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COMMENTARY
Year : 2020  |  Volume : 13  |  Issue : 6  |  Page : 703-704  

Empathy in the time of artificial intelligence: Fiction not fact may hold the key


Department of Otorhinolaryngology, KS Hegde Medical Academy, Nitte (Deemed to be University), Mangalore, Karnataka, India

Date of Submission09-Apr-2020
Date of Decision10-Apr-2020
Date of Acceptance23-Jun-2020
Date of Web Publication6-Nov-2020

Correspondence Address:
Vadisha Srinivas Bhat
Department of Otorhinolaryngology, KS Hegde Medical Academy, Nitte (Deemed to be University), Mangalore - 575 018, Karnataka
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/mjdrdypu.mjdrdypu_165_20

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How to cite this article:
Bhat VS. Empathy in the time of artificial intelligence: Fiction not fact may hold the key. Med J DY Patil Vidyapeeth 2020;13:703-4

How to cite this URL:
Bhat VS. Empathy in the time of artificial intelligence: Fiction not fact may hold the key. Med J DY Patil Vidyapeeth [serial online] 2020 [cited 2020 Dec 2];13:703-4. Available from: https://www.mjdrdypv.org/text.asp?2020/13/6/703/300124



The editorial “Empathy in the time of artificial intelligence: Fiction not fact may hold the key” is most relevant in the current situation in the field of health and medical education.[1] Empathy, which is the ability to understand and share the feelings of another, is an essential aspect for fulfilling the two interrelated roles of an Indian medical graduate: professionalism and clinician.[2] Clinicians' ability to empathize with their patients is a crucial component of adequate health care. A clinician's empathy is beneficial for the patients, and there is a linear relationship between empathy and positive clinical outcome.[3] Empathy is therapeutic by reducing the anxiety of the patients.[4] Furthermore, empathic communication may help to avoid many doctor–patient miscommunications leading to violence. Hence, formal teaching empathy has entered the traditional undergraduate medical education curriculum. However, in India, this aspect of medical education was not well organized until recently, when the Medical Council of India proposed reform in medical education by including Attitude, Ethics, and Communication (AETCOM) skills.

Worldwide, there are few studies on empathy among medical students, with varying results. Some studies showed that empathy declines throughout undergraduate medical education, which is a matter of concern because we expect an increase in empathy.[5] They also showed a relationship of empathy with the students' choice of specialty, where a student opting for a core subject like general medicine and pediatrics had more empathy compared to noncore or paraclinical subjects.[6] Some other studies did not show a significant change of empathy during the course.[7] Still, they noted that empathy scores were better in those students having openness for experience and agreeableness, during the admission to the course.[7] Interestingly, most of the studies showed that empathy scores are better among female students.[6],[7],[8] However, empathy and compassion cannot be considered as merely inherent traits of a doctor but can be enhanced through training interventions; AETCOM can be a practical module.

Since AETCOM starts in the very first year of MBBS, in the foundation course itself, students are taught to have the feeling of what it means to be a “patient” or “doctor.” Doctor–patient relations and communication are taught during the rest of the first year. This is an excellent way to start the MBBS course, well before they begin to learn what the human structure, function, and the disease is. It makes them feel for what they are here. During this crucial training period, fictions are the key to teach empathy. As rightly mentioned by the author, before joining the MBBS course, at least for few years, most of the students will be deprived of the extracurricular activities to get an excellent result so that they can get admission into one of the best medical colleges of their choice. Concentrating on the hard sciences and neglecting the arts and humanities may result in an emotionally stunted doctor, even if the students get entry into the best institution.

AETCOM is the right module to use “fiction” in teaching, as fiction has an additional advantage of being a stress buster. However, care is needed not to get diverted from the intended goal. Studies are supporting the fact that significant improvements in medical student empathy and attitudes toward the humanities can be achieved by participating in literature-based interventions.[9] Nonfictional autobiographies like “when breath becomes air,” a story of an Indian-American neurosurgeon, who suffered a lung cancer can be useful resources for teaching empathy.[10] Although artificial intelligence is now able to do many tasks, they can reduce the burden on a clinician so that he can be more empathetic, as machines lack human qualities such as empathy and compassion.[11]


  Conclusion Top


Empathy is a quality that is essential in fulfilling two critical roles in an Indian medical graduate: clinician and professional. Empathy can be reinforced on medical students by effective use of fiction. Fiction can be incorporated effectively into AETCOM modules to teach empathy to undergraduate students. While artificial intelligence can perform numerous tasks in the field of medicine, machines cannot be empathetic as a human being, hence necessitating the need for teaching empathy in medical schools.



 
  References Top

1.
Banerjee A. Empathy in the time of artificial intelligence: Fiction, not fact, may hold the key. Med J DY Patil Vidyapeeth 2020;13:97-9.  Back to cited text no. 1
  [Full text]  
2.
Medical Council of India. Competency-Based Undergraduate Curriculum for Indian Medical Graduates. Available from: https://www.mciindia.org/CMS/wp-content/uploads/2019/01/UG-Curriculum-Vol-II. Pdf. [Last accessed on 2020 Apr 05].  Back to cited text no. 2
    
3.
Srivastava AK, Tiwari K, Vyas S, Semwal J, Kandpal SD. Teaching clinical empathy to undergraduate medical students of Dehradun: A quasi-experimental study. Indian J Community Health 2017;29:258-63.  Back to cited text no. 3
    
4.
Halpern J. What is clinical empathy? J Gen Intern Med 2003;18:670-4.  Back to cited text no. 4
    
5.
Hojat M, Gonnella J, Mangione S, Nasca T, Magee M. Physician empathy in medical education and practice: Experience with The Jefferson Scale of Physician Empathy. Semin Integr Med 2005;1:25-41.  Back to cited text no. 5
    
6.
Newton BW, Savidge MA, Barber L, Cleveland E, Clardy J, Beeman G, et al. Differences in medical students' empathy. Acad Med 2000;75:1215.  Back to cited text no. 6
    
7.
Costa P, Magalhães E, Costa MJ. A latent growth model suggests that empathy of medical students does not decline over time. Adv Health Sci Educ 2013;18:509-22.  Back to cited text no. 7
    
8.
Patel S, Pelletier-Bui A, Smith S, Roberts MB, Kilgannon H, Trzeciak S, et al. Curricula for empathy and compassion training in medical education: A systematic review. PLoS One 2019;14:e0221412.  Back to cited text no. 8
    
9.
Shapiro J, Morrison E, Boker J. Teaching empathy to first year medical students: Evaluation of an elective literature and medicine course. Educ Health (Abingdon) 2004;17:73-84.  Back to cited text no. 9
    
10.
Kalanithi P. When Breath Becomes Air. New York: Random House; 2016.  Back to cited text no. 10
    
11.
Buch VH, Ahmed I, Maruthappu M. Artificial intelligence in medicine: Current trends and future possibilities. Br J Gen Pract 2018;68:143-4.  Back to cited text no. 11
    




 

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