title: Details acquired from medical history and patients' experience of empathy--two sides of the same coin.
abstract: BACKGROUND
  History taking and empathetic communication are two important aspects in successful physician-patient interaction. Gathering important information from the patient's medical history is needed for effective clinical decision making while empathy is relevant for patient satisfaction. We wanted to investigate whether medical students near graduation are able to combine both skills as required in daily medical practice.
  
  
  METHODS
  Thirty near graduates from Hamburg Medical School participated in an assessment for clinical competences including a consultation hour with five standardized patients. Each patient interview was videotaped and standardized patients rated participants with the CARE questionnaire for consultation and relational empathy. All videotaped interviews were rated with a checklist based on the number of important medical aspects for each case. Data were analysed with the linear mixed model to correct for random effects. Regression analysis was performed to look for correlations between the number of questions asked by a participant and their respective empathy rating.
  
  
  RESULTS
  Of the 123 aspects that could have been gathered in total, students only requested 56.4% (95% CI 53.5-59.3). While no difference between male and female participants was found, a significant difference (p<.001) was observed between the two parts of the checklist with 61.1% (95% CI 57.9-64.3) of aspects asked for in part 1 (patient's symptoms) versus 52.0 (95 47.4-56.7) in part 2 (further history). All female standardized patients combined rated female participants (mean score 14.2, 95% CI 12.3-16.3) to be significantly (p<.01) more empathetic than male participants (mean score 19.2, 95% CI 16.3-22.6). Regression analysis revealed no correlation between the number of medical aspects gathered by a participant and his or her respective empathy score given by the standardized patient in the CARE questionnaire.
  
  
  CONCLUSIONS
  Gathering sufficient medical data from a patient's history and empathetic communication are two completely separate sides of the coin of history taking. While both skills have to be acquired during medical school training with particular focus on their respective learning objectives, medical students need to be provided with additional learning and feedback opportunities where they can be observed exercising both skills combined as required in physicians' daily practice.
authors: University Medical Centre Hamburg-Eppendorf, Department of Internal Medicine, Martinistr, 52, 20246 Hamburg, Germany.
authors: Friedemann
authors: F
authors: Ohm
authors: Daniela
authors: D
authors: Vogel
authors: Susanne
authors: S
authors: Sehner
authors: Marjo
authors: M
authors: Wijnen-Meijer
authors: Sigrid
authors: S
authors: Harendza
mesh_terms: D002983:Clinical Competence / Q000592:standards; D003142:Communication; D004645:Empathy; D005260:Female; D006801:Humans; D008297:Male; D008487:Medical History Taking / Q000592:standards; D017060:Patient Satisfaction; D010817:Physician-Patient Relations; D011795:Surveys and Questionnaires; D014741:Video Recording
references: Med Teach. 2004 Jun;26(4):374-6
references: 15203853
references: Acad Med. 2010 Nov;85(11):1772-6
references: 20881825
references: Eur J Gen Pract. 2004 Sep;10(3):93-7
references: 15534573
references: J Fam Pract. 2000 Sep;49(9):796-804
references: 11032203
references: Med Educ. 2010 Mar;44(3):272-9
references: 20444058
references: Acad Med. 1997 Jan;72(1):57-61
references: 9008571
references: Am J Med. 1996 Aug;101(2):210-6
references: 8757362
references: Med Educ. 2002 Oct;36(10):901-9
references: 12390456
references: Med Educ. 1991 May;25(3):224-9
references: 1857278
references: Adv Health Sci Educ Theory Pract. 2013 Dec;18(5):1009-27
references: 23400369
references: Med Educ. 2004 Jan;38(1):25-31
references: 14962023
references: Pediatrics. 1970 Apr;45(4):623-7
references: 5438165
references: J Med Educ. 1976 May;51(5):410-5
references: 1263231
references: CMAJ. 1995 May 1;152(9):1423-33
references: 7728691
references: Br J Gen Pract. 2002 Oct;52 Suppl:S22-6
references: 12389766
references: Med Educ. 2009 Mar;43(3):254-9
references: 19250352
references: Clin Geriatr Med. 2000 Feb;16(1):25-36, vii-viii
references: 10723615
references: Acad Med. 1994 Nov;69(11):883-5
references: 7945684
references: West J Med. 1992 Feb;156(2):163-5
references: 1536065
references: Br Med J. 1975 May 31;2(5969):486-9
references: 1148666
references: Patient Educ Couns. 2007 Sep;68(1):16-22
references: 17482418
references: J Health Soc Behav. 1987 Dec;28(4):375-88
references: 3429807
references: Lancet. 1976 Sep 11;2(7985):556-8
references: 60632
references: Z Arztl Fortbild Qualitatssich. 2005;99(7):419-23
references: 16277056
references: N Z Med J. 2008 Sep 22;121(1282):51-7
references: 18815604
references: Psychother Psychosom Med Psychol. 2008 Jan;58(1):5-15
references: 17429761
references: Acad Med. 2003 Aug;78(8):802-9
references: 12915371
references: Med Educ. 2009 Nov;43(11):1097
references: 19788643
references: Int J Psychiatry Med. 1999;29(3):347-56
references: 10642908
references: Adv Health Sci Educ Theory Pract. 2000;5(1):3-10
references: 12386472
references: Med Educ. 1998 May;32(3):283-8
references: 9743783
references: Patient Educ Couns. 2011 Mar;82(3):448-54
references: 21111558
references: Am Surg. 2009 Jul;75(7):584-90; discussion 590-1
references: 19655602