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Empathy, Health professions students, Psychometrics, Validity, Scales


Purpose: Empathy is the ability to understand and identify with another person’s feelings, and is important to develop in students. It is often measured using the Jefferson Scale of Empathy in Health Professions Students (JSE-HPS), which has significant cost. The Kiersma-Chen Empathy Scale (KCES) was developed to measure empathy at no cost. Initial reliability was determined from a cohort of pharmacy and nursing students. The purpose of this study was to determine psychometric properties of the KCES, comparing it to the JSE-HPS for validity for students in pursuing a career in healthcare-related fields.

Subjects: Students in healthcare fields of study at a mid-sized private university.

Methods/ description: IRB approval was obtained. A link to an anonymous survey was sent to all students in the Physical Therapy, Pharmacy, Pre-Health Sciences, Speech and Language Pathology, Audiology, Physician Assistant, Dentistry, and Athletic Training programs during the first week of the term. Two reminders were sent one week and two weeks after the initial invitation to participate. The survey consisted of a demographics questionnaire, the 15-item KCES, and the 20-item Jefferson Scale of Empathy – Health Professions Student (JSE-HPS) scale. For analyses involving both scales, the KCES and JSE-HPS scores were adjusted using the equation 100 × (observed score − minimum possible score) / score range. Continuous outcome measures were expressed as means with 95% confidence intervals (95%CI) and medians with interquartile ranges (IQR). Statistical significance of observed differences and associations was considered at a £ .05.

Results: Three-hundred thirty-eight students completed the survey (n= 235 female; 69.5%), Eighty-one percent of the sample (n=173) was aged 18-27 years. The KCES and JSE-HPS are internally consistent (Cronbach’s α = 8.47 and 8.82 respectively), although only 3 KCES items and no JSE-HPS items demonstrated robust item-total correlation. Adjusted total scores for KCES and JSE-HPS were significantly correlated, suggesting they have high concurrent validity (r = 0.789; p <0.001). In addition, KCES and JSE-HPS scores were significantly correlated for the KCES cognitive (r = 0.775; p <0.001) and affective (r = 0.702; p <0.001) subscales. Total scores for KCES and JSE-HPS did not significantly differ between student physical therapists and students from other health professions.

Conclusions: The KCES demonstrates internal consistency in health professional students, and has high concurrent validity with the JSE-HPS. The KCES subscales significantly correlate with both the total KCES score and the JSE-HPS score. The KCES is a suitable no-cost instrument to measure empathy in health professional students, including doctor of physical therapy students, assisting programs in developing students’ empathy towards patients.

Clinical relevance: The KCES is a valid no-cost option to measure empathy of students in the health sciences including physical therapy during a course or through the curriculum.


IRB #19-27