Differences in empathy toward patients between medical and nonmedical students: an fMRI study

• Type of Material: Article
• Authors: Shin Ah Kim, Korea University; Young-Mee Lee, Korea University College of Medicine; Stephan Hamann, Emory University; Sang Hee Kim, Korea University
• Language: English
• Date: 2021-10-01
• Publisher: Springer
• Publication Version: Final Published Version
• Copyright Statement: © The Author(s) 2021
• License: Creative Commons Attribution 4.0 International
• Final Published Version (URL): http://dx.doi.org/10.1007/s10459-021-10045-y
• Title of Journal or Parent Work: Advances in Health Sciences Education
• Volume: 26
• Issue: 4
• Start Page: 1207
• End Page: 1227
• Grant/Funding Information: This work was supported by the National Research Foundation of Korea grants funded by the Ministry Science and ICT (NRF-2017M3C7A1041823 and NRF-2020R1A2C2007193 to SHK and NRF-2016R1A2B4013614 to YML), Republic of Korea.
• Keywords: Affective empathy; Medical students; fMRI; Students, Medical; Brain Mapping; Patient; Cognitive empathy; Brain; Magnetic Resonance Imaging; Humans; Empathy
• Research Categories: Psychology, Cognitive; Biology, Neuroscience; Engineering, Biomedical

Abstract

There is growing concern about a potential decline in empathy among medical students over time. Despite the importance of empathy toward patients in medicine, it remains unclear the nature of the changes in empathy among medical students. Thus, we systematically investigated affective and cognitive empathy for patients among medical students using neuroscientific approach. Nineteen medical students who completed their fifth-year medical curriculum and 23 age- and sex-matched nonmedical students participated in a functional magnetic resonance imaging study. Inside a brain scanner, all participants read empathy-eliciting scenarios while adopting either the patient or doctor perspective. Brain activation and self-reported ratings during the experience of empathy were obtained. Behavioral results indicated that all participants reported greater emotional negativity and empathic concern in association with the patient perspective condition than with the doctor perspective condition. Functional brain imaging results indicated that neural activity in the posterior superior temporal region implicated in goal-relevant attention reorienting was overall increased under the patient perspective than the doctor perspective condition. Relative to nonmedical students, medical students showed decreased activity in the temporoparietal region implicated in mentalizing under the patient perspective versus doctor perspective condition. Notably, this same region showed increased activity under the doctor versus patient condition in medical students relative to nonmedical students. This study is among the first to investigate the neural mechanisms of empathy among medical students and the current findings point to the cognitive empathy system as the locus of the primary brain differences associated with empathy toward patients.