Thomas Jefferson UniversityJefferson Medical College

Main menu:

Research Studies

The Jefferson Longitudinal Study of Medical Education is the most comprehensive, extensive, and uninterrupted longitudinal database of its kind maintained in one medical school. It was implemented in 1970 with the intention to track all Jefferson students throughout their medical education and professional careers. Data were collected retrospectively for those who matriculated between 1964 and 1970, and prospectively from 1971 to date. It now includes data for 11,133 individuals from 49 medical school classes.

The database includes demographics, personal qualities, performance measures in medical school, board scores, responses to matriculation and graduation questionnaires, program directors' ratings of clinical competence in residency, and career follow-up surveys. The Longitudinal Study is routinely updated for all graduates using data from local sources as well as the AAMC, AMA and ABMS. Follow-up data also include career outcomes from the AMA’s national data file, faculty appointments from the AAMC, board certification from the ABMS, and periodic alumni surveys. Important statistics retrieved from the Longitudinal Study database on demographics, performance on licensing examinations, geographic location, specialty, evaluations of clinical competence in residency, and perceptions of students and graduates on medical education at Jefferson are routinely prepared for the College’s annual report.

The Longitudinal Study serves as a unique tool for institutional research and academic management of the outcomes assessment requirements of accrediting bodies, including the LCME for the medical school, the ACGME for residency programs, and the Middle States Commission on Higher Education for the University. The most recent LCME accreditation review observed that:

“The Longitudinal Study continues to represent a unique information resource that serves as an invaluable tool for evaluation of educational program effectiveness. The Longitudinal Study enables the Center to provide the medical school with vital information about the intermediate and long-term outcomes of the curriculum.”   

A total of 185 studies using information from the Longitudinal Study have been published in peer-reviewed journals. Recent studies include:

  • Peer Nomination, Performance and Medical Students' Personal Qualities
    In collaboration with the Office of Student Affairs, we examined the relationships between peer nomination, performance in medical school and on licensing examination, personality profiles, and empathy in a study published in Academic Medicine.
  • Psychometrics of the Scale of Attitudes Toward Physician Pharmacist Collaboration We developed a new instrument that measurers attitudes toward physician-pharmacist collaboration and, in this study, we examined its psychometrics among medical students. Results were published in Medical Teacher.
  • Psychostimulant Drug Abuse and Personality in Medical Students
    Two year-4 medical students who were interested in studying the prevalence of psycho-stimulant drug abuse in medical students and their personality profiles were assisted by the Center research staff to correlate the incidents of drug abuse with measures of personality maintained in the longitudinal data base. This study will be published in Medical Teacher.

The Jefferson Scale of Empathy (JSE) was developed by researchers at the Center for Research in Medical Education and Health Care at Jefferson Medical College to measure empathy in physicians and health professionals (HP version) and medical students (S-version). A version of the scale for health professional students (HP Student version) is now available.

It has been translated into 42 languages and is being used by researchers and educators worldwide. This scale has enjoyed broad national and international attention. As of this date, we have received over 850 requests (375 from outside the US) for permission to use the scale. Center faculty and colleagues at Jefferson have published 41 articles about their research find-ings in professional peer-reviewed journals; and our list of publications by other national and international researchers include over 70 publications in which the JSE was used.

Students' Empathy During Encounters with Simulated Patients: In a collaborative study with the University Clinical Skills and Simulation Center, we examined the rela­tionships between simulated patients’ as­sessment of medical students’ interpersonal skills and empathy through ten Objective Structured Clinical Examination (OSCE) stations with students’ self-report empathy in a study published in Medical Teacher.

Student Empathy, Gender and Ethnicity: In another study published in Academic Medicine using the same data, we addressed the issue of fairness in testing by examining the effects of student’s gender and ethnicity on simulated patients’ assessment of students’ empathy. This study was published in the August 2011 issue of Academic Medicine.

Measurement of Empathic and Sympathetic Orientation Toward Patient Care: Based on the notion that empathy and sympathy in patient care could have different consequences in clinical outcomes, we developed an instrument for measuring empathic and sympathetic orientations toward patient care and provided evidence in support of psychometrics of the instrument. The study was published in the August 2011 issue of Academic Medicine.

Physician Empathy and Shadowing Patients in Emergency Medicine: In a collaborative study with the Jefferson emergency medicine residency program, we conducted a pilot study to examine changes in empathy among emergency medicine residents who were instructed to shadow patients in the emergency room, compared to a control group. This study was presented at the 2011 Council of Residency Directors in Emergency Medicine Annual Meeting, San Diego CA. The study’s abstract was published in Academic Emergency Medicine. Based on the findings of this study, the Jefferson emergency medicine residency program plans to continue implementing the shadowing experience to all new residents.

Empathy and Patient Outcomes – In a study conducted with colleagues from the Department of Family and Community Medicine, we examined the link between physician empathy and patient outcomes among 891 diabetic patients of 29 family physicians. This study which was published in Academic Medicine enjoyed broad media coverage.  In another study of 242 primary care physicians and their 20,961 diabetic patients in Parma Italy, the hypothesis of a significant association between physician empathy and patient outcomes (acute metabolic complications that required hospitalization in diabetic patients) was confirmed. (see graph). This study was supported through a collaborative agree-ment between the Parma Local Health Authority, Parma, Italy; the Regional Health Care and Social Agency, Regione Emilia-Romagna, Italy; the Health Care Authority, Regione Emilia-Romagna, Italy; and the Thomas Jefferson University. The study was published in Academic Medicine, and has enjoyed broad media coverage in the U.S. and Italy.



Patients’ Perception of Physician Empathy:
In collaboration with Depart­ment of Family and Community Medicine, we conducted a study to examine the rela­tionship between patients’ perception of physician empathy, and patient outcomes by extracting data from 535 out-patients’ electronic records who completed the Jefferson Scale of Patient Perceptions of Physician Empathy sent to them by mail. This study was published in the International Journal of Medical Education.

Patients’ Satisfaction with Primary Care Physicians: In collaboration with Depart­ment of Family and Community Medicine, we developed a brief instrument (10 items) for measuring patients’ overall satisfaction with their primary care physicians and its link to physician empathy perceived by patients. Five hundred thirty five patients completed a mailed survey. This study was published in Family Medicine.

Enhancement of Empathy in Medical and Pharmacy Students: In a workshop presented at the Chicago School of Pharmacy and Chicago College of Osteopathic Medicine, Midwestern University, we used a variation of the “aging game” in which volunteer students were coached to play the roles of an elderly patient and an administrator of a long-term care facility. They used a written skit provided by us.  Other students observed the interactions between the two, and discussed their feedback after the play in a small group. The purpose of the game was to enhance empathic understanding of students.

Psychometrics of the Health Professions Student Version of the Jefferson Scale of Empathy (JSE-HPS) in Pharmacy and Nursing Students: In two studies, we examined the validity and reliability of a newly adapted version of the Jefferson Scale of Empathy for administration to students in health professions other than medicine. In the first study, in collaboration with researchers at Department of Nursing, College of Health Professions, Armstrong Atlantic State University in Savannah, Georgia, nursing students participated in the study which was published in the Journal of Interprofessional Care.  The second study, in collaboration with researchers at Chicago College of Pharmacy, Midwestern University, pharmacy students participated in the study which will be published in the American Journal of Pharmaceutical Education.

Rocking Chair Project and Empathy: The Rocking Chair Project offers family medicine residents the opportunity to deliver and assemble a rocking chair in the homes of indigent mothers of new born babies. We are collaborating in the assessment of the effectiveness of this project on residents’ empathy.  Preliminary findings of a pilot study were published in Family Medicine.  We have completed a nationwide three-year longitudinal study to further examine the short- and long-term effects of the Rocking Chair Project on the enhancement of empathy among participating family medicine residents compared to a control group. For more information: www.rockingchairproject.org.

With funding from the National Board of Medical Examiners’ Edward J. Stemmler, MD Medical Education Research Fund, Center re­searchers investigated the predictors and out­comes of physicians' lifelong learning based on a national survey of 3,195 Jefferson graduates between 1975 and 2000.  Major findings sum­marized, in “Measurement and correlates of physician lifelong learning,” were published Academic Medicine. A new version of the scale was developed by a group of medical education re­searchers at the Virginia Commonwealth University Medical School led by Drs. Paul Mazmanian and Angela Wetzel who worked with the Center to adapt the Jefferson Scale of Physician Lifelong Learning for administration to medical students.  The study was presented at the Annual Meeting of the AAMC and published in Academic Medicine

We also wrote two book chapters on physician lifelong learning, one appeared in the "Handbook of Lifelong Learning Development" (Edited by Margaret Caltone, Nova Science Publishers, 2010, Chapter2, pp. 37-78), and the other was included in a monograph published in 2012 by NOVA Science Publishers entitled “Continuing Professional Development and Lifelong Learning: Issues, Impacts, and Outcomes” edited by Drs. Greg Neimeyer and Jennifer Taylor.

Center faculty continued to work with faculty in the Department of Family and Community Medicine, and faculty from the Jefferson School of Nursing and the School of Pharmacy to enhance inter-professional education. This new inter-professional curriculum emphasizes teamwork and learning opportunities for medical, nursing and other students in the health professions.  The following studies were developed:

  • Student Attitudes - A paper entitled "Attitudes of students in medicine, nursing, occupational and physical therapy toward inter-professional education" was published in the Journal of Allied Health.  
  • Collaboration with the School of Nursing - In collaboration with the Jefferson School of Nursing, we analyzed changes in nursing students' empathy during their education.