Does empathy change during undergraduate medical education? - A meta-analysis

Purpose: The aim of this meta-analysis was to synthesize the existing evidence examining how empathy changes during undergraduate medical education and assess whether different types of measures produce different results. Method: Three electronic bibliographic databases were last searched on 28 November 2018. Quantitative studies including a measure of empathy in medical undergraduate students and a comparison of the results among the different years of study were included. All analyses were guided by Lipsey and Wilson and conducted using Comprehensive Meta-Analysis software. Results: The overall sample size for the twelve studies (n = 12) was 4906 participants. Results indicate a significant effect (g = 0.487, SE = 0.113, 95% CI = 0.265, 0.709), suggesting that there is moderate evidence that empathy scores changed. Studies using the Jefferson's Scale for Physician Empathy (JSPE) reported higher effect sizes (g = 0.834, SE = 0.219, 95% CI = 0.406, 1.263), while the effect size for studies using other scales was smaller and non-significant (g = 0.099, SE = 0.052, 95% CI = -0.003, 0.201). Conclusions: This review indicated significant evidence that self-ratings of empathy changed across the years of medical education. However, we need to be cautious because this effect was only significant when empathy was assessed using the JSPE.