Cognitive and behavioural empathy: are 4th and 6th medical students different?

Area of Science:

• Medical Education
• Empathy Research
• Clinical Skills Assessment

Background:

• Medical student empathy is reported to decline during clinical training.
• Previous studies primarily used self-reports for cognitive/affective empathy.
• This study investigates cognitive, affective, and behavioral empathy in medical students.

Purpose of the Study:

• To compare cognitive, affective, and behavioral empathy between fourth- and sixth-year medical students.
• To assess empathy using both self-report measures and objective behavioral observation.
• To determine if empathy dimensions change during the transition to clinical practice.

Main Methods:

• Fourth- and sixth-year medical students participated in a videotaped Objective Structured Clinical Examination (OSCE) with standardized patients.
• Cognitive/affective empathy was measured using the Cognitive and Affective Empathy Scale (QCAE) and Jefferson Scale of Empathy (JSE).
• Behavioral empathy was assessed via verbal (VR-CoDES-P) and nonverbal coding of OSCE recordings.

Main Results:

• No significant differences were found in self-reported cognitive/affective empathy scores (JSE, QCAE) between the two groups.
• Fourth-year students demonstrated significantly higher verbal empathy compared to sixth-year students.
• No significant differences were observed in nonverbal empathy behaviors between the fourth- and sixth-year groups.

Conclusions:

• Self-reported cognitive and affective empathy levels remain stable between the fourth and sixth years of medical school.
• Observed differences in behavioral empathy are primarily linked to changes in verbal communication, not nonverbal cues.
• Findings suggest that specific aspects of empathy, like verbal responsiveness, may evolve during clinical training.