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PLoS One. 2013 Jun 5;8(6):e65159. doi: 10.1371/journal.pone.0065159. Print 2013.

Empathy as a function of clinical exposure--reading emotion in the eyes.

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  • 1School of Psychiatry, University of NSW, Sydney, New South Wales, Australia.



Evidence based largely on self-report data suggests that factors associated with medical education erode the critical human quality of empathy. These reports have caused serious concern among medical educators and clinicians and have led to changes in medical curricula around the world. This study aims to provide a more objective index of possible changes in empathy across the spectrum of clinical exposure, by using a behavioural test of empathic accuracy in addition to self-report questionnaires. Moreover, non-medical groups were used to control for maturation effects.


Three medical groups (N = 3×20) representing a spectrum of clinical exposure, and two non-medical groups (N = 2×20) matched for age, sex and educational achievements completed self-report measures of empathy, and tests of empathic accuracy and interoceptive sensitivity.


Between-group differences in reported empathy related to maturation rather than clinical training/exposure. Conversely, analyses of the "eyes" test results specifically identified clinical practice, but not medical education, as the key influence on performance. The data from the interoception task did not support a link between visceral feedback and empathic processes.


Clinical practice, but not medical education, impacts on empathy development and seems instrumental in maintaining empathetic skills against the general trend of declining empathic accuracy with age.

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