Journal Article

Curricula for empathy and compassion training in medical education: A systematic review

Trzeciak, Stephen, Patel, Sundip, Pelletier-Bui, Alexis, Roberts, Brian W., Smith, Stephanie, Roberts, Michael B., Kilgannon, Hope

2019

Overview

Empathy and compassion are vital components of health care quality; however, physicians frequently miss opportunities for empathy and compassion in patient care. Despite evidence that empathy and compassion training can be effective, the specific behaviors that should be taught remain unclear. We synthesized the biomedical literature on empathy and compassion training in medical education to find the specific curricula components (skills and behaviors) demonstrated to be effective. We searched CENTRAL, MEDLINE, EMBASE, and CINAHL using a previously published comprehensive search strategy. We screened reference lists of the articles meeting inclusion criteria to identify additional studies for potential inclusion. Study inclusion criteria were: (1) intervention arm in which subjects underwent an educational curriculum aimed at enhancing empathy and/or compassion; (2) clearly defined control arm in which subjects did not receive the curriculum; (3) curriculum was tested on physicians (or physicians-in-training); and (4) outcome measure assessing the effect of the curriculum on physician empathy and/or compassion. We performed a qualitative analysis to collate and tabulate effects of tested curricula according to recommended methodology from the Cochrane Handbook. We used the Cochrane Collaboration's tool for assessing risk of bias. Fifty-two studies (total n = 5,316) met inclusion criteria. Most (75%) studies found that the tested curricula improved physician empathy and/or compassion on at least one outcome measure. We identified the following key behaviors to be effective: (1) sitting (versus standing) during the interview; (2) detecting patients' non-verbal cues of emotion; (3) recognizing and responding to opportunities for compassion; (4) non-verbal communication of caring (e.g. eye contact); and (5) verbal statements of acknowledgement, validation, and support. These behaviors were found to improve patient perception of physician empathy and/or compassion. Evidence suggests that training can enhance physician empathy and compassion. Training curricula should incorporate the specific behaviors identified in this report.

• Publisher: Public Library of Science,Public Library of Science (PLoS)
• Subject: Attitude of Health Personnel / Biology and Life Sciences / Compassion / Criteria / Curricula / Curriculum / Delivery of Health Care - ethics / Education / Education, Medical - organization & administration / Emergency medical care / Emotions / Empathy / Evaluation / Evidence-based medicine / Handbooks / Health Knowledge, Attitudes, Practice / Humans / Medical care quality / Medical education / Medical personnel / Medical personnel training / Medicine and Health Sciences / Oral communication / Patient care / Patient compliance / Patients / People and Places / Physician-Patient Relations - ethics / Physicians / Physicians - psychology / Qualitative analysis / Research and Analysis Methods / Risk assessment / Social Sciences / Students / Study and teaching / Systematic review / Training / Verbal communication