BMJ Open (Jun 2019)

Investigating the relation between self-assessment and patients’ assessments of physicians-in-training empathy: a multicentric, observational, cross-sectional study in three teaching hospitals in Brazil

  • Mônica Oliveira Bernardo,
  • Dario Cecilio-Fernandes,
  • Alba Regina de Abreu Lima,
  • Julian Furtado Silva,
  • Hugo Dugolin Ceccato,
  • Manuel João Costa,
  • Marco Antonio de Carvalho-Filho

DOI
https://doi.org/10.1136/bmjopen-2019-029356
Journal volume & issue
Vol. 9, no. 6

Abstract

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ObjectivesThis study investigated the associations between self-assessed empathy levels by physicians in training and empathy levels as perceived by their patients after clinical encounters. The authors also examined whether patient assessments were valid and reliable tools to measure empathy in physicians in training.DesignA multicentric, observational, cross-sectional study.SettingThis study was conducted in three public teaching hospitals in Brazil.ParticipantsFrom the 668 patients invited to participate in this research, 566 (84.7%) agreed. Of these, 238 (42%) were male and 328 (58%) were female. From the invited 112 physicians in training, 86 (76.8%) agreed. Of the 86 physicians in training, 35 (41%) were final-year medical students and 51 (59%) were residents from clinical and surgical specialties. The gender distribution was 39 (45%) males and 47 (51%) females.Primary and secondary outcome measuresPhysicians in training filled the Jefferson Scale of Physician Empathy (JSE) and the Interpersonal Reactivity Index. Patients answered the Jefferson Scale of Patient’s Perceptions of Physician Empathy (JSPPPE) and the Consultation and Relational Empathy Scale (CARE).ResultsThis study found non-significant correlations between patient and physicians-in-training self-assessments, except for a weak correlation (0.241, p<0.01) between the JSPPPE score and the JSE compassionate care subscore. CARE and JSPPPE scales proved to be valid and reliable instruments.ConclusionsPhysicians-in-training self-assessments of empathy differ from patient assessments. Knowledge about empathy derived from self-assessment studies probably does not capture the perspective of the patients, who are key stakeholders in patient-centred care. Future research on the development of physician empathy or on outcomes of educational interventions to foster empathy should include patient perspectives.