Table 1
The questionnaire used in this study. Assumptions: items 2, 4, 5, 9, 10, 13, 15–17 and 20 are indicators of perspective taking; items 1, 7, 8, 11, 12, 14, 18 and 19 are indicators of compassionate care; and items 21–23 are indicators of willingness to show empathic behaviour
|
1 |
I believe that empathy is an important therapeutic factor in medical treatment |
|
2 |
Patients feel better when their physicians understand their feelings |
|
3 |
It is difficult for a physician to view things from a patient’s perspectives |
|
4 |
Understanding body language is as important as verbal communication in physician-patient relationships |
|
5 |
A physician’s sense of humour contributes to a better clinical outcome |
|
6 |
Because people are different, it is difficult to see things from the patient’s perspective |
|
7 |
Attention to patients’ emotions is not important in history taking |
|
8 |
Attentiveness to patients’ personal experiences does not influence treatment outcomes |
|
9 |
Physicians should try to stand in their patients’ shoes when providing care to them |
|
10 |
Patients value a physician’s understanding of their feelings, which is therapeutic in its own right |
|
11 |
Patients’ illnesses can be cured only by medical or surgical treatment; therefore physicians’ emotional ties with the patients do not have a significant influence in medical or surgical treatment |
|
12 |
Asking patients about what is happening in their personal lives is not helpful in understanding their physical complaints |
|
13 |
Physicians should try to understand what is going on in their patients’ minds by paying attention to their non-verbal cues and body language |
|
14 |
I believe that emotion has no place in the treatment of medical illness |
|
15 |
Empathy is a therapeutic skill without which the physician’s success is limited |
|
16 |
Physicians’ understanding of the emotional status of their patients, as well as that of their families, is one important component of the physician-patient relationship |
|
17 |
Physicians should try to think like their patients in order to render better care |
|
18 |
Physicians should not allow themselves to be influenced by strong personal bonds between their patients and their family members |
|
19 |
I do not enjoy reading non-medical literature of the arts |
|
20 |
I believe that empathy is an important therapeutic factor in medical treatment |
|
21 |
I will show empathic behaviour to patients when I see their distress |
|
22 |
I will show empathic behaviour to patients when I see them feeling pain |
|
23 |
I will show empathic behaviour to patients when I hear their difficult experiences |
Table 2
Confirmatory factor analysis for retrospective pre-training (comparative fit index = 0.947; Tucker-Lewis index = 0.940; root mean square error of approximation = 0.057) and post-training (comparative fit index = 0.918; Tucker-Lewis index = 0.908; root mean square error of approximation = 0.068): standardized loadings
|
Factor |
Item |
Pre |
Post |
|---|---|---|---|
|
Perspective taking |
2 |
0.522 |
0.494 |
|
4 |
0.631 |
0.651 | |
|
5 |
0.319 |
0.319 | |
|
9 |
0.736 |
0.652 | |
|
10 |
0.467 |
0.474 | |
|
13 |
0.773 |
0.732 | |
|
15 |
0.495 |
0.397 | |
|
16 |
0.799 |
0.744 | |
|
17 |
0.432 |
0.404 | |
|
20 |
0.721 |
0.724 | |
|
Compassionate care |
1 |
0.499 |
0.455 |
|
7 |
0.782 |
0.714 | |
|
8 |
0.862 |
0.779 | |
|
11 |
0.794 |
0.836 | |
|
12 |
0.774 |
0.756 | |
|
14 |
0.684 |
0.785 | |
|
18 |
0.183 |
0.253 | |
|
19 |
0.542 |
0.580 | |
|
Willingness to show Empathic behaviour |
21 |
0.958 |
0.949 |
|
22 |
0.986 |
0.973 | |
|
23 |
0.946 |
0.941 |
Table 3
Confirmatory factor analysis for retrospective pre-training: factor correlations
|
Factor |
Factor |
Pre |
Post |
|---|---|---|---|
|
Perspective taking |
Compassionate care |
0.494 |
0.469 |
|
Perspective taking |
Willingness to show empathic behaviour |
0.631 |
0.699 |
|
Compassionate care |
Willingness to show empathic behaviour |
0.244 |
0.334 |
Table 4
Means (and standard deviations) for perspective taking, compassionate care and willingness to show empathic behaviour for retrospective pre- and post-training per number of medical interviewing training sessions
|
Occasion |
Medical |
Perspective |
Compassionate |
Willingness to show |
|---|---|---|---|---|
|
Interviewing training sessions |
Taking |
Care |
Empathic behaviour | |
|
Pre |
1 |
5.522 (0.829) |
5.372 (0.783) |
5.033 (1.108) |
|
2 |
5.262 (0.940) |
5.097 (0.866) |
5.346 (1.294) | |
|
3 |
5.209 (0.986) |
5.380 (0.793) |
5.392 (1.173) | |
|
Pre |
1 |
5.560 (0.999) |
5.679 (0.678) |
5.544 (1.030) |
|
2 |
5.522 (1.041) |
5.548 (0.858) |
5.843 (1.163) | |
|
3 |
5.552 (1.022) |
5.740 (0.748) |
5.912 (1.167) |
Table 5
Qualitative descriptive analysis of students’ open-ended responses
|
What students learned |
Learning how to show empathic attitudes to patients |
|
Learning the procedure of medical interviewing | |
|
Learning the importance of patients’ perspective taking | |
|
Learning the importance of plain explaining | |
|
Recognizing that communication skill are learnable | |
|
Influence of communication on physician-patient healing relationship | |
|
Learning the importance of listening to patients | |
|
Recognizing that medical interviewing training is a process of socialization | |
|
Variety of patients’ responses to the same question | |
|
Learning the importance of efficacy of communication | |
|
Recognizing that empathy is an essential characteristic of a good physician | |
|
Learning that appropriate spacing is important | |
|
What students found difficult to learn |
Difficulty of patients’ perspective taking |
|
Difficulty of empathizing patients’ feelings | |
|
Difficulty of conveying what doctor wants to patients | |
|
Difficulty of feeling compassion despite showing empathic behaviour |