The Impact of Empathy and Perspective-Taking on Medical Student Satisfaction and Performance: A Meta-Ethnography and Proposed Bow-Tie Model

Background: Empathy and perspective-taking are, respectively, associated with improved healthcare and educational outcomes. However, numerous studies show that medical students are experiencing a significant decline in self-reported empathy. We aim to examine the impact of empathy and perspective-taking on medical student satisfaction and performance. Methods: Qualitative evidence synthesis was performed using a meta-ethnography approach. Six electronic bibliographic databases were searched for papers published during 2000–2021, including those exploring empathy or perspective-taking in medical education concerning medical student satisfaction and performance and involving medical students. The Critical Appraisal Skills Programme was used to appraise the quality of each included paper critically. Results: In total, 851 articles were identified, and 15 studies were included. Six third-order constructs were synthesized and integrated via a “Bow-Tie” model. This included blending humanism in clinical skills with personal experiences, vicarious learning, challenging pre-conceived notions, curricular and pedagogical inculcation, collective expressions of empathy with secure catharsis, and multi-stakeholder perspectives and involvement. Conclusion: This Bow-Tie model provides a novel framework that integrates the contextual factors to better understand the roles of empathy and perspective-taking in medical education. This aids the planning of interventions, such as in the medical humanities to achieve the desired outcomes.