Emotional and Cognitive Empathy in First-Year Medical Students

Objectives. Doctors’ empathy towards their patients is considered important for treatment outcome. However, during medical school there might be a decline in empathy called “hardening of the heart.” This study evaluated the cognitive and emotional empathy in medical students and investigated the influence of a preference for a specialty and students attachment styles. Methods. 126 first-year medical students were included and completed the Reading the Mind in the Eyes Test revised version (RME-R), the Balanced Emotional Empathy Scale (BEES), and the Experiences in Close Relationships-Revised Adult Attachment Questionnaire (ECR-R). Results. Students identified of 36 photographs in the RME-R test correctly (norm: 26). The female students’ mean BEES total score was and the male students’ ; . The female students’ mean BEES score was significantly ( ) below the female norm of 60. Students who preferred a specialty with continuity of patient care scored significantly higher in the BEES ( ). A more avoidant attachment style was associated with a lower BEES score ( ). Conclusion. The students showed low emotional and cognitive empathy scores and an avoidant attachment style. This supports the inclusion of specific training in cognitive and emotional empathy in medical education. 1. Introduction Patients usually speak without interruption for less than 90 seconds when they sit down to talk to their doctor, but the way the doctor behaves during this initial period sets the tone for trust and disclosure in the doctor-patient relationship [1]. Doctors’ empathy towards their patients is considered important not only to ensure that they are good listeners, but also to facilitate delivering bad news or assisting their patients in coping with their illness. Research has shown that medical students have an average or above-average level of empathy at the beginning of medical school. However, the phenomenon of “hardening of the heart” [2], with a decline in empathy during the course of medical school, has been reported in several studies [3–5]. It has therefore been suggested that medical education should include approaches to retain and enhance empathy [6]. The phenomenon of empathy, which includes the ability to understand the mental and affective states of others, has been described as a cornerstone of our lives as “social animals” [7]. There is a growing body of research on empathy in medical school (for an overview see [8]); however, this research has mostly focused on the cognitive aspect of empathy in terms of perspective-taking and “standing in the patient’s