Impact of a narrative medicine programme on healthcare providers’ empathy scores over time

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Abstract

Background

The cultivation of empathy for healthcare providers is an important issue in medical education. Narrative medicine (NM) has been shown to foster empathy. To our knowledge, there has been no research that examines whether a NM programme affects multi-professional healthcare providers’ empathy. Our study aims to fill this gap by investigating whether a NM programme effects multi-professional healthcare providers’ empathy.

Methods

A pre-post questionnaire method was used.142 participants ( n = 122 females) who attended the NM programme were divided into single ( n = 58) and team groups ( n = 84) on the basis of inter-professional education during a period of 2 months. Perceptions of the NM programme were collected using our developed questionnaire. Empathy levels were measured using the Chinese version of Jefferson Scale of Empathy - Healthcare Providers Version (JSE-HP) – at three time points: prior to (Time 1), immediately after (T2), and 1.5 years (T3) after the programme.

Results

Participants’ perceptions about the NM programme ( n = 116; n = 96 females) suggested an in enhancement of empathy (90.5%). Empathy scores via the JSE-HP increased after the NM programme (T1 mean 111.05, T2 mean 116.19) and were sustainable for 1.5 years (T3 mean 116.04) for all participants ( F(2297) = 3.74, p < .025). A main effect of gender on empathy scores was found ( F(1298) = 5.33, p < .022). No significant effect of gender over time was found but there was a trend that showed females increasing empathy scores at T2, sustaining at T3, but males demonstrating a slow rise in empathy scores over time.

Conclusions

NM programme as an educational tool for empathy is feasible. However, further research is needed to examine gender difference as it might be that males and females respond differently to a NM programme intervention.

Electronic supplementary material

The online version of this article (doi:10.1186/s12909-017-0952-x) contains supplementary material, which is available to authorized users.

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Most cited references 28

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Sex differences in empathy and related capacities.

Nancy Eisenberg, Randy Lennon (1983)

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Empathy in medical students as related to academic performance, clinical competence and gender.

M Hojat, J. S. Gonnella, S Mangione … (2002)

Empathy is a major component of a satisfactory doctor-patient relationship and the cultivation of empathy is a learning objective proposed by the Association of American Medical Colleges (AAMC) for all American medical schools. Therefore, it is important to address the measurement of empathy, its development and its correlates in medical schools. We designed this study to test two hypotheses: firstly, that medical students with higher empathy scores would obtain higher ratings of clinical competence in core clinical clerkships; and secondly, that women would obtain higher empathy scores than men. A 20-item empathy scale developed by the authors (Jefferson Scale of Physician Empathy) was completed by 371 third-year medical students (198 men, 173 women). Associations between empathy scores and ratings of clinical competence in six core clerkships, gender, and performance on objective examinations were studied by using t-test, analysis of variance, chi-square and correlation coefficients. Both research hypotheses were confirmed. Empathy scores were associated with ratings of clinical competence and gender, but not with performance in objective examinations such as the Medical College Admission Test (MCAT), and Steps 1 and 2 of the US Medical Licensing Examinations (USMLE). Empathy scores are associated with ratings of clinical competence and gender. The operational measure of empathy used in this study provides opportunities to further examine educational and clinical correlates of empathy, as well as stability and changes in empathy at different stages of undergraduate and graduate medical education.

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Analyzing the "nature" and "specific effectiveness" of clinical empathy: a theoretical overview and contribution towards a theory-based research agenda.

Melanie Neumann, Jozien Bensing, Stewart Mercer … (2009)

To establish sound empirical evidence that clinical empathy (abbreviated as CE) is a core element in the clinician-patient relationship with profound therapeutic potential, a substantial theoretical-based understanding of CE in medical care and medical education is still required. The two aims of the present paper are, therefore, (1) to give a multidisciplinary overview of the "nature" and "specific effectiveness" of CE, and (2) to use this base as a means of deriving relevant questions for a theory-based research agenda. We made an effort to identify current and past literature about conceptual and empirical work focusing on empathy and CE, which derives from a multiplicity of disciplines. We review the material in a structured fashion. We describe the "nature" of empathy by briefly summarizing concepts and models from sociology, psychology, social psychology, education, (social-)epidemiology, and neurosciences. To explain the "specific effectiveness" of CE for patients, we develop the "Effect model of empathic communication in the clinical encounter", which demonstrates how an empathically communicating clinician can achieve improved patient outcomes. Both parts of theoretical findings are synthesized in a theory-based research agenda with the following key hypotheses: (1) CE is a determinant of quality in medical care, (2) clinicians biographical experiences influence their empathic behavior, and (3) CE is affected by situational factors. The main conclusions of our review are twofold. First of all, CE seems to be a fundamental determinant of quality in medical care, because it enables the clinician to fulfill key medical tasks more accurately, thereby achieving enhanced patient health outcomes. Second, the integration of biographical experiences and situational factors as determinants of CE in medical care and medical education appears to be crucial to develop and promote CE and ultimately ensuring high-quality patient care. Due to the complexity and multidimensionality of CE, evidence-based investigations of the derived hypotheses require both well-designed qualitative and quantitative studies as well as an interdisciplinary research approach.

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Author and article information

Contributors

Po-Jui Chen: play1367@hotmail.com

Chien-Da Huang: +886-3-3281200 , cdhuang@adm.cgmh.org.tw

San-Jou Yeh: ysjepsrf@cgmh.org.tw

Journal

Journal ID (nlm-ta): BMC Med Educ

Journal ID (iso-abbrev): BMC Med Educ

Title: BMC Medical Education

Publisher: BioMed Central (London )

ISSN (Electronic): 1472-6920

Publication date (Electronic): 5 July 2017

Publication date PMC-release: 5 July 2017

Publication date Collection: 2017

Volume: 17

Electronic Location Identifier: 108

Affiliations

[1 ]GRID grid.145695.a, Department of Medicine, , Chang Gung University, College of Medicine, ; Taipei, Taiwan

[2 ]ISNI 0000 0001 0711 0593, GRID grid.413801.f, , Chang Gung Medical Education Research Center (CG-MERC), Department of Thoracic Medicine, Chang Gung Memorial Hospital, ; 199 Tun Hua N. Rd, Taipei, Taiwan

[3 ]GRID grid.145695.a, Department of Medical Education, , Chang Gung University, College of Medicine, ; Taipei, Taiwan

[4 ]GRID grid.145695.a, Thoracic Medicine, , Chang Gung University, College of Medicine, ; Taipei, Taiwan

[5 ]GRID grid.145695.a, Cardiology, Chang Gung Memorial Hospital, , Chang Gung University, College of Medicine, ; Taipei, Taiwan

Article

Publisher ID: 952

DOI: 10.1186/s12909-017-0952-x

PMC ID: 5499008

PubMed ID: 28679379

SO-VID: 7faa3daf-2be1-4912-a27b-b07e53352d47

License:

Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

History

Date received : 15 September 2016

Date accepted : 26 June 2017

Funding

Funded by: Chang Gung Memorial Hospital, Taiwan

Award ID: CDRPG 3D0011-3

Award Recipient : Chien-Da Huang

Funded by: The Ministry of Science and Technology, Taiwan, ROC

Award ID: MOST 104-2511-S-182-009

Award Recipient : Chien-Da Huang

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ScienceOpen disciplines: Education

Keywords: narrative medicine,empathy,educational programme,gender

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ScienceOpen disciplines: Education

Keywords: narrative medicine, empathy, educational programme, gender

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Impact of a narrative medicine programme on healthcare providers’ empathy scores over time

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Abstract

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Electronic supplementary material

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SDG 5: Gender Equality

Most cited references 28

Sex differences in empathy and related capacities.

Empathy in medical students as related to academic performance, clinical competence and gender.

Analyzing the "nature" and "specific effectiveness" of clinical empathy: a theoretical overview and contribution towards a theory-based research agenda.

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