When training clinically competent doctors, most medical schools focus upon components
of the interpersonal process between doctor and patient, such as empathy in the doctorpatient
relationship. This study investigated the relationship between empathy and clinical
competence among medical students.
Sixty students from an Australian Graduate School of Medicine participated in the study.
Clinical competence was assessed in an Objective Structured Clinical Examination
(OSCE). Empathy was rated by an independent observer of the clinical interaction in
OSCE stations using the Rating Scales for the Assessment of Empathic Communication
in Medical Interviews (REM). In addition, empathy was self-rated using the Jefferson
Scale of Physician Empathy (student version).
Observed empathic behaviour, as rated objectively by an independent observer, was
strongly associated with clinical competence and was evident across diverse types of
consultations and a wide range of medical conditions. Observable empathy was also
strongly associated with patients' ratings of the students' clinical performance. However,
self rated empathy was not associated with clinical competence.
Discussion & Conclusion
The results suggest that a doctor-patient relationship fostered by empathy appears to
complement the skills and knowledge required to effectively care for a patient. Strategies
that enhance the behavioural expression of empathy may make medical students seem
more clinically competent to both examiners and to patients. However, evidence that
the medical students' internal emotions are discrepant with their behaviour raises difficult
questions regarding the fundamental nature of genuine empathy, with potential implications
for the sustainability of the positive relationship between empathy and clinical competence.