Bruce W. Newton

Bio: Bruce W. Newton is an academic researcher from Campbell University. The author has contributed to research in topics: Spinal cord & Empathy. The author has an hindex of 13, co-authored 28 publications receiving 941 citations. Previous affiliations of Bruce W. Newton include University of Arkansas for Medical Sciences.

Is there hardening of the heart during medical school

Abstract: PurposeTo determine whether vicarious empathy (i.e., to have a visceral empathic response, versus role-playing empathy) decreases, and whether students choosing specialties with greater patient contact maintain vicarious empathy better than do students choosing specialties with less patient

Differences in medical students' empathy.

Abstract: Medical students' Balanced Emotional Empathy Scale scores were compared by year, sex, and expressed specialty choice. Scores were lower for students choosing non-core specialties, and for M4 men students compared with M3 men students.

Walking a fine line: is it possible to remain an empathic physician and have a hardened heart?

Abstract: Establishing an empathic physician-patient relationship is an essential physician skill. This chapter discusses the sexually dimorphic aspects of the neural components involved in affective and cognitive empathy, and examines why men and women medical students or physicians express different levels of empathy. Studies reveal levels of medical student affective or cognitive empathy can help reveal which medical specialty a student will enter. The data show students or physicians with higher empathy enter into specialties characterized by large amounts of patient contact and continuity of care; and individuals with lower levels of empathy desire specialties having little or no patient contact and little to no continuity of care. Burnout and stress can decrease the empathy physicians had when they first entered medical school to unacceptable levels. Conversely, having a too empathetic physician can let patient conditions and reactions interfere with the ability to provide effective care. By learning to blunt affective empathic responses, physicians establish a certain degree of empathic detachment with the patient in order to provide objective care. However, a physician must not become so detached and hardened that their conduct appears callous, because it is still important for physicians, especially those in specialties with a large amount of patient contact, to use empathic communication skills.

Systematic review of depression, anxiety, and other indicators of psychological distress among U.S. and Canadian medical students.

Abstract: PurposeTo systematically review articles reporting on depression, anxiety, and burnout among U.S. and Canadian medical students.MethodMedline and PubMed were searched to identify peer-reviewed English-language studies published between January 1980 and May 2005 reporting on depression, anxie

The Devil is in the Third Year: A Longitudinal Study of Erosion of Empathy in Medical School

Abstract: Purpose This longitudinal study was designed to examine changes in medical students’ empathy during medical school and to determine when the most significant changes occur. Method Four hundred fifty-six students who entered Jefferson Medical College in 2002 (n 227) and 2004 (n 229) completed the Jefferson Scale of Physician Empathy at five different times: at entry into medical school on orientation day and subsequently at the end of each academic year. Statistical analyses were performed for the entire cohort, as well as for the “matched” cohort (participants who identified themselves at all five test administrations) and the “unmatched” cohort (participants who did not identify themselves in all five test administrations). Results Statistical analyses showed that empathy scores did not change significantly during the first two years of medical school. However, a significant decline in empathy scores was observed at the end of the third year which persisted until graduation. Findings were similar for the matched cohort (n 121) and for the rest of the sample (unmatched cohort, n 335). Patterns of decline in empathy scores were similar for men and women and across specialties. Conclusions It is concluded that a significant decline in empathy occurs during the third year of medical school. It is ironic that the erosion of empathy occurs during a time when the curriculum is shifting toward patient-care activities; this is when empathy is most essential. Implications for retaining and enhancing empathy are discussed.

Empathy decline and its reasons: a systematic review of studies with medical students and residents.

Abstract: Purpose Empathy is a key element of patient– physician communication; it is relevant to and positively influences patients’ health. The authors systematically reviewed the literature to investigate changes in trainee empathy and reasons for those changes during medical school and residency. Method The authors conducted a systematic search of studies concerning trainee empathy published from January 1990 to January 2010, using manual methods and the PubMed, EMBASE, and PsycINFO databases. They independently reviewed and selected quantitative and qualitative studies for inclusion. Intervention studies, those that evaluated psychometric properties of self-assessment tools, and those with a sample size 30 were excluded. Results Eighteen studies met the inclusion criteria: 11 on medical students and 7 on residents. Three longitudinal and six cross-sectional studies of medical students demonstrated a significant decrease in empathy during medical school; one cross-sectional study found a tendency toward a decrease, and another suggested stable scores. The five longitudinal and two cross-sectional studies of residents showed a decrease in empathy during residency. The studies pointed to the clinical practice phase of training and the distress produced by aspects of the “hidden,” “formal,” and “informal” curricula as main reasons for empathy decline.

Physician empathy: definition, components, measurement, and relationship to gender and specialty.

Abstract: OBJECTIVE: There is a dearth of empirical research on physician empathy despite its mediating role in patient-physician relationships and clinical outcomes. This study was designed to investigate the components of physician empathy, its measurement properties, and group differences in empathy scores. METHOD: A revised version of the Jefferson Scale of Physician Empathy (with 20 Likert-type items) was mailed to 1,007 physicians affiliated with the Jefferson Health System in the greater Philadelphia region; 704 (70%) responded. Construct validity, reliability of the empathy scale, and the differences on mean empathy scores by physicians’ gender and specialty were examined. RESULTS: Three meaningful factors emerged (perspective taking, compassionate care, and standing in the patient’s shoes) to provide support for the construct validity of the empathy scale that was also found to be internally consistent with relatively stable scores over time. Women scored higher than men to a degree that was nearly signifi...

Physicians' Empathy and Clinical Outcomes for Diabetic Patients

Abstract: Purpose To test the hypothesis that physicians’ empathy is associated with positive clinical outcomes for diabetic patients. Method A correlational study design was used in a university-affiliated outpatient setting. Participants were 891 diabetic patients, treated between July 2006 and June 2009, by 29 family physicians. Results of the most recent hemoglobin A1c and LDL-C tests were extracted from the patients’ electronic records. The results of hemoglobin A1c tests were categorized into good control (7.0%) and poor control (9.0%). Similarly, the results of the LDL-C tests were grouped into good control (100) and poor control (130). The physicians, who completed the Jefferson Scale of Empathy in 2009, were grouped into high, moderate, and low empathy scorers. Associations between physicians’ level of empathy scores and patient outcomes were examined. Results Patients of physicians with high empathy scores were significantly more likely to have good control of hemoglobin A1c (56%) than were patients of physicians with low empathy scores (40%, P .001). Similarly, the proportion of patients with good LDL-C control was significantly higher for physicians with high empathy scores (59%) than physicians with low scores (44%, P .001). Logistic regression analyses indicated that physicians’ empathy had a unique contribution to the prediction of optimal clinical outcomes after controlling for physicians’ and patients’ gender and age, and patients’ health insurance. Conclusions The hypothesis of a positive relationship between physicians’ empathy and patients’ clinical outcomes was confirmed, suggesting that physicians’ empathy is an important factor associated with clinical competence and patient outcomes. Empathy, an essential component of the physician–patient relationship, may be linked to positive patient outcomes. Although this notion is consistent with the conceptual view of physician–patient relationships, 1–3 empirical data supporting the association between physicians’ empathy and tangible clinical outcomes are difficult to find. Several studies generally support the notion that the quality of the physician–patient relationship (as a proxy for empathic engagement in patient care) has a positive influence on patient