A brief instrument to measure patients' overall satisfaction with primary care physicians.

BACKGROUND AND OBJECTIVES: A brief and psychometrically sound scale to measure patients' overall satisfaction with their primary care physicians would be useful in studies where a longer instrument is impractical. The purpose of this study was to develop and examine the psychometrics of a brief instrument to measure patients' overall satisfaction with their primary care physicians. METHODS: Research participants included 535 outpatients (between 18--75 years old, 66% female) who completed a mailed survey that included 10 items for measuring overall satisfaction with their primary care physician who was named on the survey. Patients were also asked about their perceptions of physician empathy, preventive tests recommended by the physician (colonoscopy, mammogram, and prostate-specific antigen (PSA) for age and gender appropriate patients) and demographic information. RESULTS: Factor analysis of the patient satisfaction items resulted in one prominent component. Corrected item-total score correlations of the patient satisfaction scale ranged from 0.85 to 0.96; correlation between patient satisfaction scores and patient perception of physician empathy was 0.93, and correlation with recommending the physician to family and friends was 0.92. Criterion-related validity coefficients were mostly in the 0.80s and 0.90s. Patient satisfaction scores were significantly higher for those whose physicians recommended preventive tests (colonoscopy, mammogram, and PSA-compliance rates >.80). Cronbach's coefficient alpha for patient satisfaction scale was 0.98. CONCLUSIONS: Empirical evidence supported the validity and reliability of a brief patient satisfaction scale that has utility in the assessments of educational programs aimed at improving patient satisfaction, medical services, and patient outcomes in primary care settings.

Measuring empathy in healthcare profession students using the Jefferson Scale of Physician Empathy: health provider--student version.

While empathy is commonly accepted as a mutually beneficial aspect of the health provider-patient relationship, evidence exists that many health profession students are unable to demonstrate this important skill. This study, the initial phase of a 2-year longitudinal series, examined measurement properties of the Jefferson Scale of Physician Empathy (JSPE) adapted for administration to health profession students (JSE-HPS version), and investigated group differences of empathy scores in the baccalaureate nursing (BSN) program within the College of Health Professions at a public university in the southeastern part of the USA. The 20-item survey and a demographic questionnaire were completed by 265 BSN students. Correlational analyses, t-test, and analysis of variance were used to examine internal relationships and group differences. Results showed the median item-total score correlation was statistically significant (0.42). The internal consistency of the scale (Cronbach's coefficient α) was 0.78, falling within the generally agreed standard. Test-retest reliability coefficients were acceptable at 0.58 (within 3 months interval) and 0.69 (within 6 months interval) between testing. Women scored higher than men and older students outscored younger classmates. No significant relationship was found between empathy scores and ethnicity, previous non-nursing degree, or importance of religion to the participant. These findings support measurement properties of the JSE-HPS version, and can bolster the confidence of researchers in using the Scale for measuring empathy in diverse health profession students, as one component of program evaluation as well as evaluating interprofessional learning activities among diverse healthcare professional students and interprofessional collaboration.

The devil is in the third year: a longitudinal study of erosion of empathy in medical school.

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.