], students’ empathetic abilities were limited due to personal stresses that reduced their emotional availability.
‘There is a limit regarding a person ‘s emotional capacity, [empathy is easier when one] doesn’t have additional personal stress, three friends with problems and a sick father or something else.’ [There was not enough data, and reporting was not sufficiently complete to formally investigate sources of heterogeneity. However, we did note a few potential causes of heterogeneity.
While we did not have enough studies from different continents to conduct subgroup analyses by country or continent, the three studies from Asia were represented in all four analytical themes, while the study from Africa was represented in three of the four analytical themes.. We had a high level of confidence in the evidence for ‘complexity’, ‘stressful organisational culture’, ‘role models’, and ‘prioritisation of biomedical knowledge’.
Four themes were related to both positive and negative changes in empathy. While inadequate teaching and assessment were found to diminish empathy, formal empathy training was found to enhance empathy. Furthermore, while a lack of experience was reported to limit a student’s ability to empathise, if they or their family members had life experiences similar to those of the complex patients they saw, they found it easier to empathise.
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