Umeå University's logo

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 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: 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.

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.