Shades of acceptance and adjustment; a discursive psychological analysis to showcase empathy in medical students

Background: Empathy is a crucial prosocial behaviour. Medical education greatly emphasizes fostering empathy as a positive aspect of personal and professional development. Moreover, empathic practitioners produce improved patient care and clinical outcomes. However, medical schools often struggle to nurture empathetic behaviours among students despite a proclaimed empathy cultivating curricula. Research reveals complex patterns in empathy development among medical students, with disparities in adoptions across academic years. In this study, we explored how empathy is perceived during undergraduate medical training.

Methods: This qualitative study was conducted with medical students using focused group discussions and structured interview questions. These were developed according to the perceived behavioural construct of the theory of planned behaviour. Data was analysed using critical discursive psychology to identify students' use of language and shifting understandings about empathy.

Results: Our analysis showed that empathy is not a static trait but a complex and evolving process comprising two primary repertoires: Acceptance, where students passively adopt existing norms, and Adjustment, where they actively recalibrate their emotional responses to maintain genuine empathy. We identified that students take on five-character roles (confident beginner, passive observer, reflective learner, problem solver, and autonomous learner) while justifying their intentional choices.

Conclusion: These findings highlight insights concerning students' perceptions of empathy enactment, ranging from acceptance to adjustment. These constructs indicate students' ability to engage in clinical practices, perceive their roles as future doctors, and express their emotions. Medical educators should guide students in moving from passive acceptance to active adjustment by encouraging emotional awareness and by promoting diverse interpretations that support the development of empathetic professionals.