BACKGROUND: The integration of arts and humanities (A&H) into physician assistant (PA) preclinical curriculum may enhance student performance and improve their patient rapport. Arts and humanities content could promote the personal and professional qualities we desire in clinicians including competence, compassion, and empathy. The aim of this research was to determine what PA students report learning from A&H modules designed to foster personal insight and perspective-taking.
METHODS: The \"Introduction of Humanities & Arts into Physician Assistant Education\" (IHAPAE) project is an intercampus collaboration between 2 Midwest Universities. The IHAPAE faculty collaboratively created and delivered A&H-based modules within first-year communication courses. Two cohorts of PA students (N = 130) participated in modules and subsequently attended exploratory focus groups to elicit their perceptions of the A&H curriculum.
RESULTS: Using a constructivist grounded theory approach for data analysis, we found that PA students perceived multiple benefits. Specifically, module content promoted reflection and stress reduction, improved their continuity of care notes, provided utility in cultivating empathy in patient communication, and introduced students to A&H approaches they could recommend to patients.
CONCLUSIONS: The process model that emerged from student perceptions fits well with existing emotional regulation theory and provides empirical evidence for cultivation of empathy and patient-centeredness. Given the positive outcomes of our project, PA programs should consider the value of incorporating the A&H activities into their curriculum to enhance the student experience and develop essential provider attributes and skills.

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Emotional reactions to salient stimuli are well documented in psychophysiological research. However, some individual variables that can influence how people process emotions (i.e., empathy traits) have received little consideration. The present study investigated the relationship between emotions and empathy. Forty participants completed the Interpersonal Reactivity Index, a questionnaire that measure general and specific empathy dimensions. Then, emotional (erotic and mutilation) and non-emotional pictures were presented, during electroencephalographic recording. Valence and arousal were evaluated for each stimulus. Behavioral results revealed a positive correlation between the arousal induced by mutilation pictures and personal distress (i.e., feeling discomfort in emergency situations). At the electrophysiological level, theta activity elicited by positive and negative emotion processing in the superior frontal gyrus was associated with personal distress. Moreover, erotic-related theta in the middle frontal gyrus was associated with subjective judgement of erotic stimulus valence. Overall, theta activity modulated the interplay between emotions and empathy.

UNASSIGNED: Frontotemporal Degeneration (FTD) is a common cause of early onset dementia with symptoms often presenting before 65 years of age and adding tremendous burden on caregivers. FTD caregiving research describes patient behavioral symptoms such as apathy and disinhibition as primary sources of poor caregiver psychological health; however, little attention has been paid to other common patient behaviors, such as loss of empathy. To better understand the relationship between empathy loss and FTD caregiver outcomes, this integrative review aimed to address the question: How does the loss of empathy in a person living with FTD (PLwFTD) impact the caregiver?
UNASSIGNED: Quantitative and qualitative articles were found in PubMed, the Cumulative Index to Nursing and Allied Health Literature (CINAHL), and Scopus and were assessed for quality using the Crowe Critical Appraisal Tool (CCAT). Through constant comparative analysis, articles were assessed to abstract common themes in the literature.
UNASSIGNED: From 333 citations, 8 qualitative and 8 quantitative studies published between 2010 and 2022 were included. Three main themes were uncovered: 1) caregiver emotional reactions to the PLwFTD; 2) caregiver psychological distress; 3) changes in the relationship.
UNASSIGNED: This review emphasizes the detrimental impact of empathy loss on FTD caregivers. Understanding these underexplored consequences is critical in understanding the well-being of caregivers and promoting ways to support caregivers.

OBJECTIVE: To translate, culturally adapt and evaluate the psychometric properties of an Italian version of the Active Empathic Listening Scale (AELS-It) for first year students on a Bachelor degree in nursing.
BACKGROUND: Active and empathic listening is characterised by the active and emotional involvement of the listener and is particularly important for nurses to understand and address patients\' needs. When nurses demonstrate to patients that they are active and empathic listeners, it leads to deeper engagement and trust, strengthens the nurse-patient relationship and enhances the quality of care. Consequently, it is essential to incorporate active and empathic listening into nursing education, as it equips future nurses to communicate and respond to patients\' needs effectively. AELS is a tool that measures active and empathic listening styles. To the best of our knowledge, no study has validated and psychometrically tested AELS among nursing students and no studies have examined the application of the AELS scale within the Italian context.
METHODS: A three-phase validation study.
METHODS: The tool was first translated and adapted into Italian. A panel of 12 experts in nursing education evaluated the face and content validity. The psychometric properties of the Italian AELS (AELS-It) were assessed in a sample of nursing students. The dimensionality and construct validity of the tool were tested through exploratory and confirmatory factor analyses. Reliability was estimated using both traditional and composite methods.
RESULTS: A total of 207 students were included. The overall content validity index was 0.9. The exploratory factor analysis confirmed a three factor structure. Confirmatory factor analysis showed a second-order factor structure with adequate fit indices. The reliability of the second-order factor analysis for the scale was adequate, with Cronbach\'s α (0.877) and Composite-ω (0.875).
CONCLUSIONS: The Italian version of AELS-It proved to be a reliable tool to test active empathic listening in Italian nursing students and it could be a useful instrument in nursing education.

Purpose Empathetic engagement is considered a vital component in forming respect-based relationships between patients and clinicians, leading to more optimal patient care. The purpose of this study was to explore whether there was a relationship between dental hygiene students\' levels of empathy and student demographics including age, gender, year in school, and the degree type of dental hygiene program attending.Methods This was a cross-sectional observation study conducted among dental hygiene undergraduate students attending three dental hygiene programs in the Midwestern United States. Two programs offered associate degrees and one offered a baccalaureate degree. Participants completed the 20-item Jefferson Scale of Empathy©, student edition (JSE-S) along with demographic questions including age, gender, year in dental hygiene program, and degree type of dental hygiene program. Descriptive statistics and comparisons of the empathy scores were conducted using t-test and one-way analysis of variance (ANOVA). Regressions were conducted to determine whether the students\' year in dental hygiene program and the type of degree program were predictors of empathy.Results Forty-one participants completed the questionnaire for a 65% response rate. The mean empathy score was 83.05 ± 10.04 among the participants. There were no statistically significant differences between levels of empathy of first- and second-year students or those attending a two-year institution versus a four-year university. Age, year in program, and type of degree were not shown to be predictors of empathy.Conclusion Results from this study did not show relationships or predictors of empathy with dental hygiene students\' demographics or type of degree program. Future research should expand beyond a small homogenous convenience sample and include a longitudinal gauge to assess potential fluctuations in empathy as students progress throughout the curriculum and as practicing clinicians.

UNASSIGNED: The prevalence of impostor syndrome among PhD students has increased rapidly in recent years, having very negative effects on their mental and psychological health as well as on their doctoral journey. This exploratory study aims to examine whether there is a causal correlation between impostor syndrome among PhD students and empathy among supervisors.
UNASSIGNED: This study encompasses 562 doctoral students (300 females, 262 males) and 152 Tunisian supervisors (68 females, 84 males).
UNASSIGNED: Employing ANOVA, significant influences on impostor syndrome emerge for gender, marital status, professional status, and the doctoral enrollment level (p < 0.001). Concurrently, supervisors\' empathy is significantly affected by gender, marital status, and experience (p < 0.001). Linear regression establishes a noteworthy negative correlation (p = 0.045): a 1-unit increase in empathy correlates with a 0.122-unit decrease in impostor syndrome.
UNASSIGNED: These findings underscore the intricate relationship between socio-professional factors, empathy, and impostor syndrome within the academic milieu, offering crucial insights for interventions and psychological support. The study aligns with the broader context of understanding mental health challenges in academia, emphasizing the imperative for ongoing support initiatives.

BACKGROUND: Empathy is a key competency and is essential for doctor-patient relationships. Studies have proven a continuous reduction of empathy in medical students during their study period. The use of SPs is positively evaluated for competency acquisition and real patient communication training has positive effects on empathy empowerment. Therefore, the present study focusses on the impact of simulated patient (SP) vs real patient (RP) communication training on empathetic behaviour in undergraduate medical students.
METHODS: The prospective evaluation took place during a 210-minute skills lab unit on medical communication for 3rd year medical students. Study participants were allocated in advance to one of three groups: one group trained with an SP (SP-group) and was informed about the fact that it was an SP; another group trained with an SP but assumed to encounter an RP (incognito patient group (IP-group)); the last group trained with an RP and was correctly informed about it (real patient group (RP-group). Self-assessed empathy was measured by using Jefferson Scale of Physician Empathy (JSPE) and Interpersonal Reactivity Index (IRI), as these are the most commonly used instruments for assessing empathy. Study participants were evaluated on empathetic behaviour by their group-associated patient using the Consultation and Relational Empathy (CARE) scale.
RESULTS: 146 students participated. There was no significant difference in self-assessed empathy between groups for JSPE and IRI. External assessment via CARE showed a statistically significant difference between SP-group and IP-group , as well as between SP-group and RP-group. There was no significant difference between IP-group and RP-group. This means that students training with real patients (or who believed them to be real) did receive significantly lower performance ratings on their empathy.
CONCLUSIONS: The results demonstrate a significant lower external empathy rating for students who had trained with a real patient or if they were in the belief of having encountered a real patient; this may be due to inhibitions and a lack of routine. Therefore, we recommend implementing SPs in the early study period with the gradual integration of RPs in the student\'s further course of study.

UNASSIGNED: Teaching communication skills plays a pivotal role in medical curricula. The aim of this article is to describe and evaluate a new communication curriculum developed at the Faculty of Medicine, University of Augsburg (KomCuA), which was conceptualized by an interdisciplinary team based on recommended quality standards (i.e., helical, integrated, longitudinal).
UNASSIGNED: A total of 150 medical students enrolled in the 1st, 3rd, and ≥5th semester participated in the study. They completed an online survey (numerical rating scales and validated questionnaires) evaluating their current communication skills, how these developed across the curriculum in terms of quality and self-confidence, and how helpful they considered practicing in small group tutorials with simulated patients. The students\' attitudes towards communication and empathy in the context of medical care were additionally assessed. The students\' responses were compared across semesters using one-way univariate analysis of variance (ANOVA).
UNASSIGNED: Overall, students reported improved communications skills due to attending the KomCuA and further considered practicing with simulated patients as being very helpful (large effect sizes). Compared to 1st semester students, 3rd and ≥5th semester students reported better communication skills (medium to large effect sizes). Additionally, ≥5th semester students showed stronger agreement towards the relevance of empathy in the context of medical care (medium effect size) compared to both 1st and 3rd semester students.
UNASSIGNED: The KomCuA has shown to be an effective communication curriculum to support medical students in the development of their communication skills and positive attitudes towards empathy. Additional studies assessing students\' communication skills and empathic attitudes longitudinally are warranted to confirm the present results and to gain further knowledge on how these essential skills and attitudes develop across medical curricula.
UNASSIGNED: Die Vermittlung kommunikativer Kompetenzen spielt in der medizinischen Ausbildung eine zentrale Rolle. Ziel dieses Artikels ist es, ein neues Kommunikationscurriculum an der Medizinischen Fakultät der Universität Augsburg (KomCuA) zu beschreiben und zu evaluieren, welches von einem interdisziplinären Team basierend auf empfohlenen Qualitätsstandards (d.h. helikal, integriert, longitudinal) konzipiert wurde.
UNASSIGNED: An der Online-Studie nahmen insgesamt 150 Medizinstudierende aus den Semestern 1., 3. und ≥5. teil. Mithilfe numerischer Bewertungsskalen und validierter Fragebögen wurden Aspekte wie Kommunikationskompetenz, Veränderungen in Qualität und Sicherheit der eigenen Kommunikation und Nutzen der Übungen mit Schauspielpatient*innen erfasst. Zusätzlich wurden die Einstellungen der Studierenden zu Kommunikation und Empathie im Kontext der medizinischen Versorgung bewertet. Die Antworten der Studierenden wurden mithilfe von Varianzanalysen (ANOVA) über die Semester hinweg verglichen.
UNASSIGNED: Insgesamt gaben die Studierenden an, dass sich ihre Kommunikationskompetenz durch die Teilnahme am KomCuA verbessert habe, und bewerteten das Üben mit Schauspielpatient*innen als sehr hilfreich (große Effektstärken). Im Vergleich zu den Studierenden des 1. Semesters berichteten die Studierenden des 3. und ≥5. Semesters über bessere Kommunikationskompetenzen (mittlere bis große Effektstärken). Die Relevanz von Empathie im Kontext der medizinischen Versorgung (mittlere Effektstärke) wurde von den Studierenden des ≥5. Semesters höher eingestuft als von Studierenden des 1. und 3 Semesters.
UNASSIGNED: Das KomCuA hat sich als wirksames Kommunikationscurriculum erwiesen, das sowohl die Entwicklung von Kommunikationskompetenzen bei Medizinstudierenden befördert als auch zu einer positiven Einstellung zur Rolle von Empathie beiträgt. Weitere Studien, in denen Kommunikationskompetenzen und empathischen Einstellungen der Studierenden im Längsschnitt untersucht werden, sind notwendig, um die vorliegenden Ergebnisse zu bestätigen und weitere Erkenntnisse darüber zu gewinnen, wie sich Kommunikation und Einstellungen im Laufe des Studiums entwickeln.

UNASSIGNED: Situational Judgement Tests (SJT) are a cost-efficient method for the assessment of personal characteristics (e.g., empathy, professionalism, ethical thinking) in medical school admission. Recently, complex open-ended response format SJTs have become more feasible to conduct. However, research on their applicability to a German context is missing. This pilot study tests the acceptability, reliability, subgroup differences, and validity of an online SJT with open-ended response format developed in Canada (\"Casper\").
UNASSIGNED: German medical school applicants and students from Hamburg were invited to take Casper in 2020 and 2021. The test consisted of 12 video- and text-based scenarios, each followed by three open-ended questions. Participants subsequently evaluated their test experience in an online survey. Data on sociodemographic characteristics, other admission criteria (Abitur, TMS, HAM-Nat, HAM-SJT) and study success (OSCE) was available in a central research database (stav).
UNASSIGNED: The full sample consisted of 582 participants. Test-takers\' global perception of Casper was positive. Internal consistency was satisfactory in both years (α=0.73; 0.82) while interrater agreement was moderate (ICC(1,2)=0.54). Participants who were female (d=0.37) or did not have a migration background (d=0.40) received higher scores. Casper scores correlated with HAM-SJT (r=.18) but not with OSCE communication stations performance. The test was also related to Abitur grades (r=-.15), the TMS (r=.18), and HAM-Nat logical reasoning scores (r=.23).
UNASSIGNED: This study provides positive evidence for the acceptability, internal consistency, and convergent validity of Casper. The selection and training of raters as well as the scenario content require further observation and adjustments to a German context to improve interrater reliability and predictive validity.
UNASSIGNED: Situational Judgement Tests (SJTs) sind eine kosteneffiziente Methode zur Beurteilung von persönlichen Eigenschaften (z.B. Empathie, Professionalität, ethisches Denken) bei der Zulassung zum Medizinstudium. Die Durchführung komplexer SJTs mit offenem Antwortformat ist in jüngster Zeit einfacher geworden. Es fehlen jedoch Untersuchungen zu ihrer Anwendbarkeit im deutschen Kontext. Diese Pilotstudie testet die Akzeptanz, Reliabilität, Subgruppenunterschiede und Validität eines in Kanada entwickelten Online-SJTs mit offenem Antwortformat („Casper“).
UNASSIGNED: Studienbewerber*innen aus Deutschland und Medizinstudierende aus Hamburg wurden eingeladen, Casper in den Jahren 2020 und 2021 zu absolvieren. Der Test bestand aus 12 video- und textbasierten Szenarien, auf die jeweils drei offene Fragen folgten. Die Teilnehmenden bewerteten anschließend ihre Testerfahrung in einer Online-Umfrage. Daten zu soziodemografischen Merkmalen, weiteren Zulassungskriterien (Abitur, TMS, HAM-Nat, HAM-SJT) und zum Studienerfolg (OSCE) waren in einer zentralen Forschungsdatenbank (stav) verfügbar.
UNASSIGNED: Die Gesamtstichprobe bestand aus 582 Teilnehmenden. Die allgemeine Wahrnehmung von Casper durch die Testteilnehmenden war positiv. Die interne Konsistenz war in beiden Jahren zufriedenstellend (α=0,73; 0,82), während die Interrater-Übereinstimmung mäßig war (ICC(1,2)=0,54). Weibliche Teilnehmerinnen (d=0,37) oder Teilnehmende ohne Migrationshintergrund (d=0,40) erzielten höhere Testwerte. Die Casper Testwerte korrelierten mit dem HAM-SJT (r=.18), aber nicht mit der Leistung in OSCE-Kommunikationsstationen. Der Test zeigte auch Zusammenhänge mit der Abiturnote (r=-.15), dem TMS (r=.18) und dem HAM-Nat-Subtest für logisches Denken (r=.23).
UNASSIGNED: Die Studie liefert positive Belege für die Akzeptanz, interne Konsistenz und konvergente Validität von Casper. Die Auswahl und Schulung der Beurteiler*innen sowie die Inhalte der Szenarien bedürfen weiterer Untersuchungen und Anpassungen an den deutschen Kontext, um die Interrater-Reliabilität und prädiktive Validität zu verbessern.