Write a case study about the new empathy-focused medical curriculum for the University of Leicester’s Stoneygate Centre for Empathic Healthcare, based on an interview and recently published research.
There are many reasons why people choose to study medicine. Alongside an interest in science, prospective students and healthcare professionals often cite a desire to help and care for others.
Delivering compassionate and empathic healthcare is a central tenet for educators, patients, healthcare professionals and policymakers. For example, empathy is core to the General Medical Council’s strategy for making patient interactions matter, it is taught across many medical schools, and three-quarters of doctors and patients believe empathy and compassion are important in treatment. In reality, research shows that just 0.4 per cent to 0.6 per cent of patient interactions are expressions of empathy or compassion. So where does empathy go, and why?
The hidden curriculum that drains empathy from medical students
Despite empathy and communication skills being taught by medical educators, several studies suggest empathy gradually declines through medical school, particularly during clinical placements. After systematically reviewing all the available evidence, the team at the University of Leicester’s newly launched Stoneygate Centre for Empathic Healthcare are the first to uncover why.
Published in BMC Medical Education and co-produced with Leicester medical students, their study finds that subtle, non-formal influences over students in clinical environments is to blame. These include a stressful workload, high-pressure organisational cultures, ineffective role models, and a focus on the biomedical model of disease rather a patient-centred approach.
Faced with this “hidden curriculum”, students develop coping strategies, including cynicism, to desensitise themselves from pressured clinical environments. Crucially, the study finds that medical students also emotionally distance themselves from patients.
Leading the step-change in empathy-focused teaching
“Despite empathy being taught in medical schools, our Centre’s research on the hidden curriculum shines the spotlight on a real need for medical education to be better,” says General Practitioner Dr Andy Ward, Associate Professor and Education Lead at the Stoneygate Centre.
Dr Ward and the Stoneygate Centre team, led by Evidence-Based Medicine expert Professor Jeremy Howick, are on a mission to tackle this empathy decline by embedding empathy at the heart of healthcare. This starts with education, where Dr Ward is working with Curriculum Development Lead Dr Rachel Winter to integrate empathy teaching right across Leicester Medical School’s undergraduate curriculum. This is a global first for medical education, with the University of Leicester being the only medical school to tackle the decline of empathy in this way.
“As an innovative medical school, we have recently piloted an empathy curriculum with our Foundation Year students and found that students come into Year 1 with a real advantage over their peers when it comes to empathy,” says Dr Ward, who has been teaching medicine for nearly 20 years.
Empathy-focused training is not new and has been piloted in other parts of the world. As a centre for excellence, the Stoneygate Centre will bring together the best of what has worked, evaluate it, extend it, and combine it with cutting-edge new forms of teaching that enable students to walk a mile in their patient’s shoes.
“By enhancing and extending empathy training across the entire curriculum, our approach is to enhance empathy skills in ways that require little time or resource,” says Dr Ward. “For example, simply asking a patient what it feels like to receive a physical examination can have a real impact on students’ understanding of the patient experience, providing them with an empathic perspective they can take into their own practice. Our curriculum is already tightly packed, so at every stage we will be asking – what is it like for the patient?”
Other forms of teaching will include a focus on the holistic model of disease, bringing patients into the classroom, teaching empathic communication skills, training for role models, and peer support.
Building an evidence-base for empathic healthcare
The Centre’s empathy-focused training programmes for students and healthcare professionals will be sensitive to the resources available in modern health systems, so they can be adopted and spread across medical schools and health systems globally.
Dr Ward also hopes the Centre can kick-start a ripple effect where clinicians who teach Leicester Medical School’s empathy-focused curriculum start to see their own practice change.
“Naturally, when you teach you reflect on what you have taught and then take this into your own clinical setting,” says Dr Ward. “Alongside this, when our students become Foundation Year Doctors, our aim is for them to experience less burnout and have fewer complaints because they are practising empathically. We need to capture these experiences are part of our research.”
For health systems and policymakers, the Stoneygate Centre’s research team are taking an evidence-based approach to understanding how empathic healthcare can lead to higher patient satisfaction or fewer patient safety incidents.
“If we want to see sustained change across the health system, then we must build a case of evidence to support it. Medical schools, hospitals and health systems will respond to that and will want to change their policies and deliver their own empathy-focused training programmes. We have an exciting few years ahead of us, and as an educator, I’m really looking forward to seeing the benefits this brings to our students and their patients.”