Studies show discrepancies between self- and observer-ratings of empathy among
medical students. Presently, there has been limited data and discussion exploring this
finding. This study explored the discrepancies between self- and observer-ratings of
empathy by comparing individual differences among medical students. Specifically,
whether medical students who demonstrated discrepancies in self- and observer-ratings
of empathy differ from those who did not demonstrate discrepancies, with regards to
personality, attachment, and clinical competence.
Sixty medical students participated in the study. Empathy was rated by an independent
observer during simulated patient encounters. In addition, empathy was self-rated using
the Jefferson Scale of Physician Empathy (student version). Personality was measured
using the Big Five Inventory and attachment was assessed using the Experiences in
Close Relationships Questionnaire. Clinical competence was evaluated by medical
examiners during an Objective Structured Clinical Examination.
Results: The majority of students performed in accordance with their self-ratings of
empathy. Of those students who had discrepant scores, the majority had inflated selfratings
as opposed to higher observer-ratings. A one-way ANOVA revealed significant
differences between the groups on extraversion, openness, and total competence scores.
It appears that students differ with regards to extraversion, openness, and total competence.
We propose that a deficit in metacognitive abilities, in addition to lower clinical competence,
affects medical student's abilities to provide accurate self-assessments. Furthermore,
in the minority of cases, it appears that medical students learn that it pays to adopt the
view that “if you cannot feel it, fake it”.