Simulating empathy: A qualitative experiential study of embedded resident learners in an empathy curriculum

Physician empathy and communication skills are crucial parts of a successful emergency department (ED) interaction. This study aimed to evaluate whether these skills can be improved through a novel curriculum where interns act as patients for their senior residents during simulated ED cases.

Twenty-five residents participated in the curriculum. Prior to the cases, participants filled out the Toronto Empathy Questionnaire (TEQ). They then completed three simulated cases, with the 11 interns portraying the patients and the 14 seniors (postgraduate year [PGY]-2 and PGY-3 residents) in the physician role. Following the cases, the residents participated in a recorded, structured focus group. At the conclusion of the session participants again filled out the TEQ and answered a Likert questionnaire on their thoughts about the curriculum. Qualitative analysis was used to determine themes from the debriefs.

Twenty-two residents completed all components of the study. The mean (±SD) TEQ scores pre- and postcurriculum for all residents were 46.2 (±4.64) pre and 47.9 (±6.03) post (ns). On qualitative analysis, we derived four major themes: empathy, communication, feedback, and physician experience. The most common subthemes discussed were empathy for the patient situation and the importance of communicating visit expectations. On a 5-point Likert survey related to the simulated cases, respondents rated comfort providing feedback to their peers (mean ± SD 4.41 ± 0.95) and gaining insight into the patient experience (mean ± SD 4.27 ± 0.83).

The embedded intern exercise was rated well by resident participants, with no observed change in empathy scores. Qualitative analysis identified empathy and communication as major themes. Residents enjoyed this style of simulation and found it realistic.