Beyond Empathy Decline: Do the Barriers to Compassion Change across Medical Training?

Autor/inn/en	Wang, Clair X. Y.; Pavlova, Alina; Fernando, Antonio T.; Consedine, Nathan S.
Titel	Beyond Empathy Decline: Do the Barriers to Compassion Change across Medical Training?
Quelle	In: Advances in Health Sciences Education, 27 (2022) 2, S.521-536 (16 Seiten)Infoseite zur Zeitschrift PDF als Volltext Verfügbarkeit
Zusatzinformation	ORCID (Wang, Clair X. Y.) ORCID (Pavlova, Alina) ORCID (Fernando, Antonio T.) ORCID (Consedine, Nathan S.)
Sprache	englisch
Dokumenttyp	gedruckt; online; Zeitschriftenaufsatz
ISSN	1382-4996
DOI	10.1007/s10459-022-10100-2
Schlagwörter	Empathy; Barriers; Health Services; Medical Students; Clinical Experience; Training; Foreign Countries; Altruism; Environmental Influences; Family Influence; New Zealand + Suchen Sie Ihr Suchwort? Empathie; Health service; Gesundheitsdienst; Gesundheitswesen; Ausbildung; Ausland; Altruistic behavior; Altruismus; Environmental influence; Umwelteinfluss; Neuseeland
Abstract	Background: Despite being a mandated, foundational value in healthcare, research on compassion remains limited. Studying the individual, patient, clinical, and contextual factors that interfere with compassion--the "barriers"--may clarify our understanding of the origins of compassion and identify potential targets for improving patient-centred care. Studies of the related construct of empathy have suggested that medical students report declines with increasing clinical experience. In contrast, when comparing physicians with medical students, increased clinical experience predicts lower barriers to compassion. Whether--and how--a similar experience-related decline in the factors that interfere with compassion occurs across medical training remains unknown. Aims: To describe how the barriers to compassion vary across clinical training in medical students. Method: New Zealand medical students (N = 351) in their clinical years (Years 4-6) completed measures of the Barriers to Physician Compassion (BPCQ) and potential covariates such as demographics, work burden factors, and dispositional factors. The BPCQ indexes the extent to which barriers in four domains (individual, patient, clinical, and contextual) interfere with a physician/student's compassion towards patients. Analyses of variance and regression analyses were used to explore the effect of year level on the four types of barriers. Results: Year 4 students reported slightly lower student-related, environmental and patient/family-related (but not clinical) barriers than Year 6 students (effect size: [omega][superscript 2] < 0.05); all barriers increased comparably across training. Controlling for relevant confounds, regression analyses confirmed that lower year level predicted lower barriers to compassion. Higher self-compassion, but not gender, predicted lower barriers. Conclusions: In extending studies of empathy decline, this report suggests that students experience higher barriers to compassion as clinical training progresses. This is in contrast to existing studies contrasting physicians with medical students, where greater experience was associated with lower perceived barriers to compassion. Self-compassion may offset increases in barriers to care. (As Provided).
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Erfasst von	ERIC (Education Resources Information Center), Washington, DC
Update	2024/1/01