How do medical students without formal training in empathy development understand empathy in the context of patient care?

Background Empathy is a crucial component of clinical practice and professionalism. Quantitative studies have reported empathy erosion in medical students. However, studies investigating medical students' perspectives on their understanding and behavioral expressions of empathy with patients are limited. Objective This study aimed to explore medical students' perspectives on the nature, significance, and expressions of empathy during their undergraduate training. Methods The study used a qualitative phenomenological approach. Twenty-five medical students (out of a total of 45) were invited to participate. Semi-structured online interviews were conducted to elicit experiential details from participants. The recorded interviews were transcribed verbatim, and data were analyzed using Braun and Clarke's thematic analysis method. Results Students described their beliefs and understanding about empathy and reflected on the process of empathizing with patients. Most students defined empathy as having four interrelated and overlapping dimensions: cognitive, affective, behavioral, and moral. In addition, they believed that empathizing with patients was a bidirectional relational process, necessitating empathic inclination, adequate time, a non-judgmental approach, and effective communication and listening skills. Conclusion Empathy is more than a personal attribute; it is a multi-faceted, dynamic, and bidirectional relational process. Adequate time, support, stress management strategies, formal training, and encouragement from experienced teachers are crucial elements to fostering genuine or deep empathy in medical students. In addition, students should be trained in developing emotional regulation and maintaining an appropriate balance between professional detachment and empathic connections.