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TIP EĞİTİMİNDE EMPATİ: DOKTOR OLMADAN ÖNCE HASTA YAKINI OL

Yıl 2024, Cilt: 23 Sayı: 71, 47 - 70
https://doi.org/10.25282/ted.1537724

Öz

Giriş: Empati, duygusal zekanın bir parçası ve etkili iletişim becerileri açısından tıp disiplinlerinde önemli bir kavramdır. Preklinik aşamada hasta ile teması olmayan tıp fakültesi ikinci sınıf öğrencilerinde uygulanan “Doktor olmadan önce hasta yakını ol projesi” ve bu projesi ile, empatinin öğrenciler tarafından içselleştirilmesi amaçlanmıştır.
Gereç ve Yöntem: Öğrencilerin hasta ve yakınlarıyla etik kurallar çerçevesinde görüşmesi, hastanedeki tanı ve tedavi süreçlerini görmeleri sağlandı. Araştırmanın nicel boyutunda uygulama öncesinde Jefferson Empati Ölçeği öğrenci versiyonu ile genel empati ölçeğini içeren anket formu uygulanmış, uygulama sonrasında Jefferson Empati Ölçeği öğrenci versiyonu ve genel empati ölçeği tekrar uygulanmıştır. Araştırmanın nitel boyutunda öğrencilerden deneyimlerine dayalı olarak yeniden değerlendirme yazmaları istenmiş, Hazırlanan bu raporlar doküman olarak ele alınmış ve analize tabi tutulmuştur.
Bulgular: Yaş ortalaması 20,31 ± 0,85 olup, %55,7’si (n=64) kız öğrencilerden oluşmaktadır. Empati uygulama etkinliği öncesine göre, empati uygulama etkinliği sonrasında Jefferson Empati ölçeği puanında anlamlı şekilde yükseliş olmuştur (p=0.0001). Toronto Empati ölçeği puanı empati uygulama etkinliği sonrasında, empati uygulama etkinliği öncesine göre istatistiksel olarak anlamlı fark olmamakla birlikte, artış göstermektedir (p=0.097). Nitel raporları incelendiğinde, empati ifadesi içeren toplam 354 koda ulaşılmıştır. En çok hastalık ve hastane sürecinin zorluğu, bekleme süresi ve hastalığa üzülme ile empati kurulduğu görülmüştür.
Tartışma: Sonuç olarak, bu çalışmanın sonucunda hem nitel hem nicel olarak empati düzeylerinin arttığı, hasta memnuniyetinin olduğunu bulduk. Bu nedenle yaptığımız projenin tüm tıp fakültelerinin eğitim müfredatında uygulanabilir olduğu kanaatindeyiz.

Kaynakça

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  • 2- Dereboy C. Teaching empathy in medical education. Turk Psikiyatri Derg, 2005, 16.2: 83-9.
  • 3- Hemmerdınger, J.M., Stoddart, S, Lılford, R. J. A systematic review of tests of empathy in medicine. BMC medical education, 2007, 7: 1-8. https://doi.org/10.1186/1472-6920-7-24
  • 4- Suchman, A. L., et al. A model of empathic communication in the medical interview. Jama, 1997, 277.8: 678-682. https://doi.org/10.1001/jama.1997.03540320082047
  • 5- Grıffın, S. J. Effect on health-related outcomes of interventions to alter the interaction between patients and practitioners: a systematic review of trials. The Annals of Family Medicine, 2004, 2.6: 595-608. https://doi.org/10.1370/afm.142.
  • 6- Neumann, M., Edelhäuser, F., Tauschel, D., Fischer, M. R., Wirtz, M., Woopen, C., et al. Empathy decline and its reasons: a systematic review of studies with medical students and residents. Academic medicine. 2011; 86(8), 996-1009. https://doi.org/10.1097/ACM.0b013e318221e615
  • 7- Liu, J., Gan, Y., Jiang, H., Li, L., Dwyer, R., Lu, K., et al. Prevalence of workplace violence against healthcare workers: a systematic review and meta-analysis. Occupational and environmental medicine. 2019. https://doi.org/10.1136/oemed-2019-105849
  • 8- Mento, C., Silvestri, M. C., Bruno, A., Muscatello, M. R. A., Cedro, C., Pandolfo, G., et al. Workplace violence against healthcare professionals: A systematic review. Aggression and violent behavior. 2020; 51:101381. https://doi.org/10.1016/j.avb.2020.101381
  • 9- Kılınç, M., Uludağ, A. The Relationship Between Aggressive Behavior And Empathic Tendency Levels Of Health Workers. Gaziantep University Journal of Social Sciences. 2017;16 (3): 809-825. https://doi.org/10.21547/jss.307207
  • 10- Arafa, A., Shehata, A., Youssef, M., Senosy, S. Violence against healthcare workers during the COVID-19 pandemic: a cross-sectional study from Egypt. Archives of Environmental & Occupational Health, 2022: 77(8): 621-627. https://doi.org/10.1080/19338244.2021.1982854
  • 11- Mansur, F. The Effect of Problems in Health Communication on Violence Against Physicians. Business Academy Journal. 2022; 3(1): 57-69. https://doi.org/10.26677/TR1010.2022.964
  • 12- Nam, S. H., Lee, D. W., Seo, H. Y., Hong, Y. C., Yun, J. Y., Cho, S. J. Et al. Empathy With Patients and post-traumatic stress response in verbally abused healthcare workers. Psychiatry investigation, 2011; 18(8): 770. https://doi.org/10.30773/pi.2021.0066
  • 13- Shapiro J. Walking a mile in their patients’ shoes: empathy and othering in medical students’ education. Philosophy, Ethics, and Humanities in Medicine, 2008; 3:10. https://doi.org/10.1186/1747-5341-3-10
  • 14- Pohontsch, N. J., Stark, A., Ehrhardt, M., Kötter, T., Scherer, M. Influences on students’ empathy in medical education: an exploratory interview study with medical students in their third and last year. BMC Medical Education, 2018;18(1): 1-9. https://doi.org/10.1186/s12909-018-1335-7
  • 15- Weissmann, P. F., Branch, W. T., Gracey, C. F., Haidet, P., & Frankel, R. M. Role modeling humanistic behavior: learning bedside manner from the experts. Academic Medicine, 2006;81(7): 661-667. https://doi.org/10.1097/01.ACM.0000232423.81299.fe
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  • 20- Charon, R. Reading, writing, and doctoring: literature and medicine. The American journal of the medical sciences, 2000; 319(5): 285-291. https://doi.org/10.1016/S0002-9629(15)40754-2
  • 21- Shapiro, J., Duke, A., Boker, J., Ahearn, C. S. Just a spoonful of humanities makes the medicine go down: introducing literature into a family medicine clerkship. Medical education, 2005; 39(6): 605-612. https://doi.org/10.1111/j.1365-2929.2005.02178.x
  • 22- Crewell, J. W. Qualitative, Quantitative and Mixed Method Approach. Yogyakarta: Student Literature. 2016
  • 23- Gönüllü, İ., Öztuna, D. A Turkish Adaptation of the Student Version of the Jefferson Scale of Physician Empathy. Marmara Medical Journal. 2012; 25(2).
  • 24- Totan, T., Dogan, T., Sapmaz, F. The Toronto Empathy Questionnaire: Evaluation of Psychometric Properties among Turkish University Students. Eurasian Journal of Educational Research, 2012; 46, 179-198.
  • 25- Braun, V., Clarke, V. Using thematic analysis in psychology. Qualitative research in psychology. 2006; 3(2): 77. https://doi.org/10.1191/1478088706qp063oa
  • 26- Braun, V., Clarke, V. What can “thematic analysis” offer health and wellbeing researchers? International journal of qualitative studies on health and well-being. 2014;9(1): 26152. https://doi.org/10.3402/qhw.v9.26152
  • 27- Yıldırım, A., Şimşek, H. Sosyal Bilimler Nitel Araştırma Yöntemleri (11. Baskı) [Social Sciences Qualitative Research Methods.]. Seçkin Yayıncılık. 2018
  • 28- Bansal, P., Verma, A. Patient initiated violence on physicians: Bibliometric analysis. International Journal of Healthcare Management 2023; 1-19. https://doi.org/10.1080/20479700.2023.2290778
  • 29- Kadioglu, S., Ogenler, O., Kadioglu, F., Okuyaz, S. The impact of clinical education on the empathy level of medical students. 2011. https://www.annalsmedres.org/index.php/aomr/article/view/3323
  • 30- Bozkir, C., Tekin, C., Mete, B., Nacar, E., & Ozer, A. Communication Skills, Empathic Tendency and Affecting Factors of Assistant Doctors in Inonu Universty, Faculty of Medicine, Malatya [İnönü Üniversitesi Tıp Fakültesi Asistan Doktorların İletişim Becerileri, Empatik Eğilimleri ve Etkileyen Faktörler]. Medicine Science, 2015; 4(3): 2473-2487. https://doi.org/10.5455/medscience.2015.04.8269
  • 31- Gönüllü, İ., Erden, Ş., Gökmen, D. Evaluation of student empathy level during the first five years of medical education at Ankara University. Yükseköğretim ve Bilim Dergisi, 2017; 3: 651-656. https://doi.org/10.5961/jhes.2017.241
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  • 53- Pohontsch, N. J., Stark, A., Ehrhardt, M., Kötter, T., Scherer, M. Influences on students’ empathy in medical education: an exploratory interview study with medical students in their third and last year. BMC Medical Education, 2018;18(1): 1-9. https://doi.org/10.1186/s12909-018-1335-7

EMPATHY IN MEDICAL EDUCATION: BE A RELATIVE BEFORE BECOMING A DOCTOR

Yıl 2024, Cilt: 23 Sayı: 71, 47 - 70
https://doi.org/10.25282/ted.1537724

Öz

Introduction: Empathy is an important concept in medical disciplines as part of emotional intelligence and effective communication skills. “Be a relative before becoming a doctor” project is intended to be applied to medical school students who do not have contact with the patient at the preclinical stage which will enable students to internalize empathy.
Materyal and method: Students were enabled to meet with the patient and their relatives within ethical rules and to see the diagnosis and treatment processes in the hospital. In the quantitative dimension of the research, a survey form containing the Jefferson Empathy Scale student version and the general empathy scale was applied before the practice, the Jefferson Empathy Scale student version and the general empathy scale were applied again after the practice. In the qualitative dimension of the research, students were asked to write reoprts based on their experiences, and the reports they wrote were treated as documents and analyzed.
Results: The mean age of the students was 20.31±0.85 and 55.7% (n=64) were female students. There was a significant increase in the Jefferson empathy scale score after the empathy practice activity compared to before the empathy practice activity (p=0.0001). Toronto Empathy Scale score increases after the empathy practice activity, although there is no statistically significant difference compared to before the empathy practice activity (p=0.097). When the qualitative reports of students were examined, a total of 354 codes containing the expression of empathy were found. It was observed that empathy was most frequently expressed with waiting time, personal satisfaction and sadness about the disease.
Discussion: As a result of this study, in which we evaluated empathy levels both qualitatively and quantitatively, we found that empathy levels increased and patient satisfaction. Fort his reason, we believe that our project is applicable in the educational curriculum of all medical faculties.

Kaynakça

  • 1- Sağlam E. An Overview of Empathy Education in Medical Faculties, What Can Be Done to Improve It? World of Medical Education. 2019;18(55): 62-69. https://doi.org/10.25282/ted.517847
  • 2- Dereboy C. Teaching empathy in medical education. Turk Psikiyatri Derg, 2005, 16.2: 83-9.
  • 3- Hemmerdınger, J.M., Stoddart, S, Lılford, R. J. A systematic review of tests of empathy in medicine. BMC medical education, 2007, 7: 1-8. https://doi.org/10.1186/1472-6920-7-24
  • 4- Suchman, A. L., et al. A model of empathic communication in the medical interview. Jama, 1997, 277.8: 678-682. https://doi.org/10.1001/jama.1997.03540320082047
  • 5- Grıffın, S. J. Effect on health-related outcomes of interventions to alter the interaction between patients and practitioners: a systematic review of trials. The Annals of Family Medicine, 2004, 2.6: 595-608. https://doi.org/10.1370/afm.142.
  • 6- Neumann, M., Edelhäuser, F., Tauschel, D., Fischer, M. R., Wirtz, M., Woopen, C., et al. Empathy decline and its reasons: a systematic review of studies with medical students and residents. Academic medicine. 2011; 86(8), 996-1009. https://doi.org/10.1097/ACM.0b013e318221e615
  • 7- Liu, J., Gan, Y., Jiang, H., Li, L., Dwyer, R., Lu, K., et al. Prevalence of workplace violence against healthcare workers: a systematic review and meta-analysis. Occupational and environmental medicine. 2019. https://doi.org/10.1136/oemed-2019-105849
  • 8- Mento, C., Silvestri, M. C., Bruno, A., Muscatello, M. R. A., Cedro, C., Pandolfo, G., et al. Workplace violence against healthcare professionals: A systematic review. Aggression and violent behavior. 2020; 51:101381. https://doi.org/10.1016/j.avb.2020.101381
  • 9- Kılınç, M., Uludağ, A. The Relationship Between Aggressive Behavior And Empathic Tendency Levels Of Health Workers. Gaziantep University Journal of Social Sciences. 2017;16 (3): 809-825. https://doi.org/10.21547/jss.307207
  • 10- Arafa, A., Shehata, A., Youssef, M., Senosy, S. Violence against healthcare workers during the COVID-19 pandemic: a cross-sectional study from Egypt. Archives of Environmental & Occupational Health, 2022: 77(8): 621-627. https://doi.org/10.1080/19338244.2021.1982854
  • 11- Mansur, F. The Effect of Problems in Health Communication on Violence Against Physicians. Business Academy Journal. 2022; 3(1): 57-69. https://doi.org/10.26677/TR1010.2022.964
  • 12- Nam, S. H., Lee, D. W., Seo, H. Y., Hong, Y. C., Yun, J. Y., Cho, S. J. Et al. Empathy With Patients and post-traumatic stress response in verbally abused healthcare workers. Psychiatry investigation, 2011; 18(8): 770. https://doi.org/10.30773/pi.2021.0066
  • 13- Shapiro J. Walking a mile in their patients’ shoes: empathy and othering in medical students’ education. Philosophy, Ethics, and Humanities in Medicine, 2008; 3:10. https://doi.org/10.1186/1747-5341-3-10
  • 14- Pohontsch, N. J., Stark, A., Ehrhardt, M., Kötter, T., Scherer, M. Influences on students’ empathy in medical education: an exploratory interview study with medical students in their third and last year. BMC Medical Education, 2018;18(1): 1-9. https://doi.org/10.1186/s12909-018-1335-7
  • 15- Weissmann, P. F., Branch, W. T., Gracey, C. F., Haidet, P., & Frankel, R. M. Role modeling humanistic behavior: learning bedside manner from the experts. Academic Medicine, 2006;81(7): 661-667. https://doi.org/10.1097/01.ACM.0000232423.81299.fe
  • 16. Ahrweiler, F., Scheffer, C., Roling, G., Goldblatt, H., Hahn, E. G., Neumann, M. Clinical practice and self-awareness as determinants of empathy in undergraduate education: a qualitative short survey at three medical schools in Germany. GMS Zeitschrift Für Medizinische Ausbildung, 2014;31(4). https://doi.org/10.3205/zma000938
  • 17- Jeffrey, D. I., Jeffrey, D. I. Embedding Empathy-Based Ethics into Practice, Education and Research. Empathy-Based Ethics: A Way to Practice Humane Medicine, 2020;113-134. https://doi.org/10.1007/978-3-030-64804-6_9
  • 18- Markham, B., Gessner, M., Warburton, S. W., Sadler, G. Medical students become patients: a new teaching strategy. Academic Medicine, 1979;54(5): 416-8.
  • 19- Dow, A. W., Leong, D., Anderson, A., Wenzel, R. P., VCU Theater-Medicine Team*. Using theater to teach clinical empathy: a pilot study. Journal of general internal medicine. 2007;22: 1114-1118. https://doi.org/10.1007/s11606-007-0224-2
  • 20- Charon, R. Reading, writing, and doctoring: literature and medicine. The American journal of the medical sciences, 2000; 319(5): 285-291. https://doi.org/10.1016/S0002-9629(15)40754-2
  • 21- Shapiro, J., Duke, A., Boker, J., Ahearn, C. S. Just a spoonful of humanities makes the medicine go down: introducing literature into a family medicine clerkship. Medical education, 2005; 39(6): 605-612. https://doi.org/10.1111/j.1365-2929.2005.02178.x
  • 22- Crewell, J. W. Qualitative, Quantitative and Mixed Method Approach. Yogyakarta: Student Literature. 2016
  • 23- Gönüllü, İ., Öztuna, D. A Turkish Adaptation of the Student Version of the Jefferson Scale of Physician Empathy. Marmara Medical Journal. 2012; 25(2).
  • 24- Totan, T., Dogan, T., Sapmaz, F. The Toronto Empathy Questionnaire: Evaluation of Psychometric Properties among Turkish University Students. Eurasian Journal of Educational Research, 2012; 46, 179-198.
  • 25- Braun, V., Clarke, V. Using thematic analysis in psychology. Qualitative research in psychology. 2006; 3(2): 77. https://doi.org/10.1191/1478088706qp063oa
  • 26- Braun, V., Clarke, V. What can “thematic analysis” offer health and wellbeing researchers? International journal of qualitative studies on health and well-being. 2014;9(1): 26152. https://doi.org/10.3402/qhw.v9.26152
  • 27- Yıldırım, A., Şimşek, H. Sosyal Bilimler Nitel Araştırma Yöntemleri (11. Baskı) [Social Sciences Qualitative Research Methods.]. Seçkin Yayıncılık. 2018
  • 28- Bansal, P., Verma, A. Patient initiated violence on physicians: Bibliometric analysis. International Journal of Healthcare Management 2023; 1-19. https://doi.org/10.1080/20479700.2023.2290778
  • 29- Kadioglu, S., Ogenler, O., Kadioglu, F., Okuyaz, S. The impact of clinical education on the empathy level of medical students. 2011. https://www.annalsmedres.org/index.php/aomr/article/view/3323
  • 30- Bozkir, C., Tekin, C., Mete, B., Nacar, E., & Ozer, A. Communication Skills, Empathic Tendency and Affecting Factors of Assistant Doctors in Inonu Universty, Faculty of Medicine, Malatya [İnönü Üniversitesi Tıp Fakültesi Asistan Doktorların İletişim Becerileri, Empatik Eğilimleri ve Etkileyen Faktörler]. Medicine Science, 2015; 4(3): 2473-2487. https://doi.org/10.5455/medscience.2015.04.8269
  • 31- Gönüllü, İ., Erden, Ş., Gökmen, D. Evaluation of student empathy level during the first five years of medical education at Ankara University. Yükseköğretim ve Bilim Dergisi, 2017; 3: 651-656. https://doi.org/10.5961/jhes.2017.241
  • 32- Igde, F. A., Sahin, M. K. Changes in empathy during medical education: an example from Turkey. Pakistan Journal of Medical Sciences, 2017;33(5): 1177. https://doi.org/10.12669/pjms.335.13074
  • 33- Yeniçeri, E. N., Yıldız, E., Seydaoğulları, A., Güleç, S., Çetin, E. S., Baldemir, E. Relation of emotional intelligence and emphaty among medical students in Muğla Sıtkı Koçman University. Turkish Journal of Family Practice. 2015; 19(2): 99-107. https://doi.org/10.15511/tahd.15.02099
  • 34- Williams, B., Brown, T., McKenna, L., Palermo, C., Morgan, P., Nestel, D., et al. Student empathy levels across 12 medical and health professions: an interventional study. Journal of Compassionate Health Care. 2015;2: 1-6. https://doi.org/10.1186/s40639-015-0013-4
  • 35- Hojat, M., Vergare, M. J., Maxwell, K., Brainard, G., Herrine, S. K., Isenberg, G. A., et al. The devil is in the third year: a longitudinal study of erosion of empathy in medical school. Academic medicine, 2009; 84(9): 1182-1191. https://doi.org/10.1097/ACM.0b013e3181b17e55
  • 36- Rosenthal, S., Howard, B., Schlussel, Y. R., Herrigel, D., Smolarz, B. G., Gable, B., et al. Humanism at heart: preserving empathy in third-year medical students. Academic medicine, 2011;86(3): 350-358. https://doi.org/10.1097/ACM.0b013e318209897f
  • 37- Ohm, F., Vogel, D., Sehner, S., Wijnen-Meijer, M., Harendza, S. Details acquired from medical history and patients’ experience of empathy–two sides of the same coin. BMC medical education, 2013;13:1-7. https://doi.org/10.1186/1472-6920-13-67
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  • 49- Chen DCR, Pahilan ME, Orlander JD. Comparing a self-administered measure of empathy with observed behavior among medical students. J Gen Intern Med. 2010;25:200–202. https://doi.org/10.1007/s11606-009-1193-4.
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Toplam 53 adet kaynakça vardır.

Ayrıntılar

Birincil Dil İngilizce
Konular Tıp Eğitimi
Bölüm Orjinal Araştırma
Yazarlar

Ahmet Kutluhan 0000-0002-9255-8022

Tugba Sarı 0000-0003-3204-2371

Z. Melek Küçükatay 0000-0002-9366-0205

Zeynep Ayvaz Tuncel 0000-0003-1817-9603

Hatice Nilüfer Süzen 0000-0002-2020-5551

Hande Şenol 0000-0001-6395-7924

Nilüfer Emre 0000-0002-6519-0920

Mehmet Yücens 0000-0001-6924-6613

Erken Görünüm Tarihi 24 Aralık 2024
Yayımlanma Tarihi
Gönderilme Tarihi 23 Ağustos 2024
Kabul Tarihi 3 Aralık 2024
Yayımlandığı Sayı Yıl 2024 Cilt: 23 Sayı: 71

Kaynak Göster

Vancouver Kutluhan A, Sarı T, Küçükatay ZM, Ayvaz Tuncel Z, Süzen HN, Şenol H, Emre N, Yücens M. EMPATHY IN MEDICAL EDUCATION: BE A RELATIVE BEFORE BECOMING A DOCTOR. TED. 2024;23(71):47-70.