title: A cross-sectional measurement of medical student empathy.
abstract: BACKGROUND
  Empathy is important in the physician-patient relationship. Prior studies have suggested that physician empathy may decline with clinical training.
  
  
  OBJECTIVE
  To measure and examine student empathy across medical school years.
  
  
  METHODS
  A cross-sectional study of students at Boston University School of Medicine in 2006. Incoming students plus each class near the end of the academic year were surveyed.
  
  
  METHODS
  The Jefferson Scale of Physician Empathy-Student Version (JSPE-S), a validated 20-item self-administered questionnaire with a total score ranging from 20 to 140. JSPE-S scores were controlled for potential confounders such as gender, age, anticipated financial debt upon graduation, and future career interest.
  
  
  RESULTS
  658 students participated in the study (81.4% of the school population). The first-year medical student class had the highest empathy scores (118.5), whereas the fourth-year class had the lowest empathy scores (106.6). Measured empathy differed between second- and third-year classes (118.2 vs 112.7, P < .001), corresponding to the first year of clinical training. Empathy appears to increase from the incoming to the first-year class (115.5 vs 118.5, P = .02). Students preferring people-oriented specialties had higher empathy scores than students preferring technology-oriented specialties (114.6 vs 111.4, P = .002). Female students were more likely than male students to choose people-oriented specialties (51.5 vs 26.9%, P < .001). Females had higher JSPE-S scores than males (116.5 vs 112.1, P < .001). Age and debt did not affect empathy scores.
  
  
  CONCLUSIONS
  Empathy scores of students in the preclinical years were higher than in the clinical years. Efforts are needed to determine whether differences in empathy scores among the classes are cohort effects or represent changes occurring in the course of medical education. Future research is needed to confirm whether clinical training impacts empathy negatively, and, if so, whether interventions can be designed to mitigate this impact.
authors.affiliation: Section of General Internal Medicine, Evans Department of Medicine, Boston University School of Medicine, Boston, MA, USA. daniel.chen@bmc.org
authors.forename: Daniel
authors.initials: D
authors.lastname: Chen
authors.forename: Robert
authors.initials: R
authors.lastname: Lew
authors.forename: Warren
authors.initials: W
authors.lastname: Hershman
authors.forename: Jay
authors.initials: J
authors.lastname: Orlander
mesh_terms: D000328:Adult; D000704:Analysis of Variance; D001291:Attitude of Health Personnel; D003430:Cross-Sectional Studies; D004504:Education, Medical, Undergraduate; D004645:Empathy; D005260:Female; D006801:Humans; D008297:Male; D011336:Probability; D012737:Sex Factors; D013337:Students, Medical / Q000523:psychology*; D011795:Surveys and Questionnaires; D013997:Time Factors