Why might medical student empathy change throughout medical school? a systematic review and thematic synthesis of qualitative studies
Abstract Background Several studies suggest that medical student empathy declines throughout medical school. However, no studies have synthesised the evidence regarding why empathy declines. Objective To conduct a systematic review and thematic synthesis of qualitative studies investigating why stud...
| Main Authors: | , , , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2023-04-01
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| Series: | BMC Medical Education |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12909-023-04165-9 |
| _version_ | 1797836391162314752 |
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| author | Jeremy Howick Maya Dudko Shi Nan Feng Ahmed Abdirashid Ahmed Namitha Alluri Keith Nockels Rachel Winter Richard Holland |
| author_facet | Jeremy Howick Maya Dudko Shi Nan Feng Ahmed Abdirashid Ahmed Namitha Alluri Keith Nockels Rachel Winter Richard Holland |
| author_sort | Jeremy Howick |
| collection | DOAJ |
| description | Abstract Background Several studies suggest that medical student empathy declines throughout medical school. However, no studies have synthesised the evidence regarding why empathy declines. Objective To conduct a systematic review and thematic synthesis of qualitative studies investigating why student empathy may change throughout medical school. Methods We included any qualitative study that investigated why empathy might change during medical school. We searched the Medline, Scopus, CINAHL, ERIC, and APA PsycInfo databases for relevant studies. All databases were searched from their inception to 18 July 2022. We also searched the reference lists of the included studies and contacted experts to identify additional studies. We used the Joanna Briggs Institute tool to evaluate the risk of bias in the included studies. Overall confidence in our results was assessed using the Confidence in the Evidence from Reviews of Qualitative research (CERQual) approach. We used thematic methods to synthesise our findings. Results Our searches yielded 2523 records, and 16 studies involving a total of 771 students were eligible for analysis. Most studies (n = 11) were from Europe or North America. The descriptive themes and sub-themes were identified for each study. Increased complexity in patients and their diseases, together with the ‘hidden curriculum’ (including a stressful workload, prioritisation of biomedical knowledge, and (sometimes) poor role models), led to student adaptations, such as cynicism and desensitisation. Students’ prior lives and professional experiences appeared to exacerbate the decline in empathy. However, there were bias concerns for most of the included studies. Discussion Many of the included studies included were small, and some did not include demographic participant data. Given the likely benefits of providing empathic care for patients and practitioners, medical education interventions should focus on developing an ‘empathic hidden curriculum’ that mitigates the decline in medical student empathy. Trial registration A protocol for this systematic review was submitted for registration with the International Prospective Register of Systematic Reviews (PROSPERO) on 28 July 2022 (registration number CRD42022347856). |
| first_indexed | 2024-04-09T15:08:05Z |
| format | Article |
| id | doaj.art-03401ada5a484efa89dac5074b5d3689 |
| institution | Directory Open Access Journal |
| issn | 1472-6920 |
| language | English |
| last_indexed | 2024-04-09T15:08:05Z |
| publishDate | 2023-04-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Medical Education |
| spelling | doaj.art-03401ada5a484efa89dac5074b5d36892023-04-30T11:19:11ZengBMCBMC Medical Education1472-69202023-04-0123111310.1186/s12909-023-04165-9Why might medical student empathy change throughout medical school? a systematic review and thematic synthesis of qualitative studiesJeremy Howick0Maya Dudko1Shi Nan Feng2Ahmed Abdirashid Ahmed3Namitha Alluri4Keith Nockels5Rachel Winter6Richard Holland7Medical School, Stoneygate Centre for Excellence in Empathic Healthcare, University of Leicester, University of Leicester, George Davies CentreMedical School, Stoneygate Centre for Excellence in Empathic Healthcare, University of Leicester, University of Leicester, George Davies CentreThe University of North Carolina at Chapel HillMedical School, Stoneygate Centre for Excellence in Empathic Healthcare, University of Leicester, University of Leicester, George Davies CentreDartmouth CollegeUniversity Library, University of LeicesterMedical School, Stoneygate Centre for Excellence in Empathic Healthcare, University of Leicester, University of Leicester, George Davies CentreMedical School, Stoneygate Centre for Excellence in Empathic Healthcare, University of Leicester, University of Leicester, George Davies CentreAbstract Background Several studies suggest that medical student empathy declines throughout medical school. However, no studies have synthesised the evidence regarding why empathy declines. Objective To conduct a systematic review and thematic synthesis of qualitative studies investigating why student empathy may change throughout medical school. Methods We included any qualitative study that investigated why empathy might change during medical school. We searched the Medline, Scopus, CINAHL, ERIC, and APA PsycInfo databases for relevant studies. All databases were searched from their inception to 18 July 2022. We also searched the reference lists of the included studies and contacted experts to identify additional studies. We used the Joanna Briggs Institute tool to evaluate the risk of bias in the included studies. Overall confidence in our results was assessed using the Confidence in the Evidence from Reviews of Qualitative research (CERQual) approach. We used thematic methods to synthesise our findings. Results Our searches yielded 2523 records, and 16 studies involving a total of 771 students were eligible for analysis. Most studies (n = 11) were from Europe or North America. The descriptive themes and sub-themes were identified for each study. Increased complexity in patients and their diseases, together with the ‘hidden curriculum’ (including a stressful workload, prioritisation of biomedical knowledge, and (sometimes) poor role models), led to student adaptations, such as cynicism and desensitisation. Students’ prior lives and professional experiences appeared to exacerbate the decline in empathy. However, there were bias concerns for most of the included studies. Discussion Many of the included studies included were small, and some did not include demographic participant data. Given the likely benefits of providing empathic care for patients and practitioners, medical education interventions should focus on developing an ‘empathic hidden curriculum’ that mitigates the decline in medical student empathy. Trial registration A protocol for this systematic review was submitted for registration with the International Prospective Register of Systematic Reviews (PROSPERO) on 28 July 2022 (registration number CRD42022347856).https://doi.org/10.1186/s12909-023-04165-9EmpathySystematic reviewQualitativeCommunicationMedical schoolEducation |
| spellingShingle | Jeremy Howick Maya Dudko Shi Nan Feng Ahmed Abdirashid Ahmed Namitha Alluri Keith Nockels Rachel Winter Richard Holland Why might medical student empathy change throughout medical school? a systematic review and thematic synthesis of qualitative studies BMC Medical Education Empathy Systematic review Qualitative Communication Medical school Education |
| title | Why might medical student empathy change throughout medical school? a systematic review and thematic synthesis of qualitative studies |
| title_full | Why might medical student empathy change throughout medical school? a systematic review and thematic synthesis of qualitative studies |
| title_fullStr | Why might medical student empathy change throughout medical school? a systematic review and thematic synthesis of qualitative studies |
| title_full_unstemmed | Why might medical student empathy change throughout medical school? a systematic review and thematic synthesis of qualitative studies |
| title_short | Why might medical student empathy change throughout medical school? a systematic review and thematic synthesis of qualitative studies |
| title_sort | why might medical student empathy change throughout medical school a systematic review and thematic synthesis of qualitative studies |
| topic | Empathy Systematic review Qualitative Communication Medical school Education |
| url | https://doi.org/10.1186/s12909-023-04165-9 |
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