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Empathy is crucial in forming a good relationship between patients and healthcare providers. Research on empathy in health care has largely focused on healthcare providers and students and less on the patient's perspective. This study's aim was to investigate patients' experience of empathy in healthcare interactions, to better understand and accommodate to patients' needs. Semi-structured interviews with patients were analyzed inspired by constructivist Grounded Theory. Three categories were formed-"I need you to focus on me," "I am more than my disease" and "I know myself and the disease" and the core category: "I want to be known as a whole human being." This study has provided a deeper insight on how empathy can be operationalized in healthcare interactions from a patient perspective. Patients experience health care interactions as dependent on empathic engagement and hampered by inequity due to knowledge hierarchies and lack of personal sharing. This study emphasizes patient & sacute; need for doctors to be more personal, and to experience a mutual sharing with their doctors to not feel vulnerable or left out in the consultation.

Background: Empathy — the ability to recognize others’ emotions, understand their feelings and situations, and respond in a helpful way — is a fundamental component of the patient–doctor relationship. It is associated with several positive outcomes in patient care. However, numerous quantitative studies suggest that empathy tends to decline during medical education and as doctors progress through clinical training. This thesis adopts a qualitative approach to explore the prerequisites for, and potential challenges to, empathy in healthcare, through the perspectives and lived experiences of medical students, doctors, and patients.

Method: This thesis is based on empirical material from four different interview studies, all of which employed a qualitative analysis, inspired by qualitative content analysis and constructivist grounded theory.

Findings and reflections: Junior doctors describe empathy as contextual and influenced by, for example time constraints and workplace culture. Additionally, senior colleagues were seen as particularly important role models in developing and maintaining empathic abilities. Senior doctors reported a daily balancing act, navigating challenges between individual and structural conditions that may affect empathy. Medical students experienced clashes between theoretical teachings and clinical reality regarding empathy, and they made efforts to develop and sustain empathy during their education. Patients expressed a longing for a more personal connection with healthcare personnel. They described inequities in the patient-doctor relationship, which could be partly bridged through empathy.

Conclusions: Both doctors and patients consider empathy crucial in the patient – doctor relationship. However, there are challenges related to empathy both in individual interactions and at a structural level in clinical and educational contexts. To maintain and further develop empathy, doctors need working conditions that allow for collegial reflection and conversations that promote empathy. This approach would also benefit medical students, who are influenced by teachers and clinical doctors as role models for empathy.

Background: Empathy has proven to be a fundamental component in the patient-doctor relationship and correlates to several positive outcomes in patient care. Despite this, research suggests that empathy decreases during medical education. To increase the understanding of empathy development during medical education, this study explores medical students’ experiences of learning empathy in the transition from theoretical to practical context.

Methods: Eleven semi-structured interviews with students at a medical school in Sweden. The interviews were transcribed verbatim and analysed using grounded theory.

Results: The analysis resulted in three categories and a core category "Lost in translation". Early on, students regard empathy as a valued and necessary skill. While students generally encounter high expectations of being empathic, they also met gendered expectations. There is a mismatch between the theoretical and the practical teaching of empathy. The core category refers both to the students feeling lost in their own professional development and empathy becoming lost in the translation from theory to clinical practice.

Conclusion: The results describe clashes between theory and clinical reality and the efforts of the students to develop and maintain empathy in this context. To encourage students to develop empathy it is necessary for both educators and practitioners to acknowledge, and attempt to bridge, the gap between the theoretical and the practical curriculum regarding empathy.

Background: Communication skills training in patient centered communication is an integral part of the medical undergraduate education and has been shown to improve various components of communication. While the effects of different educational interventions have been investigated, little is known about the transfer from theoretical settings to clinical practice in the context of communication skills courses not integrated in the clinical curriculum. Most studies focus on single factors affecting transfer without considering the comprehensive perspective of the students themselves. The aim of this study is to explore how the students experience the transition to clinical practice and what they perceive as challenges in using patient centered communication.

Methods: Fifteen 4th year medical students were interviewed 3 weeks after the transition from an advanced communication skills course to surgical internship using semi-structured interviews. Qualitative content analysis was used to analyze the interviews.

Results: The analysis resulted in a theme 'When theory meets reality- a mismatch in communication'. It was comprised of four categories that encompassed the transfer process, from theoretical education, practical communication training and surgical internship to students' wishes and perceived needs.

Conclusions: We concluded that preparing the students through theoretical and practical training should reflect the reality they will face when entering clinical practice. When educating medical students as a group, their proclivity for perfectionism, high performance environment and achievement-related stress should be taken into consideration. The role of tutors being role models, offering guidance, giving feedback and providing support plays a major part in facilitating transfer of communication skills. To enable transfer to a larger extent, the environment needs to promote patient centeredness and students need more opportunities to practice communication with their patients.

Empathy in the doctor-patient relationship is of great importance and has long been considered a true professional virtue for doctors. Despite the general agreement concerning the importance of empathy, there is no consensus regarding the definition of empathy in medical research. While several quantitative studies, measuring empathy as an individual trait, show a decline in empathy among medical students, other studies have shown that empathy is influenced by contextual factors as well as the availability of role models. Therefore, further studies about the transition from medical school to clinical work also including the perspective of senior doctors are needed. The study presented in this article aims to better understand the clinical conditions for empathy through interviews with senior doctors about their lived experience of empathy. Twelve senior doctors, from different specialities were interviewed using a semi-structured approach. The data was analysed using content analysis. The analysis resulted in the main theme: Empathy as a silent art–a doctor‘s daily balancing act. This main theme comprised three categories: “A tacit, yet language-dependent process”, “A daily balancing act” and “An unsupported path towards mastery”. Doctors face many challenges in their daily balancing act between individual and structural conditions that may affect empathy. In order to maintain and further develop empathy, doctors need working conditions allowing for collegial reflection and conversations that promote empathy.

Background: Medical students have a higher risk for depression, anxiety, stress-related symptoms, burnout, and suicide, and more rarely seek professional help or treatment than the general population. Appeals are being made to address the mental health and resilience of physicians-to-be. The novel program Training for Awareness, Resilience, and Action (TARA) was originally developed to treat depressed adolescents, targeting specific neuroscientific findings in this population. TARA has shown feasibility and preliminary efficacy in clinically depressed adolescents and corresponding brain-changes in mixed community adolescent samples. The present study investigated the feasibility and acceptability of TARA as a potential indicated prevention program for symptoms of depression, anxiety, stress and burnout in Swedish medical students.

Methods: We conducted a single-arm trial with 23 self-selected students in their early semesters of medical school (mean age 25.38 years, 5 males and 18 females), with or without mental disorders. All participants received TARA. Self-reported symptoms of depression, anxiety, perceived stress and psychological inflexibility were collected before (T0) and after the intervention (T1). Qualitative data on the participants’ experiences of TARA were collected in focus-group interviews conducted halfway through the program and upon completion of the program. Individual interviews were also conducted 2 years later. Qualitative content analysis was performed.

Results: The mean attendance rate was 61.22% and the dropout rate was 17.40%. The Child Session Rating Scale administered after every session reflected an overall acceptable content, mean total score 34.99 out of 40.00. Trends towards improvement were seen across all outcome measures, including the Hospital Anxiety and Depression Scale Anxiety (t = 1.13, p = 0.29) and Depression (t = 1.71, p = 0.11) subscales, Perceived Stress Scale (t = 0.67, p = 0.51) and Avoidance and Fusion Questionnaire for youth (t = 1.64, p = 0.10). None of the participants deteriorated markedly during the intervention. Qualitative content analysis resulted in a main theme labeled: “An uncommon meeting-ground for personal empowerment”, with 4 themes; “Acknowledging unmet needs”, “Entering a free zone”, “Feeling connected to oneself and others” and “Expanding self-efficacy”.

Conclusion: TARA is feasible and acceptable in a mixed sample of Swedish medical students. The students’ reports of entering an uncommon meeting-ground for personal empowerment supports effectiveness studies of TARA in this context.

Background: Empathy has long been recognized as a fundamental part of the professionalism of doctors and is considered to be both necessary and beneficial to doctor-patient relationships, although empathy is notoriously difficult to define and measure. Previous research on empathy has mostly consisted of quantitative studies measuring and evaluating empathy levels in students or medical residents. The aim of our qualitative study was to explore the lived experience of empathy among medical interns in Sweden.

Method: We interviewed 16 medical interns, using semi-structured interviews. Content analysis was used to analyse the interviews.

Results: The analysis led to the emergence of a main theme of empathy as being multifaceted and conflictual, consisting of descriptions (subthemes) of “being” and “doing”; of being uncontrollable and contextual; biased and situated and essential and conflictual. Since the components of empathy were also found to be interwoven, to provide a more holistic presentation of the results, we applied a socio-ecological model to the results inspired by Bronfenbrenner.

Conclusions: We concluded that empathy is situated and contextual. By using the socioecological model empathy can be described as a systemic interaction between doctor and patient. Based on this we propose a more holistic approach to empathy in medical education to better prepare students for clinical practice.

Empathy is crucial in forming a good relationship between patients and healthcare providers. Research on empathy in health care has largely focused on healthcare providers and students and less on the patient’s perspective. This study´s aim was to investigate patients’ experience of empathy in healthcare interactions, to better understand and accommodate to patients’ needs.

Semi-structured interviews with patients were analyzed using constructivist Grounded Theory according to Charmaz. Three categories were formed - "I need you to focus on me", "I am more than my disease" and "I know myself and the disease" and the core category: "I want to be known as a whole human being".

This study has provided a deeper insight on how empathy can be operationalized in healthcare interactions from a patient perspective. Patients experience health care interactions as dependent on empathic engagement and hampered by inequity due to knowledge hierarchies and lack of personal sharing. This study emphasizes patients´ need for doctors to be more personal, and to experience a mutual sharing with their doctors to not feel vulnerable or left out in the consultation.