Through the Eyes of a Patient: Visuospatial Perspective Taking and Empathy in Medical Students

Physicians cognitive empathy is associated with improved diagnosis and better patient outcomes. The relationship between self-reported and performance-based measures of cognitive empathic processes is unclear. This study examined the association between medical students empathy scale scores and their empathic performance in a perspective-taking task and communication skills assessment. Undergraduate medical students (N=91) completed the following: Jefferson Scale of Physician Empathy (JSPE); Empathy Quotient (EQ); a Level-1 visual perspective-taking task (VPT). Clinical communication skills were measured in a simulation-enhanced breaking bad news assessment. Pearsons or Spearmans correlation coefficients and t-tests were used to determine correlation and group differences, respectively. Higher scores on the "Standing in Patients Shoes" sub-scale of the JSPE were associated with lower egocentric bias (r = -0.299, p < 0.05) in the VPT, which relates to capacity to adopt someone elses perspective without being erroneously influenced by our own point of view. Additionally, a lower self-perspective advantage in the VPT, reflecting less attentional priority given to the self-perspective, was associated with higher scores on the the "Cognitive Empathy" (r = -0.283, p < 0.05) and "Emotional Empathy" (r = -0.342, p < 0.01) sub-scales of the EQ. Improved communication skills performance was associated with higher scores on the "Social Skills" EQ sub-scale (r = 0.298, p < 0.005). We show that self-assessment scores are moderately associated with performance-based measures of perspective-taking and communication skills. These results are expected to lead to improved experimental designs and a better understanding of empathy in medical education.