LAUSR

We were interested to read the recent article (W€ undrich et al. 2017) concerning the use of simulated patients in the provision of empathy training to medical students. As finalyear medical students, we have undergone a range of teaching methods focused on empathy and its expression in patient–doctor interactions. We write to shed light on our perception of the relative benefits of these complementary teaching strategies. Similar to the intervention described in the article (W€ undrich et al. 2017), we have completed a course on communication skills that relied upon the use of simulated patients. The scenarios incorporated emotive themes, such as breaking bad news, encountering angry patients, and discussing sensitive issues with patients and relatives. A central theme in these scenarios was how to most effectively express empathy to a patient. However, an inherent limitation of such scenarios is that they involve actors and are developed by doctors, and as such they provide limited insight into real patients’ experiences. Our medical school curriculum has recently incorporated teaching sessions with expert patient tutors. These tutors are real patients and carers who discuss their experiences of their condition and their interactions with doctors. Sessions were candid, open and amongst the most influential teaching we have received. The session not only allowed us to explore the impact a disease has on a patient’s life, but it also equipped us with empathetic skills and approaches to use in clinical practice. The sessions were provided in several clinical areas: Palliative care, Obstetrics and Gynaecology, and Neurology. Using Palliative care as an example, we had small group sessions with recently bereaved carers who shared their experience of losing a loved one. They outlined specific examples of how doctors’ outward empathy made this difficult period better, and pitfalls to avoid. We would be interested to see future comparisons between simulated patient and expert patient tutor teaching to help identify if either is more effective in improving self-reported or behavioral expression of empathy. We might expect that these two interventions provide complementary insights into empathy. Whilst real patients enable students to better understand illness experience, simulated patients may allow a better opportunity to explore ways of effectively expressing that empathy as doctors.