How would you define empathy to someone who does not know what it means?
- Empathy is understanding another person’s feelings or situation, and imagining what it might be like to experience these things yourself
- Phrases such as ‘being in another’s shoes’, ‘seeing things through their eyes’, ‘imagining their frame of reference’, or similar all suggest empathy
- Distinguish empathy from sympathy. The former is deeper and more involved than the latter, which merely acknowledges another person’s problems or feelings
- It involves effective person-to-person communication skills as well as the ability to understand what another person is feeling
- Use examples from your daily life or medical work experience to illustrate when you have shown this or seen it in action
- Thinking that empathy is pretending to know what someone is feeling like in order to make him or her feel better about the situation
- Believing that being empathetic is an easy way of getting someone to trust you
- Thinking that empathy is a skill to be utilised only in professional settings, and not in everyday life
Why is it important for medical professionals to be empathetic towards their patients?
- When a healthcare professional tries to imagine things from the patient’s point of view it can reveal to them ways to improve their care which they may not have considered before
- A patient will find it easier to discuss their concerns with somebody who is caring empathetically for them and has taken the time to try to understand what they are going through
- A patient’s feelings, concerns, expectations and ideas are just as important as a presenting a physical complaint. By engaging with them, a healthcare professional can better understand these things, and ultimately provide better care
- An empathetic healthcare professional will help to make the patient feel at ease, and that they are valued
- Empathy can help to break down the perceived barriers between the patient and the many healthcare professionals he or she may see, and help to make what can be a daunting and seemingly anonymous environment more comfortable.
- Not having a good understanding of empathy. Confusing it with sympathy, or that it is only used when the doctor thinks the patient is depressed
- Being empathetic means I tick the box of being a nice doctor
- Thinking too pragmatically. For example, saying that empathy is important because it gives doctors a good feedback rating
Imagine that you are a medical student on a hospital ward placement. How would you explain to a patient that they need to have another blood sample taken, as the results of the last test having been lost?
- Put yourself in the shoes of the patient. What might they be worried about?
- They have been through a procedure which they may have found uncomfortable and, through no fault of their own, are being asked to go through it again
- They also might be worried about the privacy issues involved around the loss of their blood sample
- You would need to speak to them clearly and politely but make it absolutely clear what has happened so they are left in no doubt what has occurred. Do not use euphemisms
- Put yourself in their shoes; listen to their concerns and what they have to say
- You might say: ‘I am very sorry that you have to have more blood taken’
- You could also consider saying: ‘I can imagine that you are feeling frustrated about this, as you have been waiting and have not yet received results for your blood tests’
- And: ‘Please be reassured that we will not share the results of your test with anyone outside your medical team. I can see that it might be worrying that your last test was lost, but we take confidentiality very seriously and will do our absolute best to make sure that this is preserved’
- Saying things in a curt, impolite or distant manner. This is likely to further frustrate a patient who is already going through a lot
- Using euphemisms like ‘a small hiccup’ which might mislead or confuse the patient about what has happened
- Blaming other people. Even if it is somebody else’s fault, this will not make the patient feel any better
Why should members of a healthcare team show empathy towards one another as well as towards their patients?
- Working in healthcare (e.g. a hospital) can be very stressful and demanding. One’s colleagues may need support from somebody who understands this well
- Extra-professional circumstances can impact on somebody’s ability to do their job, and if they choose to share problems or concerns with you then it is important to show empathy and try to understand what they are going through
- A better understanding of one another improves a team’s ability to work well together and therefore improves patient care
- Working in a hospital can be traumatic or distressing, and this may affect team members personally. Having empathetic colleagues can make them feel more positive and that they are well supported in their work
- Citing going to the pub with members of the team to build better bonds between you as an empathetic solution
- Saying that working in medicine gives you no time for social activities, so you might as well be friendly with the people you work with
Is the practice of being an empathetic healthcare professional something that you can learn in a lecture?
- Although not the principal medium for learning about empathy, a lecture may give some insightful points about the effect that being empathetic has on patients, or ideas for how to go about conducting a good patient interview
- However, empathy is intrinsically people-based, and the skill of being empathetic is therefore developed over time spent with people in one’s role as a medical student
- By watching other senior healthcare professionals, one may realise the pitfalls in one’s own approach to interacting with patients
- Thinking a lecture could give you the stock phrases you need to seem empathetic
- Assuming empathy cannot be actively improved upon or learnt about
- Viewing empathy as less important than things like anatomy or physiology
Which is more important in Medicine, being empathetic or being sympathetic?
- Start by outlining your personal definition of empathy versus sympathy. This can vary but the standard definitions are that empathy is the ability to understand how words or actions impact other people; sympathy is the act of feeling those impacts and responding affectionately.
- Discuss what the core duties of a doctor are and therefore why demonstrating both empathy and sympathy are critical skills in the execution of those duties.
- Doctors are responsible for delivering the best possible care and outcome for the patient using a combination of academic knowledge, critical reasoning skills and communication (with colleagues, the patient and their family members). Crucially, doctors must not cause harm to the patient or perform a battery (a medical intervention performed without informed consent).
- Empathy is therefore important because it enables a doctor to understand how the patient may be feeling, what the patient may be expecting in terms of clinical outcome (i.e. would an elderly patient find limited mobility an acceptable outcome?). But critically, when interventions are painful or frightening (as in the case of a lumbar puncture or surgery), it encourages the doctor to communicate fully with the patient – the reasons for the intervention, how it will feel, the risks and the dangers of not proceeding.
- Sympathy is important in how a doctor communicates with a patient. For example, when injecting someone with a needle a doctor who shows empathy but no sympathy would say: ‘This will hurt, but it won’t do any lasting damage so don’t make a fuss.’ A doctor showing both empathy and sympathy would say: ‘Just to warn you that this might sting a little, but I’ll make it as painless and quick as possible so try to relax and not focus too much on it. It’ll be over in a second.’
- You have explored the interaction between empathy and sympathy in living up to the duties of a doctor as outlined in Good Medical Practice.
- You now need to say which is more important? Or are they both equally important? THINK: Are there circumstances where displaying too much sympathy can be detrimental?
- USE YOUR WORK EXPERIENCE if you can cite an example of when you saw these attributes on show.
- Do not immediately answer the question before outlining your definitions of the terms, the angle from which you are approaching the question and therefore your argument leading up to your conclusion. If you do this, you risk muddying your argument and not following a logical structure.
- Not thinking beforehand about the difference between the two attributes and how it relates to being a doctor (or any other healthcare professional).
As a doctor, how would you deal with a parent who has brought their child into accident and emergency and is angry about them having to wait a long time to be seen?
- Doctors sometimes encounter difficult patients but in a scenario such as this it is important to demonstrate empathy and appreciate that the individual usually has a reason for acting the way they are.
- Think about ICE – ideas, concerns and expectations. Explain how you would find out why the parent thinks they are having to wait, why they are worried about this, and what they would want you to do about the situation.
- Suggest why a parent might be feeling angry in a situation like this. They are most likely worried about their child and might think that staff are not doing enough to get patients seen quickly.
- Discuss how you would try to reassure the parent. It is important to appreciate that someone showing up to A and E may be very distressed and you want to help them be confident that their child will receive the best care possible.
- Parents or patients at A and E may also be stressed for reasons that you might not think of such as children being left at home or being late for work. This is why it is important to actually listen to the patient so that they can explain their situation and you can provide the appropriate support, such as allowing them to use a phone, for example.
- Forgetting about the patient/parent. Explaining how you would get the situation under control is fine but interviewers are more interested in how you show empathy for someone who is frustrated or stressed and address their concerns.
- Failing to ask the individual about their perspective on the situation. The ICE system is what medical student are taught to use in a scenario like this.
What would you say to a female patient who is scared to get the HPV vaccine which protects against cervical cancer?
- With this kind of question it is important to show how you would communicate your professional opinion whilst respecting the patient’s concerns and giving them a chance to explain things from their perspective.
- Explain how you would find out which aspects of the vaccination were worrying the patient; patients want to feel that they are being listened to and taken seriously.
- State that you would give the patient the relevant information about what the vaccine does and why it is important. The patient has a right to know about the treatment being recommended so that they can make an informed decision.
- Mention that you would speak in terms that the patient can understand; as a doctor it is important to adjust your communication to accommodate different types of people, even when discussing a treatment that you think might be difficult for them to understand.
- Explain that you would not push your opinion on the patient. Although they might not have your medical expertise, you cannot disregard the patient’s personal views and, ultimately, patient autonomy must be respected.
- Not respecting the patient’s opinion in your answer. Although you might think having the vaccine is the right thing to do, it is important to recognise the patient’s concerns as valid.
- Focusing too much on the vaccine itself. This question is about how you would communicate empathetically with the patient; you don’t actually need to know anything about the HPV vaccine in order to answer.
As a recently-qualified junior doctor, you are given the chance to perform your first unsupervised colonoscopy. During the procedure, the colonoscope perforates the colon, resulting in the patient becoming acutely unwell and dying just 2 days after. The patient’s family has now come to see you; how would you base your approach to the situation?
- This situation could easily be set as a role-play station or one in which you talk though your thought process.
- Start by describing the setting in which you’d want to speak to them – private, comfortable environment without disruption or time pressure.
- Explain clearly and truthfully what has happened, the family will appreciate your honesty.
- The family members will no doubt be very upset at the loss of a loved one, throughout the conversation, be aware of how the family is feeling, listen to any concerns they may have and don’t rush breaking this news.
- Given the circumstances arising as a result of a known but rare complication, it may be appropriate to tell the family that certain measures are now being put in place to prevent the same complications arising again or to say that you will undergo a phase of supervised practice for a short period of time.
- You should ensure that the family are made aware of counselling services if they were to want it at such a difficult time, as well as the ability to speak to a more senior doctor
- Jumping straight into describing what you would say – as mentioned above, start by describing that this situation evokes very strong emotions and is to be treated delicately.
- In stations where you describe your approach to a personal interaction, it’s easier to be more flippant as you don’t have the direct face-to-face contact – make sure you demonstrate the same level of empathy and respect for patients and their emotions whether in their presence or not.
What thoughts and feelings will go through the head of a patient feeling after having been told that their alcoholism has led to irreversible liver damage?
- This question aims to find out whether you are able to place yourself in the shoes of a patient and understand their emotions whilst receiving bad news such as this
- First, it may help by defining empathy and demonstrating that you are aware of the sensitive and delicate nature of this situation
- It’s important to give examples of what the patient will be feeling alongside a short description of why as well as how this might change the nature of the consultation. This will prevent your answer sounding like a list of emotions and will prevent your answer sounding pre-recorded.
- For example: ‘The patient may be feeling guilty and remorseful about their actions and their respective consequences. It may be very difficult for the patient to hear that such an effect has come about as a result of their own actions’
- After having thought about what exactly the patient might be feeling, it may indeed be worth talking to the interviewer about how you would then interact with the patient given their thoughts and feelings.
- You could discuss if there’s any measures you would take in anticipation of this consultation to make the patient feel slightly better. For instance, by describing the setting or describing techniques such as ‘signposting’.
- Going straight into the answer without first talking through the brief to ensure understanding – it’s ‘belt and braces’ but it’s better to be sure that you’ve fully understood.
- Forgetting that diagnoses such as this are life-long and will affect the individual beyond the initial response to the diagnosis.