The document summarizes a study that tracked medical students' empathy skills with curriculum changes at a university school of medicine. It found that:
1) Empathy scores modestly but significantly improved with the introduction of a new measurement tool (MIRS) and additional practice/training using this tool over multiple years.
2) Empathy scores improved further with the addition of a specific video assignment focusing on demonstrating empathy using the NURS model.
3) The improvements were found to be statistically significant based on analysis of variance testing, but the study was limited to one school with a particular curriculum and measurement approach.
9. One Way ANOVA: p<0.00 .5 4.2 83 2009 .6 4.0 79 2008 .6 4.0 77 2007 .7 3.8 84 2006 SD Mean N Year
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Notas del editor
Empathy as an important clinical skill. Copious literature, no attempt to review it here SP program embedded in first two years of the Clinical Medicine Course: Used ACIR now MIRS to teach and evaluate Interpersonal Interviewing and communication skills. Change made because MIRS has the reliability characteristics of the ACIR and better validity given the constructs of patient centered care developed in the late 20 th century One new item on the MIRS is empathy. Defined as RC Smith does with the NURS mnemonic. Students now taught with a specific set of strategies for expressing empathy. The assessment in the Fall of year 2 of medical school was a constant. It focused on focused history and physical of a knee/hip pain and the review of systems for patients with a vague complaint.
[5] The interviewer uses supportive comments regarding the patient’s emotions. The interviewer uses NURS or other specific techniques for demonstrating empathy. [3] The interviewer is neutral, neither overly positive nor negative in demonstrating empathy. [1] No empathy is demonstrated. The interviewer uses a negative emphasis or openly criticizes the patient.
Subjects were 2 nd year students who did a clinical skills assessment as part of the Clinical Medicine course in the Fall of the second year The assessment included three cases a focused h&p of knee pain, and two vague complaints weight loss and fatigue and weight gain and fatigue where there was the expectation that the student would do a complete review of systems. Each student has 25 minutes for each case and has feedback about the content and process of the encounter from the SP after each case. MIRS was scored by each SP trained to 80% agreement actual in this assessment was 87% Empathy was the outcome measure Four years of data
2006: MIRS newly introduced and explained, no prior experience with the empathy item; tape review 2007, 2008: lecture at the beginning of year 1 and 5 clinical skills assessments where empathy was scored and feedback may have been given; tape review 2009: added an empathy assignment to the 07, and 08
Pair review; bookmark video write down empathy statements that could have been included Reflect on empathy in own life
ANOVA
Modest and significant improvement with each intervention. Limitations: one school, one curriculum, no random assignment; no long term follow-up Encouraging to see improvement with interventions.
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