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Empathy training and stress : their role in medical students' responses to emotional patients Higgins, Heather Marie

Abstract

This study investigated the effects of empathy training on medical students' responses to emotionally intense situations. It also explored the interaction between empathy and stress. Thirteen volunteers from a second-year medical class completed the study which utilized a two-factor crossover design. In the first of three testing situations, each subject participated in a 15-minute videotaped interview with an actor who portrayed an angry, fearful, or grieving patient. Each medical student then completed measures of empathic understanding and perceived stress regarding the encounter, as well as scales of coping and hardiness. Each simulated patient rated the medical student's level of empathic understanding. Two raters, blind to the experimental design, analyzed the tapes and rated the medical students' degree of communicated empathy. Subjects were then randomly assigned to one of two groups: training with follow-up, or control with delayed training. The first group received four 3-hour weekly sessions in empathy training while the second group served as a wait-list control. All subjects then participated in a second taped interview and completed all measures again. The subjects in group two received the training while the first group received no further treatment. All subjects were tested a third time which concluded the experimental procedure. The principal statistical analyses comprised a series of 2 x 2 ANOVAS tested at the .05 level of significance. Results revealed that, following the training, subjects learned to interact in a more empathic manner; effect sizes ranged from 1.08 to 18.32. Also, subjects' stress levels regarding the emotionally intense encounters were reduced; the effect size was -1.95. As hypothesized, these changes in empathy and stress were not observed for the wait-list control group, while training effects were maintained for subjects in the follow-up group. Changes in hardiness and coping were not statistically significant. An outline is presented which illustrates the mediating function of empathic responding in stressful interactions. Also addressed are implications for empathy training in medical education and for communication in the physician-patient relationship.

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