Nurturing empathy in new medical professionals through a community-based educational program: a mixed-methods study

Empathy is a core component of medical professionalism and is associated with better clinical outcomes and patient satisfaction. However, empathy decline has been reported during clinical training. Community-based educational program, informed by service-learning principles, has shown promise in fostering empathy among medical and nursing students, but its impact on newly practicing physicians and nurses remains underexplored. We conducted a mixed-methods study at a tertiary hospital in Taiwan. A structured “Newcomer Camp” was implemented for first-year resident physicians and newly hired nurses. The program included didactic role-modeling sessions, a half-day experiential home visit to underserved patients, and guided reflective practice. Empathy was measured quantitatively using the Jefferson Scale of Empathy–Health Provider version (JSE-HP) before and after the camp. Qualitatively, participants responded to open-ended reflective prompts; their written reflections were analyzed thematically. Statistical analysis compared pre- vs. post-intervention JSE-HP scores (Wilcoxon signed-rank test, α = 0.05). Thematic analysis of reflections was conducted by two independent researchers to elucidate mechanisms of empathy development. A total of 116 newcomers (20 residents, 96 nurses) participated. After the camp experience, JSE-HP empathy scores increased significantly in both resident physicians (mean ± SD: 115.9 ± 15.2 to 123.0 ± 11.6, p = 0.013) and nurses (113.1 ± 14.3 to 120.5 ± 14.6, p < 0.001). Participants rated the program’s role modeling, experiential learning, and reflection components as highly impactful for their empathy (mean impact scores 6.3, 6.2, and 5.9 out of 7, respectively). Thematic analysis of 116 reflective journals revealed three major themes: Benefiting Society, Cultivating Empathy, and Learning from Service. New clinicians reported heightened awareness of social inequities and personal privilege (perspective-taking), emotional resonance with patients’ suffering (affective empathy), and strengthened altruistic motivation to help others. Role modeling by veteran volunteers inspired selfless attitudes, and hands-on service experiences “put them in patients’ shoes,” fostering both cognitive and affective empathy. A structured community-based program was associated with an immediate increase in self-reported empathy in new medical professionals. Role modeling, direct patient service, and reflection worked synergistically to promote perspective-taking and compassionate, altruistic attitudes. These findings support incorporating well-designed community experiences into early residency and nursing orientation to enhance empathy and sustain compassionate care in clinical practice.