Abstract
BACKGROUND: Empathy is the cornerstone of high-quality medical education and clinical practice. It not only serves as a vital link for establishing trust-based doctor-patient relationships but also significantly impacts patients' treatment compliance and recovery outcomes. In medical education, an empathetic approach can cultivate future medical professionals' humanistic care awareness, enabling them to better understand patients' physical and mental sufferings.However, the understanding and cultivation of empathy vary remarkably across different cultural backgrounds.Thus, there is an urgent need to conduct in-depth research to clarify these issues and promote the better development of empathy-based medical education. METHODS: A total of 24 participants, including medical students, practicing doctors, and medical teachers, were recruited for this study. Semi-structured interviews were employed as the data-collection method. Each interview lasted approximately 30-60 min, and all interviews were audio-recorded and then transcribed verbatim.For data analysis, a three-level coding approach was adopted. The analysis was independently conducted by two members of the research team to ensure reliability and consistency. RESULTS: This study delves into empathy ability within medical education. The theme analysis yields significant results: the definition of empathy involves basic understanding with distinct emotional and cognitive emphases, multi-dimensional attributes showcasing empathy's roles in clinical scenarios, and the need for regulation due to its contradictoriness. Expression of empathy hinges on establishing doctor-patient trust and communication, with diverse expression ways and impacts on treatment and relationships. Influencing factors encompass educational background, clinical environment, and individual differences. Strategies for cultivation include teacher guidance, varied methods, and curriculum integration in the first classroom, and activity practice and values guidance in the second. These findings offer valuable insights and practical implications for enhancing empathy in medical education. CONCLUSIONS: This study's core findings from cross-group analysis of medical students, doctors, and teachers show empathy in medical education is complex and multi-dimensional, involving emotional and cognitive empathy. Empathy abilities change dynamically during medical education, with students initially having high emotional empathy and later developing stronger cognitive empathy. Cultural differences in empathy, like between Western and traditional Chinese medicine, offer new perspectives. Practical implications include: designing curricula to cover both empathy types and adding cross-cultural content; using diverse teaching methods and optimizing clinical internships; organizing teacher training and improving teaching skills; establishing a comprehensive evaluation system with timely feedback. These insights and suggestions guide enhancing empathy in medical education.