Abstract
Objective
The authors address the issue of cultivating medical students’ empathy for the mentally ill by examining medical student empathy pre- and postsimulated auditory hallucination experience.
Methods
At the University of Utah, 150 medical students participated in this study during their 6-week psychiatry rotation. The Jefferson Scale of Physician Empathy, Student Version, was used before and after the experience. The auditory hallucinations were provided as part of the “Hearing Voices That Are Distressing” curriculum created by the National Empowerment Center, which attempted to simulate the experience of hearing auditory hallucinations. While the students were listening to the auditory hallucinations, they underwent a psychiatric interview and simplified cognitive testing and were asked to socially interact in the community. We conducted a paired sample t-test of significance to identify pre- and postsimulated auditory hallucination changes in medical student empathy. Fifty students were randomly selected to serve as a comparison group.
Results
The paired sample t-test revealed that after listening to the simulated auditory hallucinations and participating in the simplified neurocognitive testing, the students’ empathy score increased. Students in the comparison group had no significant difference in their empathy scores.
Conclusion
These results suggest that empathy may increase when students are given a brief glimpse into the mind of a mentally ill patient by listening to simulated auditory hallucinations. Specific interventions to increase empathy for the mentally ill can lead to a better understanding of how empathy can improve patient care, enhance the doctor-patient relationship, and direct future educational strategies.
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References
Bertakis KD, Roter D, Punam SM: The relationship of physician medical interview style to patient satisfaction. J Fam Pract 1991; 32: 175–181
Kim S, Kaplowitz S, Johnston MV: The effects of physician empathy on patient satisfaction and compliance. Eval Health Prof 2004; 27: 237–251
Zachariae R, Pedersen CG, Jensen AB, et al: Association of perceived physician communication style with patient satisfaction, distress, cancer-related self-efficacy, and perceived control over the disease. Br J Cancer 2003; 88: 658–665
Stewart MA: What is a successful doctor-patient interview? A study of interactions and outcomes. Soc Sci Med 1984; 19: 167–175
Roter DL, Hall JA, Merisca R, et al: Effectiveness of interventions to improve patient compliance: a meta-analysis. Med Care 1998; 36: 1138–1161
Suchman AL, Roter D, Green M, et al: Physician satisfaction with primary care office visits. Collaborative Study Group of the American Academy on Physician and Patient. Med Care 1993; 31: 1083–1092
Diseker RA, Michielutte R: An analysis of empathy in medical students before and following clinical experience. J Med Educ 1981; 56: 1004–1010
Hojat M, Mangione S, Nasca TJ, et al: An empirical study of decline inempathy in medical school. Med Educ 2004; 38: 934–941
Bellini LM, Baime M, Shea JA: Variation of mood and empathy during internship. JAMA 2002; 287: 3143–3146
Bellini LM, Shea JA: Mood change and empathy decline persist during three years of internal medicine training. Acad Med 2005; 80: 164–167
Evans BJ, Stanley RO, Burrows GD: Measuring medical students’ empathy skills. Br J Med Psychol 1993; 66: 121–133
Fine VK, Therrien ME: Empathy in the doctor-patient relationship: skill training for medical students. J Med Educ 1977; 52: 752–757
Sanson-Fisher RW, Poole AD: Training medical students to empathize: an experimental study. Med J Aust 1978; 1: 473–476
Kramer D, Ber R, Moore M: Increasing empathy among medical students. Med Educ 1989; 23: 168–173
Winefield HR, Chur-Hansen A: Evaluating the outcome of communication skill teaching for entry-level medical students: does knowledge of empathy increase? Med Educ 2000; 34: 90–94
Shapiro J, Morrison E, Boker J: Teaching empathy to first year medical students: evaluation of an elective literature and medicine course. Educ Health (Abingdon) 2004; 17: 73–84
Lancaster T, Hart R, Gardner S: Literature and medicine: evaluating a special study module using the nominal group technique. Med Educ 2002; 36: 1071–1076
Henry-Tillman R, Deloney LA, Savidge M, et al: The medical student as patient navigator as an approach to teaching empathy. Am J Surg 2002; 183: 659–662
Wilkes M, Milgrom E, Hoffman JR: Toward more empathic medical students: a medical student hospitalization experience. Med Educ 2002; 36: 528–533
Shapiro J, Hunt L: All the world’s a stage: the use of theatrical performance in medical education. Med Educ 2003; 37: 922–927
DasGupta S, Charon R: Personal illness narratives: using reflective writing to teach empathy. Acad Med 2004; 79: 351–356
Stepien KA, Baernstein A: Educating for empathy. J Gen Intern Med 2006; 21: 524–530
Hojat M, Mangione S, Nasca TJ, et al: The Jefferson Scale of Physician Empathy: development and preliminary psychometric data. Educ and Psychol Measurement 2001; 61: 349–365
Folstein MF, Folstein SE, McHugh PR: Mini-Mental State: a practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res 1975; 12: 189–198
Hojat M, Mangione S, Nasca TJ, et al: The Jefferson Scale of Physician Empathy: development and preliminary psychometric data. Edu Psychol Meas 2001; 61: 349–365
DiLalla LF, Hull SK, Dorsey JK: Effect of gender, age, and relevant course work on attitudes toward empathy, patient spirituality, and physician wellness. Teach Learn Med 2004; 16: 165–170
Martineau TM, Humphrey C, Matoon G, et al: Factors influencing the communications skills of first-year clinical medical students. Med Educ 1991; 25: 127–134
Hojat M, Gonnella JS, Nasca TJ, et al: Empathy in medical students as related to academic performance, clinical competence, and gender. Med Educ 2002; 36: 522–527
Mercer SW, Maxwell M, Heaney D, et al: The Consultation and Relational Empathy (CARE) measure: development and preliminary validation and reliability of an empathy-based consultation process measure. Fam Pract 2004; 21: 699–705
Jarski RW, Gjerde CL, Bratton BD, et al: A comparison of four empathy instruments in simulated patient-medical student interactions. J Med Educ 1985; 60: 545–551
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Bunn, W., Terpstra, J. Cultivating Empathy for the Mentally Ill Using Simulated Auditory Hallucinations. Acad Psychiatry 33, 457–460 (2009). https://doi.org/10.1176/appi.ap.33.6.457
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DOI: https://doi.org/10.1176/appi.ap.33.6.457