Authors: Tomobi O et al.
Anesthesia & Analgesia, February 3, 2026, 10.1213/ANE.0000000000007919
This mixed-methods observational study examined empathy in anesthesiology trainees during pre-anesthesia encounters using validated instruments from three perspectives: trainee self-assessment, patient ratings, and external physician observer assessment.
Twenty-four trainees were observed across 151 pre-anesthesia patient encounters (minimum five per trainee). The study incorporated:
• Jefferson Scale of Empathy (JSE) – trainee self-report
• Resident Wellness Scale – trainee well-being
• Jefferson Scale of Patient Perceptions of Physician Empathy (JSPPPE) – patient-reported empathy
• Jefferson Empathy Scale for Observers (JSEO) – physician observer rating
Quantitative findings
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Empathy and training level
There was a moderate negative correlation between the JSE subdomain “walking in the patient’s shoes” and year of training (r = −0.451, P = .021), suggesting that empathy scores declined as residents progressed. -
Empathy and wellness
There was a modest negative correlation between time spent with patients and trainee wellness (r = −0.421, P = .041), implying that trainees with lower wellness scores may spend more time in encounters. -
Gender differences
Male trainees spent significantly more time in pre-anesthesia consultations than female trainees (396 ± 80 seconds vs 323 ± 50 seconds, P = .035).
Male trainees also received higher patient-reported empathy scores (JSPPPE 33.1 ± 3.0 vs 32.2 ± 3.0, P = .020).
On multivariable analysis, male gender predicted higher patient-reported empathy (P = .022). Year of training predicted empathy scores in both self-assessment (JSE: P = .013) and observer ratings (JSEO: P = .023).
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Patient vs observer discrepancy
Thematic qualitative analysis demonstrated a disconnect between what observers identified as empathic behaviors and what patients perceived as empathy. Patients placed substantial importance on clarity, information delivery, and communication efficiency, sometimes more than overt relational cues.
Interpretation
This study highlights three nuanced findings:
• Empathy appears to decline modestly with advancing training, at least in certain dimensions.
• Patients rated male trainees as more empathic, despite empathy being traditionally characterized as female-associated in broader literature.
• Perceived empathy in anesthesiology may be tightly linked to clarity of information exchange rather than overt emotional expressiveness.
The gender finding is particularly interesting. Male trainees both spent more time and received higher patient ratings, suggesting that time investment and communication structure may influence perception more than presumed emotional attunement.
Unlike longitudinal specialties, anesthesiology pre-op encounters are brief and task-focused. Patients may define empathy less as emotional validation and more as competence, clarity, and efficiency.
Key Points
• Empathy scores in trainees may decline modestly over years of training.
• Male trainees received higher patient-reported empathy scores in this cohort.
• Time spent in consultation differed by gender.
• Patient-perceived empathy and observer-rated empathy do not perfectly align.
• Information clarity and efficiency may drive perceived empathy in anesthesia pre-op encounters.
What You Should Know
For programs overseeing residents or CRNAs, empathy training in anesthesiology may need to be specialty-specific. Traditional communication curricula emphasizing emotional validation alone may miss what patients in high-anxiety, short-duration pre-op settings actually value.
Structured communication that balances:
• Clear risk explanation
• Efficient reassurance
• Calm authority
• Focused listening
may be more influential than longer emotionally expressive encounters.
As someone who oversees large anesthesia teams, this paper supports examining not just “are we empathic?” but “how do patients define empathy in our setting?”
Thank you to Anesthesia & Analgesia for allowing us to summarize and share this article.