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J Pain Symptom Manage. 2020 Feb 28. pii: S0885-3924(20)30094-4. doi: 10.1016/j.jpainsymman.2020.02.008. [Epub ahead of print]

The Empathy Project: A Skills Development Game: Innovations in Empathy Development.

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Department of Hospice & Palliative Care, Gundersen Health System, La Crosse, WI, USA. Electronic address:
Department of Surgery, Stanford University, Stanford, CA, USA.



Empathy is increasingly described as a learnable skill and is included in professionalism requirements for healthcare providers, yet there are few effective tools for developing and practicing empathy skills.


An educational innovation intended to isolate and develop skills to respond to patients' emotions. The game-based tool was developed "on-the-job" during the authors' Hospice and Palliative Medicine fellowship year and was played with learners in various disciplines.


Feedback from learners was overwhelmingly positive, though a key factor in optimization of learning was the presence of a communication expert as facilitator. Learner responses were measured using a novel assessment tool, and findings suggest statistically significant expansion of language and intent to express empathy. Learners demonstrated immediate growth in naming emotions, reflecting understanding and respect of emotional expression, and supporting and exploring emotional content.


This innovative game-based learning tool is low cost and feasible to deploy. It could be easily incorporated into medical education curricula aimed at developing communication skills, especially the skill of responding to emotion with empathy. Future research is needed to assess the effects the innovation has on behavior, as well as its impact on patient-centered outcomes.

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