Empathy in AI for Health and Care Settings-Definition, Expression, and Measurement: Protocol for a Scoping Review

"Empathy" is widely discussed in health and care settings and is increasingly claimed as an attribute of artificial intelligence (AI) systems (eg, socially assistive robots and chatbots), but the term is used inconsistently across the literature. In research on AI in these settings, it is often unclear what authors mean by "empathic AI," what systems do that is intended to be empathic, and how empathy is assessed. This matters because perceived empathy can shape users' experience of AI-mediated support and their willingness to engage with these systems.

This study aims to map how empathy is defined, operationalized, and evaluated in peer-reviewed AI research in health and care settings and to describe interactional design features commonly reported in systems perceived as more empathic.

This protocol outlines a scoping review following Joanna Briggs Institute guidance and is reported in accordance with PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews). We use "AI" as an umbrella term and will extract and classify each system's type (eg, rule-based or large language model-based). We will search PubMed (MEDLINE), Embase, PsycInfo, CINAHL, Scopus, IEEE Xplore, and the ACM Digital Library databases. Two reviewers will screen titles and abstracts using ASReview and full texts by using Rayyan. We will extract study characteristics, empathy definitions and framing, empathy-related system behaviors and design features, and evaluation methods, and synthesize findings thematically.

This scoping review forms a part of the first author's doctoral research, funded by an Engineering and Physical Sciences Research Council studentship from October 2025. Pilot searches were conducted on January 20, 2026; full searches and synthesis are planned for 2026, with publication anticipated in 2027. The review will produce (1) a summary of how empathy is defined in AI research in health and care settings, (2) a grouped list of the main empathic interactional behaviors and design features described, and (3) an overview of how empathy is measured across studies. Where studies report empathy ratings, we will summarize which features are most commonly present in higher-rated systems within comparable contexts.

The review will provide a clearer picture of what researchers mean by "AI empathy" in health and care settings and what system features are most commonly used when trying to build it. These findings may help guide the development of more empathic AI systems.

PRR1-10.2196/93078.