title: An exploration of changes in cognitive and emotional empathy among medical students in the Caribbean.
abstract: OBJECTIVE
  This study explored the empathy profile of students across five years of medical training. In addition the study examined whether the Jefferson Scale for Physician Empathy correlated with a measure of cognitive empathy, the Reading the Mind in the Eyes Test and a measure of affective empathy, the Toronto Empathy Questionnaire.
  
  
  METHODS
  The study was a comparative cross-sectional design at one Caribbean medical school. Students were contacted in class, participation was voluntary and empathy was assessed using all three instruments Descriptive statistics were calculated and differences between groups evaluated using non-parametric tests.
  
  
  RESULTS
  Overall 669 students participated (response rate, 67%). There was a significant correlation between the Jefferson Scale of Physician Empathy and the Toronto Empathy Questionnaire (ρ = 0.48), both scales indicating a decline in medical student empathy scores over time. There was, however, little correlation between scores from the Reading the Mind in the Eyes Test and the Jefferson Scale of Physician Empathy. Female students demonstrated significantly higher scores on all three measures.
  
  
  CONCLUSIONS
  Medical students' lower empathy scores during their final years of training appear to be due to a change in the affective component of empathy. These findings may reflect an adaptive neurobiological response to the stressors associated with encountering new clinical situations. Attention should be paid not only to providing empathy training for students but also to teaching strategies for improved cognitive processing capacity when they are encountering new and challenging circumstances.
authors.affiliation: Faculty of Medical Sciences, University of the West Indies, St. Augustine, Trinidad and Tobago, West Indies.
authors.forename: Farid F
authors.initials: FF
authors.lastname: Youssef
authors.affiliation: Faculty of Medical Sciences, University of the West Indies, St. Augustine, Trinidad and Tobago, West Indies.
authors.forename: Paula
authors.initials: P
authors.lastname: Nunes
authors.affiliation: Faculty of Medical Sciences, University of the West Indies, St. Augustine, Trinidad and Tobago, West Indies.
authors.forename: Bidyadhar
authors.initials: B
authors.lastname: Sa
authors.affiliation: Faculty of Medical Sciences, University of the West Indies, St. Augustine, Trinidad and Tobago, West Indies.
authors.forename: Stella
authors.initials: S
authors.lastname: Williams
mesh_terms: D000328:Adult; D017691:Caribbean Region; D003430:Cross-Sectional Studies; D004501:Education, Medical; D004645:Empathy; D005260:Female; D006801:Humans; D008297:Male; D010817:Physician-Patient Relations; D012577:Schools, Medical; D013337:Students, Medical / Q000523:psychology*; D011795:Surveys and Questionnaires; D013997:Time Factors; D055815:Young Adult
keywords: Caribbean; Medical students; affective empathy; cognitive empathy