Empathy and Relational Science Program

The focus of the Empathy and Relational Science Program is on empathy in the patient-clinician relationship. Research documents that empathy tends to decline throughout medical training and that this decline is often not addressed. Our program goals are to provide expertise in critical domains to address the need for greater relational skills in healthcare and to improve provided well-being and career satisfaction. By addressing greater satisfaction in both patients and providers, we aim for improvement in all medical encounters.

Our research is grounded in the neurobiology and physiology of human interaction and emotion and is informed by relational sciences. We offer evidence-based empathy education that optimizes the patient experience, promoting respectful, compassionate, and effective communication at all levels of healthcare.

Studies have demonstrated that the degree of clinician empathy plays a significant role in improving outcomes in medicine, predicting quality of care, patient safety and satisfaction, and in decreasing malpractice claims. We also participate in interdisciplinary research collaborations and believe that empathy plays an important role across industries, including fields such as executive coaching, management and leadership, and education.

The Empathy and Relational Science Program offers teaching, training, consultation, and research to improve empathy in healthcare.

History

The program has grown from decades of academic and pedagogical experience in optimizing the patient-clinician relationship. Dr. Helen Riess, director of the Empathy and Relational Science Program, is a psychiatrist who developed an empathy training approach based on cutting-edge research in the neurobiology and physiology of empathy at Mass General. This approach has been rigorously tested at Mass General and the Massachusetts Eye and Ear Infirmary in pilot studies and a randomized controlled trial. The training resulted in improved physician empathy, determined by patient ratings before and after the training, and demonstrates that empathic skills can be learned and enhanced. Dr. Riess and her colleagues have devoted their careers to mentoring resident physicians in relational skills.

Patient satisfaction of medical care is a foremost priority of Massachusetts General Hospital and Mass General Brigham. Our empathy training approach was integral to a quality improvement initiative at Massachusetts General Hospital that trained over 1500 physicians. Increased scrutiny of patient satisfaction ratings has led to leadership efforts to improve how our patients receive care. These efforts have resulted in improved patient satisfaction with their healthcare providers.

Research Activities

We have an active research program that seeks to integrate the human aspects of interpersonal interaction at all levels of healthcare with current research on the neurobiology and physiology of emotion, empathy, and the healing relationship.

Current Research

Nonverbal Clinician Communication

Empathy is essential for clinicians to communicate caring and create a positive patient experience. Nonverbal communication in particular has been shown to play a significant role in judgments of clinician empathy. We are exploring perceptions of nonverbal clinician communication.

Inter-Professional Communication

Inter-professional communication is crucial to providing quality health care to patients. Communication failures seem to be associated with adverse patient events. Studies suggest that such communication failures are the result of a lack of team integration and poor relationships between medical professionals. We are exploring the dynamics or inter-professional communication and effects on team cooperation and patient outcomes.

Cultural Empathy

Nonverbal and verbal communication is interpreted differently depending on one’s cultural upbringing. Understanding and responding compassionately to others relies on one’s ability to incorporate cultural aspects of empathy. We are examining features of empathy, which may be universal or culture specific, to determine how empathy can be best utilized globally.

Completed Research

Pilot Testing of Empathy Training

The development and pilot testing of a sophisticated empathy training program that sought to improve patient outcomes by integrating relational science into the training of healthcare professionals. A preliminary study investigating our training program showed significant improvements in physician empathy.

Randomized Controlled Trial of Empathy Training

We conducted a larger, multi-site randomized controlled trial, which showed that resident physicians who received our training program were rated by their patients as more empathic than physicians assigned to residency training as usual.

Long-term Follow-Up Study of Empathy Education Program

We conducted a follow-up study of our RCT empathy education, which investigated the long-term stability of improvements in physician empathy. The study also yielded qualitative data from physicians regarding their subjective experiences during the training, and their assessment of the long-term impact of the training on their clinical practices.

Systematic Literature Review

We conducted a systematic literature review of all randomized controlled trials investigating whether communication training of healthcare professionals improves patient outcomes. The purpose of this review was to systematically assess the current state of research evidence for the beneficial effects of communication training. The project serves as a guide to future research in this area.

Professional Training

The Empathy and Relational Science Program offers training to enhance empathy in healthcare providers. The training incorporates translational research in the neurobiology and physiology of emotions to improve patient and health care provider relationships with an emphasis on empathy. Using didactic and experiential learning, participants learn the basic science of emotional connection.

The training teaches techniques to improve detection and management of emotional states in patients, and to respond with empathy and compassion. This training was the subject of a randomized, controlled trial of physicians at MGH and resulted in significant improvement in patient perception of physician empathy.

Program Members

• Lidia Schapira MD
• Áine Lorié, PhD
• Diego Reinero
• Tess Lauricella
• Andrea Heberlein, PhD
• Margot Phillips, MD

Resources

In the News

At MGH, Schooling Doctors in the Power of Empathy, Boston Globe 

Should We Train Doctors for Empathy?, Greater Good Magazine 

Why Nice Doctors Are Better Doctors, US News

Instilling Empathy Among Doctors Pays Off for Patient Care, CNN

Efforts to Instill Empathy Among Doctors Is Paying Dividends, PBS NewsHour

Teaching Doctors How to Engage More and Lecture Less, Washington Post

The Emotion Roadmap: Interview with Dr. Helen Riess, 89.5FM WPKN

Building Empathy in Healthcare, Greater Good Magazine 

‘Touching’ on Something Bigger — in New Book, Betsy MacGregor Says Medicine Shouldn’t Be Divorced From Empathy, Huffington Post 

Can Empathy Be As Effective As Aspirin?, Gold Foundation 

Academic Articles

Riess, H. (2015). The impact of clinical empathy on patients and clinicians: Understanding empathy's side effects. AJOB Neuroscience, 6(3), 51-53. 

Kelley, J. M., Kraft-Todd, G., Schapira, L., Kossowsky, J., & Riess, H. (2014). The influence of the patient-clinician relationship on healthcare outcomes: a systematic review and meta-analysis of randomized controlled trials. PloS one,9(4), e94207.

Riess, H., & Kraft-Todd, G. (2014). EMPATHY: a tool to enhance nonverbal communication between clinicians and their patients. Academic Medicine, 89(8), 1108-1112.

Riess, H., Kelley, J. M., Bailey, R. W., Dunn, E. J., & Phillips, M. (2012). Empathy training for resident physicians: a randomized controlled trial of a neuroscience-informed curriculum. Journal of general internal medicine, 27(10), 1280-1286.

Hétu, S., Taschereau-Dumouchel, V., & Jackson, P. L. (2012). Stimulating the brain to study social interactions and empathy. Brain stimulation, 5(2), 95-102.

Zaki, J., & Ochsner, K. N. (2012).The neuroscience of empathy: progress, pitfalls and promise. Nature neuroscience, 15(5), 675-680.

Riess, H. (2010).Empathy in medicine—a neurobiological perspective. JAMA,304(14), 1604-1605.

Decety, J., & Jackson, P. L. (2006). A social-neuroscience perspective on empathy. Current directions in psychological science, 15(2), 54-58.

Doctor-Patient Relationship Media Reports

Who’s Listening? Who Cares? - The Arnold P. Gold Foundation Blog, June 26, 2015 

How to Teach Doctors Empathy - The Atlantic, March 15, 2015

Can Doctors Learn Empathy? - The New York Times, June 21, 2012