Silent Mentor programme increases medical students' empathy levels

Medical students often embark on the medical journey with a staunch resolution to attain the knowledge and humanitarian qualities that they believe define a great doctor. However, a myriad of factors, including medical technological advancements, modern teaching methods and work-related stressors, have resulted in the decline in humanitarian qualities and empathy levels amongst medical students as they progress through medical school.¹ We hypothesised that the integration of empathy interventional strategies into medical education would ameliorate this phenomenon.

The Silent Mentor programme is a unique, voluntary, self-willed body donation programme, which conducts workshops aimed at medical students in Malaysia. This programme incorporates humanities and integrates empathy interventional strategies into a purposeful holistic biomedical framework.

Seventeen workshops were conducted from year 2012 to 2015 and 656 participants were recruited into the quasi-experimental study. In each workshop, students were assigned to a Silent Mentor (body donor). They conducted home visits to learn the life story of their respective Silent Mentors and were encouraged to think critically about the values and motives behind their altruistic donation. An initiation ceremony launched the 4-day cadaveric workshop whereby students introduced their Silent Mentors to other workshop attendees, family members said their final farewells and appropriate religious rituals were performed. During the workshop, participants cleansed and maintained the bodies, and attended cadaveric dissection to learn anatomy and basic surgical skills. At the end of the workshop, students examined their Silent Mentors to ensure wounds were appropriately closed, dressed and placed their Silent Mentor in a gracefully designed coffin. The programme drew to a close with family members and volunteers congregating for a gratitude and cremation ceremony to celebrate the lives and selfless contribution in remembrance of the Silent Mentors. The Jefferson Scale of Empathy (JSE) was used to measure participants' empathy levels as they progressed through the programme.

At baseline, the mean total score obtained by the medical students in the JSE was 106.57 (SD = 17.26). This figure rose to 112.34 (SD = 19.90) after the students' participation in the Silent Mentor workshops. There were no significant differences in the estimated marginal means of empathy amongst students when the scores were regressed for independent variables and Levene's test showed homogeneity of variances.

The Silent Mentor programme showed to provide comprehensive medical education. Concurrent anatomy and basic surgical skills learning contextualised and empowered the students' capacity to empathise with the donors, bridging the division between hard sciences and soft humanities. With the association of skills with the memory of the Silent Mentors, it is anticipated that the skills acquired will be transferred to the participants' future patients; the students' sense of emotional gratitude towards their Silent Mentors may stimulate motivation and diligence towards a positive medical career.

A follow up study on this cohort of students should be done to assess whether empathy levels could be maintained. Furthermore, with the move towards patient-centred care, further studies should be done to assess patient-perceived empathy levels amongst health care professionals.