Feeling it or faking it? An exploration of discrepant self-and observer-ratings of emapthy among medical students

Objective Studies show discrepancies between self- and observer-ratings of empathy among medical students. Presently, there has been limited data and discussion exploring this finding. This study explored the discrepancies between self- and observer-ratings of empathy by comparing individual differences among medical students. Specifically, whether medical students who demonstrated discrepancies in self- and observer-ratings of empathy differ from those who did not demonstrate discrepancies, with regards to personality, attachment, and clinical competence. Method Sixty medical students participated in the study. Empathy was rated by an independent observer during simulated patient encounters. In addition, empathy was self-rated using the Jefferson Scale of Physician Empathy (student version). Personality was measured using the Big Five Inventory and attachment was assessed using the Experiences in Close Relationships Questionnaire. Clinical competence was evaluated by medical examiners during an Objective Structured Clinical Examination. Results: The majority of students performed in accordance with their self-ratings of empathy. Of those students who had discrepant scores, the majority had inflated selfratings as opposed to higher observer-ratings. A one-way ANOVA revealed significant differences between the groups on extraversion, openness, and total competence scores. Conclusions It appears that students differ with regards to extraversion, openness, and total competence. We propose that a deficit in metacognitive abilities, in addition to lower clinical competence, affects medical student's abilities to provide accurate self-assessments. Furthermore, in the minority of cases, it appears that medical students learn that it pays to adopt the view that "if you cannot feel it, fake it".