Empathy Leak.

Another interesting paper. This time in the Journal of Professional Nursing.
Julia Ward and her colleagues ask the questions:
Are there significant changes in empathy over time in undergraduate nursing students?

Does the extent of exposure to clinical experiences affect changes in empathy among undergraduate nursing students?

Study participants in this longitudinal study included 214 undergraduate nursing students in the US who completed a 2 surveys, 12 months apart, which included the Jefferson Scale of Empathy¹.

The decline was more pronounced among those students with more clinical encounters with patients during the
pretest/posttest 1-year interval and among those with prior work experiences in health care settings.

Check that again. What they are saying is that increasing contact with patients resulted in a decline in empathy. Not a good thing.

A similar study amongst medical students² suggested
several reasons for this erosion of empathy including:

• lack of strong role models
• negative attitudes from clinical faculty
• an intimidating educational environment
• perception of belittleness
• heavy educational assignment or clinical duties
• patients’ negativity

8 Strategies to seal the empathy leak:

The articles authors propose 10 strategies for fostering/enhancing empathy during the education process. But I think this should be relevant to all of us during our professional development (we are all students):

1. acquisition of student interpersonal skills by providing training that directs the student to recognise an empathic opportunity when communicating with
   patients
2. analysing audio-or video-taped patient encounters with students to help them identify positive and negative interviewing factors
3. exposing students to positive role models to improve students’ capacity for
   empathy
4. role-playing with students using standardised patients and low-fidelity simulations to increase student understanding and sensitivity to the physical and psychosocial problems of older adults
5. enabling students to shadow a patient whereby students (with the patient’s
   permission) spend a day with the patient as a way of learning to see them as a person, not as a number or disease
6. making it possible for students to experience pseudohospitalization to better understand patient problems when they are hospitalised
7. encouraging the studying of literature and the arts that would provide students with a rich source of knowledge and insight about human experiences
8. helping students improve their narrative skills by giving them the opportunity to
   listen attentively to patients’ narratives of their illness rather than trying to complete a clinical assignment.

The authors conclude:

Nursing is an art and a science. By promoting scientific inquiry into empathy and translating it into evidence-based practice, we leverage the science of nursing to substantiate the art of nursing and ultimately elevate its practice.

Source: The Empathy Enigma: An Empirical Study of Decline in Empathy Among Undergraduate Nursing Students

1. originally developed to measure empathy amongst medical students and physicians [↩]
2. Hojat, M.,Vegare, M. J.,Maxwell,K., Brainard, G.,Herrine, S.K., Isenberg, G. A.,et al. (2009). The devil is in the third year: A longitudinal study of erosion of empathy in medical school. Academic Medicine, 84, 1182/1191. [↩]