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Table 6 Modified Kirkpatrick’s framework (Barr et al.’s six-level classification adaptation) [155]

From: A systematic scoping review of approaches to teaching and assessing empathy in medicine

Kirkpatrick outcome level Outcome Studies that achieved this outcome
Level 1 Participant reaction
Learners’ views on the learning experience and its interprofessional nature
• Participants reported decreased stress [133, 149, 151]
• Participants had a positive experience with the intervention [3, 57, 138]
Level 2a Change in own attitudes and change in attitudes towards team members of the interprofessional groups • Increased empathic tendency [130, 135, 146, 150, 153]
• Participants reported increased empathy [41, 55, 83]
• Improved self-reported ability to show empathy [54, 107]
Level 2b Change in knowledge or skills
Including knowledge and skills related to the interprofessional activity
• Improvement in self-rated empathy scores using validated scales [1, 4, 8, 9, 11, 16, 19, 47,49,49, 52, 60, 61, 65, 68, 71,73,73, 75, 78, 79, 82, 87, 90, 94,96,96, 100, 104, 106, 108, 110, 114, 121, 123, 124, 127, 132, 137, 141]
• Increased understanding of empathy from analysis of reflections or artworks [9, 51, 67, 71, 84, 92, 136, 139]
Level 3 Behavioural change
Identify individual transfer of
interprofessional learning
• Improved empathic communication with standardised patients [2, 5, 7, 13, 15, 17, 40, 46, 50, 56, 60, 64, 88, 91, 99, 111, 112, 115,117,118,118, 120, 134, 147].
• Increased confidence with clinical interactions [77, 105, 126, 143, 144]
Level 4a Change in organisational practice
Wider change in organisational practice and delivery of care
• Increased sense of belonging among participants [122]
• Reduced participant burnout [59, 140, 152]
Level 4b Change in clinical outcome
Improvement in patient care
• Increased emphatic communication or attitudes with patients [6, 42, 43, 53, 62, 98, 103, 119]
• Improved patient satisfaction [38, 39, 85]
• Barriers to empathy and administrative changes to curb them were identified by participants [66, 70, 142]
• Participants identified lapses in patient care [63]
• Improved patient rated empathy score [12]