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Comparative Study
. 2025 Apr 16;25(1):554.
doi: 10.1186/s12909-025-07109-7.

Unveiling empathy determinants across borders: a comparative analysis of medical students from two geo-sociocultural backgrounds

Fernanda Balbinot  1 , Lionel Voirol  2 , Stéphane Guerrier  3 , Mucyo Karemera  3 , Raphaël Feser  2 , Anne Baroffio  4 , Margaret W Gerbase  5   6
Affiliations
Comparative Study

Unveiling empathy determinants across borders: a comparative analysis of medical students from two geo-sociocultural backgrounds

Fernanda Balbinot et al. BMC Med Educ. .

Abstract

Background: Empathy plays a pivotal role in healthcare professions, influencing patient satisfaction and treatment outcomes. Understanding the determinants of empathy in medical students is essential. However, findings from previous studies have been inconsistent. We hypothesized that part of this variability may be attributed to the influence of the geo-sociocultural context. In this study, we aimed to compare the longitudinal determinants of empathy in four cohorts of medical students from two distinct geo-sociocultural backgrounds.

Methods: This study included 199 medical students from Porto Alegre, Brazil and Geneva, Switzerland who were in their 1 st and 4 th years of training and agreed to participate on both occasions. The outcome variable was empathy scores (total and subdimensions) assessed through the Jefferson Scale of Empathy for Medical Students (JSE-S). Independent variables included gender, personality, motives for studying medicine, specialty preferences, and the level of motivation for medical studies. Multivariate regression analyses were conducted to investigate the associations between independent variables and empathy at each site in years 1 and 4.

Results: In year 1, the personality trait openness to experience was associated with higher empathy (total score) in both Porto Alegre (b = 0.503, p ≤ 0.01) and Geneva (b = 0.592, p ≤ 0.001), with this association persisting over time. However, the relationships between empathy and the other independent variables varied significantly depending on the site.

Conclusions: The determinants of empathy were significantly modulated by the geo-sociocultural context. The personality trait openness to experience was the only consistent determinant of empathy across both sites over time. Associations between empathy and gender, motives for studying medicine, and specialty preferences were site specific. Our findings underscore the importance of considering students' backgrounds when assessing empathy teaching and learning.

Keywords: Cross-cultural; Empathy; Gender; Medical students; Motivations; Personality; Specialty preference.

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Conflict of interest statement

Declarations. Ethics approval and consent to participate: The study project was submitted to the Chair of the Geneva Cantonal Commission for Ethical Research (CCER) and designated as exempt from formal review. The study was approved by the Ethics Committee of Research in Humans from the Federal University of Health Sciences of Porto Alegre (protocol number 1.151.091). Informed consent was obtained from all subjects participating in the study. Consent for publication: Not applicable. Competing interests: The authors declare no competing interests.

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