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首页> 外文期刊>Advances in health sciences education: theory and practice >Development of a metacognitive effort construct of empathy during clinical training: a longitudinal study of the factor structure of the Jefferson Scale of Empathy
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Development of a metacognitive effort construct of empathy during clinical training: a longitudinal study of the factor structure of the Jefferson Scale of Empathy

机译：临床训练过程中共情的元认知努力建构的发展：共情的杰斐逊量表的因素结构的纵向研究

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Empathy is crucial for effective clinical care but appears to decline during undergraduate medical training. Understanding the nature of this decline is necessary for addressing it. The Jefferson Scale of Empathy (JSE) is used to measure medical students' clinical empathy attitudes. One recent study described a 3-factor model of the JSE. This model was found in responses from matriculating medical students, but little is known about how the factor structure of the scale changes during clinical training. The Learning Environment Study is a longitudinal prospective study of two cohorts from 28 medical schools. At matriculation and at the end of each subsequent year, students self-reported clinical empathy attitudes using the JSE. Data from 4,797 students were randomly partitioned for exploratory (EFA) and confirmatory factor analyses using responses from preclinical and clinical years of medical school. Five models were compared for confirmatory factor analysis: two null models for control, the recent 3-factor model, and the two models resulting from the EFAs of preclinical and clinical year responses. Preclinical year responses yielded a 3-factor model similar to the recent 3-factor model. Clinical year responses yielded a 4-factor model ("feelings," "importance," "ease," and "metacognitive effort") suggesting changes in the structure of clinical empathy attitudes over time. Metacognitive effort showed the largest decline over time. The model is a better fit for both preclinical and clinical responses and may provide more insight into medical students' clinical empathy attitudes than other models. The emergence of metacognitive effort in the clinical years suggests empathy may become more nuanced for students after clinical exposure and may account for much of the observed decline in clinical empathy attitudes.
机译：移情对于有效的临床护理至关重要，但在本科医学培训期间似乎会下降。了解这种下降的性质对于解决它是必要的。杰斐逊共情量表（JSE）用于衡量医学生的临床共情态度。最近的一项研究描述了JSE的三要素模型。该模型是从入学医学生的反应中发现的，但对临床培训期间量表的因素结构如何变化知之甚少。学习环境研究是对来自28所医学院校的两个队列的纵向前瞻性研究。在入学时和随后的每一年末，学生使用JSE自我报告临床同理心态。使用来自医学院的临床前和临床年份的响应，对来自4,797名学生的数据进行了随机分配，以进行探索性（EFA）和验证性因素分析。比较了五个模型以进行验证性因素分析：两个空白对照模型，最近的三因素模型以及两个由临床前和临床年份反应的EFA产生的模型。临床前年份的响应产生了类似于最近的三因素模型的三因素模型。临床年份的回答产生了一个4因子模型（“感觉”，“重要性”，“缓解”和“元认知努力”），表明了临床共情态度结构随时间的变化。随着时间的流逝，元认知努力显示出最大的下降。与其他模型相比，该模型更适合临床前和临床反应，并且可以提供更多有关医学生临床共情态度的见解。在临床年份中，元认知努力的出现表明，在学生接触临床后，同理心可能会使学生变得更加细微，并可能解释了所观察到的大部分临床同情心态度的下降。

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