Conceptual
Framework
What is Medical Empathy
and
Why Is It Important?
Definition of Medical Empathy
A Multidimensional Approach
1. Emotive: The ability to subjectively experience and share in another’s psychological state or intrinsic feelings
2. Moral: An internal altruistic force that motivates the practice of empathy
3. Cognitive: The helper’s intellectual ability to identify and understand another person’s feelings and perspective from an objective stance
4. Behavioural: Communicative response to convey understanding of another’s perspective (Neumann et al., 2012, p. 2)
Working in Undergraduate Medical Education as well as personal experiences have resulted in observing a lack of empathy within the healthcare system. Observations include seeing students disengaged when interacting with patients, not participating in empathy engaging activities and having low performance evaluations when communicating with standardized patients who are trained educational actors. Negative experiences as a patient include feelings of abandonment, condescending behaviour from physicians and a general lack of empathy towards sensitive illnesses. “A positive patient-physician relationship is a critical element in the practice of medicine and in the art of healing, however, such relationships have been severely strained by changes in the economics of medical practice as well as recent developments in the organization and delivery of health care” (Hojat et al., 2002, p. 1566).
Empathy involves both cognitive and affective emotional experiences. Hojat et al. (2002) briefly define the cognitive attribute as, “an ability to understand the patient’s inner experiences and perspective and a capability to communicate this understanding” (p. 1564).
“Clinical empathy, as it relates to the patient–doctor relationship, is often divided into two dimensions. The first, affective, describes the passive emotional response of one individual to the emotions of another. The second, cognitive, is an active skill that may be acquired and is amenable to nurturing” (Batt-Rawden et al., 2013, p. 1171).
When conducting a search in the 2016-2017 academic year of objectives linked to the topic of empathy at the Schulich School of Medicine & Dentistry there were 70 results. Of the 70 objectives, only 10 objectives were associated to courses in first and second years. The remaining objectives were tagged to clinical training. As a Master of Professional Education candidate, a variety of pedagogical practices have been taught throughout the academic journey and how to analyze problems of practice to develop meaningful outcomes. The purpose in presenting this literature review is for both medical trainees and physicians to gain a new perspective of empathy training that will encourage lifelong learning on how to address patients in an empathetic way.
Empathy impacts all involved in the healthcare system including the students, faculty, staff and most importantly, the patients and we may assume that all physicians are empathetic, but this is unrealistic and not always the case, which is why empathy training must continue and the culture of empathy must change. The subject-matter of empathy may be considered a sensitive topic so in order to engage all learners, it is essential that a conceptual framework is developed that meets the need of multiple intelligences.
This video is an example of medical empathy and its importance.
“Empathy training needs to be introduced as part of the curriculum so that it is perceived by students as a useful skill to be fostered, rather than an extraneous skill that can be neglected” (Hardy, 2017, p. 240). Empathy is often lumped into what some would call “soft skills” in medicine, instead of a primary objective that physicians must meet. In order to change this perception, I investigated the current medical educational practices for empathy training and promotion.