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Objective: To determine the level of and factors associated with empathy among medical students.
Materials and Methods: This cross-sectional study surveyed all first- to sixth-year medical students at the Faculty
of Medicines, Prince of Songkla University, at the end of the 2020 academic year. The questionnaires consisted of:
1) The personal and demographic information questionnaire, 2) The Toronto Empathy Questionnaire, and 3) Thai
Mental Health Indicator-15. Data were analyzed using descriptive statistics, and factors associated with empathy
level were assessed via chi-square and logistic regression analyses.
Results: There were 1010 participants with response rate of 94%. Most of them were female (59%). More than half
(54.9%) reported a high level of empathy. There was a statistically significant difference in empathy levels between
pre-clinical and clinical medical students; in regards to empathy subgroups (P-value < 0.001). The assessment of
emotional states in others by demonstrating appropriate sensitivity behavior, altruism, and empathic responding
scores among the pre-clinical group were higher than those of the clinical group. Multivariate analysis indicated
that female gender, pre-clinical training level, and minor specialty preference were factors associated with empathy
level. The protective factor that significantly improved the level of empathy was having fair to good mental health.
Conclusion: More than half of the surveyed medical students reported a high level of empathy. The protective factor
that improved the level of empathy was good mental health. However, future qualitative methods, longitudinal
surveillance, or long-term follow-up designs are required to ensure the trustworthiness of these findings.
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