A lack of empathy in healthcare can be disastrous
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A lack of empathy in healthcare can be disastrous. Empathy is a core skill that medical students require. Here’s what can be done about it
A lack of empathy in healthcare can be disastrous
Image by pexels
A lack of empathy in healthcare can be disastrous. In the UK, between 2005 and 2009, hundreds of avoidable deaths occurred at the Mid Staffordshire NHS Foundation Trust. The Francis report, which investigated the causes of the failings, concluded that a lack of empathy contributed to the catastrophe.
More recently, dozens of tragic, unnecessary infant and maternal deaths occurred at the Shrewsbury and Telford Hospitals. The Ockenden Report, which investigated the causes of these deaths, stated that lack of empathy exacerbated the problem.
Meanwhile, research suggests empathy in doctors may even reduce premature death in patients with type 2 diabetes.
Empathy is a core skill that medical students require. The General Medical Council, which sets the standards and outcomes for medical student education and training in the UK, says that empathy is central to their strategy.
However, a “hidden curriculum” in medical school can reduce medical student empathy. A new study, published in BMC Medical Education, is the first to systematically demonstrate why empathy declines during medical training and raises important questions about the priorities of current medical education.
Empathy is known to reduce patient pain and improve their satisfaction with care, and protects against doctor burnout. It’s also cost-effective according to a study that compared longer, empathic consultations with standard consultations.
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Based on its importance, you might hope that empathy increases throughout medical school. Yet levels of empathy in medical students often decline as their training progresses.
In a recently published systematic review, my colleagues and I analysed data from 16 qualitative studies and 771 medical students. Our review included any qualitative study that investigated why empathy might change during medical school.
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We found that when medical students transition from the first phase of medical school which is mostly lecture based, to the second phase of medical school which is more clinical and patient-facing, they are met with a “hidden” informal curriculum.
This curriculum includes subtle, non-formal influences over students. For example, there is often an unbalanced focus on the biomedical model of disease, which focuses on the body as a machine, over the “biopsychosocial” model of disease, which includes biological, psychological and social factors.
But also the way that the curriculum is structured to create a stressful workload, and to promote the influence of role models (who may show little empathy themselves) has an effect. Students, who are likely to have little experience of what being a patient is like, often adapt to this hidden curriculum by developing cynicism and becoming emotionally distanced and desensitised. This, in turn, lowers empathy.
Like all studies, our review has some limitations. The studies included in the review were small, very few were from outside Europe or North America, and many were of limited quality. However, the remarkable consistency of the identified themes warrants rigorous efforts to reverse the empathy decline.
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By bringing the cause of empathy decline to light, our study paves the way for educational programmes that foster, maintain and even enhance empathy in medical students. These interventions are described briefly below.
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Implementing these empathy interventions is difficult given the pressures on the tightly packed medical school curriculum. But it is possible. The Stoneygate Centre for Empathic Healthcare at the University of Leicester is currently developing and piloting all of them.
Empathy benefits patients and practitioners, yet it declines throughout medical school. Now that we have identified the causes of its deterioration, medical schools can focus on curriculum interventions that enhance it.
Article by Jeremy Howick. Professor and Director of the Stoneygate Centre for Excellence in Empathic Healthcare, University of Leicester
This article is republished from The Conversation under a Creative Commons license. Read the original article.