This study aimed to determine standard data and provisional cut-off scores for the JSE-S instrument among Japanese medical students using 11 years of data obtained from Japanese medical schools. The normative data reported have potential implications for medical education when comparing an individual’s JSE-S scores to determine relative percentile ranks. For example, if a male medical student has her JSE-S score between 121 and 125, he is in the top 80 compared to another male medical student whose JSE-S score is between 111 and 115. ~91st percentile. Place him in the 50-63 percentile.
Comparison with previous studies
Here, we describe findings on standard data and JSE-S provisional cut-off scores for Japanese medical school entrants in comparison to previous studies conducted in the United States (N.= 2,637) [19] and Spain (N. = 893) [20] For first-year medical students. First, we compared it with the American findings, which incorporated his 11-year data from 2002 to his 2012. [19]The average JSE-S score in this survey was about 2 points higher for men and about 4 points higher for women than in Japan. Several factors may contribute to this difference. First, the age at which medical school is entered is higher in the United States. According to a survey that reported on the characteristics of U.S. medical school entrants, more than 98% of his entrants from 2001 to 2015 said he was 21 years of age or older at the time of enrolment. [31]The average age of US study participants was 23.4 years [19]In recent years, about 85% of medical school entrants in Japan are under the age of 21 at the time of enrollment. [32]Most Japanese students enter medical school immediately or within a few years after graduating from high school.
Second, US entrants come from a wide range of backgrounds in undergraduate majors, including humanities, arts, and social sciences. [33, 34]A previous study found that first-year osteopathic medical students in the United States who majored in Social and Behavioral Sciences and Arts and Humanities scored higher on average on the JSE-S than those with a background in Chemical and Physical Sciences. has been shown to be high. [30]In addition, you may have more experience prior to entering medical school, such as pursuing alternative careers, engaging in family obligations, and international travel, living, and work experience. [35, 36]However, most Japanese entrants enter medical school directly from high schools with courses in chemistry and physical sciences, with the exception of those who may have failed the first attempt. Freshmen in Japan have just been released from the rigorous striving to pass competitive entrance exams and may not yet develop empathy. Thus, U.S. enrollees are likely to have more experience and be more personally mature by being exposed to situations that foster empathy. This may be the reason for the finding that scores are higher for American students than for Japanese students.
The type of survey administration, i.e., a hard copy questionnaire for 2011-2019 entrants or an online questionnaire for 2020-2021 entrants, did not affect JSE-S scores (data not shown). yeah).This result is consistent with that of the United States [19].
The findings were then compared to a Spanish-language survey conducted in 2019 at eight medical schools in Madrid. [20]The average JSE score in Spain was approximately 7 points higher for men and 8 points higher for women than in Japan. The Spanish study participant was a first-year medical student who had not yet been in contact with a patient, and her average age was 18.9 when the survey was conducted. This is similar to our study. The difference in average score between Spain and Japan may be due to the difference in response rate and the difference in her JSE version used for the survey. The response rates for the Spanish and Japanese studies were 59.7% and 97.5% respectively. Most Japanese students responded to the questionnaire, but Spanish students who were more empathetic may have responded selectively, leading to higher average scores for Spanish participants.
The JSE version used in the Spanish study was the HP version for doctors and practitioners of all medical professions, not the S version for medical students. The JSE was originally developed to measure the orientation or attitude of medical students towards physician empathy in patient care situations. That is the S version. An HP version was then developed to measure empathy among medical practitioners and other healthcare professionals. Although the two versions are very similar in context, the wording in the HP version is slightly different in some items, making it more relevant to empathic behavior of caregivers than empathic orientation and attitudes of physicians. has been changed to For example, in the S version, there was a description that “Every person is different, so it is difficult for doctors to see things from the patient’s point of view.” In the HP version, this item has been corrected as follows: [37]Respondents in the S version may have been scored more strictly, as this version refers to general physician empathy rather than the respondent’s own empathy. This may have contributed to the lower average scores of Japanese students using the JSE-S version compared to Spanish students using the HP version.
Cultural traits can also be important factors influencing empathy. A previous study investigating race- and ethnicity-related differences in mean JSE-S scores among American osteopathic medical students found that Asian students were more A low average score was indicated. [30]In general, Japanese people tend to be calm, ambiguous, and humble, and to communicate with others in ways that censor themselves. [38]Many Japanese patients may be reluctant to express their feelings and emotions to others, including health care professionals. There may have been differences in empathy scores among students. These differences may also be attributed to differences in medical professionalism in Japanese and Western cultures. 1 article [39] suggests that BushidoJapan’s personal code of conduct, which derives from the ancient samurai, may influence the behavior of modern Japanese physicians. BushidoIt includes concepts such as personal autonomy, gender roles, and ethical concepts that differ from the physician charter used in Western medical societies. However, these assumptions should be further investigated in future studies.
strengths and limitations
Advantages of our study include a relatively large sample size, using 11 years of data, and the ability to provide normative data by gender for Japanese medical students and provisional cut-off scores for the JSE-S. Includes high response rates. Several previous studies have shown that average scores of empathy in medical students increase after educational programs/interventions. However, there are limited studies examining the educational effect according to the level of empathy. Nevertheless, a study in the United States found that students’ empathy scores were lower in clinical years than in preclinical years, and that students with high baseline empathy had a smaller decrease in empathy than those with low baseline empathy. has been reported. [40]In contrast, our preliminary data suggest that the effectiveness of professional/educational programs for enhancing empathy in students is higher in students with moderate baseline empathy than in students with low or high baseline empathy. It shows that students tend to be higher. Therefore, by determining normative data and cut-off scores, it is possible to evaluate educational effectiveness and design educational programs and methods according to the level of empathy of students.
Our study also has some limitations. First, the data were collected at a single institution, which may affect the generalizability of our findings. However, the medical schools of the universities in this study are typical of Japanese national medical schools in terms of average age of admission and gender distribution of enrollees. From 2011 to 2021, the proportion of female students in our medical schools and all national medical schools in Japan was about the same, 31.3% and 33.2% respectively. [41]When applying to this medical school, students face a high level of competition compared to other medical schools in Japan, but these are not extremely high. Okayama University is consistently ranked within the top 15. In addition to preparing for entrance exams, many students have experienced extracurricular activities such as extracurricular activities. volunteer work. Therefore, the data in this study can be considered representative of all national medical colleges in Japan.
Second, we were only able to compare our results with two previous studies. These studies, like ours, investigated first-year medical student cut-off scores and separated by sex. I could not do it.
Third, due to the unavailability of these data, we were unable to include student age and experience as variables in our analysis. Empathy can be influenced by the student’s age and pre-medical school experiences. However, most Japanese students enter medical school immediately after high school or within a few years, so these variables are unlikely to have a significant impact on the results.
Fourth, a future study may compare high-scoring (above the top JSE-S cutoff score) with low-scoring (below the bottom cutoff score) students reported in this study. The validity and practicality of the cut-off score should be confirmed. For scales of clinical performance to determine whether differences in clinical performance ratings exist as expected.
