Exploring the Impact of Professional Acting on Empathy Development in Medical Students [version 3; peer review: 1 approved, 2 approved with reservations, 1 not approved]

Background Empathy is central to patient-centred care and professional identity, yet medical students’ empathy often declines as they transition into clinical training. Theatre-based, arts-and-humanities interventions have been proposed to support empathic communication, but are usually evaluated with self-report rather than performance-based measures. Methods We conducted a single-institution, single-group pre–post pilot evaluation of an extracurricular, four-week theatre-based empathy programme for third-year medical students. All 60 students were eligible; 18 volunteered on a first-come, first-served basis, and 12 who attended all eight sessions and completed both assessments formed the analytic sample. The programme, co-facilitated by a professional actor and clinician, was grounded in Kolb’s experiential learning cycle and applied theatre principles. Teaching methods included repeated doctor–patient role-plays in breaking-bad-news scenarios, alternating doctor/patient perspectives, and structured feedback on communication and emotional presence. Observable empathic communication behaviours in simulated consultations were measured before and after the programme using the Empathetic Communication Assessment Form (five domains, 10-point scale), rated by the faculty member and actor. Pre–post differences were analysed with paired-samples t-tests and within-subject effect sizes (Cohen’s d). Results Students (n = 12) showed significant improvements across all domains. Mean increases ranged from +1.3 to +2.6 points on the 10-point scale, with large effect sizes (Cohen’s d ≈ 1.5–2.8). The largest gains were in Empathetic Communication (+2.2), Relating to the Listener (+2.6) and Verbal Communication (+2.4). All students improved in their overall checklist score (range +0.8 to +3.1). Conclusions This small, single-group pilot suggests that a brief, theatre-based, pre-clerkship programme co-facilitated by a professional actor and clinician may enhance observable empathic communication behaviours in simulated breaking-bad-news encounters. Although limited by the small, self-selected sample and absence of a control group, the findings support further, larger-scale and longitudinal evaluation of theatre-based empathy teaching within arts-and-humanities-informed medical curricula.