Validation of a Modified Jefferson Scale of Empathy for Observers to Assess Trainees

Leah Mallory, Tufts University School of Medicine (L Mallory), The Hannaford Simulation Center at Maine Medical Center, Maine. Electronic address:
Rebecca Floyed, Dell Medical School (R Floyed), University of Texas at Austin, Tex.
Cara Doughty, Baylor College of Medicine (C Doughty), Texas Children's Hospital Simulation Center, Baylor College of Medicine/Texas Children's Hospital, Houston, Tex.
Tonya Thompson, University of Arkansas for Medical Sciences (T Thompson), Little Rock, Ark.
Joseph Lopreiato, Uniformed Services University of the Health Sciences (J Lopreiato), The Val G. Hemming Simulation Center, Silver Spring, Md.
Todd P. Chang, Keck School of Medicine of USC (TP Chang), Children's Hospital Los Angeles, Los Angeles, Calif.


OBJECTIVE: "Demonstrate insight and understanding into emotion" is a competency amenable to simulation-based assessment. The Jefferson Scale of Patient Perceptions of Physician Empathy (JSPPPE) has validity evidence for patients to assess provider empathy. A version adapted for a third-party observers does not exist. Our aim was to modify the JSPPPE and use recorded standardized encounters to obtain validity evidence. METHODS: This cross-sectional study used video and data collected from 2 pediatric residencies. In 2018, 4 raters reviewed 24 videos of 12 interns communicating with standardized patients (SP) in 2 encounters and completed a modified JSPPE for observers (JSEO). Reliability between raters was established using Intraclass Correlations (ICC). JSEO mean scores were correlated to Essential Elements of Communication (EEC), JSPPPE, and faculty composite interpersonal communication (IC) scores using Spearman Rank. RESULTS: The mean ICC for all 4 raters was 0.573 (0.376-0.755). When ICC was calculated for pairs of raters, Rater 1 was an outlier. ICCs for mean scores for pairs among the 3 remaining raters was 0.81 to 0.84. Mean JSEO scores from the four raters correlated with the JSPPPE (rho = 0.45, P = .03) and IC (rho = 0.68, P < .001), but not the EEC (rho = 0.345, P = .1). CONCLUSIONS: We found validity evidence for the use of a modified JSPPPE for an observer to assess empathy in a recorded encounter with a SP. This may be useful as medical educators shift toward competency-based tracking. The brevity of this tool and potential assessment using video are also appealing.