Empathy, Self-Reflection, and Curriculum Choice
Main Article Content
Abstract
We administered the Jefferson Scale of Empathy and the Groningen Reflection Ability Scale to 61 of 64 entering medical students who self-selected a problem-based learning curricular track and to 163 of 198 who self-selected a lecture-based track (response rates of 95.3% and 82.3%, respectively, with no statistically significant differences in mean age or sex). Mean empathy and self-reflection ability scores were significantly higher among students who chose problem-based learning. Women scored higher than men in empathy. Women choosing problem-based learning had the highest empathy scores. Studies comparing students’ performance and achievements in different curricular tracks should consider differences in personal characteristics such as capability for empathy and self-reflection that may cause students to prefer one pedagogic approach over another and affect their outcomes.
Article Details
1. Publication and Promotion: In consideration of the Publisher’s agreement to publish the Work, Author hereby grants and assigns to Publisher the non-exclusive right to print, publish, reproduce, or distribute the Work throughout the world in all means of expression by any method now known or hereafter developed, including electronic format, and to market or sell the Work orany part of it as Publisher sees fit. Author further grants Publisher the right to use Author’s name in association with the Work inpublished form and in advertising and promotional materials
2. Copyright: Copyright of the Work remains in Author’s name.
3. Prior Publication and Attribution: Author agrees not to publish the Work in print form prior to publication of the Work by the Publisher. Author agrees to cite, by author, title, and publisher, the original Interdisciplinary Journal of Problem-based Learning publication when publishing the Work elsewhere
4. Author Representations: The Author represents and warrants that the Work:
(a) is the Author’s original Work and that Author has full power to enter into this Agreement;
(b) does not infringe the copyright or property of another;
(c) contains no material which is obscene, libelous, defamatory or previously published, in whole or in part.
Author shall indemnify and hold Publisher harmless against loss of expenses arising from breach of any such warranties.
5. Licensing and Reuse: Reuse of the published Work will be governed by a Creative Commons Attribution-NonCommercial 4.0 International License (CC BY-NC 4.0; http://creativecommons.org/licenses/ by-nc/4.0/). This license lets others remix, tweak, and build upon the Work non-commercially; although new works must acknowledge the original Interdisciplinary Journal of Problem-based Learning publication and be non-commercial, they do not have to be licensed on the same terms.
References
ABIM Foundation. American Board of Internal Medicine; ACP-ASIM Foundation. American College of Physicians-American Society of Internal Medicine; European Federation of Internal Medicine. (2002). Medical professionalism in the new millennium: a physician charter. Annals of Internal Medicine, 136(3), 243–246. http://dx.doi.org/10.7326/0003-4819-136-3-200202050-00012
Albanese, M. A., & Mitchell, S. (1993). Problem-based learn- ing and student achievement: a review of literature on its outcomes and implementation issues. Academic Medicine, 68(1), 52–81. Erratum published August 1993, Academic Medicine, 68(8), 615. http://dx.doi.org/10.1097/00001888-199301000-00012
Association of American Medical Colleges & Howard Hughes Medical Institute Committee. (2009). Scientific foundations for future physicians. http://www.hhmi.org/grants/pdf/08-209_AAMC-HHMI_report.pdf.
Aukes, L. C., Geertsma, J., Cohen-Schotanus, J., Zwierstra, R. P., & Slaets, J. P. J. (2007). The development of a scale to measure personal reflection in medical practice and education. Medical Teacher, 29(2–3), 177–182. http://dx.doi.org/10.1080/01421590701299272
Barrows, H. S. & Tamblyn, R. (1980). Problem-based learning: An approach to medical education. New York: Springer.
Berg, K., Majdan, J. F., Berg, D., Veloski, J., & Hojat, M. (2011). Medical students’ self-reported empathy and simulated patients’ assessments of student empathy: an analysis by gender and ethnicity. Academic Medicine, 86, 984–988. http://dx.doi.org/10.1097/ACM.0b013e3182224f1f
Berkson, L. (1993). Problem-based learning: have the expectations been met? Academic Medicine, 68(10), S79–S88. http://dx.doi.org/10.1097/00001888-199310000-00053
Chen, D., Lew, R., Hershman, W., & Orlander, J. (2007). A cross-sectional measurement of medical student empathy. Journal of General Internal Medicine, 22(10), 1434–1438.
http://dx.doi.org/10.1007/s11606-007-0298-x
Colliver, J. A. (2000). Effectiveness of problem-based learning curricula: research and theory. Academic Medicine, 75(3), 259–266. http://dx.doi.org/10.1097/00001888-200003000-00017
Coulehan, J. (2005). Viewpoint: today’s professionalism: engaging the mind but not the heart. Academic Medicine, 80(10), 892–898. http://dx.doi.org/10.1097/00001888-200510000-00004
Dochy, F., Segers, M., Van den Bossche, P., & Gijbels, D. (2003). Effects of problem-based learning: a meta-analysis. Learning and Instruction, 13(5), 533–568. http://dx.doi.org/10.1016/S0959-4752(02)00025-7
Dolmans, D., & Gijbels, D. (2013). Research on problem-based learning: future challenges. Medical Education, 47(2), 214–218. http://dx.doi.org/10.1111/medu.12105
Donner, R. S., & Bickley, H. (1993). Problem-based learning in American medical education: an overview. Bulletin of the Medical Library Association, 81(3), S. 294–298.
Epstein, R. M. (1999). Mindful practice. Journal of the American Medical Association, 282(9), 833–839. http://dx.doi.org/10.1001/jama.282.9.833
Epstein, R. M. (2003). Mindful practice in action. II: Cultivating habits of mind. Families, Systems, & Health, 21, 11–17. http://dx.doi.org/10.1037/h0089495
Epstein, R. M., & Hundert, E. M. (2002). Defining and as- sessing professional competence. Journal of the American Medical Association, 287(2), 226–235. http://dx.doi.org/10.1001/jama.287.2.226
General Medical Council. (2009). Tomorrow’s doctors: Outcomes and standards for undergraduate medical education. http://www.gmcuk.org/TomorrowsDoctors_2009.pdf_39260971.pdf
Gijbels, D., Dochy, F., Van den Bossche, P., & Segers, M. (2005). Effects of problem-based learning: a meta-analysis from the angle of assessment. Review of Educational Research, 75(1), 27–61. http://dx.doi.org/10.3102/00346543075001027
Hartling, L., Spooner, C., Tjosvold, L., & Oswald, A. (2010). Problem-based learning in pre-clinical medical education: 22 years of outcome research. Medical Teacher, 32(1), 28–35. http://dx.doi.org/10.3109/01421590903200789
Hojat, M. (2007). Empathy in patient care: Antecedents, develop- ment, measurement, and outcomes. New York: Springer Verlag.
Hojat, M., Gonnella, J. S., Mangione, S., Nasca, T. J., Veloski, J. J., Erdmann, J. B., Callahan, C. A., & Magee, M. (2002a). Empathy in medical students as related to academic performance, clinical competence and gender. Medical Education, 36(6), 522–527. http://dx.doi.org/10.1046/j.1365-2923.2002.01234.x
Hojat, M., Gonnella, J. S., & Maxwell, K. (2009a). Jefferson Scales of Empathy (JSE): Professional manual & user’s guide. Philadelphia: Jefferson Medical College, Center for Research in Medical Education and Health Care.
Hojat, M., Gonnella, J. S., Nasca, T. J., Mangione, S., Veloksi, J. J., & Magee, M. (2002b). The Jefferson Scale of Physician Empathy: further psychometric data and differences by gender and specialty at item level. Academic Medicine, 77(10 Suppl), S58-S60. http://dx.doi.org/10.1097/00001888-200210001-00019
Hojat, M., Gonnella, J. S., Nasca, T. J., Mangione, S., Vergare, M., & Magee, M. (2002c). Physician empathy: definition, components, measurement, and relationship to gender and specialty. American Journal of Psychiatry, 159(9), 1563-1569. http://dx.doi.org/10.1176/appi.ajp.159.9.1563
Hojat, M., Mangione, S., Nasca, T. J., Cohen, M. J. M., Gonnella, J. S., Erdmann, J. B., Veloski, J., & Magee, M. (2001). The Jefferson Scale of Physician Empathy: Development and preliminary psychometric data. Educational and Psychological Measurement, 61, 349–365. http://dx.doi.org/10.1177/00131640121971158
Hojat, M., Mangione, S., Nasca, T. J., Gonnella, J. S., & Magee, M. (2005a). Empathy scores in medical school and ratings of empathic behavior in residency training 3 years later. The Journal of Social Psychology, 145(6), 663–672. http://dx.doi.org/10.3200/SOCP.145.6.663-672
Hojat, M., Vergare, M. J., Maxwell, K., Brainard, G., Herrine, S. K., Isenberg, G. A., Veloski, J., & Gonnella, J. S. (2009b). The devil is in the third year: a longitudinal study of erosion of empathy in medical school. Academic Medicine, 84(9), 1182– 1191. http://dx.doi.org/10.1097/ACM.0b013e3181b17e55
Hojat, M., Zuckerman, M., Magee, M., Mangione, S., Nasca, T., Vergare, M., & Gonnella, J. S. (2005b). Empathy in medical students as related to specialty interest, personality, and perceptions of mother and father. Personality and Individual Differences, 39(7), 1205–1215. http://dx.doi.org/10.1016/j.paid.2005.04.007
Inui, T. S. (2003). A flag in the wind: educating for professionalism in medicine. Washington, DC: Association of American Medical Colleges. https://members.aamc.org/eweb/upload/A%20Flag%20in%20the%20Wind%20Report.pdf.
Kalaian, H. A, Mullan, P. B., & Kasim, R. M. (1999). What can studies of problem-based learning tell us? Synthesizing and modeling PBL effects on National Board of Medical Examination performance Hierarchical Linear Modeling meta-analytic approach. Advances in Health Sciences Education: Theory and Practice, 4(3), 209–221. http://dx.doi.org/10.1023/A:1009871001258
Kataoka, H. U., Koide, N., Ochi, K., Hojat, M., & Gonnella, J. S. (2009). Measurement of empathy among Japanese medical students: psychometrics and score differences by gender and level of medical education. Academic Medicine, 84(9), 1192–1197. http://dx.doi.org/10.1097/ACM.0b013e3181b180d4
Magalhães, E., Salgueira, A. P., Costa, P., & Costa, M. J. (2011). Empathy in senior year and first year medical students: a cross-sectional study. BMC Medical Education, 11, 52. http://dx.doi.org/10.1186/1472-6920-11-52
Neumann, M., Edelhäuser, F., Tauschel, D., Fischer, M. R., Wirtz, M., Woopen, C., Haramati, A., & Scheffer, C. (2011). Empathy decline and its reasons: A systematic review of studies with medical students and residents. Academic Medicine, 86(8), 996–1009. http://dx.doi.org/10.1097/ACM.0b013e318221e615
Newman, M. (2003). Special Report 2: A pilot systematic review and meta-analysis on the effectiveness of problem- based learning. Retrieved from http://www.heacademy.ac.uk/assets/documents/subjects/medev/pbl_report.pdf
Novack, D. H. (1987). Therapeutic aspects of the clinical encounter. Journal of General Internal Medicine, 2(5), 346– 355. http://dx.doi.org/10.1007/BF02596174
Novack, D. H., Suchman, A. L., Clark, W., Epstein, R. M., Najberg, E., & Kaplan, C. (1997). Calibrating the physician. Personal awareness and effective patient care. Working Group on Promoting Physician Personal Awareness, American Academy on Physician and Patient. Journal of the American Medical Association, 278(6), 502–509. http://dx.doi.org/10.1001/jama.1997.03550060078040
Rogers, C. R. (1946). Significant aspects of client-centered therapy. American Psychologist, 1, 415–422. http://dx.doi.org/10.1037/h0060866
Rogers, C. R. (1975). Empathic: An unappreciated way of being. The Counseling Psychologist, 5, 2–10. http://dx.doi.org/10.1177/001100007500500202
Rogers, C. R. (1979). The foundations of the person-centered approach. Education, 100, 98-07.
Rosenthal, S., Howard, B., Schlussel, Y. R., Herrigel, D., Smo- larz, B. G., Gable, B., Vasquez, J., Grigo, H., & Kaufman, M. (2011). Humanism at heart: preserving empathy in third-year medical students. Academic Medicine, 86, 350– 358. http://dx.doi.org/10.1097/ACM.0b013e318209897f
Rueckert, L., & Naybar, N. (2008). Gender differences in empathy: the role of the right hemisphere. Brain and Cognition, 67(2), 162–167. http://dx.doi.org/10.1016/j.bandc.2008.01.002
Schindler, B. A., Landau, B. J., Novack, D. H., Russo, D. M., & Smith, R. C. (2010). Drexel University College of Medicine. Academic Medicine, 85(9 Suppl): S480–S484. http://dx.doi.org/10.1097/ACM.0b013e3181ea3a74
Strobel, J., & van Barneveld, A. (2009). When is PBL more effective? A meta-synthesis of meta-analyses comparing PBL to conventional classrooms. Interdisciplinary Journal of Problem-based Learning, 3(1), 44–58. http://dx.doi.org/10.7771/1541-5015.1046
Swinscow, T. D. V. (1997). Statistics at square one (9th ed.). London: British Medical Association.
Vernon, D. T. & Blake, R. L. (1993). Does problem-based learning work? A meta-analysis of evaluative research. Academic Medicine, 68(7), 550–553. http://dx.doi.org/10.1097/00001888-199307000-00015
Walker, A., & Leary, H. (2009). A problem-based learning meta-analysis: differences across problem types, implementation types, disciplines, and assessment levels. In- terdisciplinary Journal of Problem-based Learning, 3(1), 12–43. http://dx.doi.org/10.7771/1541-5015.1061