Is There a Relation Between Work-related Perception and Empathy with the Clinical Performance of Residents in China?

Since the nationwide launch of the Standardized Residency Training Program (SRTP) in China, residents have faced multiple barriers from work and the environment, and their empathy, work-related perception, and clinical performance are constantly scrutinized by training administrators and educators. This study aimed to investigate the influence of empathy of residents on their clinical performance and the possible mediating role of work-related perception. A multi-center cross-sectional study was conducted including 1160 residents from 10 cities in Liaoning Province between March and October 2020. Participants completed an array of self-reported questionnaires, regarding demographic characteristics, work-related perception, clinical performance, and empathy (measured by the Perspective Taking and Empathic Concern subscales of the Chinese version of Interpersonal Reactivity Index). The relationships among empathy, work-related perception, and clinical performance were examined using a structural equation model (SEM). Of the 1160 residents, 961 (82.8%) completed the questionnaires. The final SEM produced a good fit to the sample data, with CMIN/DF = 2.11 ( P  < 0.001), CFI = 0.97, GFI = 0.98, AGFI = 0.97, RMSEA (90% CI) = 0.034 (0.024, 0.044), and SRMR = 0.031. The model indicated the following: (1) work-related perception of residents had a significant positive predictive effect on clinical performance; (2) empathy had a significant positive predictive effect on work-related perception; and (3) work-related perception partially mediated the relationship between empathy and clinical performance among residents. These findings provide a reference for SRTP administrators and educators to apply work-related interventions for directly or indirectly improve the clinical performance of residents.