Changes in Self-Reported Empathy After a Basic Medical Communication Course Among Premedical Students: Single-Group...

Empathy is essential to patient-centered care, yet erosion of empathy has been reported during medical training. Although educational interventions may support empathy development, longitudinal evidence on whether these changes persist remains limited, particularly in non-Western settings.

This study examined changes in overall, emotional, and cognitive self-reported empathy scores and confidence in applying empathy at baseline, immediately after, and 6 months after a basic medical communication course among Korean premedical students. It also explored whether trajectories in self-reported empathy scores differed by gender.

In this single-group longitudinal study, 82.1% (119/145) of second-year premedical students completed surveys at all 3 time points. The required 15-week course included 12 instructional hours on medical communication theory, nonviolent communication, and peer clinical interview role-play. No formal communication- or empathy-focused instruction was provided during follow-up. Self-reported empathy scores were measured using the Korean student version of the Jefferson Scale of Empathy, and 2 additional items assessed confidence in applying empathy in daily life and in physician-patient relationships. Repeated-measures and mixed-design repeated-measures ANOVAs were used.

Overall self-reported empathy scores changed significantly over time (F2,236=13.41; P<.001), increasing from baseline (mean 5.30, SD 0.57) to immediately after the course (mean 5.55, SD 0.62) and remaining above baseline at 6 months (mean 5.48, SD 0.60). Emotional empathy scores increased from baseline to immediately after the course and remained above baseline at 6 months (mean 5.43, SD 0.58; mean 5.66, SD 0.63; and mean 5.59, SD 0.61, respectively; F2,236=10.67; P<.001), as did cognitive empathy scores (mean 4.10, SD 1.18; mean 4.50, SD 1.30; and mean 4.51, SD 1.24, respectively; F2,236=8.80; P<.001). Female students had higher overall empathy scores across assessments than male students (F1,117=6.09; P=.02), but time-by-gender interactions were not significant for overall, emotional, or cognitive empathy (F2,234=0.33 and P=.72, F2,234=0.32 and P=.73, and F2,234=0.12 and P=.89, respectively). Confidence in applying empathy in daily life increased from baseline to immediately after the course and remained higher at 6 months (mean 5.02, SD 1.04; mean 5.26, SD 0.97; and mean 5.26, SD 0.82, respectively; F2,236=5.18; P=.006). Confidence in applying empathy in physician-patient relationships showed a significant overall time effect (mean 4.91, SD 1.09; mean 5.13, SD 1.04; and mean 5.13, SD 0.97, respectively; F2,236=3.46; P=.03), but Bonferroni-adjusted pairwise comparisons were not significant (baseline vs immediately after the course, adjusted P=.07; baseline vs 6-month follow-up, adjusted P=.06; and immediately after the course vs 6-month follow-up, adjusted P>.99).

Participation in a basic medical communication course was associated with higher self-reported empathy scores and greater confidence in applying empathy in daily life, with gains maintained at 6 months; empathy trajectories did not differ significantly by gender. Controlled studies are needed to determine the independent and sustained effects of the course.