Internship and Empathy: Variations Across Time and Specialties. Issue 10 (October 2015)

• Record Type: Journal Article
• Authors: Avasarala, Sameer K.; Whitehouse, Sarah; Drake, Sean M.
• Is Part Of: Southern medical journal. Volume 108:Issue 10(2015)
• Publication Date: 2015-10
• Subjects: empathy -- internship -- graduate medical education -- Interpersonal Reactivity Index; Medicine -- Periodicals; 610.5
• DOI: 10.14423/SMJ.0000000000000347
• Languages: English
• ISSNs: 0038-4348

Abstract

Abstract : Objectives: To assess whether any differences exist in Interpersonal Reactivity Index (IRI) scores among postgraduate year 1 (PGY-1) residents across specialties. Methods: PGY-1 residents representing 11 specialties at our academic institution were invited to take a Web-based IRI survey at three time points. The specialties were condensed into several binary groups for analysis: internal medicine (IM) versus non-IM; primary care (IM, family medicine) versus nonprimary care; emergency medicine (EM, including the combined IM/EM) versus non-EM; surgical specialties (general surgery, obstetrics and gynecology, otolaryngology, orthopedics, urology) versus nonsurgical specialties (EM, family medicine, IM, neurology, pathology, and psychiatry); men versus women; and age groups. A repeated-measures generalized-estimating equations approach was taken to analyze the effect of specialty and time on each of the four IRI subscales. Results: Of 94 PGY-1 residents invited to participate at each time point, 74 (77.1%) completed the survey at least once. Response rates at each time point were similar (mean 47.9%). When comparing the IM (n = 35) and non-IM (n = 39) groups, the perspective-taking subscale was found to be significantly lower in the non-IM group ( P = 0.006). Among male (n = 46) versus female residents (n = 26), the personal-distress subscale was significantly different overall ( P = 0.041) but not among time points. No other significant differences were found between groups. The conglomerate subscale scores throughout the year did not show a dramatic change. Conclusions: Our study of IRI subscales in PGY-1 residents showed no major difference among specialties across 1 year except for IM residents, who scored significantly higher (more favorably) in the perspective-taking subscale. Contrary to previous studies, we did not observe a substantial decline in the empathic concern subscale IM residents over their first year. Abstract : The internship year of graduate medical education is well known to be to a critical transition period between medical school and practicing medicine professionally. Empathy is an intangible interpersonal skill set that is relied upon heavily to interact with patients. The Accreditation Council for Graduate Medical Education's Next Accreditation System clearly emphasizes physicians being evaluated on their level of empathy. Previous studies have documented a steady decline in empathy throughout the internship year; however, a baseline measure of empathy and the rate of decline in interns between different specialties has not been thoroughly investigated.