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Can empathy be preserved in medical education?

  • Seeberger, Astrid1
  • Lönn, Annalena1
  • Hult, Håkan1
  • Weurlander, Maria2
  • Wernerson, Annika1
  • 1 Division of Renal Medicine, Department of Clinical Science, Intervention and Technology (CLINTEC), Karolinska Insti-tutet, Stockholm, Sweden
  • 2 Department of Learning, School of Education and Communication in Engineering Science (ECE), KTH Royal Institute of Technology, Stockholm, Sweden
Published Article
International Journal of Medical Education
Publication Date
Apr 20, 2020
DOI: 10.5116/ijme.5e83.31cf
PMID: 32311676
PMCID: PMC7246122
PubMed Central


Objectives The aim of this study was to investigate changes in empathy during medical education, as well as to identify promoters and inhibitors of empathy and analyse their roles. Methods We used qualitative content analysis to examine 69 critically reflective essays written by medical students as a part of their final examination at the end of the medical program. The essays were based on previous self-evaluations performed each term and represented retrospective reflections on their professional development. Results A majority of the students felt that their empathy did not decrease during medical education. On the contrary, many felt that their empathy had increased, especially the cognitive part of empathy, without loss of affective empathy. Many of them described a professionalisation process resulting in an ability to meet patients with preserved empathy but without being overwhelmed by emotions. They identified several factors that promoted the development of empathy: a multiplicity of patients, positive role models, and educational activities focusing on reflection and self-awareness. They also identified inhibitors of empathy: lack of professional competence and a stressful and empathy-hostile medical culture. Conclusions Our analysis of these retrospective reflections by students suggests that empathy can be preserved during medical education, despite the presence of important inhibitors of empathy. This finding might be due to the presence of more potent promoters and/or to the fact that educational activities might result in a decreased susceptibility to empathy-decreasing circumstances.

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