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2025 ; 25
(1
): 1483
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A systematic review identifying effective teaching methods and their combinations
for increasing empathy in physicians: pairwise and network meta-analysis
#MMPMID41131541
Ngo H
; Sokolovic N
; Hu J
; Jenkins J
BMC Med Educ
2025[Oct]; 25
(1
): 1483
PMID41131541
show ga
BACKGROUND: Demonstrating empathy is fundamental for providing patient-centered
care, however, what components are most effective is not known. Thus, the aim of
this study was to identify key teaching methods and intervention characteristics
for increasing empathy skills across medical training. METHOD: This study was
part of a larger systematic review, which was pre-registered: CRD42018100100. We
performed a systematic review, pairwise meta-analysis (PMA) and network
meta-analysis (NMA). A systematic search was used across PsycINFO, Medline,
CINAHL, Social Work Abstracts, ERIC, ABI/INFORM, and the Cochrane Central
Register of Controlled Trials from the inception of the respective databases to
October 9, 2022. Studies included randomized controlled trials (RCTs) examining
behavioural interventions which targeted empathy skills for physicians and
medical students. Studies were excluded if reported summary data could not be
converted to an effect size; if the author were unable to be contacted; and if
the study did not compare substantively different intervention combinations. Risk
of bias was assessed using the Cochrane risk-of-bias tool. Data were pooled using
random-effects PMA and NMA. RESULTS: 308 full-text studies were found, of which
111 met the inclusion criteria, totalling 11,111 participants. Overall, a medium
effect of interventions was found [d?=?0.50 (95% CI?=?0.40, 0.60)], meaning the
empathy skills of participants improved moderately compared to those in control
groups. Publication bias was evident and heterogeneity was high (I(2)?=?79.19,
p?.001). Subgroup analyses of the PMA revealed the following moderators were
statistically significant: teaching method, intervention formats, control group;
measurement type, and number of teaching methods used. The consistency assumption
was met [?(2) [?(33)=?39.11, p?=?.21] for the NMA. The NMA revealed that didactic
and rehearsal were most frequently included among the most effective teaching
method combinations. CONCLUSIONS: By using PMA and NMA, we provide novel insights
on effective intervention components for improving empathy in medicine. To
improve aggregation of evidence, transparent and standardized reporting from
studies may help reduce heterogeneity. Overall, our results support the notion
that interventions need not be expensive nor prolonged to be effective.
SUPPLEMENTARY INFORMATION: The online version contains supplementary material
available at 10.1186/s12909-025-07917-x.