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μ˜κ³ΌλŒ€ν•™μƒλ“€μ˜ 곡감 ν‘œν˜„ λŠ₯λ ₯은 μ–΄λ– ν•œκ°€?

Abstract

Purpose:

Empathy is an important trait of a physician and a key element in the physician-patient relationship. This study evaluated the ability to express empathy in medical students.

Methods:

Medical student empathy was measured by the modified Pencil-and-Paper Empathy Rating Test of Winefield and Chur-Hansen. The subjects comprised 110 medical students. The data were analyzed by descriptive analysis and t-test using SPSS version 21.0 (IBM Corp.).

Results:

Empathy rating test scores were low-level in medical students (mean, 12.59). There were no differences in the level of ability to express empathy between genders (t=-1.714, p=0.089).

Conclusion:

Our results suggest that practical training in expressing empathy should be included in medical education and that an empathy training program must be focused on changes in behavior.

μ„œλ‘ 

곡감은 μ˜μ‚¬-ν™˜μž κ΄€κ³„μ—μ„œ 맀우 μ€‘μš”ν•œ μš”μ†Œλ‘œ 의료인의 핡심 μ—­λŸ‰μ΄λ‹€. 20μ„ΈκΈ° μ€‘λ°˜λΆ€ν„° μ˜λ―ΈκΆŒμ—μ„œλŠ” μ˜μ‚¬μ˜ 역할을 μƒˆλ‘­κ²Œ 규λͺ…ν•˜λ©° 쒋은 μ˜μ‚¬μ˜ μ—­λŸ‰ κ°€μš΄λ° ν™˜μžμ™€ 쒋은 관계λ₯Ό μœ μ§€ν•˜κ³  신뒰받을 수 μžˆλŠ” μ˜μ‚¬μ†Œν†΅μ˜ μ€‘μš”μ„±μ„ κ°•μ‘°ν•˜μ˜€κ³ [1], κ΅­λ‚΄μ—μ„œλ„ μž„μƒμ  λŠ₯λ ₯κ³Ό ν•¨κ»˜ ν™˜μžμ˜ μž…μž₯에 κ³΅κ°ν•˜κ³  κ²½μ²­ν•˜λ©° κΆŒμœ„μ μ΄μ§€ μ•Šμ€ λͺ¨μŠ΅μœΌλ‘œ 친절히 μ„€λͺ…ν•΄ μ£ΌλŠ” 것을 쒋은 μ˜μ‚¬μ˜ 자질둜 νŒŒμ•…ν•œ λ°” μžˆλ‹€[2]. μ‹€μ œλ‘œ λ§Žμ€ κ²½ν—˜μ  연ꡬλ₯Ό 톡해 곡감은 ν™˜μžλ“€μ˜ μ§„λ£Œ λ§Œμ‘±λ„, μΉ˜λ£Œμ΄ν–‰ μˆ˜μ€€, μž„μƒμ  성과에 긍정적인 영ν–₯을 λ―ΈμΉœλ‹€κ³  보고된 λ°” μžˆλ‹€[3,4,5].
μ΄λŸ¬ν•œ 연ꡬ듀은 ν•™μƒλ“€μ˜ 곡감 λŠ₯λ ₯ 증진이 μ˜ν•™κ΅μœ‘μ˜ μ€‘μš”ν•œ μ‘Έμ—… 성과이며, 이λ₯Ό μœ„ν•œ ꡐ윑 ν”„λ‘œκ·Έλž¨μ˜ 개발과 운영이 μ˜κ³ΌλŒ€ν•™μ˜ μ€‘μš”ν•œ μ—­ν•  κ°€μš΄λ° ν•˜λ‚˜μž„μ„ μ‹œμ‚¬ν•΄ μ€€λ‹€. ν•˜μ§€λ§Œ κ·Έ μ€‘μš”μ„±μ— λΉ„ν•΄ ν•™μƒλ“€μ˜ 곡감 λŠ₯λ ₯을 ν™•μΈν•˜κ³  μžˆλŠ” μ—°κ΅¬λŠ” μ–‘μ μœΌλ‘œ 맀우 λΆ€μ‘±ν•˜λ‹€. λ˜ν•œ μ„ ν–‰ 연ꡬ λŒ€λΆ€λΆ„ ν•œκ΅­νŒ 제퍼슨 곡감 척도(Jefferson Scale of Empathy, S-version, Korean edition; JSE-S-K)λ₯Ό μ‚¬μš©ν•˜κ³  μžˆμ–΄ μ—°κ΅¬μ˜ λ‚΄μš© μ—­μ‹œ μ œν•œμ μ΄λ‹€. 일반적으둜 곡감 λŠ₯λ ₯은 β€˜κ³΅κ°μ„ μž˜ν•  수 μžˆλŠ”κ°€β€™λ₯Ό μΈ‘μ •ν•˜λŠ” 도ꡬ와 β€˜ν‘œν˜„λœ 곡감 λ°˜μ‘β€™μ„ μΈ‘μ •ν•˜λŠ” 도ꡬλ₯Ό ν™œμš©ν•˜μ—¬ ν™•μΈν•˜κ²Œ λ˜λŠ”λ°[6], JSE-S-K μ²™λ„λŠ” β€˜λ‚˜λŠ” ν™˜μžμ—κ²Œ κ³΅κ°ν•˜λŠ” 것이 μ˜ν•™μ  μΉ˜λ£Œμ—μ„œ μ€‘μš”ν•œ μΉ˜λ£Œμš”μ†ŒλΌκ³  λ―ΏλŠ”λ‹€β€™μ™€ 같은 λ¬Έν•­μœΌλ‘œ 주둜 곡감에 λŒ€ν•œ 인식과 νƒœλ„λ₯Ό μΈ‘μ •ν•˜μ—¬ 곡감을 잘 ν•  수 μžˆλŠ”μ§€λ₯Ό 확인할 뿐, μ‹€μ œ 학생듀이 곡감 ν‘œν˜„μ„ μ œλŒ€λ‘œ ν•˜κ³  μžˆλŠ”μ§€μ— λŒ€ν•œ μ •λ³΄λŠ” 얻을 수 μ—†κΈ° λ•Œλ¬Έμ΄λ‹€.
이에 이 μ—°κ΅¬λŠ” 아직 ꡭ내에 μ†Œκ°œλœ λ°” μ—†λŠ” μΈ‘μ • 도ꡬλ₯Ό μ‚¬μš©ν•˜μ—¬ μ˜κ³ΌλŒ€ν•™μƒλ“€μ΄ μ–Έμ–΄μ μœΌλ‘œ κΈ°μˆ ν•œ λ‚΄μš©μ„ 톡해 μ‹€μ œ 곡감 ν‘œν˜„ λŠ₯λ ₯을 평가해 보고자 ν•˜μ˜€λ‹€. ꡬ체적인 연ꡬ λ¬Έμ œλŠ” λ‹€μŒκ³Ό κ°™λ‹€. 첫째, μ˜κ³ΌλŒ€ν•™μƒλ“€μ˜ 곡감 ν‘œν˜„ λŠ₯λ ₯은 μ–΄λ– ν•œκ°€? λ‘˜μ§Έ, 성별에 따라 곡감 ν‘œν˜„ λŠ₯λ ₯에 차이가 μžˆλŠ”κ°€?

λŒ€μƒ 및 방법

1. λŒ€μƒ

μ„œμšΈ μ†Œμž¬ Cμ˜κ³ΌλŒ€ν•™ μ˜ν•™κ³Ό 4ν•™λ…„ 학생 116λͺ…을 λŒ€μƒμœΌλ‘œ 곡감 ν‘œν˜„ λŠ₯λ ₯을 μΈ‘μ •ν•˜μ˜€λ‹€. μ‹€μ œ μ—°κ΅¬μ—μ„œλŠ” 결츑값이 있던 일뢀 ν•™μƒλ“€μ˜ 데이터λ₯Ό μ œμ™Έν•œ 110λͺ…μ˜ 검사 κ²°κ³Όκ°€ ν™œμš©λ˜μ—ˆλ‹€. 이 쀑 남학생은 66λͺ…, 여학생은 44λͺ…μ΄μ—ˆλ‹€.

2. 도ꡬ

Winefield & Chur-Hansen [7]κ°€ μ‚¬μš©ν•œ Pencil-and- Paper Empathy Rating Testλ₯Ό μ‚¬μš©ν•˜μ˜€λ‹€(Appendix 1). 이 κ²€μ‚¬μ§€λŠ” 10κ°€μ§€μ˜ κ°„λ‹¨ν•œ λŒ€ν™” 상황을 μ œμ‹œν•˜κ³  μΉœκ΅¬κ°€ μžμ‹ μ—κ²Œ λ‹€μŒκ³Ό 같은 λ‚΄μš©μ„ λ§ν•œλ‹€λ©΄ μ–΄λ–»κ²Œ λŒ€μ‘ν•  것인지λ₯Ό μ•½ 15λΆ„ λ™μ•ˆ μ‹€μ œλ‘œ λŒ€ν™”ν•˜λ“― κ΅¬μ–΄μ²΄λ‘œ κΈ°λ‘ν•˜λ„λ‘ λ˜μ–΄ μžˆλ‹€. 연ꡬ에 μ‚¬μš©ν•œ ν•œκ΅­μ–΄ 버전 κ²€μ‚¬μ§€λŠ” μ—°κ΅¬μž 1인이 μ˜μ–΄ 원문 검사지λ₯Ό λ²ˆμ—­ν•œ ν›„ μ™ΈλΆ€ μ „λ¬Έκ°€ 검증을 거쳐 μ΅œμ’…μ μœΌλ‘œ μ™„μ„±ν•˜μ˜€λ‹€. 응닡 λ‚΄μš©μ€ ν›ˆλ ¨ 받은 ν‰κ°€μžκ°€ μ½”λ”© κ·œμΉ™μ— 따라 0~4점 척도λ₯Ό μ‚¬μš©ν•˜μ—¬ μ±„μ ν•œ ν›„ 총 40점 만점으둜 곡감 λŠ₯λ ₯을 ν‰κ°€ν•˜μ˜€λ‹€(Appendix 2). 이 κ²€μ‚¬μ§€μ˜ 내적 일관성 신뒰도와 ν‰μ •μž κ°„ μ‹ λ’°λ„λŠ” 각각 0.83 (pre-test), 0.91 (post-test)κ³Ό 0.96으둜 λ³΄κ³ λœλ‹€[7].

3. 뢄석 방법

μˆ˜μ§‘λœ λ°μ΄ν„°λŠ” 연ꡬ λ¬Έμ œμ— 따라 IBM SPSS Statistics version 21.0 ν”„λ‘œκ·Έλž¨(IBM Corp., Chicago, USA)을 μ΄μš©ν•˜μ—¬ λΉˆλ„λΆ„μ„, κΈ°μˆ ν†΅κ³„, t-testλ₯Ό μ‹€μ‹œν•˜μ—¬ ν™•μΈν•˜μ˜€μœΌλ©° λͺ¨λ“  μœ μ˜μˆ˜μ€€μ€ 0.05μ—μ„œ κ²€μ¦ν•˜μ˜€λ‹€.

κ²°κ³Ό

κ°œλ³„ λŒ€ν™” 상황에 μ˜κ³ΌλŒ€ν•™μƒλ“€μ΄ μ‘λ‹΅ν•œ λ‚΄μš©μ„ ν‰κ°€ν•œ κ²°κ³Ό 1점 μˆ˜μ€€(non-empathetic)의 곡감 ν‘œν˜„μ΄ κ°€μž₯ λ§Žμ•˜μœΌλ©°, 4점 μˆ˜μ€€(facilitative)의 곡감 ν‘œν˜„μ„ ν•œ 학생은 μ—†μ—ˆλ‹€(Table 1). μ˜κ³ΌλŒ€ν•™μƒλ“€μ˜ 곡감 ν‘œν˜„ μ μˆ˜λŠ” μ΅œμ†Œ 8점, μ΅œλŒ€ 23점, 평균 12.59μ μ΄μ—ˆμœΌλ©°, 남학생보닀 μ—¬ν•™μƒμ˜ 평균 μ μˆ˜κ°€ λ†’μ•˜μ§€λ§Œ(남, 12.24 vs. μ—¬, 13.11), κ·Έ 차이가 ν†΅κ³„μ μœΌλ‘œ μœ μ˜ν•˜μ§€λŠ” μ•Šμ•˜λ‹€(Table 2).

κ³ μ°°

곡감은 μ˜μ‚¬-ν™˜μžμ˜ 치료적 관계 ν˜•μ„±μ— 결정적인 역할을 ν•œλ‹€[8]. λ”°λΌμ„œ μ˜μ‚¬κ°€ 되기 μœ„ν•œ μ€€λΉ„ 과정에 μžˆλŠ” μ˜κ³ΌλŒ€ν•™μƒλ“€μ—κ²Œ 곡감은 맀우 μ€‘μš”ν•œ μ—­λŸ‰μ΄λ‹€. 이에 이 μ—°κ΅¬λŠ” μ˜κ³ΌλŒ€ν•™μƒλ“€μ΄ μ‹€μ œλ‘œ μ‚¬μš©ν•˜λŠ” 언어적 λ°˜μ‘μ„ 톡해 곡감 ν‘œν˜„λŠ₯λ ₯을 μΈ‘μ •ν•΄ λ³΄μ•˜λ‹€.
연ꡬ κ²°κ³Ό, μ˜κ³ΌλŒ€ν•™μƒλ“€μ˜ 곡감 ν‘œν˜„ λŠ₯λ ₯은 평균 12.59μ μ΄μ—ˆμœΌλ©° 70% μ΄μƒμ˜ 학생듀이 10μ μ—μ„œ 13점 사이에 λΆ„ν¬ν•˜κ³  μžˆμ—ˆλ‹€. 성별에 λ”°λΌμ„œλŠ” 남학생 보닀 μ—¬ν•™μƒμ˜ μ μˆ˜κ°€ λ‹€μ†Œ λ†’μ•˜μ§€λ§Œ κ·Έ 차이가 ν†΅κ³„μ μœΌλ‘œ μœ μ˜ν•˜μ§€λŠ” μ•Šμ•˜λ‹€. 즉, λŒ€λΆ€λΆ„μ˜ μ˜κ³ΌλŒ€ν•™μƒλ“€μ΄ 주어진 μ—΄ 가지 λŒ€ν™” 상황에 λŒ€μ²΄λ‘œ 1점 μˆ˜μ€€μ— ν•΄λ‹Ήν•˜λŠ” 곡감 ν‘œν˜„μ„ μ‚¬μš©ν•˜μ—¬ μ‘λ‹΅ν•œ 것이닀.
ν•œ 예둜 β€œλΆ€λͺ¨λ‹˜μ€ λ‚˜λ₯Ό νž˜λ“€κ²Œ ν•œλ‹€. μ „ν˜€ ν₯미도 μ—†λŠ” λ¬Όλ¦¬λ‚˜ 화학을 κ³΅λΆ€ν•˜λΌκ³  κ°•μš”ν•˜μ‹ λ‹€.β€λΌλŠ” λŒ€ν™” μƒν™©μ—μ„œ 전체 학생 쀑 83.6%κ°€ μƒλŒ€λ°©μ˜ 감정을 μ „ν˜€ κ³ λ €ν•˜μ§€ μ•Šκ³ , 폐쇄적 μ§ˆλ¬Έμ„ μ‚¬μš©ν•˜μ—¬ λ‚΄μš©μ„ ν™•μΈν•˜κ±°λ‚˜ μžμ‹ μ˜ νŒλ‹¨μ— κ·Όκ±°ν•˜μ—¬ 일방적으둜 쑰언을 ν•˜λŠ” 데 그치고 μžˆμ—ˆλ‹€. ꡬ체적인 응닡 λ‚΄μš©μ€ λ‹€μŒκ³Ό κ°™λ‹€. β€œλΆ€λͺ¨λ‹˜κ³Ό λŒ€ν™”λ₯Ό ν•΄ 봐.”, β€œλΆ€λͺ¨λ‹˜μ΄ λ„ˆλ₯Ό νž˜λ“€κ²Œ ν•˜λ €κ³  ν•˜λŠ” 게 μ•„λ‹ˆλΌ λ„ˆμ˜ 미래λ₯Ό μœ„ν•΄μ„œ κ·ΈλŸ¬μ‹œλŠ” κ±°μ•Ό.”, β€œν₯λ―Έ μ—†λŠ” 일이라도 λ‚˜μ€‘μ—λŠ” 쒋은 κ²½ν—˜μ΄ 될 수 μžˆμ§€ μ•Šμ„κΉŒ?”, β€œν•˜κ³  싢은 일만 ν•˜λ©΄μ„œ μ‚¬λŠ” μ‚¬λžŒμ€ μ—†μ–΄.” 반면 같은 λŒ€ν™”μƒν™©μ— β€œκ·Έ κ³Όλͺ©λ“€μ€ μ§„μ§œ μ§œμ¦λ‚˜λ„λ‘ 지겹지. λ‚˜λ„ 정말 싫을 λ•Œκ°€ μžˆμ–΄. κ·Έλž˜λ„ λ„ˆλ₯Ό λ―Έμ›Œν•΄μ„œ κ·ΈλŸ¬μ‹œλŠ” 건 μ•„λ‹ˆκ³  λ‚˜λ¦„μ˜ 생각과 λ°°λ € λ•Œλ¬Έμ— ν•˜μ‹œλŠ” 말씀이싀 κ±°μ•Ό. λΆ€λͺ¨λ‹˜κ³Ό λŒ€ν™”λ₯Ό ν•΄ λ³΄λŠ” 건 μ–΄λ–¨κΉŒ?”, β€œλΆ€λͺ¨λ‹˜μ΄ ν•˜κΈ° 싫은 일을 ν•˜λΌκ³  ν•˜μ‹œλ‹ˆ 정말 νž˜λ“€κ² λ‹€. μ†μƒν•˜κ² λ„€. 이런 μ–˜κΈ°λ₯Ό λΆ€λͺ¨λ‹˜κ³Ό ν•΄ λ³΄μ•˜λ‹ˆ?” λ“± μƒλŒ€λ°©μ΄ μ²˜ν•œ 상황과 느끼고 μžˆλŠ” 감정에 ꡬ체적으둜 κ³΅κ°ν•˜λ©° κ°œλ°©ν˜• μ§ˆλ¬Έμ„ 톡해 문제 해결을 도와주렀 ν•œ 학생은 전체 인원 쀑 13.6% 밖에 λ˜μ§€ μ•Šμ•˜μœΌλ©°, β€œλ„€κ°€ 정말 ν•˜κ³  싢은 것은 무엇인데? 그런데 그것을 μ™œ κ³΅λΆ€ν•˜λΌκ³  ν•˜μ‹œλ‹ˆ? λ„€κ°€ ν•˜κ³  싢은 것에 λŒ€ν•΄ λ°˜λŒ€λ₯Ό ν•˜μ‹œλŠ” κ±°λ‹ˆ? μ†μƒν•˜κ² λ‹€. 이런 이야기λ₯Ό λΆ€λͺ¨λ‹˜κ³Ό ν•΄ λ³΄μ•˜μ–΄?”와 같이 λ‚΄μš©κ³Ό 감정 λͺ¨λ‘μ— κ³΅κ°ν•˜κ³  μžˆλŠ” 학생은 2.7%에 κ·Έμ³€λ‹€. 더 λ‚˜μ•„κ°€ μƒλŒ€λ°©μ„ κ²©λ €ν•˜κ³  μ§€μ§€ν•˜λ©° 자기 ν†΅μ°°μ˜ λ‹¨κ³„κΉŒμ§€ μœ λ„ν•œ 학생은 ν•œ λͺ…도 μ—†μ—ˆλ‹€.
곡감의 μ€‘μš”μ„±μ„ μΈμ‹ν•˜κ³  μžˆλ‹€ ν•˜λ”λΌλ„ μ‹€μ œλ‘œ 그것을 언어와 ν–‰λ™μœΌλ‘œ ν‘œν˜„ν•˜μ§€ λͺ»ν•˜λ©΄ 곡감에 λŒ€ν•œ μΆ©λΆ„ν•œ μ—­λŸ‰μ„ κ°–μΆ”κ³  μžˆλ‹€κ³  ν•  μˆ˜λŠ” 없을 것이닀. μ—­λŸ‰μ€ νƒœλ„μ™€ μΈμ‹λΏλ§Œ μ•„λ‹ˆλΌ 그것을 μ‹€μ œλ‘œ μ‹€μ²œν•  수 μžˆλŠ” νž˜μ„ 포함해야 ν•˜κΈ° λ•Œλ¬Έμ΄λ‹€. λ”°λΌμ„œ μ˜ν•™κ΅μœ‘μ€ 일련의 연ꡬ κ²°κ³Όλ₯Ό μ°Έκ³ ν•˜μ—¬ ν˜„μž¬ μ§„ν–‰λ˜κ³  μžˆλŠ” ꡐ윑 λ‚΄μš©μ„ μ κ²€ν•˜κ³  ν•™μƒλ“€μ˜ 곡감 ν‘œν˜„ λŠ₯λ ₯ ν–₯상에 도움을 쀄 수 μžˆλŠ” μ‹€μ œμ μΈ ν”„λ‘œκ·Έλž¨μ„ μ œκ³΅ν•  수 μžˆλ„λ‘ λ…Έλ ₯ν•΄μ•Ό ν•  ν•„μš”κ°€ μžˆλ‹€. 특히 곡감 λŠ₯λ ₯은 μƒκ°μ΄λ‚˜ νƒœλ„μ˜ λ³€ν™”κ°€ μ•„λ‹Œ ν–‰λ™μ˜ 변화에 μ΄ˆμ μ„ 두고 κ²½ν—˜μ  접근을 톡해 학생 슀슀둜 μƒκ°ν•˜κ³  λ°˜μ‘ν•  수 μžˆλ„λ‘ ν•΄ μ£Όμ–΄μ•Ό ν•  것이닀[9]. 연ꡬ λŒ€μƒμ€ λ‹€λ₯΄μ§€λ§Œ Bandura의 자기효λŠ₯감과 곡감적 λŠ₯λ ₯ 증진 원리에 κΈ°μ΄ˆν•œ λ©˜ν† λ§ ν”„λ‘œκ·Έλž¨[10]κ³Ό 집단 상담 ν”„λ‘œκ·Έλž¨[11]μ—μ„œ ν†΅μ œ 집단에 λΉ„ν•΄ ν”„λ‘œκ·Έλž¨ μ°Έμ—¬ 학생 μ§‘λ‹¨μ˜ μ •μ„œμ  곡감 λŠ₯λ ₯이 μœ μ˜ν•˜κ²Œ ν–₯μƒλ˜κ³  μžˆλŠ” 의미 μžˆλŠ” κ²°κ³Όλ₯Ό λ³΄κ³ ν•œ 연ꡬ가 μžˆλ‹€. 졜근 μ˜ν•™κ΅μœ‘μ—μ„œ 상담, λ©˜ν† λ§, 컀리어 μ½”μΉ­μ˜ ν•„μš”μ„±μ— λŒ€ν•œ 인식이 높아지며 κ΄€λ ¨ ν”„λ‘œκ·Έλž¨μ„ μ€€λΉ„ν•˜λŠ” λŒ€ν•™μ΄ λŠ˜μ–΄λ‚˜κ³  μžˆλŠ” 좔세이닀. λ”°λΌμ„œ μ΄λŸ¬ν•œ ν”„λ‘œκ·Έλž¨μ„ κ°œλ°œν•  λ•Œμ— 곡감 증진 ν”„λ‘œκ·Έλž¨κ³Ό μ ‘λͺ©μ„ μ‹œλ„ν•΄ λ³Ό 것을 μ œμ•ˆν•œλ‹€. 특히 μ΄λŸ¬ν•œ ν”„λ‘œκ·Έλž¨μ„ ν•™λ…„λ³„λ‘œ κ΅¬μ„±ν•˜μ—¬ ν•™μƒλ“€μ—κ²Œ μ§€μ†μ μœΌλ‘œ 의미 μžˆλŠ” κ²½ν—˜μ„ μ œκ³΅ν•΄ μ€€λ‹€λ©΄ 곡감 ν‘œν˜„λŠ₯λ ₯ ν–₯상을 κ°€μ Έμ˜¬ 수 μžˆμ„ 것이라 κΈ°λŒ€ν•œλ‹€.
이 μ—°κ΅¬μ˜ μ œν•œμ κ³Ό 후속 연ꡬ에 λŒ€ν•œ μ œμ–Έμ€ λ‹€μŒκ³Ό κ°™λ‹€. 첫째, 일개 μ˜κ³ΌλŒ€ν•™μƒμ„ λŒ€μƒμœΌλ‘œ ν•˜μ˜€μœΌλ―€λ‘œ 전체λ₯Ό λŒ€ν‘œν•˜μ—¬ μΌλ°˜ν™”ν•˜κΈ° μ–΄λ ΅λ‹€. λ”°λΌμ„œ 연ꡬ λŒ€μƒμ„ ν™•λŒ€ν•˜μ—¬ μ˜κ³ΌλŒ€ν•™μƒλ“€μ˜ 곡감 ν‘œν˜„ λŠ₯λ ₯ μˆ˜μ€€μ„ 보닀 μ •ν™•ν•˜κ²Œ 확인해야할 ν•„μš”κ°€ μžˆλ‹€. λ‘˜μ§Έ, 성별에 λ”°λ₯Έ 차이에 λŒ€ν•œ 원인을 규λͺ…ν•˜μ§€ λͺ»ν•˜μ˜€λ‹€. 이 μ—°κ΅¬μ—μ„œλŠ” ν†΅κ³„μ μœΌλ‘œ μœ μ˜ν•œ 차이가 μ—†μ—ˆμ§€λ§Œ Winefield & Chur-Hansen [7]의 μ—°κ΅¬μ—μ„œλ„ 남학생에 λΉ„ν•΄ μ—¬ν•™μƒμ˜ 곡감 ν‘œν˜„ λŠ₯λ ₯이 λ†’μ•˜λ˜ 것에 λΉ„μΆ”μ–΄ λ³Έλ‹€λ©΄, 성별에 λ”°λ₯Έ 차이λ₯Ό μ‚΄νŽ΄λ³΄λŠ” 것은 의미 μžˆλŠ” μž‘μ—…μ΄ 될 것이닀. λ˜ν•œ 더 λ‚˜μ•„κ°€ 곡감 ν‘œν˜„ λŠ₯λ ₯에 영ν–₯을 λ―ΈμΉ˜λŠ” μš”μΈλ“€μ„ νŒŒμ•…ν•˜λŠ” 후속 연ꡬ가 μ§„ν–‰λœλ‹€λ©΄ 곡감 증진 ν”„λ‘œκ·Έλž¨μ˜ λ‚΄μš©μ„ ꡬ성할 λ•Œμ— μœ μš©ν•œ μ •λ³΄λ‘œ ν™œμš©λ  수 μžˆμ„ 것이닀. μ…‹μ§Έ, ν‰κ°€μž ν›ˆλ ¨μ„ 톡해 μ½”λ”© κ·œμΉ™μ„ μˆ™μ§€ν•œ ν›„ ν•™μƒλ“€μ˜ 곡감 ν‘œν˜„μ„ μ±„μ ν•˜μ˜€μ§€λ§Œ, ν‰μ •μ˜ 였λ₯˜λ₯Ό μ™„μ „νžˆ ν†΅μ œν–ˆλ‹€κ³  λ‹¨μ–Έν•˜κΈ°λŠ” μ–΄λ ΅λ‹€. 학생듀이 μ‹€μ œλ‘œ μ‚¬μš©ν•œ 단어듀을 μ·¨ν•©ν•˜μ—¬ μ½”λ”© κ·œμΉ™μ— 따라 λ°°μ—΄ν•œ 단어집을 λ§Œλ“€μ–΄ μΆ”ν›„ μ—°κ΅¬μ—μ„œ 평가 κ·Όκ±° 자료둜 ν™œμš©ν•œλ‹€λ©΄ ν‰κ°€μž κ°„μ˜ 차이λ₯Ό 쀄일 수 μžˆμ„ 것이닀. λ„·μ§Έ, λ°œν™”(utterance) μž₯λ©΄μ—μ„œλŠ” 언어적 ν‘œν˜„κ³Ό ν•¨κ»˜ μ–΅μ–‘, 어감, μ–΄μ‘°, μžμ„Έ, μ–Όκ΅΄ ν‘œμ • λ“±μ˜ 비언어적 ν‘œν˜„μ΄ μƒλ‹Ήνžˆ μ€‘μš”ν•œ 역할을 λ‹΄λ‹Ήν•œλ‹€. μ—°κ΅¬μžλ“€μ€ ν•™μƒλ“€μ—κ²Œ μ‹€μ œλ‘œ λŒ€ν™”ν•˜λ“― κ΅¬μ–΄μ²΄λ‘œ κΈ°μˆ ν•˜λ„λ‘ μΆ©λΆ„νžˆ μ•ˆλ‚΄ν•˜μ˜€μ§€λ§Œ, 이미 문자둜 기둝된 언어적 ν‘œν˜„μ—μ„œ μ΄λŸ¬ν•œ 뢀뢄듀은 νŒŒμ•…ν•˜κΈ° μ–΄λ ΅λ‹€. λ”°λΌμ„œ 직접 κ΄€μ°°, λΉ„λ””μ˜€ λ…Ήν™”, λ…ΉμŒ λ“± 보닀 μ •ν™•ν•˜κ²Œ 곡감 ν‘œν˜„ λŠ₯λ ₯을 ν™•μΈν•˜κΈ° μœ„ν•œ λ…Έλ ₯이 μš”κ΅¬λœλ‹€.

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TableΒ 1.
Distributions of Response Types
Case Response types
Aggressive/derogatory Non-empathetic Partially acceptable Interchangeable/empathetic Facilitative
1 - 92 (83.6) 15 (13.6) 3 (2.7) -
2 2 (1.8) 41 (37.3) 64 (58.2) 3 (2.7) -
3 - 89 (80.9) 18 (16.4) 3 (2.7) -
4 1 (0.9) 84 (76.4) 22 (20.0) 3 (2.7) -
5 - 88 (80.0) 20 (18.2) 2 (1.8) -
6 - 99 (90.0) 10 (9.1) 1 (0.9) -
7 2 (1.8) 75 (68.2) 28 (25.5) 5 (4.5) -
8 1 (0.9) 78 (70.9) 30 (27.3) 1 (0.9) -
9 1 (0.9) 88 (80.0) 20 (18.2) 1 (0.9) -
10 - 90 (81.8) 19 (17.3) 1 (0.9) -

Data are expressed as number (%).

TableΒ 2.
Medical Students’ Empathy Expression Scores by Gender
Gender No. Min Max Mean SD t p-valuea)
Male 66 8 22 12.24 2.46 -1.714 0.089
Female 44 10 23 13.11 2.83
Total 110 8 23 12.59 2.64

SD: Standard deviation.

a) p-values from t-test.

Appendices

AppendixΒ 1.

Instructions and Trigger Statements Used in the 10-Item Empathy Scale

In order that we may assess the effectiveness of this practical in teaching basic medical communication skills, students are asked to complete the task below. Your participation is voluntary, anonymous, and designed to allow evaluation of this project. Please help. Imagine that each of the following statements has been made to you by someone you care about. Beneath each one, fill in what you regard as an appropriate verbal response. [Two lines were allowed beneath each item.]
1. My parents really get me down. They insist I study Physics and Chemistry, when I'm not at all interested in those subjects.
2. I thought I'd have a talk with you because you did well in that subject. But, you've been no help to me at all.
3. My children tell me I'm old-fashioned. After all I've done for them! However hard I try, they just don't appreciate me.
4. So, I studied hard for years, and now, nobody wants to give me a job. Perhaps I'll go back and work on the farm.
5. If my exam marks don't improve, I'm going to fail and lose my government allowance. I don't know what to do.
6. I just can't communicate with my parents. Whenever I try to explain how I feel about things, they get all upset and call me a fool.
7. I finally got up courage to tell him that we all think he's big-headed. Then, he turned on me and made me feel so stupid, I ended up apologizing and slinking away.
8. I try so hard to please everybody, but it always seems to go wrong. Nobody seems to care whether I'm around or not.
9. Whenever I try to get close to someone of the opposite sex, I always mess it up. Am I so physically unattractive? How do I turn them off?
10. My brother has started to act so strangely. He's very, very nervousβ€”I'm wondering if I should do anything.

Adapted from Winefield HR, Chur-Hansen A. Evaluating the outcome of communication skill teaching for entry-level medical students: does knowledge of empathy increase? Med Educ 2000; 34: 90-94 [7].

AppendixΒ 2.

Coding Rules of Pencil-and-Paper Empathy Rating Test

Scale Coding rules
0= Aggressive or derogatory response
1= Non-empathetic: does not acknowledge feeling or content of trigger; includes advice, reassurance, closed question
2= Partially acceptable: open-ended question or response that acknowledges feeling or content of trigger
3= Interchangeable/empathetic: acknowledges both the feeling and the content of the trigger (i.e., some variation of the classic 'you feel...because...')
4= Facilitative: reflects but also adds deeper feeling and meaning to the trigger statement in a way that encourages self-exploration (not really to be expected after a brief statement of the problem)

Adapted from Winefield HR, Chur-Hansen A. Evaluating the outcome of communication skill teaching for entry-level medical students: does knowledge of empathy increase? Med Educ 2000; 34: 90-94 [7].

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