Date Published: May 2, 2019
Publisher: Public Library of Science
Author(s): Colm M. P. O’Tuathaigh, Alia Nadhirah Idris, Eileen Duggan, Patricio Costa, Manuel João Costa, Alejandro Arrieta.
Existing research has suggested that self-reported empathy in medical students is moderated by personality traits and diverse demographic and educational factors including age, gender, nationality, career aspirations, as well as year of curriculum. It is unclear how empathy, personality, and background factors might impact on students’ attitudes towards professionalism in medicine.
A cross-sectional questionnaire-based study was conducted in first and final year medical students at an Irish medical school. The following instruments were administered: (a) Jefferson Scale of Empathy; (b) NEO Five-Factor Inventory (NEO-FFI-3); (c) Attitudes towards Professionalism Scale. Demographic and educational variables were also measured. Descriptive and correlational analysis was conducted to examine the association between empathy, personality, professionalism-related attitudes and additional measures. Regression analysis was used to examine determinants of attitudes towards professional behaviour.
Both selected NEO-FFI personality traits and empathy were independently associated with distinct categories of professional behaviour. Specifically, Openness to Experience was associated with higher empathy scores, and higher ‘Social responsibility’. Extraversion was linked with higher scores on the “Personal characteristics” and “Interactions with team” categories, while Conscientiousness was also positively associated with “Personal characteristics”. In agreement with previous studies, the personality traits most associated empathy were Agreeableness and Openness to Experience. Empathy did not vary according to programme year or career specialty preference.
This study is the first to show that empathy and personality factors may act as determinants of students’ attitudes towards medical professionalism in a manner which is dependent upon category of professional behaviour.
Empathy is regarded as an essential physician attribute and is best defined a multidimensional construct, involving cognitive (the ability to understand and reflect someone else’s perspective), affective (ability to perceive subjectively another person’s inner experiences and natural feelings) and behavioural (the ability to competently communicate that one understands these feelings and perspectives) components [1–5].
In the present study, several of the NEO-FFI personality traits were independently associated with distinct categories of professional behaviour in the current sample of medical students. Based on the multiple regression analyses, Openness to Experience was associated with higher empathy scores, and higher ‘Social responsibility’ category scores; this latter category is focused on patient advocacy, improving access to care, and managing conflicts of interest. Agreeableness was also weakly correlated with increased JSE scores. Extraversion was linked with higher scores on the “Personal characteristics” and “Interactions with team” categories, while Conscientiousness was also positively associated with scores under the “Personal characteristics” category. Empathy levels also emerged as a significant positive predictor of score variation in the “Social responsibility professional behaviour category.
Our study is the first examination of how personality and self-reported empathy impact upon attitudes towards different categories of professional behaviour in medicine. Consistent with previous results, it identified Agreeableness and Openness to Experience as correlates of empathy, while both Extraversion, Openness to Experience and Conscientiousness were significant predictors of perceived importance ascribed to different aspects of medical professionalism. Neither year of study, age, nor career specialty preference had any effect on empathy values, but graduate-entry medical students demonstrated increased empathy and both increased Openness to Experience and Conscientiousness relative to direct-entry students.