By: Kevin Dong, 2023 PharmD Candidate, Holli Temple, PharmD, and Ashley Castleberry, PharmD, MEd
As a first year pharmacy student and lover of data, I jumped at the opportunity to participate in a research study that analyzed medication lists taken from patients receiving hemodialysis who practiced mindfulness as a technique for fluid restriction.1 I didn’t realize how this experience in data entry would change my perspective on empathy.
As I stared at the hundreds of columns in a spreadsheet, I wondered how these numbers related to patients. Each number represented a specific aspect to a patient’s story, and the sum recounted their holistic experience. Initially, I had a narrow view of their story. I couldn’t understand why certain patients would score themselves a 1 or 2 (out of 10) on adherence to their medication regimen or fluid restriction. I thought: “It shouldn’t be THAT hard to remember to take 1 or 2 medications each day.” But as I analyzed other parts of their data, I realized an “average” patient took around 10 different medications daily, had multiple chronic conditions, and underwent a minimum of three dialysis sessions per week- each three to four hours. As I typed their medication data into each cell, I imagined myself having to follow such complex medication regimens daily. I was overwhelmed. I gained new awareness for the daily commitment required by patients to maintain their current health status.
Simulations for Empathy:
Empathy is defined as the ability to understand and share the feelings of another.2 The pharmacy education literature recommends teaching empathy through simulations.3 During my first year, I participated in a medication adherence simulation, which involved entering seven medications and their regimens into an app. It sent daily reminders to take my medication, but it was still difficult to achieve full adherence due to my busy schedule. Although this experience was helpful, this simulation couldn’t provide a holistic outlook on the severity of what some patients experience.
Around the same time that semester, I started analyzing medication data from study participants, which took my learning to the next level. I learned to empathize beyond the complex medication regimens. I gained insight into the patients’ weekly dialysis schedule, food and fluid restrictions, and other chronic medical conditions. I grasped how kidney disease affects every aspect of their lives–including social interactions, emotional health, and overall quality of life. Having a comprehensive view of their schedule allowed me to empathize more than simply simulating their medication regimen.
Empathy is a skill that can be developed in other ways besides simulations.3, Studies utilizing project-based learning and the addition of mindfulness based empathy training (MBET), a technique to practice focus and awareness,4 have shown increased empathy in healthcare and non healthcare students measured by an empathy scale.4,5 MBET can be applied beyond data analysis to any project-based learning to add empathy as a supplemental learning objective.4,5 Practicing mindfulness and awareness while researching and analyzing patient experiences has shown to enhance empathy development.4
Tips for Students:
For all students, be mindful of how your didactic curriculum affects patients. While writing a SOAP note or a medication reconciliation, practice putting yourself in the patient’s shoes. For students involved in database analysis, ask yourself: “What can I learn from the patients whose data I am analyzing?” Try to understand what the different implications of the data represent for a patient and its impact on their lives beyond a number in a cell – you might even develop more skills than just research methodology.
Tips for Educators:
Educators who want to teach empathy through research or data analysis can explicitly create this learning opportunity by including empathy development as a research objective, creating activities to foster empathy, and checking-in with students periodically as research progresses. Consider having your research students:
· Analyze a dataset for Patient Reported Outcomes.
· Assist with collecting data directly from patients.
· Volunteer and interact with the patient population being studied.
· Reflect regularly about how the data is affecting them.
Empathy is an essential skill to learn as a student pharmacist. By analyzing study data, I learned to translate each of the numbers in the spreadsheet into different facets of a patient and compiling pieces of their puzzle together to form a complete story. It’s like a twist on an old saying: “a spreadsheet is worth a thousand words.”
Thank you to the outstanding faculty members at the University of Texas: Dr. Karen Rascati and Principle Investigator Dr. Gayle Timmerman for the feedback, encouragement, and opportunity.
1. A Brief Mindful Drinking/Eating Intervention for Hemodialysis Patients With Fluid Restrictions – No Study Results Posted. ClinicalTrials.gov. https://clinicaltrials.gov/ct2/show/results/NCT04016311?view=results.
2. Moudatsou M, Stavropoulou A, Philalithis A, Koukouli S. The Role of Empathy in Health and Social Care Professionals. Healthcare. 2020;8(1):26. doi:10.3390/healthcare8010026
4. Can Gür G, Yilmaz E. The effects of mindfulness-based empathy training on empathy and aged discrimination in nursing students: A randomised controlled trial. Complement Ther Clin Pract. 2020;39:101140. doi:10.1016/j.ctcp.2020.101140
5. Kim KJ. Project-based learning approach to increase medical student empathy. Med Educ Online. 2020;25(1):1742965. doi:10.1080/10872981.2020.1742965
Kevin Dong is a 2nd year pharmacy student at the University of Texas at Austin College of Pharmacy. Educational scholarship interests include research, industry, and independent pharmacy. In his free time, Kevin enjoys running and being outside.
Holli Temple, PharmD, is a Clinical Associate Professor in the Division of Pharmacy Practice at the University of Texas at Austin College of Pharmacy. Educational scholarship interests include assessment of innovative teaching and learning activities. In her free time, Holli enjoys spending time with family, running with friends, and snow-skiing in Utah.
Ashley Castleberry, PharmD, MAEd is a Clinical Associate Professor and Division Head in the Division of Pharmacy Practice at The University of Texas at Austin College of Pharmacy. Educational scholarship interests include metacognition, assessment, and qualitative research. In her free time, Ashley enjoys cooking and spending time with her family.
Pulses is a scholarly blog supported by Currents in Pharmacy Teaching and Learning