# Does Clinical Training Influence Empathy in Dental Students? Evidence from a Cross-Sectional Study in Lithuania

## TL;DR

This study found that empathy in Lithuanian dental students declines as they progress through clinical training, particularly in their final year.

## Contribution

The study provides new evidence on empathy changes in Lithuanian dental students during clinical training using a validated empathy scale.

## Key findings

- Fifth-year dental students had significantly lower empathy scores than third- and fourth-year students.
- Perspective Taking and Compassionate Care subscales declined in final-year students, while Standing in the Patient’s Shoes remained stable.
- The Lithuanian version of the JSE-HPS was confirmed as a reliable and valid tool for measuring empathy.

## Abstract

Background/Objectives: Empathy is a core component of professional competence in dentistry, influencing patient-centered care and treatment outcomes. Evidence suggests that empathy may decline during clinical training, but data from Lithuanian dental students are lacking. This study aimed to assess empathy levels and subscale patterns among Lithuanian dental students and examine their association with academic year. Methods: A cross-sectional study was conducted among third- to fifth-year dental students at the two universities in Lithuania. The Lithuanian version of the Jefferson Scale of Empathy–Health Professions Students (JSE-HPS) was used to measure total empathy and three subscales: Perspective Taking (PT), Compassionate Care (CC), and Standing in the Patient’s Shoes (SPS). Internal consistency was assessed using Cronbach’s alpha. Factor validity was examined via principal component analysis with Varimax rotation and Kaiser normalization. Differences across academic years were analyzed using Kruskal–Wallis tests. Results: A total of 252 students completed the questionnaire (response rate: 93%). The Lithuanian JSE-HPS demonstrated good internal consistency (α = 0.808) and confirmed a three-factor structure. The mean total empathy score was 106.07 ± 12.55. JSE-HPS scores differed significantly between dental classes (p < 0.001). Fifth-year students had significantly lower JSE-HPS scores than third- and fourth-year students (101.65 vs. 107.05 and 109.36; p = 0.035 and p = 0.007). PT and CC scores significantly declined in fifth-year students compared with earlier years, whereas SPS scores remained stable. Conclusions: The Lithuanian version of the JSE-HPS is a reliable and psychometrically sound tool for assessing empathy. Clinical training was significantly associated with a decline in total empathy scores among Lithuanian dental students, highlighting the impact of academic progression on both cognitive and affective components of empathy. Given the cross-sectional design, causal inferences cannot be drawn.