SynthesisBMC medical education2023
Why might medical student empathy change throughout medical school? a systematic review and thematic synthesis of qualitative studies.
Synthesis in BMC medical education, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 41 papers, 2 of them syntheses that pooled it.
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Who cites it
41 citing papers in PubMed, 2 syntheses or guidelines pooled it, 76 citations in OpenAlex.
- A systematic review identifying effective teaching methods and their combinations for increasing empathy in physicians: pairwise and network meta-analysis.BMC medical education · 2025Pooled it
- Efficacy of interventions aimed at reducing explicit and implicit weight bias in healthcare students: A systematic review and meta-analysis.Obesity reviews : an official journal of the International Association for the Study of Obesity · 2025Pooled it
- Talking to migrant children and adolescents with cancer: development of a multimodal skills training in migrant-sensitive communication for paediatric oncologists.European journal of pediatrics · 2026Trial
- A scoping review on the use of virtual patients for enhancing empathy in medical students.Medical education online · 2026Article
- Safeguarding medical empathy and cultivating compassion in contemporary medicine.Internal medicine journal · 2026Review
- Patient-centered communication in chiropractic education: A cross-sectional survey of chiropractic students in North America.The Journal of chiropractic education · 2026Article
- They Don't Even Know Your Name: An Intergenerational Modeling Deficit in Patient-Centered Practice.Cureus · 2026Article
- "Medical science educator · 2026Article
- Patient-Centered Attitudes and Associated Factors Among Medical Students in Spain: A Cross-Sectional Study.Cureus · 2026Article
- Learning to listen: mixed-methods study of medical students' perspectives on communication training.BMC medical education · 2026Article
- Improvement of medical students' stress, dispositional mindfulness, well-being and flourishing during the first academic year of a medical curriculum integrating a well-being longitudinal strand.BMC medical education · 2026Article
- Longitudinal trajectories of empathy among chinese medical students: a five-year prospective study using a dual-scale assessment.BMC medical education · 2026Article
- Patient Involvement to Promote Empathy in Preclinical Medical Students: Cross-Sectional Intervention Study.Journal of participatory medicine · 2026Article
- Does Clinical Training Influence Empathy in Dental Students? Evidence from a Cross-Sectional Study in Lithuania.Dentistry journal · 2026Article
- Re-visioning intercultural relational empathy.Advances in health sciences education : theory and practice · 2026Article
- Gaining Empathy for the Learner: A Way to Identify Unique Themes and Patterns in Medical Student Experiences.Medical science educator · 2026Article
- Between scientific capital and emotional capital: a cross-sectional study on the empathetic clinical gaze in Swedish medical education.Frontiers in medicine · 2026Article
- Prevalence, Digital Tools, and Management Strategies for Depression in Medical Students: A Narrative Review.Advances in medical education and practice · 2026Review
- Fostering empathy in healthcare: impact of a simulation-based educational program on professionals' relational skills.Frontiers in medicine · 2026Article
- When suffering becomes a game: a critical examination of gamification in medical education and its implications for compassion and empathy.Frontiers in medicine · 2026Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
8 authors at 3 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundSeveral studies suggest that medical student empathy declines throughout medical school. However, no studies have synthesised the evidence regarding why empathy declines.
objectiveTo conduct a systematic review and thematic synthesis of qualitative studies investigating why student empathy may change throughout medical school.
methodsWe included any qualitative study that investigated why empathy might change during medical school. We searched the Medline, Scopus, CINAHL, ERIC, and APA PsycInfo databases for relevant studies. All databases were searched from their inception to 18 July 2022. We also searched the reference lists of the included studies and contacted experts to identify additional studies. We used the Joanna Briggs Institute tool to evaluate the risk of bias in the included studies. Overall confidence in our results was assessed using the Confidence in the Evidence from Reviews of Qualitative research (CERQual) approach. We used thematic methods to synthesise our findings.
resultsOur searches yielded 2523 records, and 16 studies involving a total of 771 students were eligible for analysis. Most studies (n = 11) were from Europe or North America. The descriptive themes and sub-themes were identified for each study. Increased complexity in patients and their diseases, together with the 'hidden curriculum' (including a stressful workload, prioritisation of biomedical knowledge, and (sometimes) poor role models), led to student adaptations, such as cynicism and desensitisation. Students' prior lives and professional experiences appeared to exacerbate the decline in empathy. However, there were bias concerns for most of the included studies. DISCUSSION: Many of the included studies included were small, and some did not include demographic participant data. Given the likely benefits of providing empathic care for patients and practitioners, medical education interventions should focus on developing an 'empathic hidden curriculum' that mitigates the decline in medical student empathy.
trial registrationA protocol for this systematic review was submitted for registration with the International Prospective Register of Systematic Reviews (PROSPERO) on 28 July 2022 (registration number CRD42022347856).
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.