–293.CrossRefGoogle Scholar
  72. Zenasni, F., Boujut, E., Woerner, A., & Sultan, S. (2012). Burnout and empathy in primary care: Three hypotheses. British Journal of General Practice, 62, 346–347.CrossRefGoogle Scholar

Copyright information

© The Author(s) 2019

Authors and Affiliations

  1. 1.University of EdinburghEdinburghUK

Personalised recommendations

Cite chapter

Buy options