THE EVALUATION OF EMPATHY LEVEL OF UNDERGRADUATE DENTAL STUDENTS IN PAKISTAN: A CROSS-SECTIONAL STUDY
AbstractBackground: Empathy is of significant importance in the dentist-patient relationship. The objective of the current study was to assess the empathy level of students at the culmination of their respective academic year, studying in first to fourth year across the undergraduate dental school of Pakistan. Methods: The cross–sectional study of undergraduate dental students was carried out at the dental school of Riphah International University in Islamabad, Pakistan in 2017. The survey was conducted with each class as they approached near the completion of their academic year. The Jefferson Scale of Physician Empathy– Health Professions Student Version (JSE-HPS version), was used in the study for measuring empathy. JSE-HPS is a valid and reliable self-reporting instrument comprising of 20 items. The total score on this instrument ranges between 20 and 140. ANOVA test and Independent sample t-test were used to analyze the data on SPSS 24. Results: Two hundred and twenty-two students participated in this study. The mean empathy score of students was 101.15±13.73. The mean empathy score of the first-year dental students was the highest (104.70±15.53) followed by the scores of second year students (102.70±13.48); the third-year class had the lowest mean empathy score (98.63±11.53) that corresponded to the first year of clinical training and final year students had a score of 99.48±13.96. Dichotomization of data showed statistically significant difference between the mean empathy scores of students studying in the preclinical and clinical years. The difference in the mean empathy scores of male and female students was found to be statistically significant. The JSE-HPS was found to be reliable with Cronbach’s alpha=0.77. Conclusion: The present study revealed a statistically significant decline in empathy levels of undergraduate dental students when the empathy levels of the students studying in the preclinical years and clinical years were compared. The JSE–HPS was found to be a reliable instrument for assessing the empathy levels of dental students.Keywords: Empathy; Communication; Dental education
Faulkner A, Argent J, Jones A. Effective communication in health care: exploring the skills of the teachers. Patient Educ Couns 2001;45(3):227–32.
Checkland K, Marshall M, Harrison S. Re-thinking accountability: trust versus confidence in medical practice. Qual Saf Health Care 2004;13(2):130–5.
Hottel TL, Hardigan PC. Improvement in the interpersonal communication skills of dental students. J Dent Educ 2005;69(2):281–4.
World Dental Federation. FDI Policy statement basic dental education. [Internet]. 2015. [cited 2018 April 11]. Available from: http://www.fdiworld dental.org/media/80313/6fdi_draft_ps_ basic_ dental_education_2015_gab_final_24 _09_ 2015.pdf.
Higher Education Commission of Pakistan. Curriculum of Bachelor of Dental Surgery five years programme. [Internet]. 2011. [cited 2018 April 11]. Available from: http://www.hec.gov.pk/InsideHEC/ Divisions/ AECA/ Curriculum Revision/Documents/Draft-BDS-2011.pdf
Schouten B, Eijkman M, Hoogstraten J. Dentists' and patients' communicative behaviour and their satisfaction with the dental encounter. Community Dent Health 2003;20(1):11–5.
Jones LM, Huggins TJ. Empathy in the dentist-patient relationship: review and application. N Z Dent J 2014;110(3):98–104.
Sherman JJ, Cramer A. Measurement of changes in empathy during dental school. J Dent Educ 2005;69(3):338–45.
Mercer SW, Reynolds WJ. Empathy and quality of care. Br J Gen Pract 2002;52(Suppl):S9–12.
Nestel D, Betson C. An evaluation of a communication skills workshop for dentists: cultural and clinical relevance of the patient-centred interview. Br Dent J 1999;187(7):385–8.
Neumann M, Edelhäuser F, Tauschel D, Fischer MR, Wirtz M, Woopen C, et al. Empathy decline and its reasons: a systematic review of studies with medical students and residents. Acad Med 2011;86(8):996–1009.
Gonzalez M, Abu Kasim N, Naimie Z. Soft skills and dental education. Eur J Dent Educ 2013;17(2):73–82.
Brownell AKW, Côté L. Senior residents' views on the meaning of professionalism and how they learn about it. Acad Med 2001;76(7):734–7.
SurveyMonkey. Sample size calculator. [internet]. 2018. [cited 2018 April 11]. Available from: https://www.surveymonkey.com /mp/sample-size-calculator/
Hojat M, Mangione S, Nasca TJ, Rattner S, Erdmann JB, Gonnella JS, et al. An empirical study of decline in empathy in medical school. Med Educ 2004;38(9):934–41.
Hojat M. Empathy in patient care: antecedents, development, measurement, and outcomes: Springer Science & Business Media; 2007.
Babar MG, Omar H, Lim LP, Khan SA, Mitha S, Ahmad SF, et al. An assessment of dental students’ empathy levels in Malaysia. Int J Med Educ 2013;4:223.
Hojat M, Gonnella JS, Nasca TJ, Mangione S, Vergare M, Magee M. Physician empathy: definition, components, measurement, and relationship to gender and specialty. Am J Psychiatry 2002;159(9):1563–9.
Magalhães E, Salgueira AP, Costa P, Costa MJ. Empathy in senior year and first year medical students: a cross-sectional study. BMC Med Educ 2011;11(1):52.
Bland JM, Altman DG. Cronbach's alpha. BMJ 1997;314(7080):572.
Khalifesoltani F, Nilchian F, Yosefi A, Hosseinpour K. Empathy levels in undergraduate and postgraduate dental students in Isfahan Faculty of Dentistry in 2011. J Isfahan Dent Sch 2012:753–62.
Beattie A, Durham J, Harvey J, Steele J, McHanwell S. Does empathy change in first‐year dental students? Eur J Dent Educ 2012;16(1):e111–6.
Chen D, Lew R, Hershman W, Orlander J. A cross-sectional measurement of medical student empathy. J Gen Intern Med 2007;22(10):1434–8.
Hojat M, Vergare MJ, Maxwell K, Brainard G, Herrine SK, Isenberg GA, et al. The devil is in the third year: a longitudinal study of erosion of empathy in medical school. Acad Med 2009;84(9):1182–91.
Shariat SV, Habibi M. Empathy in Iranian medical students: measurement model of the Jefferson scale of empathy. Med Teach 2013;35(1):e913–8.
Beattie A, Durham J, Harvey J, Steele J, McHanwell S. Does empathy change in first-year dental students? Eur J Dent Educ 2012;16(1):111–6.
Colliver JA, Conlee MJ, Verhulst SJ, Dorsey JK. Reports of the decline of empathy during medical education are greatly exaggerated: a reexamination of the research. Acad Med 2010;85(4):588–93.
Hojat M, Gonnella JS, Veloski J. Rebuttals to critics of studies of the decline of empathy. Acad Med 2010;85(12):1812.
Aggarwal VP, Garg R, Goyal N, Kaur P, Singhal S, Singla N, et al. Exploring the missing link–Empathy among dental students: An institutional cross-sectional survey. Dent Res J 2016;13(5):419–23.
Eisenberg N, Lennon R. Sex differences in empathy and related capacities. Psychol Bull 1983;94(1):100.
Harton HC, Lyons PC. Gender, empathy, and the choice of the psychology major. Teach Psychol 2003;30(1):19–24.
Kelley JM, Kraft-Todd G, Schapira L, Kossowsky J, Riess H. The influence of the patient-clinician relationship on healthcare outcomes: a systematic review and meta-analysis of randomized controlled trials. PloS One 2014;9(4):e94207.
Welly A, Lang H, Welly D, Kropp P. Impact of Dental Atmosphere and Behaviour of the Dentist on Children’s Cooperation. Appl Psychophysiol Biofeedback 2012;37(3):195–204.
Gönüllü İ, Öztuna D. A Turkish Adaptation of the Student Version of the Jefferson Scale of Physician Empathy. Marmara Med J 2012;25(2).