Teaching empathy to first year medical students: evaluation of an elective literature and medicine course

Empathy is critical to the development of professionalism in medical students, and the humanities-particularly literature-have been touted as an effective tool for increasing student empathy. This quantitative/qualitative study was undertaken to assess whether reading and discussing poetry and prose related to patients and doctors could significantly increase medical student empathy and appreciation of the relevance of the humanities for their own professional development.

In 2000-2001, first year students (n=22) volunteered for an eight-session literature and medicine elective and were randomly assigned to either immediate participation in the class or a wait-list group, who participated in the same class 6 months later. Complete pre- and post-intervention data for 16 students from both groups were obtained for two quantitative measures of empathy and an attitudes-toward-the-humanities scale. Students also participated in a qualitative group interview pre- and post-intervention.

Empathy and attitudes toward the humanities improved significantly (p<0.01) after participation in the class when both groups of students were combined. The scaled treatment effect size was in the moderate range (> or =0.60 standard deviation units) for both measures that had statistically significant pre-to-post changes. Furthermore, student understanding of the patient's perspective became more detailed and complex after the intervention. Students were also more likely post-intervention to note ways reading literature could help them cope with training-related stress.

A brief literature-based course can contribute to greater student empathy and appreciation for the value of humanities in medical education.