Reliability of the Kiersma-Chen Empathy Scale in Health Professions Students


Physical Therapy


Purpose: Empathy is the ability to understand and identify with another person’s feelings, and is important to develop in students. It is theorized to involve cognitive and affective domains. The Kiersma-Chen Empathy Scale (KCES) was developed to measure these at no cost. Initial reliability was determined from a cohort of pharmacy and nursing students. The purpose of this study was to assess the reliability of the KCES in a diverse cohort of health professions students including physical therapy (PT) and pre-PT students.

Methods/Description: IRB approval was obtained. Students in Physical Therapy (DPT), Pre-PT, Pharmacy (PharmD), Speech-Language Pathology (Bachelors, Masters SLP), Audiology (AuD), Physician Assistant (PA), and Dentistry (DDS) programs received an electronic version of the KCES (test 1) and a demographics form at the start of Fall term. Researchers made an in-class announcement, and an email reminder was sent several days later. A second survey (test 2) was sent at the second week, followed by an email reminder. The lead researcher matched and de-identified the surveys. A blinded researcher performed data analysis. Descriptive statistics were calculated. Cronbach’s a was used to assess scale homogeneity at each test administration for total, cognitive, and affective scores. Pearson correlation was used to assess the association between subscales and total score. Two-way intraclass correlation coefficients with random effects were used to determine reliability for total, cognitive, and affective scores between tests. Minimum detectable change outside the 95% confidence interval (MDC95) was calculated for total and subscale scores as an estimate of responsiveness.

Results/Outcomes: Two hundred three students completed the KCES (n=154 female; 79.6%), and most commonly ranged in age from 23-27 years (n=98; 48.3%). The total score demonstrated good internal consistency reliability (Test 1 = .809; Test 2 = .870). Cognitive and affective scores demonstrated fair internal consistency reliability at Test 1 (cognitive = .701; affective = .672) and Test 2 (cognitive = .764, affective = .787). Deleting two items mildly increased internal consistency reliability for total and subscale scores. For Test 1 and Test 2, the subscale scores demonstrated significant and strong correlations with the total score, but significant and fair correlations with each other. The total score (.704) and subscale scores (cognitive = .687; affective = .623) demonstrated moderate test-retest reliability. MDC95 were 12.8, 8.4, and 6.5 points for the total, cognitive, and affective scores, respectively.

Conclusions/Relevance to the conference theme: The KCES and its cognitive and affective subscales demonstrate sufficient test-retest and internal consistency reliability in health professions students. The subscales demonstrate convergent and divergent validity. Data regarding responsiveness may be used to assess the relevance of potential changes in total and subscale scores in response to educational methods. The KCES is an appropriate instrument to measure empathy in health professional students.

Document Type


Publication Date

Fall 10-16-2020

Publication Title

Educational Leadership Conference (ELC) of the American Academy of Physical Therapy Education

Conference Dates

10/16/2020 - 10/18/2020

Conference Location


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