Promoters and detractors of empathy levels in Brazilian medical students between 2010-2021
DOI:
https://doi.org/10.17058/rips.v6i2.18261Keywords:
Empathy, Health Student, Medical StudentsAbstract
Introduction: empathy is an essential skill for establishing a quality doctor-patient relationship, especially when promoting the effectiveness of diagnostic and therapeutic processes. In view of recent curricular reforms aimed at a humanistic and renovating teaching, it is necessary to study which factors influence the levels of empathy among medical students in Brazil. Objective: to identify common characteristics and determinants of empathy levels among medical students in Brazil. Methods: integrative literature review, searching for articles indexed on the PubMed and Scholar Google platforms, using the terms "medical students" AND "empathy", and their equivalents in Portuguese. Inclusion criteria were: publications in the last ten years (2011-2021), in Portuguese or English, that dealt with undergraduate medical education in Brazil. Theses, experience reports, opinion articles, texts not available in full, or whose content did not match the research object were excluded. Results: 0f 4,175 articles found, twelve met the inclusion criteria. The studies showed differences in the levels of empathy according to gender, with females having the highest scores; family and cultural aspects; and choice of medical specialty. Most articles found alterations in the levels of empathy among medical students at different stages of the course – the initial semesters had higher levels than the final semesters –, with a significant decline throughout the course, although there is still some controversy on the subject, since that some studies obtained stable scores. In addition, the incidence of depression, anxiety, and social stress were found to negatively affect empathy, with stress being indicated as the main cause of this decline. Professors were pointed out as examples of promoters or detractors of an empathetic doctor-patient relationship. All the studies analyzed called attention to the indispensable insertion of empathy-promoting guidelines in the mandatory curriculum, since medical graduation was indicated as the main moment of decline in empathic levels. Conclusion: there is an urgent need for project initiatives that aim to develop empathy levels in students, as well as to promote their mental health during the course, revisiting the parameters used as the basis for medical education. Opening this space for discussion, dialogue and development will bring psycho-emotional benefits not only for students, but also for professors, future professionals, and patients.
Downloads
References
Brazeau CM, Schroeder R, Rovi S, Boyd L. Relationships between medical student burnout, empathy, and professionalism climate. Acad Med 2010; 85(10):S33-6. doi: http://dx.doi.org/10.1097/ACM.0b013e3181ed4c47
Costa FD; Azevedo RCS. Empatia, relação médico-paciente e formação em medicina: um olhar qualitativo. Rev Bras Educ Med 2010; 34(2):261-269.
Stepien KA, Baernstein A. Educating for empathy. A review. J Gen Intern Med. 2006;21(5): 524-30. doi: http://dx.doi.org/10.1111/j.1525-1497.2006.00443.x
Hojat M, Mangione S, Nasca TJ, Cohen MJ, Gonnella JS, Erdmann JB, et al. The Jefferson Scale of Physician Empathy: development and a preliminary psychometric data. Educ Psychol Meas 2001; 61:349-365. doi: https://doi.org/10.1177/00131640121971158
Halpern J. From detached concern to empathy: humanizing medical practice. New York: Oxford University Press. 2001.
Brasil. Ministério da Educação. Resolução nº 3, de 20 de junho de 2014. Institui Diretrizes Curriculares Nacionais do Curso de Graduação em Medicina e dá outras providências. Brasília, jun. 2014.
Sampaio LR, Oliveira LC, Pires MFDN. Empatia, depressão, ansiedade e estresse em Profissionais de Saúde Brasileiros. Psicol Ciênc 2020; 14(2):e2215. doi: https://doi.org/10.22235/cp.v14i2.2215
Hojat M. Empathy in patient care: antecedents, development, measurement, and outcomes. New York: Springer. 2007.
Schutte NS, Malouff JM, Bobik C, Coston TD, Greeson C, Jedlicka C. Emotional intelligence and interpersonal relations. J Soc Psychol 2001; 141(4):523-536. doi: https://doi.org/10.1080/00224540109600569
Provenzano BC, Machado APG, Rangel M, Aranha RNA. Empatia médica e a graduação em medicina. Rev HUPE 2014; 13(4):19-25. doi: http://dx.doi.org/10.12957/rhupe.2014.13941
Monteiro LN, Braga BP, Canuto AMM, Gêda TF. Análise da empatia dos estudantes de medicina no primeiro ano de curso na Universidade Federal de Alagoas – UFAL. Braz J of Develop 2020; 6(2):6972-6984. doi: http://dx.doi.org/10.34117/bjdv6n2-119
Nascimento HCF, Ferreira Júnior WA, Silva AMTC, Carvalho IGMD, Bastos GCFC, Almeida RJD, et al. Análise dos níveis de empatia de estudantes de nedicina. Rev Bras Educ Med 2018; 42(1);152-160. doi: http://dx.doi.org/10.1590/1981-52712018v42n1RB20170057
Thomazi L, Moreira FG, Marco MA. Avaliação da evolução da empatia em alunos do quarto ano da graduação em medicina da Unifesp em 2012. Rev Bras Educ Med 2014; 38(1):87-93. doi: http://dx.doi.org/10.1590/S0100-55022014000100012
Vaz BMC, Paraizo VA, Almeida RJ. Aspectos relacionados a empatia médica em estudantes de medicina: uma revisão integrativa. RBMC 2021; 7(17):43-49. doi: http://dx.doi.org/10.36414/rbmc.v7i17.90
Moreto G, González-Blasco P, Pessini L, Craice-De Benedetto MA. La erosión de la empatía en estudiantes de medicina: reporte de un estudio realizado en una universidad en São Paulo. Atencion Fam 2014; 21(1):16-19. doi: http://dx.doi.org/10.1016/S1405-8871(16)30005-0
Batista NA, Lessa SS. Aprendizagem da empatia na relação médico-paciente: um olhar qualitativo entre estudantes do internato de escolas médicas do nordeste do Brasil. Rev Bras Educ Med 2019; 43(1):349-356. doi: http://dx.doi.org/10.1590/1981-5271v43suplemento1-20190118
Lucchetti G, Damiano RF, DiLalla LF, Lucchetti ALG, Moutinho ILD, Silva OE, et al. Cross-cultural differences in mental health, quality of life, empathy, and burnout between US and brazilian medical students. Acad Psychiatry 2018; 42(1):62-67. doi: http://dx.doi.org/10.1007/s40596-017-0777-2
Fontana NS, Vilela AAF, Ribeiro AA, Ferreira VC, Peres GM, Macedo MR, et al. Estudo das variáveis que contribuem para o nível de empatia nos acadêmicos de medicina. Braz J of Health and Biomedical Services 2020; 19(1):57-61.
Lacombe JB, Valadares ES, Catani RR, Mendonça T, Paro HBMDS, Morales NMO, et al. Spirituality of medical students: associations with empathy and attitudes in the doctor-patient relationship. Rev Bras Educ Med 2021; 45(2):e066.
Ikeda LH, Barbosa MR, Oliveira RA, Bernardo MO. Empatia no cotidiano do curso de graduação de medicina a partir de uma revisão integrativa. Braz J of Develop 2019; 5(3):2068-2079.
Paro HBMS, Silveira PS, Perotta B, Gannam S, Enns SC, Giaxa RR, et al. Empathy among medical students: is there a relation with quality of life and burnout? PLoS ONE 2014; 9(4):e94133. doi: http://dx.doi.org/10.1371/journal.pone.0094133
Brasil. Ministério da Saúde. Secretaria de Atenção à Saúde. Núcleo Técnico da Política Nacional de Humanização. HumanizaSUS: documento base para gestores e trabalhadores do SUS. 4. ed. Brasília: Ministério da Saúde; 2008.
Brasil. Ministério da Saúde. Secretaria de Atenção à Saúde. Política Nacional de Humanização – PNH (folheto). 1. ed. Brasília: Ministério da Saúde; 2013.
Castaldelli-Maia JM, Lewis T, Santos NM, Picon F, Kadhum M, Farrell SM, et al. Stressors, psychological distress, and mental health problems amongst brazilian medical students. Int Rev Psychiatry 2019; 31(7):603-607. doi: https://doi.org/10.1080/09540261.2019.1669335
Tawfik DS, Profit J, Morgenthaler TI, Satele DV, Sinsky CA, Dyrbye LN, et al. Physician burnout, well-being, and work unit safety grades in relationship to reported medical errors. Mayo Clin Proc 2018; 93(11):1571-1580. doi: https://doi.org/10.1016/j.mayocp.2018.05.014
Shanafelt TD, Balch CM, Bechamps G, Russell T, Dyrbye L, Satele D, et al. Burnout and medical errors among American surgeons. Ann Surg 2010; 251(6):995-1000. doi: http://dx.doi.org/10.1097/SLA.0b013e3181bfdab3
Halbesleben JRB, Rathert C. Linking physician burnout and patient outcomes: exploring physicians and patients. Health Care Manage Rev 2008; 33(1):29-39. doi: https://doi.org/10.1097/01.hmr.0000304493.87898.72
Wallace JE, Lemaire JB, Ghali WA. Physician wellness: a missing quality indicator. Lancet 2009; 374(9702):1714-1721. doi: https://doi.org/10.1016/s0140-6736(09)61424-0
Rios IC, Sirino CB. A humanização no ensino de graduação em medicina: o olhar dos estudantes. Rev Bras Educ Med 2015; 39(3):401-409. doi: http://dx.doi.org/10.1590/1981-52712015v39n3e00092015
Schweller M, Wamserlei J, Strazzacappa M, Sá FC, Celeri EHRV, Carvalho-Filho MA, et al. Metodologias ativas para o ensino de empatia na graduação em medicina – uma experiência da Unicamp. Cad ABEM 2014; 10:36-46.
Downloads
Published
How to Cite
Issue
Section
License
A submissão de originais para este periódico implica na transferência, pelos autores, dos direitos de publicação impressa e digital. Os direitos autorais para os artigos publicados são do autor, com direitos do periódico sobre a primeira publicação. Os autores somente poderão utilizar os mesmos resultados em outras publicações indicando claramente este periódico como o meio da publicação original. Em virtude de sermos um periódico de acesso aberto, permite-se o uso gratuito dos artigos em aplicações educacionais e científicas desde que citada a fonte conforme a licença CC-BY da Creative Commons.
