Does empathy manifest in medical students' palliative care reflective reports?: A qualitative study

Clinical empathy involves the ability to understand problems of patients, their perspectives as well as feelings, and to act based on one’s understanding of the medical problems, in a therapeutic manner. The process of empathy may be divided into the following responses: a) Emotive: the ability to subjectively experience and share another’s psychological state; b) Moral: the altruistic force that motivates the practice of empathy; c) Cognitive: the ability to objectively analyse another person’s feelings and perspectives; and d) Behavioural: Communicative response to convey another person’s perspective. Methods: The objective of the study was to find out whether Semester 9 medical students of the IMU had documented an empathetic response following their ‘student-patient interaction’ when they visited the Hospice in Seremban and homes of patients who were under palliative care. Following the visit, students submitted a reflective report to their mentors. The author had analysed 58 such consecutive reports that were submitted during the period May 2013 to November 2016. Results: All 58 students sympathized with the plight of their patients, but only 12 of them had expressed empathy. Expression of empathy in these 12 reports was captured in the following number of instances: Emotive 5, Moral – 5, Cognitive – 7, Behavioural – 2; some expressing more than one component of empathy. Conclusion: The study showed that reflective report writing is a ‘window of opportunity’ to find out whether medical students expressed empathy. Its potential as a teaching/learning tool needs further exploration.