Reflective to be Effective: Establishing Validity Evidence for Parallel Patient-Provider Empathy Scales to Drive Self-Reflection

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Objective. Student pharmacists must cultivate self-awareness to ensure that they can assess their skill development and abilities, including affective domain skills such as empathy. External feedback can augment development, but validated assessments are needed for accuracy. Thus, the objectives of this study were to: establish validity evidence of the KCES-R (Kiersma-Chen Empathy Scale-Revised), compare student self-perceptions and standardized patient (SP) perceptions of student empathy using a parallel patient scale (KCES-PV), and evaluate student reflections on the encounter.

Methods. Student pharmacists completed an assessment of their self-perceptions of empathy (KCES-R) pre-/post-patient encounter. SPs completed the KCES-PV regarding student pharmacist empathy immediately post-encounter. Student pharmacists also watched their encounter videos and completed a self-reflection on their use of empathy. Descriptive statistics, Spearman’s rank-order correlations, exploratory factor analysis, Cronbach’s alpha, and Wilcoxon Signed-Rank test were computed. Reflections were explored using thematic analysis.

Results. The KCES-R contains 2 factors with high internal consistency and shows the ability to detect changes in empathy. Student pharmacist self-perceptions of empathy ability appeared higher than the SP evaluation. Student pharmacists had a stronger belief in the importance of expressing empathy during patient encounters and indicated a need for further development.

Conclusion. This study provides validity evidence for the use of the KCES-R and presents a parallel scale that may be used by SPs. Validated parallel scales along with reflective practice could be a potential avenue to grow self-awareness and empathy by allowing students to receive feedback and then reflect on their perceived vs actual demonstration of the skill.

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