RESEARCH ARTICLE Open Access
Compa ing empa hy in medical s uden s o
wo Po uguese medicine schools
Luiz Miguel San iago
1,2,3*
, Inês Rosendo
1,4,5
, Mona-Lisa Cou inho
1
, Ka ia Sophie Mau ício
1
, Isabel Ne o
6
and
José Augus o Simões
6,7,5
Abs ac
Backg ound: Empa hy is pa amoun in he doc o -pa ien ela ionship being a comp ehensi e and mul idimensional
concep . Sel - a ings o empa hy change ac oss he yea s o medical educa ion only when he Je e son Scale o
Physicians Empa hy is used, wi h a wo ying dec ease being ound h oughou he yea s in Medicine Schools. As he e
a e only ew s udies on he ac o s in luencing medical s uden ’s empa hy, pa icula ly o he cu icula model, his
s udy aimed o compa e he le els o empa hy o medicine s uden s o wo Schools wi h di e en cu icula models in
cen al Po ugal, he Facul y o Medicine - Uni e si y o Coimb a (FMUC) and he Facul y o Heal h Sciences - Uni e si y
o Bei a In e io (FCS-UBI).
Me hods: C oss-sec ional obse a ional s udy wi h he Je e son Scale o Physician Empa hy –s uden s’Po uguese
e sion (JSPE –sp ) o 1s , 3 d and 6 h yea s uden s o he 2017/2018 academic yea wi h desc ip i e and in e en ial
s a is ical analysis (p<0.05).
Resul s: Size ep esen a i e sample o 795 s uden s. Highe o al empa hy sco e (TES) (p=0.008)and“Pe spec i e
aking”(p= 0.001) in FCS-UBI we e ound. JSPE-TES was highe in FCS-UBI, 3 d yea (p= 0.038). Highe FCS-UBI
“Pe spec i e aking”in he 1s yea (p=0.030)and6 hyea (p= 0.044), o “Compassiona e ca e”in he 3 d (p=0.019)
and o “S anding in he pa ien ’sshoes”in he 1s yea (p= 0.018) and in FMUC o “Compassiona e ca e”in he 1s
yea (p= 0.037) and he “S anding in he pa ien ’sshoes”in yea 3 (p= 0.002) we e ound. Highe le els o empa hy
we e ound in FCS-UBI emale s uden s, o JSPE-TES (p=0.045)and“Pe spec i e aking”(p=0.001).
Conclusion: Highe empa hy le els in FCS-UBI we e ound, wi h di e en esul s in he hi d yea sugges ing in luence
o he medical cou se eaching cha ac e is ics be ween he wo Medicine schools, s uden ’s empa hy le els being
highe when ea lie and mo e in ense con ac wi h pa ien s accompanied by skilled u o s was de eloped.
Keywo ds: Medical empa hy, Medical s uden s, Doc o -pa ien ela ionship, JSPE, Medical educa ion, S uden ’sempa hy
Backg ound
Empa hy is pa amoun in he doc o -pa ien ela ionship,
con ibu ing o pa ien sa is ac ion wi h hei doc o , ease
in p o iding ele an in o ma ion, be e adhe ence o
he apy and clinical esul s, lowe li iga ion a es o
medical mal-p ac ice and le els o s ess and p o essional
bu nou [1–4].
Empa hy is a comp ehensi e and mul idimensional con-
cep . Hoja e al. ha e desc ibed i as a p edominan ly cog-
ni i e ( a he han emo ional) a ibu e ha in ol es he
abili y o unde s and ( a he han eel) he pa ien ’sexpe i-
ences, conce ns, and pe spec i es associa ed wi h he abil-
i y o communica e ha same unde s anding [5].
Empa hy can be augh and ained h ough educa-
ional p ocesses and e lec ion [6–9].
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* Co espondence: [email p o ec ed]
1
Facul y o Medicine o he Uni e si y o Coimb a, Coimb a, Po ugal
2
Gene al P ac ice/Family Medicine Clinic o he Uni e si y o Coimb a,
Coimb a, Po ugal
Full lis o au ho in o ma ion is a ailable a he end o he a icle
San iago e al. BMC Medical Educa ion (2020) 20:153
h ps://doi.o g/10.1186/s12909-020-02034-3
Thus, i is impo an o p omo e e ec i e educa ional
in e en ions ha can imp o e and main ain he le els
o empa hy in s uden s, physicians o be as well in p ac-
icing doc o s, con ibu ing o he s eng hening o he
doc o -pa ien ela ionship and o a be e heal hca e
sys em [6,8,9].
Despi e he consensus on he impo ance o empa hy
in medical educa ion and p ac ice [6], a wo ying de-
c ease in he empa hy o medical s uden s h oughou
hei yea s in Medicine Schools is epo ed [6,10–14]. A
ecen me a-analysis indica es signi ican e idence o
sel - a ings o empa hy changing ac oss he yea s o
medical educa ion only when he JSPE is used [9].
Sca ce Po uguese li e a u e ocused on he e olu ion
o empa hy in po uguese medical s uden s. A mul i-
ins i u ional s udy e eals ha empa hy and pe sonali y
o medical s uden s a e closely ela ed [7]. C oss-cul u al
adap a ion and alida ion o he Je e son Scale o Phys-
ician Empa hy –s uden s’Po uguese e sion (JSPE –
sp ) has al eady been made [1,5,15].
The e a e ew s udies on he ac o s ha can in luence
he empa hy o medical s uden s, pa icula ly he in lu-
ence o he cu icula model p ac iced in he di e en
Medicine Schools [2].
This s udy aimed o compa e he le els o empa hy o
medicine s uden s o wo Schools wi h di e en cu icu-
la models, allowing in es iga ion on he di e ences and
in luences o he eaching sys em in s uden ’s empa hy.
We compa ed he Facul y o Medicine o he Uni e -
si y o Coimb a (FMUC) and he Facul y o Heal h Sci-
ences o he Uni e si y o Bei a In e io (FCS-UBI).
To pu i in o con ex , he wo Medicine Schools ha e
he same admission p ocess o incoming s uden s, mos
o hem admi ed h ough a compe i i e na ional exam
[16,17], emales en e ing mo e in bo h schools a an ap-
p oxima e 3:1 a io, highe ma ks being obse ed o
en ande a FMUC han a FCS-UBI. FMUC ecei ing
350 s uden s a yea and FCS-UBI 150. In bo h Schools,
he cou se is 6 yea s long [16,17] bu he s uden - u o
a io is highe a FMUC 18.5 o FMUC and 3.1 o
FCS-UBI [17,18]. FMUC’s eaching is semes e ial, ap-
plies a non-in eg a ed eaching sys em, based on he
compa men aliza ion o con en s in o subjec s, empha-
sizes he “s o age”o in o ma ion [16,18,19] and e alu-
a ions a e mainly by heo e ical exams. FCS-UBI has a
qua e ly pe iod o ganiza ion and applies an in eg a ed
eaching sys em p omo ing sel -di ec ed lea ning using,
whene e possible, p oblem-based lea ning [17,20]. Ac-
co ding o Eu opean “Bologna Decla a ion”[h ps://ec.
eu opa.eu/educa ion/policies/highe -educa ion/bologna-
p ocess-and-eu opean-highe -educa ion-a ea_p
accessed on he 19 h Decembe 2019] medicine s uden s
a e o pe o m a Thesis a he end o hei s udies, so ac-
qui ing a Mas e on Medicine deg ee (MIM).
De ails on cu icula in o ma ion can be ob ained a e
he Medicine School’s websi e [16,17,19,20]. In b ie ,
analysing he cu iculum o each acul y, FCS-UBI in-
cludes mo e con en s in he a ea o human sciences,
mo e ole-playing ac i i ies and an ea lie clinical in-
p ac ice con ac wi h pa ien s [8,21,22].
This s udy objec i es we e o unde s and he di e -
ences iuni e si ies n le els o empa hy be ween FMUC
and FCS-UBI medical s uden s, and o compa e hem by
gende and schola yea .
Me hods
We pe o med a c oss-sec ional obse a ional s udy ap-
plying an ins umen o measu e he le els o empa hy
o i s , hi d and six h-yea s uden s a ending he MIM
in FMUC and FCS-UBI a e app o al by he E hics
Commi ee o Heal h o he Cen al Regional Heal h
Adminis a ion o Po ugal was g an ed.
The JSPE-sp , a sel -adminis e ed ques ionnai e allowing
e alua ion o he s uden ’s sel -pe cep ion o empa hy in
pa ien ca e, was used [5]. I is conside ed a eliable ins u-
men wi h e idence ha suppo s i s alidi y [1,5,15,23,
24]. Wi h 20 i ems, o be answe ed on a Like scale om 1
(s ongly disag ee) o 7 poin s (s ongly ag ee) i s udies
h ee componen s: “Pe spec i e aking”(10 i ems; e e s o
he abili y o analyse ano he pe son’sp oblem om he
ou side), “Compassiona e ca e”(8 i ems, de ined by he ac-
i i y in a ou o he one we see su e ing) and “S anding
in he pa ien ’sshoes”(2 i ems; e e s o he ac o hinking
as i we we e in he o he pe son’splace)[5,15,23]. The
o al sco e a ies om 20 o 140, and he highe he sco e
he highe he le el o empa hy [15,23].
The sample size was calcula ed a e he o al numbe
o s uden s o be en olled in each acul y in he aca-
demic yea 2017/2018 pe yea o a endance. FMUC
471 s uden s in he 1s yea , 328 in he 3 d yea and 314
in he 6 h yea and FCS-UBI 186 in he 1s yea , 136 in
he 3 d yea and 141 in he 6 h yea . The sample size
calcula ion was made using he si e “The Su ey Sys em
- Sample Size Calcula o ”[25] o ep esen he uni e se
wi h a 95% con idence le el and a 5% ma gin o e o .
The s udy ins umen was dis ibu ed in pape du ing
p ac ical classes o he i s , hi d and six h cu icula
yea in bo h uni e si ies, in 2018 Ap il and May. Re-
sponsible P o esso s o each andomly chosen class
we e p e iously in o med and g an ed consen . The
numbe o s uden s o be en olled, implied a d aw o
each yea classes o achie e he needed sample size, wi h
ex a classes o sample collec ion secu i y easons. S u-
den ’s pa icipa ion was indi idual, olun a y, anonym-
ous and wi h w i en in o med consen . In o ma ion on
gende (male / emale) and MIM yea ( i s / hi d /
six h) was ob ained.
San iago e al. BMC Medical Educa ion (2020) 20:153 Page 2 o 6
The SPSS®) So wa e o Windows e sion 24.0″was
used o s o age, desc ip i e and in e en ial s a is ical
analysis o da a. Checking he non-no mali y o he da a
dis ibu ion wi h he Kolmogo o -Smi no es , non-
pa ame ic es s (Mann-Whi ney es ) was used o s a -
is ical analysis. A p alue o < 0.05 was conside ed o
signi ican di e ence.
Resul s
A ep esen a i e sample size o a leas 286 ques ion-
nai es a FMUC and 210 a FCS-UBI was es ima ed. Fo
his s udy a sample o 795 medical s uden s, 420 om
FMUC and 375 om FCS-UBI was s udied. I s desc ip-
ion acco ding o he uni e si y, he MIM yea a ended
and gende is shown in Table 1. The Kolmogo o -
Smi no es showed no nume ic da a wi h no mal dis-
ibu ion (p< 0.001). Using he chi-squa e es and he
Mann-Whi ney U es , no signi ican di e ences we e
ound be ween uni e si ies o gende (p= 0.096) and
yea o MIM (p= 0.408).
Table 2shows he di e ences in he mean alue o he
answe s sco es be ween uni e si ies o o al JSPE and
each one o i s componen s (“Pe spec i e aking,”“Com-
passiona e ca e”,“S anding in he pa ien ’s shoes”).
Wi h he Mann-Whi ney U es signi ican di e ences
we e ound be ween he wo Schools o he o e all JSPE
sco e (p= 0.008) and he “Pe spec i e aking”compo-
nen sco e (p= 0.001) wi h a highe sco e in FCS-UBI.
Table 3 e eals he mean alue o he esponses pe
Medicine School and pe yea o MIM o he o al JSPE
and o each o i s componen s pe yea be ween Scholls
(“Pe spec i e aking”,“Compassiona e ca e”,“S anding
in he pa ien ’s shoes”) and o gende , again wi h
Mann-Whi ney U es . The e was signi ican di e ence
in he 3 d yea (p= 0.038), highe sco e in he FCS-UBI.
Fo “Pe spec i e aking” he e we e signi ican di e -
ences in he 1s (p= 0.030) and in he 6 h yea (p=
0.044), bo h sco es being highe in he FCS-UBI.
Fo he “Compassiona e ca e”componen , he e was a
di e ence in he 1s yea (p= 0.037), and in he 3 d yea
wi h highe sco es in he FCS-UBI (p= 0.019).
Rega ding he “S anding in he pa ien ’s shoes”compo-
nen , signi ican di e ences we e ound in he 1s yea
(p= 0.018), FCS-UBI sco ing be e , and in he 3 d yea
(p= 0.002) highe a he FMUC.
By gende be ween uni e si ies o o al JSPE and o
each o i s componen s he e was a s a is ically signi i-
can di e ence, be e o emale s uden s, o he o al
JSPE sco e (p= 0.045) and he “Pe spec i e aking”sco e
(p= 0.001), again wi h a highe sco e in FCS-UBI.
Discussion
Signi ican ly highe le els o empa hy we e ound in
FCS-UBI s uden s o he o al sco e o JSPE, o he
“Pe spec i e aking”componen and o 3 d yea s u-
den s s ill wi h highe sco es in FCS-UBI.
These esul s a e in line wi h he only s udy we ound
compa ing he le els o empa hy in wo uni e si ies wi h
di e en cu icula models in a Pakis an s udy [26]. An-
o he mul i-ins i u ional s udy e ealed he in luences o
eaching scheme on he le els o medical s uden ’s em-
pa hy hough no speci ica ion o cu icula model was
epo ed [27]. Gi en he di e en socio-economic en i-
onmen s and medical and educa ional con ex s be ween
Po ugal and Pakis an we can only ecognise ha
Table 1 Sample acco ding o Uni e si y, yea o equency o
Mas e In Medicine (MIM) and gende
FMUC n (%) FCS-UBI n (%) To al n (%)
Yea o MIM (p= 0,408)
a
1° 152 (36.2) 153 (40.8) 305 (38.4)
3° 164 (39.0) 137 (36.5) 301 (37.9)
6° 104 (24.8) 85 (27.7) 189 (23.8)
To al 420 (100) 375 (100) 795 (100)
Gende (p= 0,096)
Female 278 (69.8) 282 (75.2) 560 (72.4)
Male 120 (30.2) 93 (24.8) 213 (27.6)
To al 398 (100) 375 (100) 773 (100)
FMUC Facul y o Medicine o he Uni e si y o Coimb a, FCS-UBI Facul y o
Heal h Sciences o he Uni e si y o Bei a In e io . (*) Mann-Whi ney U
Table 2 Di e ences in he mean alue o he answe s pe
uni e si y o he o al JSPE and o each one o i s componen s
“Pe spec i e aking”,“Compassiona e ca e”and “S anding in he
pa ien ’s shoes”by Uni e si y
FMUC FCS-UBI p (*)
JSPE o al (Max = 140)
N 420 375 0.008
Mean ± SD 89.2 ± 7.6 90.6 ± 7.6
95% ic 88,2 o 89,14 89,75 o 91,34
Pe pec i e aking (Max = 70)
N 420 375 0.001
Mean ± SD 59.4 ± 5.8 60.7 ± 6.7
95% ic 58,44 o 59,21 60,04 o 61,39
Compassiona e ca e (Max = 56)
N 420 375 0.800
Mean ± SD 15.1 ± 4.1 15.2 ± 4.3
95% ic 14,71 o 15,21 14,75 o 15,61
S anding in he pa ien ’s shoes (Max = 14)
N 420 375 0.399
Mean ± SD 7.4 ± 2.3 7.3 ± 2.5
95% ic 7,32 o 7,59 7,01 o 7,52
FMUC Facul y o Medicine o he Uni e si y o Coimb a, FCS-UBI Facul y o
Heal h Sciences o he Uni e si y o Bei a In e io . (*) Mann-Whi ney U
San iago e al. BMC Medical Educa ion (2020) 20:153 Page 3 o 6
Po uguese medicine s uden s appea o be less em-
pa hic, he asons o such being specula i e.
Lowe le els o empa hy in FMUC s uden s can pos-
sibly be explained by:
Teaching cha ac e is ics o each school.
FCS-UBI cu iculum p o iding in-p ac ice classes wi h
he s uden accompanied by skilled u o oge he wi h
p ac ical sessions ollowing a heo e ical u o ial.
Analysing he cu icula o bo h Uni e si y Medical
schools [16,17]. FCS-UBI had a la ge numbe o
cu icula uni s ela ed o humanis ic sciences, wi h
emphasis on he de elopmen o in e ac ion and com-
munica ion skills. Role-playing ac i i ies a e conduc ed
egula ly wi h discussion and speci ic assessmen o
s uden s’communica i e and empa hic abili ies is made
[8,21,22]. FMUC lacks subjec s ela ed o he humanis-
ic sciences and has a mo e supe icial and limi ed ap-
p oach o clinical p ac ice s a ed in he 4 h yea o
MIM. The cu icula uni o Gene al P ac ice/Family
Medicine, is one o he wo cu icula uni s o include
he discussion o opics such as empa hy and communi-
ca ion and he pe o mance o ole-playing ac i i ies, is
only augh in he 5 h yea . So by he 3 d yea , FCS-UBI
s uden s al eady ha e had con ac wi h clinical p ac ice,
whe eas FMUC s uden s ha e no [16,17]. Tu o ’s
cha ac e is ics in luence he le els o s uden ’s empa hy
[14,21]. Thus, he di e ences be ween he wo uni e -
si ies can also be so explained, and ha dese es u u e
s udy, suppo ing in e en ions in hei u o s, upg ading
hem.
O he seconda y ac o s can also help explain di e en
le els o epa hy:
S uden - u o a io FMUC wi h a a io o 18.5
(Po uguese a e age 7.53), con as ing wi h a 3.1 a-
io in FCS-UBI. Highe s uden - u o a io a FMUC
con ibu ed o lowe sa is ac ion wi h eaching, less
clinical con ac and less oppo uni ies o de elop
empa hic ela ionships wi h pa ien s [18]. Au ho
Table 3 Di e ences in he mean alue o he esponses pe uni e si y and pe yea o MIM and gende o he o al JSPE and o
each o i s componen s “Pe spec i e aking”,“Compassiona e ca e”and “S anding in he pa ien ’s shoes”
Yea o
a endance
FMUC FCS-UBI p (be ween uni e si ies) (*)
1° 3° 6° 1° 3° 6° 1° 3° 6°
JSPE o al (Max = 140)
N 152 164 104 153 137 85 0.215 0.038 0.308
Mean ± SD 90.3 ± 9.1 90.4 ± 5.7 85.7 ± 6.9 91.8 ± 7.4 91.5 ± 7.6 86.8 ± 7.1
Pe pespec i e aking (Max = 70)
N 152 164 104 153 137 85 0.030 0.108 0.044
Mean ± SD 59.0 ± 6.1 60.4 ± 5.6 58.5 ± 5.8 60.8 ± 7.3 61.0 ± 6.5 60.1 ± 5.8
Compassiona e ca e (Max = 56)
N 152 164 104 153 137 85 0.037 0.019 0.741
Mean ± SD 16.8 ± 4.5 13.9 ± 3.6 14.5 ± 3.1 15.9 ± 5.0 14.9 ± 3.7 14.5 ± 3.6
S anding in he pa ien ’s shoes (Max = 14)
N 152 164 104 153 137 85 0.018 0.002 0.611
Mean ± SD 6.6 ± 2.3 8.2 ± 2.2 7.2 ± 2.2 7.3 ± 2.4 7.4 ± 2.6 7.0 ± 2.5
Gende Female Male Female Male Female Male
JSPE o al (Maximum = 140)
N 278 120 282 93 0.045 0.071
Mean ± SD 89.0 ± 8.1 89.8 ± 6.8 90.4 ± 7.7 91.0 ± 7.4
Pe spec i e aking (Max = 70)
N 278 120 282 93 0.001 0.777
Mean ± SD 59.7 ± 5.7 58.9 ± 6.1 61.3 ± 6.4 58.8 ± 7.0
Compassiona e ca e (Max = 56)
N 278 120 282 93 0.874 0.174
Mean ± SD 14.8 ± 3.9 15.9 ± 4.1 14.7 ± 4.1 16.6 ± 4.4
S anding in he pa ien ’s shoes (Max = 14)
N 278 120 282 93 0.321 0.704
Mean ± SD 7.3 ± 2.4 7.6 ± 2.3 7.1 ± 2.5 7.7 ± 2.4
FMUC Facul y o Medicine o he Uni e si y o Coimb a, FCS-UBI Facul y o Heal h Sciences o he Uni e si y o Bei a In e io . (*) Mann-Whi ney U
San iago e al. BMC Medical Educa ion (2020) 20:153 Page 4 o 6
da a a i m he need o adequa e ole-models o em-
pa hy. In ac FMUC s uden s ha e a 13 ECTS con-
en in Gene al P ac ice a e he 1s yea , 6 h, 5 h
yea one semes e and 6 h yea 2 mon hs wi h a
dedica ed Gene al P ac ice u o , compa ing o 30
ECST in FCS-UBI, 1s , 2nd, 4 h, 5 h and 6 h yea s
and do mos o hei in-p ac ice cases in a la ge
o e -c owded Cen al Hospi al [16,17,19,20].
Suden ’s sa is ac ion: A s uden ’s opinions pool, ound
ou ha FMUC was he na ional medicine school wi h
he wo s le el o o e all sa is ac ion and clinical each-
ing and s udy condi ions, whe eas FCS-UBI had he
highes le els [28].
So a no s udies in speci ic s uden ’s cha ac e is ics
we e pe o med o di e en ia e be ween FMUC and
FCS-UBI excep o en y ma ks, highe in Coimb a. Sig-
ni ican di e ences we e only ound in eminine gende
and only in he o al JSPE sco e and in he “Pe spec i e
aking”componen , being highe in FSC-UBI, emale
s uden s o FCS-UBI had highe le els o empa hy han
male ones.
Empa hy is posi i ely in luenced by quali y o li e and
nega i ely by a igue, s ess, and bu nou . S udies ca ied
ou in bo h uni e si ies ha pa ook in his s udy
showed ha , FCS-UBI s uden s ha e a be e quali y o
li e and a e less ulne able o s ess and a igue [28,29].
The exis ence o di e ences in empa hy be ween he
wo uni e si ies suppo s he need o conside he im-
pac o he cu iculum model and o he MIM cha ac e -
is ics on he de elopmen o he empa hic capaci ies o
medical s uden s. So se e al changes can be conside ed
in o de o inc ease he le els o empa hy in medical s u-
den s, in he long e m, in o de o imp o e and main-
ain he le els o empa hy in medical s uden s:
Educa ional in e en ions ocused on empa hic capaci-
ies by ole-playing, ideo-wa ching and eal consul a-
ions wi h pa ien s wi h analysis and discussion o
medical communica ion is deemed necessa y [22]. Also
lec u es and p ac ice o he impo ance o empa hy and
communica ion in he doc o -pa ien ela ionship and
ea ly in eg a ion o mo e con en s o he human sciences
a ea in o he s udy plan, wi h a mo e educed
s uden - u o a io, p e e ably a one o one e en i o
sho e pe iod o ime [8,9]. E en hough “empa hy
is ela ed o pe sonali y”, a ma e his s udy did no
ocus on [30,31].
Resea ch is o be con inued in his a ea.
In spi e o he a emp s o minimize bias, he e may
ha e been dis ac ion in eading he ques ionnai es. A -
emp s we e made o close he selec ion bias h ough
he andom selec ion o he classes included in he
s udy. The JSPE s uden ’s e sion e alua es sel -
pe cep ion o empa hy, which may be di e en om he
ac ual empa hic beha iou .
As p ac ical poin s om ou s udy we mus emphasize
ha (1) empa hy is a pa amoun elemen o he doc o -
pa ien ela ionship ha can be ained h ough an edu-
ca ional p ocess, (2) s uden ’s empa hy le els we e
highe when ea lie and mo e in ense con ac wi h pa-
ien s accompanied by skilled u o s was de eloped and
(3) eassessmen o cu icula pa icula i ies mus bea
in mind p ac ical ac i i ies in eal wo ld con ex , ecog-
nizing ha each s uden has i s own in insic psycho-
logic cha ac e is ics.
Conclusion
The le els o empa hy o FCS-UBI medical s uden s
we e highe han hose ound in FMUC s uden s.
Compa ing he esul s pe yea o MIM, he di e ence
was mainly in he 3 d yea wi h be e esul s in FCS-
UBI.
By gende emales sco e s a is ically di e en be ween
he wo Schools, be e in FCS-UBI.
These esul s suppo he need o eassess he lea ning
cu iculum and he eaching con ex , wi h he objec i e
o p omo ing e ec i e educa ional in e en ions in he
de elopmen o s uden empa hy.
Abb e ia ions
MIM: In eg a ed Mas e ’s deg ee in Medicine; FMUC: Facul y o Medicine o
he Uni e si y o Coimb a; FCS-UBI: Facul y o Heal h Sciences o he
Uni e si y o Bei a In e io ; JSPE –sp : Je e son Scale o Physician Empa hy –
s uden s’Po uguese e sion; TES: o al empa hy sco e
Acknowledgemen s
None a e o be done.
P ac ice Poin s
1. Empa hy, a pa amoun elemen o he doc o -pa ien ela ionship, can be
ained h ough an educa ional p ocess.
2. S uden ’s we e highe when mo e p ecocious con ac wi h pa ien s was
de eloped.
3. So eassessmen o cu icula pa icula i ies mus ba e in mind p ac ical
ac i i ies in eal wo ld con ex , bea ing he in insic cha ac e is ics o he
s uden ’s popula ion.
Au ho s’con ibu ions
MLC: concep ion, da a analysis, w i ing, e ising and manusc ip app o al.
IRS: concep ion, da a analysis, w i ing, e ising and manusc ip app o al. IN:
concep ion, da a ga he ing and analysis, w i ing, e ising and manusc ip
app o al. KM: manusc ip e ision in English scien i ic e ision and app o al.
JAS: scien i ic e ision and app o al. LMS: concep ion, da a ga he ing and
analysis, w i ing, e ising, manusc ip app o al and submission p ocessing. All
he au ho s ha e ead he manusc ip and ag ee in i s submission o BMC
Medical Educa ion and consen i is done.
Funding
No unding we e ob ained o his s udy which was been made in ou o
au ho s wo king job hou s.
A ailabili y o da a and ma e ials
All da a will become a ailable i eques ed.
E hics app o al and consen o pa icipa e
This s udy has had an e hics commi ee app o al, by he “Comissão de É ica
da ARS-C”.
San iago e al. BMC Medical Educa ion (2020) 20:153 Page 5 o 6

Consen o publica ion
All da a we e ob ained a e w i en in o med consen o answe and o
da a o be analysed and published.
Compe ing in e es s
The au ho s decla e ha hey ha e no compe ing in e es s.
Au ho de ails
1
Facul y o Medicine o he Uni e si y o Coimb a, Coimb a, Po ugal.
2
Gene al P ac ice/Family Medicine Clinic o he Uni e si y o Coimb a,
Coimb a, Po ugal.
3
CEISUC, Coimb a, Po ugal.
4
USF Coimb a Cen o, ARS
Cen o, Coimb a, Po ugal.
5
CINTESIS, Po o, Po ugal.
6
Facul y o Heal h
Sciences o he Uni e si y o Bei a In e io , Co ilhã, Po ugal.
7
USF Caminhos
do Cé oma, ARS Cen o, Coimb a, Po ugal.
Recei ed: 19 Augus 2019 Accep ed: 5 Ap il 2020
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Publishe ’sNo e
Sp inge Na u e emains neu al wi h ega d o ju isdic ional claims in
published maps and ins i u ional a ilia ions.
San iago e al. BMC Medical Educa ion (2020) 20:153 Page 6 o 6