The findings of this study are consistent with several research studies that have found similar differences in decline of empathy among medical students, particularly those studies that reported a significant erosion of empathy in the third year of medical school when students start their formal clinical training with real patients (Bellini & Shea, 2005; Benbassat and Baumal, 2004, Hojat et al., 2009). This empathy enigma needs further scrutiny because of its unfortunate effect on the humanistic dimension of patient care.
Why did the magnitude of empathy decline over time in undergraduate nursing students in Groups 2 and 3 as clinical experiences and patient exposures increased? What are the underlying factors that could possibly impact the students in the clinical setting to affect this decline? Why is student empathy not affected in Group 1? A recent study with medical students suggested several reasons for this such as lack of appropriate role models; negative attitudes from clinical faculty, attending, and residents; an intimidating educational environment; perception of belittleness; heavy educational assignment or clinical duties; and patients' negativity contributing to the erosion of empathy in medical school (Hojat et al., 2009).