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January 13, 2023

What Is the State of Compassion Education?

A Systematic Review of Compassion Training in Health Care


To investigate the current state and quality of compassion education interventions offered to health care providers during training or practice, determine how the components of each education intervention map onto the domains of an empirically based clinical model of compassion, and identify the most common approaches to compassion education.


One hundred eight peer-reviewed publications describing 103 interventions were included. Modalities ranged from establishing curricula and interventions in clinical settings to programs that used humanities-based reflective practices, clinical simulation, role modeling, and contemplative practices, with many education interventions adopting a multimodal approach. Most interventions mapped to the virtuous response domain of the Patient Compassion Model; very few mapped to the other domains of this model.


Most interventions were limited as they focused on a single domain of compassion; did not adequately define compassion; were assessed exclusively by self-report; were devoid of a comparator/control group; and did not evaluate retention, sustainability, and translation to clinical practice over time. The authors suggest that compassion education interventions be grounded in an empirically based definition of compassion; use a competency-based approach; employ multimodal teaching methods that address the requisite attitudes, skills, behaviors, and knowledge within the multiple domains of compassion; evaluate learning over time; and incorporate patient, preceptor, and peer evaluations.

Traditionally, contemporary health care provider training has undervalued the need to develop human aspects of medicine and care, such as compassion, empathy, respect, and interpersonal skills

Compassion has been identified by patients as “a virtuous and intentional response to know a person, to discern their needs and ameliorate their suffering through relational understanding and action.” Additionally, compassion is now recognized by medical professionals and health care providers as an essential feature of quality health care and a cornerstone of medical codes of ethics  and is arguably the greatest indicator of quality health care according to patients and family members. The impact of compassion extends beyond patients’ perceptions, affecting symptom burden,  quality of life, satisfaction with care, health care provider–patient relationships, patient disclosure and management of health issues, and health care costs. Further, among health care providers, compassion is associated with enhanced workplace well-being, job satisfaction, and retention. 

Published online: Academic Medicine, June 29, 2021.

Authors: By Shane Sinclair, PhD; Jane Kondejewski, PhD; Priya Jaggi, MSc; Liz Dennett, MLIS; Amanda L. Roze des Ordons, MD, MMEd; and Thomas F. Hack, PhD

Copyright © 2021 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of the Association of American Medical Colleges.

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This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial License 4.0 (CCBY-NC), where it is permissible to download, share, remix, transform, and buildup the work provided it is properly cited. The work cannot be used commercially without permission from the journal.

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