Empathy training for resident physicians: a randomized controlled trial of a neuroscience-informed curriculum

Abstract

Background: Physician empathy is an essential attribute of the patient-physician relationship and is associated with better outcomes, greater patient safety and fewer malpractice claims.

Objective: We tested whether an innovative empathy training protocol grounded in neuroscience could improve physician empathy as rated by patients.

Design: Randomized controlled trial.

Intervention: We randomly assigned residents and fellows from surgery, medicine, anesthesiology, psychiatry, ophthalmology, and orthopedics (N=99, 52% female, mean age 30.6 ± 3.6) to receive standard post-graduate medical education or education augmented with three 60-minute empathy training modules.

Main measure: Patient ratings of physician empathy were assessed within one-month pre-training and between 1-2 months post-training with the use of the Consultation and Relational Empathy (CARE) measure. Each physician was rated by multiple patients (pre-mean=4.6 ± 3.1; post-mean 4.9 ± 2.5), who were blinded to physician randomization. The primary outcome was change score on the patient-rated CARE.

Key results: The empathy training group showed greater changes in patient-rated CARE scores than the control (difference 2.2; P=0.04). Trained physicians also showed greater changes in knowledge of the neurobiology of empathy (difference 1.8; P<0.001) and in ability to decode facial expressions of emotion (difference 1.9; P<0.001).

Conclusions: A brief intervention grounded in the neurobiology of empathy significantly improved physician empathy as rated by patients, suggesting that the quality of care in medicine could be improved by integrating the neuroscience of empathy into medical education.

Figure 1.

Study recruitment flowchart.