title: Assessing medical student empathy in a family medicine clinical test: validity of the CARE measure.
abstract: BACKGROUND
  The Consultation and Relational Empathy (CARE) measure developed and validated in primary care settings and used for general practitioner appraisal is a 10-item instrument used by patients to assess doctors' empathy. The aim of this study is to investigate the validity of the CARE measure in assessing medical students' empathy during a formative family medicine clinical test.
  
  
  METHODS
  All 158 final-year medical students were assessed by trained simulated patients (SPs) - who completed the CARE measure, the Jefferson Scale of Patient Perceptions of Physician Empathy (JSPPPE), and a global rating score to assess students' empathy and history-taking ability.
  
  
  RESULTS
  Exploratory and confirmatory factor analysis identified a unidimensional structure. The CARE measure strongly correlated with both convergent measures: global rating (ρ=0.79 and <0.001) and JSPPPE (ρ=0.77 and <0.001) and weakly correlated with the divergent measure: history-taking score (ρ=0.28 and <0.001). Internal consistency was excellent (Cronbach's α=0.94).
  
  
  CONCLUSIONS
  The CARE measure had strong construct and internal reliability in a formative, undergraduate family medicine examination. Its role in higher stakes examinations and other educational settings should be explored.
authors.affiliation: Department of Family Medicine and Primary Care, The University of Hong Kong, Pokfulam, Hong Kong.|Institute of Medical and Health Sciences Education, The University of Hong Kong, Pokfulam, Hong Kong; juliechen@hku.hk.
authors.forename: Julie Y
authors.initials: JY
authors.lastname: Chen
authors.affiliation: Department of Family Medicine and Primary Care, The University of Hong Kong, Pokfulam, Hong Kong.|Institute of Medical and Health Sciences Education, The University of Hong Kong, Pokfulam, Hong Kong.
authors.forename: Weng Y
authors.initials: WY
authors.lastname: Chin
authors.affiliation: Department of Family Medicine and Primary Care, The University of Hong Kong, Pokfulam, Hong Kong.
authors.forename: Colman S C
authors.initials: CS
authors.lastname: Fung
authors.affiliation: Department of Family Medicine and Primary Care, The University of Hong Kong, Pokfulam, Hong Kong.
authors.forename: Carlos K H
authors.initials: CK
authors.lastname: Wong
authors.affiliation: Department of Family Medicine and Primary Care, The University of Hong Kong, Pokfulam, Hong Kong.
authors.forename: Joyce P Y
authors.initials: JP
authors.lastname: Tsang
mesh_terms: D000328:Adult; D002681:China; D004504:Education, Medical, Undergraduate / Q000458:organization & administration*; D004521:Educational Measurement; D004645:Empathy; D005194:Family Practice / Q000193:education*; D005260:Female; D006801:Humans; D008297:Male; D010817:Physician-Patient Relations; D015203:Reproducibility of Results; D013337:Students, Medical / Q000523:psychology*
keywords: assessment; clinical consultation; communication; empathy; medical student; primary care; psychometric; undergraduate; validation