Patient-centeredness and empathy: inborn or acquired? The role of gender and practical experience in a sample of Italian medical students

Patient-centeredness and empathy have been recognized as crucial skills in delivering high-quality medical care. Several studies have measured empathy among medical students, but very little is known about empathy and patient-centered orientation in Italian medical education context. This research presents the results from a longitudinal study that examined empathy and patient-centeredness differences by students’ gender and clinical internship during medical school. A total of 194 medical students completed a longitudinal survey consisting of the Jefferson Scale of Physician Empathy-Student Version (JSE-S) and the Patient-Practitioner Orientation Scale (PPOS). Self-report questionnaires were administered at first year, before the experience at the General Practitioner’s office (GP’s), at second year (after GP’s) and at fifth year (after the ward experience). Female students (n=98) scored significantly higher than male students at first [JSE-S: F(1,194)=24.720; ρ<.001; PPOS: F(1,194)=61.615; ρ<.001], second [JSE-S: F(1,194)=2.133; ρ=.146; PPOS: F(1,194)=9.106; ρ<.01] and fifth year [JSE-S: F(1,194)=19.882; ρ<.001; PPOS: F(1,194)=12.797; ρ<.001]. Empathy levels of students improved after the hospital practical experience [F(1,194)=7.788; ρ<.01], while patient-centeredness scores of students enhanced after GP’s internship [F(1,194)=22.486; ρ<.001]. Patterns of increasing in empathy and patient-centeredness scores were similar for men and women. The results supported the hypothesis that female students would score higher than male students. Instead, the findings did not support the hypothesis that empathy scores decline during the medical school years. Clinical and practical experience during the years of medical school seems to improve a clinical orientation centered on the person of the patient, independently by gender.