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National Norm Empathy Scores Developed for Medical Students

Paul DeMiglio


(Bethesda, MD)—Phase I of the groundbreaking nationwide “Project in Osteopathic Medical Education and Empathy (POMEE)” has recently been completed and its outcomes have been used to develop the first and only national norm table of empathy scores for medical students. This first phase of the project—the results of which are now published in Advances in Health Sciences Education—studied medical student empathy levels and how these levels correlate with osteopathic medical education (OME). Prior to this study, no assessment had ever been implemented to study empathy on a nationwide level and no national norm tables existed to measure empathy in any profession.

Phase I of POMEE measured and examined self-reported empathy levels of 6,009 students from 41 osteopathic medical colleges, branch campuses, and teaching sites—a pool representing roughly 85 percent of all incoming osteopathic medical students in the United States. The study was conducted through a web-based survey that was administered at the beginning of the 2017-2018 academic year to incoming matriculants. Along with collecting demographic information, the survey incorporated the Jefferson Scale of Empathy (JSE), an internationally-known and validated instrument for measuring empathy in the context of health professions education and patient care.

The published findings from this study include a broad range of data and, along with serving as the only national norm scores to measure empathy in any profession, also provide foundational insights into what influences medical student empathy levels. The remainder of Phase I is a study of the empathy scores on the JSE of first- through fourth-year osteopathic medical students. To further expand on the Phase I data, the next phase of the study—Phase II—will aim to determine factors that affect empathy levels in students. Phase II will consist of a five-year longitudinal study slated to run from summer 2019 to fall 2023 and will track a volunteer cohort of osteopathic student participants as they progress from their first year in medical school to their first year as a resident or fellow.

“The data garnered from the first phase of the POMEE study are truly groundbreaking and will pave the way for future research on the critical topic of empathy. The significance of physician empathy is widely accepted and endorsed by leaders in medicine and medical education, and this project is a platform to further explore the many aspects of this important physician attribute. In addition, the success we have seen thus far with POMEE could serve as a springboard for further studies across the health professions and beyond,” said Mohammadreza Hojat, PhD, Research Professor of Psychiatry and Human Behavior, Director of Jefferson Longitudinal Study, Center for Research in Medical Education and Health Care, Sidney Kimmel Medical College at Thomas Jefferson University.

Empathy has proven to be an important factor in patient outcomes and is a significant predictor of clinical competence for physicians-in-training. In a previous, smaller-scale study of medical student empathy, a statistically-significant association was found between students’ JSE scores and their school faculty’s global rankings of students’ clinical competence in core clerkships in family medicine, internal medicine, obstetrics and gynecology, pediatrics, psychiatry, and surgery.

“Research shows us that physician empathy has a direct impact on patient outcomes and experiences. What we learn from POMEE will help inform the efforts of osteopathic medical education institutions as they strive to cultivate empathy in their students. As medical educators, it is incumbent upon us to better understand the role of medical school in retaining and developing physician empathy and to make changes wherever necessary to ensure that we continue to graduate highly-competent, empathic physicians to care for our nation,” said Stephen C. Shannon, DO, MPH, President and CEO, American Association of Colleges of Osteopathic Medicine (AACOM).

Outcomes of POMEE will provide osteopathic medical educators a better understanding of the determinants affecting medical student empathy. Data from Phase II will help educators create a baseline to further inform curricular assessment in order to effect positive change on empathy retention during medical school.

POMEE is sponsored by AACOM and the American Osteopathic Association in collaboration with the Sidney Kimmel Medical College of Thomas Jefferson University and Leonard Calabrese, DO, a professor of medicine at Cleveland Clinic Lerner College of Medicine. For more information on POMEE, visit aacom.org/empathy.


The American Association of Colleges of Osteopathic Medicine (AACOM) represents the 35 accredited colleges of osteopathic medicine in the United States. These colleges are accredited to deliver instruction at 55 teaching locations in 32 states. In the current academic year, these colleges are educating more than 30,000 future physicians—25 percent of all U.S. medical students. Six of the colleges are public and 29 are private institutions.

AACOM was founded in 1898 to support and assist the nation's osteopathic medical schools, and to serve as a unifying voice for osteopathic medical education. AACOM’s mission is to promote excellence in osteopathic medical education, in research and in service, and to foster innovation and quality among osteopathic medical colleges to improve the health of the American public.