Compassion
Kathleen Rafferty (year 5 medical student)
Patient
Colleague
Self
Patients benefit from humanistic, compassionate, and empathetic care.
Patient centred care can reduce anxiety, improve communication and diagnosis, and speed up recovery. This understanding is increasingly prominent in the literature, and has increased the priority placed on nurturing empathy in medical education.
Yet research suggests empathy may in the longer term be erosive, leaving the healthcare practitioner empty. This may explain the findings that medical students become hardened, and reduce empathy after exposure to the clinical environment (1).
Another approach less explored is the development of compassion. Compassion from Latin roots ‘com’ and ‘pati’ means to suffer with, however today we might define compassion as ‘a sensitivity to the distress of self and others with a commitment to do something about it and prevent it’ (2). Research suggests (3,4) the action component of compassion can have a positive effect on the individual, which could potentially mitigate the negative emotional toll that can occur through empathy alone. This action component also positively impacts patient care, even small acts of kindness can contribute to alleviate patient suffering and improve outcomes (5).
If the development of compassion is more sustainable for healthcare practitioners and of benefit to patients, how might we encourage compassion?
Creative enquiry might be one approach because it creates a space for students to explore and reflect on compassion in a way that is meaningful to them. For example, a new module was introduced to the third year GP placement for medical students at Barts and The London, QMUL. Students explored the literature around compassion in healthcare, and reflected on examples of compassionate practice, and where compassion was lacking. Some wrote role plays or orchestrated photos to exemplar how they believe compassionate practice should look. Others created poems, drawings, and even a musical as a means for reflection on compassion and compassionate practice. Through these methods, students were able to bring a human response to a human aspect of medicine.
1) Hojat M, Vergare MJ, Maxwell K, Brainard G, Herrine SK, Isenberg GA, Veloski J, Gonnella JS. The devil is in the third year: a longitudinal study of erosion of empathy in medical school. Academic Medicine. 2009 Sep 1;84(9):1182-91.
2) Cole-King A, Gilbert P. Compassionate care: the theory and the reality. Journal of Holistic Healthcare. 2011 Dec 1;8(3).
3) Klimecki OM, Leiberg S, Ricard M, Singer T. Differential pattern of functional brain plasticity after compassion and empathy training. Social cognitive and affective neuroscience. 2014 Jun 1;9(6):873-9.
4) Weingartner LA, Sawning S, Shaw MA, Klein JB. Compassion cultivation training promotes medical student wellness and enhanced clinical care. BMC medical education. 2019 Dec 1;19(1):139.
5) RCPSYCH. Compassion in care: ten things you can do to make a difference. 2015.
6) Sinclair S, Beamer K, Hack TF, McClement S, Raffin Bouchal S, Chochinov HM, Hagen NA. Sympathy, empathy, and compassion: A grounded theory study of palliative care patients’ understandings, experiences, and preferences. Palliative medicine. 2017 May;31(5):437-47.
