|dc.contributor.author||Jeffrey, David Ian||
The main contribution offered by my research is an increased understanding of
medical students’ perceptions of empathy and the factors that influence this. By
using an innovative method in medical education research, the study
contributes to research methodology.
Empathy is accepted as a fundamental part of the patient-doctor relationship
and essential for effective clinical care. Current societal opinions are that some
healthcare professionals lack empathy and that medical students become less
empathetic during their training, although the reasons for this are not
understood. If this perceived decline is to be addressed, medical educators need
to understand students’ perspectives of the factors that influence their empathy.
Aims of the research
The study sought to gain a deeper understanding of the development of medical
students’ empathy and the factors influencing this during their undergraduate
training. It is hoped that this understanding may lead to improvements in
medical education and patient care.
Ethical approval for the study was granted by the University. A
phenomenological approach was adopted, which involved listening to the
students’ views and experiences of their course. Serial, semi-structured, indepth,
interviews were conducted with sixteen medical students. Each year the
student completed an hour-long interview over three years.
One group of eight students were followed during the preclinical years of the
course (years 1-3) and the other group, during the clinical years (years 4-6). The
interviews were audio-recorded, transcribed, coded using qualitative data
analysis software (N Vivo), and analysed using an interpretative
The students in the preclinical years described empathy as a personal attribute,
emphasising its emotional dimension. In the clinical years, students viewed
empathy differently: as a complex relational process with the patient, which
varied in depth and quality according to the clinical context. They described the
tensions between connecting with and detachment from a patient.
Students indicated influences which enhanced their empathy, including patient
contact and positive role models. They also identified barriers to empathy,
including: the medical school culture, a biomedical bias in the curriculum, a lack
of patient contact, negative role models and teaching of professionalism as
distancing from patients.
The preclinical group of students reported gaining in self-confidence during
their course. The clinical group described how their empathy with patients had
increased but they detected a conflict between empathy and efficiency.
The use of an innovative longitudinal, phenomenological approach in medical
education research generated new understanding of a complex interpersonal
view of empathy and highlighted aspects of a ‘hidden curriculum’.
The students maintained that their contact with patients was the most useful
way of developing empathy. They expressed a desire to connect emotionally
with patients but were uncertain how to balance this connection with
professional detachment. They described a marked biomedical emphasis in
their course and perceived that teaching on professionalism encouraged a
distancing from patients.
In contrast to the widely-reported opinion that there has been a decline in
medical students’ empathy, this study suggested that students perceived that
their empathy increased during their training. However, some students had
learned distancing behaviours to hide their empathetic feelings. In the light of
this research, it is hoped that medical educators will develop ways of supporting
students to deal appropriately with their own emotions and those of patients.||en
|dc.publisher||The University of Edinburgh||en
|dc.relation.hasversion||JEFFREY, D. 2000. Cancer: from Cure to Care, Manchester, Hochland and Hochland.||en
|dc.relation.hasversion||JEFFREY, D. 2014. Medical Mentoring: Supporting Students,Doctors in Training and General Practitioners, London, Royal College of General Practitioners.||en
|dc.relation.hasversion||JEFFREY, D. 2016. Clarifying empathy:the first step to more humane clinical care. British Journal of General Practice, 66, 101-102.||en
|dc.relation.hasversion||JEFFREY, D. 2016. A duty of kindness. Journal of the Royal Society of Medicine, 109, 261-263.||en
|dc.relation.hasversion||JEFFREY, D. 2016. Empathy, sympathy and compassion in healthcare:is there a problem?Is there a difference?does it matter? Journal Royal Society Medicine, 109, 446-452.||en
|dc.relation.hasversion||JEFFREY, D. 2016. A meta-ethnography of interview-based qualitative research studies on medical students’ views and experiences of empathy. Medical Teacher, 38, 1214-1220.||en
|dc.relation.hasversion||JEFFREY, D. & DOWNIE, R. 2016. Empathy-Can it be taught? J.R.Coll Physicians Edinb., 46, 107-112.||en
|dc.relation.hasversion||JEFFREY, E. & JEFFREY, D. 2013. Enhancing Compassion in End-of-Life Care Through Drama : The Silent Treatment, London, Radcliffe Publishing.||en
|dc.relation.hasversion||JEFFREY D 2017 Communicating with a human voice: developing a relational view of empathy. Journal of the Royal College of Physicians of Edinburgh, 47,266- 270.||en
|dc.subject||medical school culture||en
|dc.title||Exploring empathy with medical students: a qualitative longitudinal phenomenological study||en
|dc.type||Thesis or Dissertation||en
|dc.type.qualificationname||PhD Doctor of Philosophy||en