Changes in the Affective Empathy of Osteopathic Students: a Longitudinal Study

Establishing an empathic bond of trust with patients is a characteristic that needs to be taught to medical students. Patients feel physicians are more caring if they sense their physician is empathetic. Yet, longitudinal studies have shown an erosion of affective empathy as allopathic medical students progress through their education. Although there are studies examining cognitive empathy among osteopathic students, there has not been a longitudinal study which has examined potential changes in affective empathy.

During orientation to the Campbell University Jerry M. Wallace School of Osteopathic Medicine (M1 timepoint), and at the beginning of each subsequent academic year (M2-M4 timepoints), and just before graduation (M4F timepoint) the graduating classes of 2017–2019 were asked to voluntarily participate in a longitudinal study by filling out the Balanced Emotional Empathy Scale (BEES), which measures affective empathy. Desired specialty choice and sex was also collected at each of the five timepoints. Specialty choice was divided into Core and Non-Core groups. Core specialties are “people-oriented” and have a large amount of patient contact and continuity of care and include Family and Internal Medicine, Ob/Gyn, Pediatrics and Psychiatry. Non-Core specialties are “technical- or procedure-oriented” and are those with little or no patient contact and/or continuity of care (e.g., Radiology, Surgery, Emergency Medicine, Anesthesiology).

For men, BEES scores significantly dropped over the five timepoints (p < 0.001). While men selecting Non-Core specialties had significant drops in scores (p = 0.001); men who selected the Core specialties did not have a significant decrease. For women there was no significant drop in BEES scores, nor for women selecting Core or Non-Core specialties. Women always had larger BEES score averages than the men. Students selecting Core specialties better maintain their affective empathy than those who select Non-Core specialties.

The decline in affective empathy scores for osteopathic students has differences when compared to a similar longitudinal study of allopathic medical students.