Empathy, Arrogance and Social Desirability Among Medical Students in Puerto Rico: An Exploratory Study Post- Hurricane María

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Authors

  • Stephanie M. Vega-Molina Department of Clinical and Health Psychology, University of Florida, Gainesville, Florida, USA
  • José R. Rodríguez-Gómez Clinical Psychology Program, Carlos Albizu University, San Juan Campus, Puerto Rico
  • Coralee Pérez-Pedrogo Clinical Psychology Program, Carlos Albizu University, San Juan Campus, Puerto Rico

DOI:

https://doi.org/10.17140/SBRPOJ-5-125

Keywords:

Empathy, Jefferson Scale of Empathy, Medical students, Puerto Rico, Arrogance, Social desirability

Abstract

Introduction
Medical and psychological literature finds that empathy is crucial in the doctor-patient relationship, and that in the last 30-years there has been a decrease among college students, particularly medical students. After the passing of Hurricane María in Puerto Rico, many medical professionals migrated, leaving the island with fewer specialists to teach the remaining medical community. This is the first such study conducted with medical students in Puerto Rico. It examines the perception of empathy from the medical student perspective amidst the particular historical context of a national emergency.
Method
Three instruments were used: The Jefferson Scale of Empathy (Student Spanish Version) (JSE-S), Arrogance Scale (AS) and Social Desirability Scale. A Non-Experimental Correlational Exploratory study was carried out with 200 medical students (55.5% female; 44.5% male), who were coursing third (45.5%) or fourth year (54.5%), from three major medical schools on the island. The students signed informed consents and also answered sociodemographic questions.
Findings
The JSE-S demonstrated an acceptable internal consistency reliability (α=0.79) with 11 items and three underlying factors. Female students showed higher empathy scores than their male counterparts (M=73.96 vs. M=70.22, p=0.001). The JSE-S and the AS were inversely correlated. Results support that social desirability is not statistically significant as a moderator between empathy and arrogance. Significant differences were found on arrogance scores pertaining to medical specialty and on religious background. Empathy and arrogance were unrelated to age, coursing year, income or university of precedence.
Conclusions
Raising awareness about the importance of empathy through positive role modeling, interpersonal dynamics and valuing the doctor-patient relationship through the formative years of medical school is recommended.

References

Berger AS. Arrogance among physicians. Acad Med. 2002; 77(2): 145-147. doi: 10.1097/00001888-200202000-00010

Chen D, Lew R, Hershman W, Orlander J. A cross-sectional measurement of medical student empathy. J Gen Intern Med. 2007; 22(10): 1434-1438. doi: 10.1007/s11606-007-0298-x

Bendapudi NM, Berry LL, Frey KA, Parish JT, Rayburn WL. Patients’ perspectives on ideal physician behaviors. Mayo Clin Proc. 2006; 81(3): 338-344. doi: 10.4065/81.3.338

Sprens RN, McKinnon MC, Mar RA, Levine B. The toron-to empathy questionnaire. J Pers Assess. 2009; 91(1): 62-71. doi: 10.1080/00223890802484381

Lasch C. The Culture of Narcissism: American Life in An Age of Di-minishing Expectations. New York, USA: W. W. Norton & Company; 1979.

Wachtel P. The Poverty of Affluence: A Psychological Portrait of the American Way of Life. BC, Canada: New Society Publishers; 1989.

Durning AT. How Much Is Enough? The Consumer Society and the Future of the Earth. New York, USA: W. W. Norton & Company; 1992.

Fromm E. The Revolution of Hope: Toward a Humanized Technology. New York, USA: Harper Row; 1968.

Gruba-McCallister F. Narcissism and the empty self: To have or to be. J Individ Psychol. 2007; 63(2): 182-192.

Konrath SH, O’Brien EH, Hsing C. Changes in disposi-tional empathy in American college students over time: A me-ta-analysis. Personal Soc Psychol Rev. 2011; 15(2): 180-198. doi: 10.1177/1088868310377395

Hegazi, I., Wilson I. Maintaining empathy in medical school: It is possible. J Med Teach. 2013; 35(12): 1002-1008. doi: 10.3109/0142159X.2013.802296

Fields S, Mahan P, Tillman P, Harris J, Maxwell K, Moham-madreza H. Measuring empathy in healthcare profession students using the Jefferson Scale of Physician Empathy: Health Provid-er- student version. J Interpers Care. 2011; 25(4): 287-293. doi: 10.3109/13561820.2011.566648

Berg K, Majdan J, Berg D, Veloski J, Hojat M. Medical students’ self-reported empathy and simulated patients’ assessments of stu-dent empathy: An analysis by gender and ethnicity. Acad Med. 2011; 86(8): 984-988. doi: 10.1097/ACM.0b013e3182224f1f

Batson C, Turk C, Shaw L, Klein T. Information function of empathic emotion: Learning that we value the other’s welfare. J Pers Soc Psychol. 1995; 68(2): 300-313. doi: 10.1037/0022-3514.68.2.300

Alcorta-Garza A, González-Guerrero JF, Tavitas-Herrera SE, Rodríguez-Lara FJ, Hojat M. Validity and reliability of the Jeffer-son Scale of Physician Empathy in Mexican medial students. Salud Ment. 2005; 28(5): 57-63.

Rodríguez-Gómez J, García K, Vicenty E, Carrasquillo R. Diseño y Validación de una Escala de Arrogancia en población adulta en Puerto Rico. Eclecta. 2013; 11(18): 48-60.

Haan P, Britt M, Weinstein A. Business student’s perceptions of arrogance in academia. Coll Stud J. 2007; 41(1): 82-92.

Bauerschmidt M. Physician leader, be careful not to let arro-gance stand in for competence. Physician Exec. 2008; 34(4): 34-35.

Sutter J. 130,000 left Puerto Rico after Hurricane Maria, Cen-sus Bureau says. CNN Investigates. Web site. https://edition.cnn. com/2018/12/19/health/sutter-puerto-rico-census-update/in-33 Vega-Molina SM et al dex.html. Accessed July 30, 2020.

Cohen J. After Hurricane Maria, One Doctor’s Decision to stay in Puerto Rico. WNPR Web site. https://www.wnpr.org/post/ after-hurricane-maria-one-doctors-decision-stay-puerto-rico. Ac-cessed July 30, 2020.

Hall C, Rudowitz R, Artiga S, Lyons B. One year after the storms: Recovery and health care in Puerto Rico and the U.S. Vir-gin Islands. Medicaid. Web site. https://www.kff.org/medicaid/ issue-brief/one-year-after-the-storms-recovery-and-health-care-in-puerto-rico-and-the-u-s-virgin-islands/. Accessed July 30, 2020.

Hojat M, Gonnella JS, Nasca TJ, Mangione S, Veloksi JJ, Ma-gee M. The jefferson scale of physician empathy. Acad Med. 2002; 77(Supplement): S58-S60. doi: 10.1097/00001888-200210001-

Ferreira-Valente A, Costa P, Elorduy M, Virumbrales M, Cos-ta MJ, Palés J. Psychometric properties of the Spanish version of the Jefferson Scale of Empathy: Making sense of the total score through a second order confirmatory factor analysis. BMC Med Educ. 2016; 16(1). doi: 10.1186/s12909-016-0763-5

Hojat M, Gonnella JS. Eleven years of data on the jefferson scale of empathy-medical student version (JSE-S): Proxy norm data and tentative cutoff scores. Med Princ Pract. 2015; 24(4): 344- 350. doi: 10.1159/000381954

Webb N, Shavelson R, Haertel E. 4 Realiability coefficients and generalizability theory. Handb Stat. 2006; 26: 81-124. doi: 10.1016/ S0169-7161(06)26004-8

Field A. Discovering Statistics Using SPSS (Introducing Statistical Methods). 3rd ed. SLE Pound; 2009.

Hays S. Socially desirable response set measure. Training. Pub-lished. 1989: 476-481.

Alcorta-Garza A, San-Mart M, Delgado-Bolton R, Soler-Gonz J, Roig H, Vivanco L. Cross-validation of the spanish hp-ver-sion of the jefferson scale of empathy confirmed with some cross-cultural differences. Front Psychol. 2016; 7: 1-9. doi: 10.3389/ fpsyg.2016.01002

Montilva M, García M, Torres A, Puertas M, Zapata E. Em-patía según la escala de Jefferson en estudiantes de medicina y en-fermería en venezuela. Investig en Educ Médica. 2015; 4(16): 223-228. doi: 10.1016/j.riem.2015.04.006

Velicer W, Fava J. Effects of variable and subject sampling on factor pattern recovery. Psychol Methods. 1998; 3: 231-251. doi: 10.1037/1082-989X.3.2.231

Baskin-Sommers A, Krusemark E, Ronningstam E. Empathy in narcissistic personality disorder: From clinical and empirical perspectives. Personal Disord. 2014; 5(3): 323-333. doi: 10.1037/ per0000061 Original Research | Volume 5 | Number 2 |

Roter D, Frankel R, Hall J, Sluyter D. The Expression of emo-tion through nonverbal behavior in medical visits. J Gen Intern Med. 2005; 21: S28-S34. doi: 10.1111/j.1525-1497.2006.00306.x

Schlenker B, Leary M. Audience reaction to self-enhancing, self-denigrating, and accurate self-representations. J Exp Soc Psy-chol. 1982; 18: 89-104.

Nunes P, Williams S, Sa B, Stevenson K. A study of empa-thy decline in students from five health disciplines during their first year of training. Int J Med Educ. 2011; 2: 12-17. doi: 10.5116/ ijme.4d47.ddb0

Hojat M, Mangione S, Nasca TJ, Cohen M, Gonnella JS, Erd-mann JB, et al. The jefferson scale of physician empathy: Develop-ment and preliminary psychometric data. Educ Psychol Meas. 2001; 61(2): 349-365. doi: 10.1177/00131640121971158

Kataoka HU, Koide N, Hojat M, Gonnella JS. Measurement and correlates of empathy among female Japanese physicians. Submit your article to this journal | https://openventio.org/submit-manuscript/ Original Research | Volume 5 | Number 2 | Vega-Molina SM et al BMC Med Educ. 2012; 12(1): 48. doi: 10.1186/1472-6920-12-48

Michalec B. An assessment of medical school stressors on pre-clinical students’ levels of clinical empathy. Curr Psychol. 2010; 29: 210-221. doi: 10.1007/s12144-010-9081-y

Bucknall V, Burwais S, MacDonald D, Charles K, Clement R. Mirror mirror in the ward, who’s the most narcissistic of them all? Pathological personality traits in health care. CMAJ. 2015; 187(18): 1359-1363. doi: 10.1503/cmaj.151135

Borracci RA, Doval HC, Nuñez C, Samarelli M, Tamini S, Ta-nus E. Measurement of empathy among argentine cardiologists: Psychometrics and differences by age, gender, and subspecialty. Cardiol J. 2015; 22(1): 52-56. doi: 10.5603/CJ.a2014.0050

Kane GC, Gotto JL, Mangione S, West S, Hojat M. Jefferson scale of patient’s perceptions of physician empathy: Preliminary psychometric data. Croat Med J. 2007; 48(1): 81-86.

Published

2020-08-26

How to Cite

Stephanie M. Vega-Molina, José R. Rodríguez-Gómez, & Coralee Pérez-Pedrogo. (2020). Empathy, Arrogance and Social Desirability Among Medical Students in Puerto Rico: An Exploratory Study Post- Hurricane María. Social Behavior Research and Practice, 5(2), 24–34. https://doi.org/10.17140/SBRPOJ-5-125