title: The physician's role and empathy - a qualitative study of third year medical students.
abstract: BACKGROUND
  Empathy is important in ensuring the quality of the patient-physician relationship. Several studies have concluded that empathy declines during medical training, especially during the third year. However, there is little empirical research on what may influence a medical student's empathy. In addition, studies of empathy in medicine have generally been dominated by quantitative approaches, primarily self-assessment questionnaires. This is a paradox given the complexity and importance of empathy. In this paper we explore medical students' opinions of what may foster or inhibit empathy during medical school, with a particular emphasis on how empathy is influenced by the initiation into the physician's role.
  
  
  METHODS
  We performed semi-structured qualitative interviews with 11 third year medical students. Content analysis was used to analyse the transcribed interviews.
  
  
  RESULTS
  Five aspects of the the physician's role and the students' role acquisition emerged when the students were asked to describe what may influence their empathy: 1) Becoming and being a professional, 2) Rules concerning emotions and care, 3) Emotional control, 4) The primary importance of biomedical knowledge, and 5) Cynicism as a coping strategy.
  
  
  CONCLUSIONS
  This study suggest that the described inhibitors of empathy may originate in the hidden curriculum and reinforce each other, creating a greater distance between the physician and the patient, and possibly resulting in decreased empathy. Mastering biomedical knowledge is an important part of the students' ideals of the physician's role, and sometimes objective and distanced ideals may suppress empathy and the students' own emotions.
authors.affiliation: Department of Behavioral Sciences, Institute of Basic Medical Sciences, University of Oslo, Domus Medica, Sognsvannsveien 9, Oslo 0372, Norway. h.l.eikeland@medisin.uio.no.
authors.forename: Hanne-Lise
authors.initials: HL
authors.lastname: Eikeland
authors.forename: Knut
authors.initials: K
authors.lastname: Ørnes
authors.forename: Arnstein
authors.initials: A
authors.lastname: Finset
authors.forename: Reidar
authors.initials: R
authors.lastname: Pedersen
mesh_terms: D000223:Adaptation, Psychological; D001291:Attitude of Health Personnel; D004644:Emotions; D004645:Empathy; D005260:Female; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D010819:Physician's Role / Q000523:psychology; D010817:Physician-Patient Relations; D036301:Qualitative Research; D013337:Students, Medical / Q000523:psychology*
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