title: Measuring Empathy Levels among Kurdish Medical Students in Erbil City, Iraq: Cross-sectional study.
abstract: OBJECTIVE
  Empathy is a crucial attribute within the physician-patient relationship. This study aimed to evaluate the empathy levels of students in the College of Medicine at Hawler Medical University (HMU) in Erbil city, Iraq.
  
  
  METHODS
  This cross-sectional study took place between January and May 2015 and included all medical undergraduates enrolled at HMU (n = 989). The validated self-administered English language version of the Jefferson Scale of Physician Empathy-Student Version (JSPE-SV) was used to measure empathy levels. Students reported their conformity to each statement of the 20-item questionnaire on a 7-point Likert scale. Levels of empathy were considered directly relative to their final score.
  
  
  RESULTS
  A total of 927 students completed the questionnaire (response rate: 93.7%). The male-to-female ratio was 0.72:1 and the mean age was 21.3 ± 1.4 years. The mean empathy score was 101.9 ± 19.2. Female students had significantly higher empathy (P = 0.023) and more frequently chose people-oriented specialties (P = 0.001) than males. First-year students reported the highest mean score (112.9 ± 20.1) while fourth-year students had the lowest (92.7 ± 16.0). There was a significant decline in mean scores between first- and second-year male students (P = 0.020) and first- and fourth-year male students (P = 0.050). Students who chose people-oriented specialties had significantly higher scores than those who chose technology-oriented specialties (P = 0.002).
  
  
  CONCLUSIONS
  The studied cohort of HMU students demonstrated low empathy levels. As such, the inclusion of empathy instruction in medical school curricula is recommended to promote professionalism and patient welfare.
authors.affiliation: Department of Community Medicine, Hawler Medical University, Erbil, Iraq;
authors.forename: Awring M
authors.initials: AM
authors.lastname: Raof
authors.affiliation: Department of Preventive Health, Public Health Institute, Erbil, Iraq.
authors.forename: Bervian A
authors.initials: BA
authors.lastname: Yassin
keywords: Attitudes; Empathy; Iraq; Medical Education; Medical Students; Physician-Patient Relations