Table 2.

Summary of measurement type, measurement used, and results of each study.

Author(s)	Type of measurement	Measurement used to assess empathy	Results of changes in empathy
Chandrasekar H. et al (2018)18	Qualitative	Focus groups were conducted to assess whether students found that the workshop enhanced their learning.	Increased student insights into patients’ home lives. Students explained that narratives enabled greater understanding of nonphysician partners within the health care system. One student stated, “It broadly opened up my considering of patients’ lives after leaving the hospital and ways that their specific disease can continue to have an impact on all the different aspects of their life outside of just the symptoms that we might try to manage.”
Lucchetti A. et al (2019)19	Quantitative	Modified Maxwell–Sullivan Attitudes Scale measured empathy and attitudes towards the elderly.	Statistically significant increase in attitudes measured by UCLA-GAS(r = 0.55-0.81, P < 0.001) and empathy towards geriatrics patients measured by the Modified Maxwell-Sullivan Attitudes Scale (r = 0.51, P < 0.001). However, there were other components of the curriculum that did not include patients.
Kieran Sweeney, Paul Baker (2018)20	Quantitative and qualitative	Patient Practitioner Orientation Scale was used to measure patient-centered attitude. Post-session feedback forms were used to assess the behavioural changes students made when interacting with patients.	21 students (54%) demonstrated an increase in patient-centred attitudes, whereas 13 students (33%) demonstrated no change, and five students (13%) demonstrated a decreased score. The mean pre-session score was 78.8, whereas the mean post-session score was 82.0. Students reported that the session had given them insight into the patient experience and felt an emphasis on the value of relational care.
Cumberland et al. (2019)21	Quantitative and qualitative	Paper-based surveys (pre/post), Parkinson Attitude Scale and focus groups with students and patients were used to assess knowledge and empathy.	PD knowledge scores significantly increased with large effect size (pre-test mean = 14.77, [SD = 2.57]; post-test mean = 19.69 [SD = 2.06], Cohen’s d= 1.64). Significant change in Parkinson Attitude Scale score (p-value < 0.05) with small effect size: M= 53.66 at baseline and 55.49 at end of program with Cohen's d = 0.37. Survey results show that 91% students would recommend the program to others, and 82% would participate again. Focus group results showed that students saw their buddy as a human being and not just a patient, and that there was rise in empathy.
Darby Morhardt (2006)30	Quantitative and qualitative	Pre- and post-tests were administered for knowledge of dementia. After each visit, the students were asked to write a summary of their buddy visit experience in a journal. Diagnosed individuals and their family members were asked to evaluate the program by completing a questionnaire.	Pre to post knowledge/attitude test scores improved on average (however the article did not include data to back up this claim as the authors decided that it was outside the scope of the article) Student reflections demonstrated growth in basic knowledge regarding Alzheimer’s disease and related dementias, and in empathy and compassion for persons with dementia as seen in excerpts of their written reflections.
Bramstedt et al. (2014)22	Qualitative	Interviewers submitted narrative responses to 2 open-ended questions about their experience. Observing students completed an anonymous 10 question online survey.	All interview panelist students submitted overwhelmingly positive narrative responses to 2 open-ended questions about their experience. Indirect arm: 12/15 agreed that the session improved their understanding of the psychosocial burdens of dialysis, quality of life, and human suffering, and improved their empathy toward patients; 12/15 “Strongly agreed” or “Agreed” that the session encouraged reflective thinking and was an aid to improving their communication skills.
Shuja et al. (2014)23	Qualitative	In-depth interviews and focus group discussions were conducted to examine student emotions, feelings, and experiences when interacting with people with disabilities.	Good feedback from all students on the effect of the visits on their compassion and empathy. Major themes reflective of the personal narratives were PWDs and their sufferings, putting yourself in other's shoes and working for PWDs. The positive responses from the students revealed that this exercise made them feel the actual pain & sufferings of others.
Shapiro et al. (2019)31	Quantitative and qualitative	The Jefferson Scale for Empathy (JSE) specific for medical students was used to measure empathy. To assess the curriculum, individual medical student evaluations of each session were done. Narrative comments were also solicited and recorded.	In the pilot year, there were no significant intragroup differences pre-post HK curriculum (P = 0.451). Upon re-evaluation of second-year students in the pilot group in the latter part of their 3rd year, they did not show the characteristic “dip” in empathy documented in the literature (JSE post-HK curriculum MS2 = 114.8 standard deviation (SD) =12.7; JSE MS3 = 115.8, SD = 10.7). In the implementation year, with a revamped curriculum, scores improved significantly pre-post HK curriculum (P = 0.012 for MS1, P = 0.004 for MS2). Positive narrative entries noted the importance of incorporating clinical scenarios. Negative comments expressed doubts about being taught kindness and questioned the value of the empathetic video experience.
Player et al. (2019)24	Qualitative	Anonymous questionnaires which were co-designed by expert patients and lecturers were completed by students evaluating changes in empathy and response to the lectures. The questionnaires included free text narrative responses.	Students reported through the questionnaires that the sessions led to a rich learning experience about compassionate care, understanding the complexities and struggles of marginalised groups and giving back. Subthemes included humanity, empathy and listening and holistic care.
Hennrikus, et al. (2018)29	Qualitative	Written student illness scripts which included free response sections addressing humanism and health systems as well as end of the course student feedback were evaluated using a thematic analysis approach.	Qualitative results revealed 7 main themes among the students’ responses: patients make the basic science relevant, empathy and awareness, patient resilience, the doctor-patient relationship, cost of care, barriers to care, and support systems.
Hendriksz (2016)28	Quantitative	Anonymous electronic surveys were used to assess perceptions on the effectiveness of the sessions.	Increased empathy in responses (F-score=41, P = 0.005). 89% agreed that the sessions increased their empathy. 71% agreed that the sessions achieved the objective of increased empathy.
Singh et al. (2017)25	Quantitative & qualitative	The Toronto empathy questionnaire (TEQ) and an anonymous semi-structure feedback questionnaire were used to measure empathy and perceptions on the interventions.	Improved empathy scores measured by the Toronto Empathy Questionnaire after intervention in both groups compared to control (p = 0.011 for CDG & p = 0.046 for VSG). All students in the CDG and 88.5% in VSG felt that the session helped them assess the impact of healthcare-associated infections on patients' emotional, financial and social life and this helped them understand the difficulties faced by a patient and their relatives due to non-compliance to certain protocols. Most students (95.8%) thought the case discussion provided them an opportunity to explore their thoughts and emotions about patient suffering, which was felt by 80.8% of students in the VSG group.
Chen, et al. (2018)26	Quantitative	The first 5 questions of Jefferson Scales of Physician Empathy (JSPE) with additional feedback questions were used to evaluate empathy as well as their perspective on the use of video games to teach empathy.	Improved average empathy scores on first 5 questions of JSPE compared to before playing the game (5.7738 vs 6.2322, p = <0.0001). Most students found video games to be a better and more interesting medium to teach empathy than didactic learning with 31% saying that learning empathy through a video game was more effective than through didactic learning and 64% saying that they preferred the video game format.
Chretien, et al. (2015)27	Qualitative	Illness narratives and feedback from a writing prompt were used to evaluate students' learning and perspective on patient experience as well as group discussion sessions.	Students felt the activity was meaningful and rewarding, allowed them to see patients as patients more than an illness. Students also reported that their patient relationships felt enriched. Students brought out the following themes: patients are more than their disease, be open to opportunities to slow down and listen, stories give new insights into patients, 4) stories can affect patient care, and patients as individuals.