Cumulative Risk on the Oxytocin Receptor Gene (OXTR) Predicts Empathic Communication by Physician Assistant Students.

In the relationship between patients and health care providers, few communicative features are as significant as the providers' ability to express empathy. A robust empirical literature describes the importance of physician communication skills-particularly those that convey empathy-yet few studies have examined empathic communication by physician assistants, who provide primary care for an increasing number of Americans. The present study examines the empathic communication of physician assistant students in interactions with standardized patients. Over a 6-month period, each student conducted three clinical interviews, each of which was evaluated for empathic communication by the patients, the students' clinical instructors, and third-party observers. Students also provided saliva samples for genotyping six single-nucleotide polymorphisms on the oxytocin receptor gene (OXTR) that are linked empirically to empathic behavior. Consistent with recent research, this study adopted a cumulative risk approach wherein students were scored for their number of risky alleles on the single-nucleotide polymorphisms. Results indicated that cumulative risk on OXTR receptor gene predicted lower patient empathy scores as rated by instructors and observers, but not by standardized patients.

Empathy Between Physician Assistant Students and Standardized Patients: Evidence of an Inflation Bias.

PURPOSE: Empathic communication with patients is an essential component of quality primary care. This study examines the ability of physician assistant (PA) students to communicate empathically in clinical interviews with standardized patients. METHODS: In their first year of training, PA students conducted 3 clinical interviews with standardized patients over a 6-month period in 2014, during the second half of their didactic year. Each interview was evaluated for empathy by 4 individuals: the students themselves, their standardized patients, their clinical instructors, and third-party observers. RESULTS: Students consistently rated their empathic abilities more favorably than did patients, clinical instructors, or observers, with mean differences ranging from 0.56 to 1.92 and averaging 1.09 on a 9-point scale. Students' evaluations were most dissimilar from those of patients (difference M = 1.12) and most similar to those of observers (difference M = 1.06). The assessments of all 4 raters varied over time: students rated themselves as significantly more empathic in April (time 2) than in July (time 3) of their didactic year. Patients rated students as significantly less empathic in January of the didactic year (time 1) than at time 2 and as significantly more empathic at time 2 than time 3. Instructors rated students as significantly less empathic at time 1 than at either time 2 or time 3. Finally, observers rated students as significantly more empathic at time 1 than at either time 2 or time 3. CONCLUSIONS: PA students consistently overestimate their empathic abilities during their first year of training. Given the importance of empathy in clinical care, increased didactic efforts focused on developing and conveying empathy may be warranted in PA education.