{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,1]],"date-time":"2026-04-01T19:40:49Z","timestamp":1775072449924,"version":"3.50.1"},"reference-count":46,"publisher":"Oxford University Press (OUP)","issue":"6","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2017,6]]},"abstract":"<jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>Understanding medical student empathy is important to future patient care; however, the definition and development of clinical empathy remain unclear. The authors sought to examine the underlying constructs of two of the most widely used self-report instruments\u2014Davis\u2019s Interpersonal Reactivity Index (IRI) and the Jefferson Scale of Empathy version for medical students (JSE-S)\u2014plus, the distinctions and associations between these instruments.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Method<\/jats:title>\n                    <jats:p>Between 2007 and 2014, the authors administered the IRI and JSE-S in three separate studies in five countries, (Brazil, Ireland, New Zealand, Portugal, and the United Kingdom). They collected data from 3,069 undergraduate medical students and performed exploratory factor analyses, correlation analyses, and multiple linear regression analyses.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Exploratory factor analysis yielded identical results in each country, confirming the subscale structures of each instrument. Results of correlation analyses indicated significant but weak correlations (\n                      <jats:italic toggle=\"yes\">r<\/jats:italic>\n                      = 0.313) between the total IRI and JSE-S scores. All intercorrelations of IRI and JSE-S subscale scores were statistically significant but weak (range\n                      <jats:italic toggle=\"yes\">r<\/jats:italic>\n                      = \u22120.040 to 0.306). Multiple linear regression models revealed that the IRI subscales were weak predictors of all JSE-S subscale and total scores. The IRI subscales explained between 9.0% and 15.3% of variance for JSE-S subscales and 19.5% for JSE-S total score.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The IRI and JSE-S are only weakly related, suggesting that they may measure different constructs. To better understand this distinction, more studies using both instruments and involving students at different stages in their medical education, as well as more longitudinal and qualitative studies, are needed.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1097\/acm.0000000000001449","type":"journal-article","created":{"date-parts":[[2016,11,2]],"date-time":"2016-11-02T05:24:06Z","timestamp":1478064246000},"page":"860-867","source":"Crossref","is-referenced-by-count":63,"title":["Measuring Medical Students\u2019 Empathy: Exploring the Underlying Constructs of and Associations Between Two Widely Used Self-Report Instruments in Five Countries"],"prefix":"10.1093","volume":"92","author":[{"given":"Patr\u00edcio","family":"Costa","sequence":"first","affiliation":[{"name":"is assistant professor, School of Health Sciences, and researcher in medical education, Life and Health Sciences Research Institute, University of Minho, Braga, Portugal."}]},{"given":"Marco Antonio","family":"de Carvalho-Filho","sequence":"additional","affiliation":[{"name":"is professor of medicine, Department of Emergency Medicine, Faculty of Medical Sciences, University of Campinas (Unicamp), Campinas, Brazil."}]},{"given":"Marcelo","family":"Schweller","sequence":"additional","affiliation":[{"name":"is emergency medicine physician and preceptor, Faculty of Medical Sciences, University of Campinas (Unicamp), Campinas, Brazil."}]},{"given":"Pia","family":"Thiemann","sequence":"additional","affiliation":[{"name":"is research assistant, Palliative Care Group, Primary Care Unit, Department of Public Health and Primary Care, University of Cambridge, Cambridge, United Kingdom."}]},{"given":"Ana","family":"Salgueira","sequence":"additional","affiliation":[{"name":"is a PhD student, School of Health Sciences, and researcher in medical education, Life and Health Sciences Research Institute, University of Minho, Braga, Portugal."}]},{"given":"John","family":"Benson","sequence":"additional","affiliation":[{"name":"is senior lecturer, General Practice, and director, General Practice Education Group, Primary Care Unit, Department of Public Health and Primary Care, University of Cambridge, Cambridge, United Kingdom."}]},{"given":"Manuel Jo\u00e3o","family":"Costa","sequence":"additional","affiliation":[{"name":"is associate professor, School of Health Sciences, and researcher in medical education, Life and Health Sciences Research Institute, University of Minho, Braga, Portugal."}]},{"given":"Thelma","family":"Quince","sequence":"additional","affiliation":[{"name":"is medical educational research associate, Primary Care Unit, Department of Public Health and Primary Care and School of Clinical Medicine, University of Cambridge, Cambridge, United Kingdom."}]}],"member":"286","reference":[{"key":"R1-20230718","doi-asserted-by":"crossref","first-page":"237","DOI":"10.1177\/0163278704267037","article-title":"The effects of physician empathy on patient satisfaction and compliance.","volume":"27","author":"Kim","year":"2004","journal-title":"Eval Health Prof"},{"key":"R2-20230718","doi-asserted-by":"crossref","first-page":"331","DOI":"10.1046\/j.1365-2710.2001.00363.x","article-title":"Patient adherence to treatment: Three decades of research. A comprehensive review.","volume":"26","author":"Vermeire","year":"2001","journal-title":"J Clin Pharm Ther"},{"key":"R3-20230718","doi-asserted-by":"crossref","first-page":"e76","DOI":"10.3399\/bjgp13X660814","article-title":"Effectiveness of empathy in general practice: A systematic review.","volume":"63","author":"Derksen","year":"2013","journal-title":"Br J Gen Pract"},{"key":"R4-20230718","doi-asserted-by":"crossref","first-page":"144","DOI":"10.1016\/j.pec.2014.04.019","article-title":"Greater professional empathy leads to higher agreement about decisions made in the consultation.","volume":"96","author":"Parkin","year":"2014","journal-title":"Patient Educ Couns"},{"key":"R5-20230718","doi-asserted-by":"crossref","first-page":"359","DOI":"10.1097\/ACM.0b013e3182086fe1","article-title":"Physicians\u2019 empathy and clinical outcomes for diabetic patients.","volume":"86","author":"Hojat","year":"2011","journal-title":"Acad Med"},{"key":"R6-20230718","doi-asserted-by":"crossref","first-page":"390","DOI":"10.1016\/j.pec.2011.01.009","article-title":"Perception of empathy in the therapeutic encounter: Effects on the common cold.","volume":"85","author":"Rakel","year":"2011","journal-title":"Patient Educ Couns"},{"key":"R7-20230718","doi-asserted-by":"crossref","first-page":"1243","DOI":"10.1097\/ACM.0b013e3182628fbf","article-title":"The relationship between physician empathy and disease complications: An empirical study of primary care physicians and their diabetic patients in Parma, Italy.","volume":"87","author":"Del Canale","year":"2012","journal-title":"Acad Med"},{"key":"R8-20230718","doi-asserted-by":"crossref","first-page":"53","DOI":"10.1016\/j.pec.2013.12.007","article-title":"Physician empathy and subjective evaluation of medical treatment outcome in trauma surgery patients.","volume":"95","author":"Steinhausen","year":"2014","journal-title":"Patient Educ Couns"},{"key":"R9-20230718","doi-asserted-by":"crossref","first-page":"1100","DOI":"10.1001\/jama.293.9.1100","article-title":"Clinical empathy as emotional labor in the patient\u2013physician relationship.","volume":"293","author":"Larson","year":"2005","journal-title":"JAMA"},{"key":"R10-20230718","doi-asserted-by":"crossref","first-page":"221","DOI":"10.7326\/0003-4819-135-3-200108070-00022","article-title":"\u201cLet me see if I have this right\u2026\u201d: Words that help build empathy.","volume":"135","author":"Coulehan","year":"2001","journal-title":"Ann Intern Med"},{"key":"R11-20230718","doi-asserted-by":"crossref","first-page":"85","DOI":"10.1016\/S0738-3991(03)00086-7","article-title":"Training practitioners to communicate effectively in cancer care: It is the relationship that counts.","volume":"50","author":"Beckman","year":"2003","journal-title":"Patient Educ Couns"},{"key":"R12-20230718","doi-asserted-by":"crossref","first-page":"177","DOI":"10.1007\/s11606-006-0039-6","article-title":"How do distress and well-being relate to medical student empathy? A multicenter study.","volume":"22","author":"Thomas","year":"2007","journal-title":"J Gen Intern Med"},{"key":"R13-20230718","doi-asserted-by":"crossref","first-page":"165","DOI":"10.1207\/s15328015tlm1602_8","article-title":"Effect of gender, age, and relevant course work on attitudes toward empathy, patient spirituality, and physician wellness.","volume":"16","author":"DiLalla","year":"2004","journal-title":"Teach Learn Med"},{"key":"R14-20230718","doi-asserted-by":"crossref","first-page":"3143","DOI":"10.1001\/jama.287.23.3143","article-title":"Variation of mood and empathy during internship.","volume":"287","author":"Bellini","year":"2002","journal-title":"JAMA"},{"key":"R15-20230718","doi-asserted-by":"crossref","first-page":"1071","DOI":"10.1001\/jama.296.9.1071","article-title":"Association of perceived medical errors with resident distress and empathy: A prospective longitudinal study.","volume":"296","author":"West","year":"2006","journal-title":"JAMA"},{"key":"R16-20230718","doi-asserted-by":"crossref","first-page":"339","DOI":"10.1016\/j.pec.2008.11.013","article-title":"Analyzing the \u201cnature\u201d and \u201cspecific effectiveness\u201d of clinical empathy: A theoretical overview and contribution towards a theory-based research agenda.","volume":"74","author":"Neumann","year":"2009","journal-title":"Patient Educ Couns"},{"key":"R17-20230718","doi-asserted-by":"crossref","first-page":"307","DOI":"10.1016\/j.pec.2009.06.012","article-title":"Empirical research on empathy in medicine\u2014A critical review.","volume":"76","author":"Pedersen","year":"2009","journal-title":"Patient Educ Couns"},{"key":"R18-20230718","doi-asserted-by":"crossref","first-page":"24","DOI":"10.1186\/1472-6920-7-24","article-title":"A systematic review of tests of empathy in medicine.","volume":"7","author":"Hemmerdinger","year":"2007","journal-title":"BMC Med Educ"},{"issue":"suppl","key":"R19-20230718","first-page":"S9","article-title":"Empathy and quality of care.","volume":"52","author":"Mercer","year":"2002","journal-title":"Br J Gen Pract"},{"key":"R20-20230718","doi-asserted-by":"crossref","first-page":"451","DOI":"10.1007\/s40596-014-0133-8","article-title":"Clinical examiners, simulated patients, and student self-assessed empathy in medical students during a psychiatry objective structured clinical examination.","volume":"38","author":"O\u2019Connor","year":"2014","journal-title":"Acad Psychiatry"},{"key":"R21-20230718","doi-asserted-by":"crossref","first-page":"984","DOI":"10.1097\/ACM.0b013e3182224f1f","article-title":"Medical students\u2019 self-reported empathy and simulated patients\u2019 assessments of student empathy: An analysis by gender and ethnicity.","volume":"86","author":"Berg","year":"2011","journal-title":"Acad Med"},{"key":"R22-20230718","doi-asserted-by":"crossref","first-page":"632","DOI":"10.1097\/ACM.0000000000000175","article-title":"The impact of simulated medical consultations on the empathy levels of students at one medical school.","volume":"89","author":"Schweller","year":"2014","journal-title":"Acad Med"},{"key":"R23-20230718","doi-asserted-by":"crossref","first-page":"113","DOI":"10.1037\/0022-3514.44.1.113","article-title":"Measuring individual differences in empathy: Evidence for a multidimensional approach.","volume":"44","author":"Davis","year":"1983","journal-title":"J Pers Soc Psychol"},{"key":"R25-20230718","doi-asserted-by":"crossref","first-page":"2034","DOI":"10.1016\/j.neuroimage.2012.05.081","article-title":"Inter-individual differences in empathy are reflected in human brain structure.","volume":"62","author":"Banissy","year":"2012","journal-title":"Neuroimage"},{"key":"R26-20230718","doi-asserted-by":"crossref","first-page":"469","DOI":"10.1080\/03057240.2010.521381","article-title":"Does care reasoning make a difference? Relations between care, justice and dispositional empathy.","volume":"39","author":"Juuj\u00e4rvi","year":"2010","journal-title":"J Moral Educ"},{"key":"R27-20230718","doi-asserted-by":"crossref","first-page":"42","DOI":"10.1162\/jocn.2007.19.1.42","article-title":"The neural substrate of human empathy: Effects of perspective-taking and cognitive appraisal.","volume":"19","author":"Lamm","year":"2007","journal-title":"J Cogn Neurosci"},{"key":"R28-20230718","doi-asserted-by":"crossref","first-page":"825","DOI":"10.1016\/j.psychres.2014.09.009","article-title":"Subjective experience of emotions and emotional empathy in paranoid schizophrenia.","volume":"220","author":"Lehmann","year":"2014","journal-title":"Psychiatry Res"},{"key":"R29-20230718","doi-asserted-by":"crossref","first-page":"182","DOI":"10.1037\/a0031522","article-title":"Emotional and cognitive social processes are impaired in Parkinson\u2019s disease and are related to behavioral disorders.","volume":"27","author":"Narme","year":"2013","journal-title":"Neuropsychology"},{"key":"R30-20230718","doi-asserted-by":"crossref","first-page":"586","DOI":"10.1177\/0011128708321359","article-title":"The role of empathy and parenting style in the development of antisocial behaviors.","volume":"55","author":"Schaffer","year":"2009","journal-title":"Crime Delinq"},{"key":"R31-20230718","doi-asserted-by":"crossref","first-page":"42","DOI":"10.1037\/a0030425","article-title":"Assessing dispositional empathy in adults: A French validation of the Interpersonal Reactivity Index (IRI).","volume":"45","author":"Gilet","year":"2013","journal-title":"Can J Behav Sci"},{"key":"R32-20230718","doi-asserted-by":"crossref","first-page":"179","DOI":"10.1027\/1015-5759\/a000065","article-title":"Testing the psychometric properties of the Interpersonal Reactivity Index (IRI) in Chile.","volume":"27","author":"Fern\u00e1ndez","year":"2011","journal-title":"Eur J Psychol Assess"},{"key":"R33-20230718","doi-asserted-by":"crossref","first-page":"90","DOI":"10.1186\/1472-6920-11-90","article-title":"Stability of empathy among undergraduate medical students: A longitudinal study at one UK medical school.","volume":"11","author":"Quince","year":"2011","journal-title":"BMC Med Educ"},{"key":"R34-20230718","doi-asserted-by":"crossref","first-page":"e94133","DOI":"10.1371\/journal.pone.0094133","article-title":"Empathy among medical students: Is there a relation with quality of life and burnout?","volume":"9","author":"Paro","year":"2014","journal-title":"PLoS One"},{"key":"R35-20230718","article-title":"Reconsidering the \u201cdecline\u201d of medical student empathy as reported in studies using the Jefferson Scale of Physician Empathy\u2013Student version (JSPE-S) [published online February 10, 2015].","author":"Roff","journal-title":"Med Teach"},{"issue":"suppl 2","key":"R36-20230718","first-page":"431","article-title":"Empathy in the doctor\u2013patient relationship as viewed by first-year medical students: Data on validity and sensibility to change of the Jefferson Measure in Portugal [in Portuguese].","volume":"24","author":"Loureiro","year":"2011","journal-title":"Acta Med Port"},{"key":"R37-20230718","doi-asserted-by":"crossref","first-page":"287","DOI":"10.3109\/13561820.2011.566648","article-title":"Measuring empathy in healthcare profession students using the Jefferson Scale of Physician Empathy: Health provider\u2013student version.","volume":"25","author":"Fields","year":"2011","journal-title":"J Interprof Care"},{"key":"R38-20230718","doi-asserted-by":"crossref","first-page":"73","DOI":"10.1891\/1061-3749.17.1.73","article-title":"Reliability and validity of the Jefferson Scale of Empathy in undergraduate nursing students.","volume":"17","author":"Ward","year":"2009","journal-title":"J Nurs Meas"},{"key":"R39-20230718","doi-asserted-by":"crossref","first-page":"573","DOI":"10.1007\/s10459-012-9393-9","article-title":"Rising to the challenge: Cross-cultural adaptation and psychometric evaluation of the adapted German version of the Jefferson Scale of Physician Empathy for Students (JSPE-S).","volume":"18","author":"Preusche","year":"2013","journal-title":"Adv Health Sci Educ Theory Pract"},{"key":"R40-20230718","doi-asserted-by":"crossref","first-page":"167","DOI":"10.1080\/10401334.2010.488191","article-title":"Evaluation of empathy among Korean medical students: A cross-sectional study using the Korean version of the Jefferson Scale of Physician Empathy.","volume":"22","author":"Roh","year":"2010","journal-title":"Teach Learn Med"},{"key":"R41-20230718","doi-asserted-by":"crossref","first-page":"5","DOI":"10.1007\/s10459-015-9605-1","article-title":"Development of a metacognitive effort construct of empathy during clinical training: A longitudinal study of the factor structure of the Jefferson Scale of Empathy.","volume":"21","author":"Stansfield","year":"2016","journal-title":"Adv Health Sci Educ Theory Pract"},{"key":"R42-20230718","doi-asserted-by":"crossref","first-page":"443","DOI":"10.2147\/AMEP.S76800","article-title":"Undergraduate medical students\u2019 empathy: Current perspectives.","volume":"7","author":"Quince","year":"2016","journal-title":"Adv Med Educ Pract"},{"key":"R43-20230718","doi-asserted-by":"crossref","first-page":"625","DOI":"10.1080\/01421590500069744","article-title":"Relationships between scores of the Jefferson Scale of Physician Empathy (JSPE) and the Interpersonal Reactivity Index (IRI).","volume":"27","author":"Hojat","year":"2005","journal-title":"Med Teach"},{"key":"R44-20230718","first-page":"171","article-title":"Measuring empathy: Portuguese adaptation of the Interpersonal Reactivity Index [in Portuguese].","volume":"8","author":"Limpo","year":"2010","journal-title":"Lab Psicol"},{"key":"R45-20230718","doi-asserted-by":"crossref","first-page":"1","DOI":"10.18637\/jss.v014.i09","article-title":"The R Commander: A basic statistics graphical user interface to R.","volume":"14","author":"Fox","year":"2005","journal-title":"J Stat Softw"},{"key":"R48-20230718","doi-asserted-by":"crossref","first-page":"1192","DOI":"10.1097\/ACM.0b013e3181b180d4","article-title":"Measurement of empathy among Japanese medical students: Psychometrics and score differences by gender and level of medical education.","volume":"84","author":"Kataoka","year":"2009","journal-title":"Acad Med"},{"key":"R49-20230718","doi-asserted-by":"crossref","first-page":"1002","DOI":"10.3109\/0142159X.2013.802296","article-title":"Maintaining empathy in medical school: It is possible.","volume":"35","author":"Hegazi","year":"2013","journal-title":"Med Teach"}],"container-title":["Academic Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.lww.com\/00001888-201706000-00049","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,1]],"date-time":"2026-04-01T18:00:12Z","timestamp":1775066412000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/academicmedicine\/article\/92\/6\/860\/8349458"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2017,6]]},"references-count":46,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2017]]}},"URL":"https:\/\/doi.org\/10.1097\/acm.0000000000001449","relation":{},"ISSN":["1040-2446"],"issn-type":[{"value":"1040-2446","type":"print"}],"subject":[],"published":{"date-parts":[[2017,6]]}}}