Decline in empathy levels and sex differences in medical students from the Caribbean

Introduction: Empathy is an important trait in the training of medical students, as it has been shown that it improves the doctor-patient relationship. Objective: To evaluate the decline of empathy levels and possible sex differences in undergraduate medical students from the Universidad Central del Este, Dominican Republic. Materials and methods: Exploratory cross-sectional study. A Spanish version of the Jefferson Scale of Empathy for Medical Students (S-version) Scale was administered in September 2018 to 1 144 1styear to 5th-year medical students (887 women and 257 men). Data reliability was verified using the Cronbach’s alpha and the intraclass correlation coefficient (ICC). A generalized linear equation model (Type III) was applied to analyze data and the Wald chi-squared test was used to determine differences in overall empathy levels and the mean scores obtained in each of its three components based on the year of medical training and sex. Results: Cronbach’s alpha was satisfactory (0.839), and the ICC was 0.834 (F=5.68; p=0.005). The variability of the estimated curves in relation to empathic behavior by course (year of medical training) and sex was observed using linear and non-linear regression equations: Wald χ2=115.6, p=0.0001 between courses; and Wald χ2 =12.85, p=0.001 between men and women. Conclusions: Sex differences were observed regarding empathy levels in the study population. Moreover, a decline in empathy levels (overall empathy and Compassionate Care component in men and Walking in the Patient’s Shoes component in men and women) was also observed as students progressed in their medical training. The behavior of these data raises questions regarding the need to determine the factors causing these differences and the decline in empathy levels.