Empathy is related to clinical competence in medical care
Introduction When training clinically competent doctors, most medical schools focus upon components of the interpersonal process between doctor and patient, such as empathy in the doctorpatient relationship. This study investigated the relationship between empathy and clinical competence among medical students. Method Sixty students from an Australian Graduate School of Medicine participated in the study. Clinical competence was assessed in an Objective Structured Clinical Examination (OSCE). Empathy was rated by an independent observer of the clinical interaction in OSCE stations using the Rating Scales for the Assessment of Empathic Communication in Medical Interviews (REM). In addition, empathy was self-rated using the Jefferson Scale of Physician Empathy (student version). Results Observed empathic behaviour, as rated objectively by an independent observer, was strongly associated with clinical competence and was evident across diverse types of consultations and a wide range of medical conditions. Observable empathy was also strongly associated with patients' ratings of the students' clinical performance. However, self rated empathy was not associated with clinical competence. Discussion & Conclusion The results suggest that a doctor-patient relationship fostered by empathy appears to complement the skills and knowledge required to effectively care for a patient. Strategies that enhance the behavioural expression of empathy may make medical students seem more clinically competent to both examiners and to patients. However, evidence that the medical students' internal emotions are discrepant with their behaviour raises difficult questions regarding the fundamental nature of genuine empathy, with potential implications for the sustainability of the positive relationship between empathy and clinical competence.
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