Factors Influencing Empathy in Clinical Medical Education

Factors Influencing Empathy in Clinical Medical Education | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Factors Influencing Empathy in Clinical Medical Education JIANG ZHIQIANG, ZHU TINGTING This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-8697656/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract Background: Empathy is a fundamental professional competence in medical education, yet evidence suggests that empathy development may stagnate during medical training. Emotional intelligence and self-efficacy have been proposed as important psychological predictors of empathy; however, their relative roles across different stages of medical education remain unclear. Methods: This study employed a two-wave cohort design to investigate empathy development among undergraduate clinical medicine students in China. Participants completed validated measures of empathy, emotional intelligence, and self-efficacy during the early stage of training and again in the later stage. Descriptive analyses, group comparisons, and multivariate regression models were used to examine developmental changes and the relative contributions of emotional intelligence and self-efficacy to empathy. Results: Empathy levels showed only modest improvement across training stages. Emotional intelligence demonstrated a stable and significant positive association with empathy at both time points, whereas self-efficacy showed weak and inconsistent effects after controlling for emotional intelligence. Among emotional intelligence dimensions, emotional perception and emotional regulation emerged as the strongest predictors of empathy. In addition, gender and rural–urban background were associated with differences in empathy levels and the strength of these relationships. Conclusions: The findings indicate that emotional intelligence, rather than self-efficacy, plays a central role in empathy development among medical students. These results suggest that confidence-based educational approaches alone may be insufficient to foster empathic competence in emotionally complex clinical contexts. Integrating emotional intelligence–focused training into early medical curricula may provide a more effective pathway for supporting sustainable empathy development in medical education. Empathy Emotional intelligence Self-efficacy Clinical medical education Medical students Humanistic education Gender differences Emotional regulation Doctor–patient relationship 1. Background Empathy is widely recognized as a core professional competency in medical education, playing a crucial role in doctor–patient communication, clinical decision-making, and patient satisfaction. Empirical evidence consistently shows that higher physician empathy is associated with improved treatment adherence, better clinical outcomes, and reduced medical disputes[ 1 ]. Despite sustained reforms in medical curricula and increasing attention to medical humanities, numerous studies have reported stagnation or even decline in empathy as students progress through clinical training, a phenomenon often referred to as the “empathy erosion” effect[ 2 – 3 ]. Understanding the psychological mechanisms underlying empathy development in medical students has therefore become a central concern in contemporary medical education research. Among the individual-level factors examined, emotional intelligence (EI) and self-efficacy (SE) have received particular attention. However, existing findings remain fragmented, and the relative roles of these constructs in shaping empathy—especially across different stages of medical training—are not yet fully understood. Emotional intelligence and empathy Emotional intelligence refers to the capacity to perceive, understand, regulate, and utilize emotions in oneself and others. In clinical contexts, EI enables medical students to recognize patients’ emotional cues, manage their own emotional responses, and engage in emotionally appropriate communication[ 4 ]. Prior research has consistently demonstrated positive associations between EI and empathy among healthcare students and professionals, suggesting that EI may function as a proximal psychological resource that directly supports empathic engagement[ 5 ]. Theoretical models of EI emphasize emotion-related information processing as a core mechanism linking EI to social functioning. From this perspective, empathy is not merely an attitudinal disposition but an emotionally grounded capability that depends on effective emotional perception and regulation. Accordingly, EI—particularly its components related to emotional perception and regulation—may serve as a key driver of empathy development during medical training [ 6 ]. Self-efficacy and its boundary conditions Self-efficacy, defined as individuals’ beliefs in their capability to organize and execute actions required to manage prospective situations, has been shown to predict academic performance, learning engagement, and professional identity in medical education[ 7 ]. High self-efficacy may increase students’ confidence in handling clinical tasks and interpersonal challenges. However, evidence regarding its role in fostering empathy is mixed[ 8 – 11 ]. Unlike EI, which is intrinsically emotion-oriented, self-efficacy is primarily task- and performance-oriented. In emotionally complex clinical encounters—such as those involving patient suffering, uncertainty, or conflict—confidence in one’s abilities alone may be insufficient to elicit empathic understanding[ 12 ]. This suggests that self-efficacy may function as a distal and context-dependent factor in empathy development, exerting its influence only under certain emotional or situational conditions[ 13 – 14 ]. Developmental perspective and cultural context Most prior studies have examined EI, self-efficacy, and empathy using cross-sectional designs, limiting insight into how these constructs evolve across different stages of medical education[ 15 – 16 ]. A developmental perspective is particularly important in medical training, where students transition from classroom-based learning to emotionally demanding clinical practice [ 17 – 19 ]. Furthermore, cultural and contextual factors may shape the ways in which psychological resources translate into empathic behavior. In collectivist societies such as China, emotional socialization, family structure (e.g., only-child status), and rural–urban background may influence emotional learning and interpersonal sensitivity. Examining empathy development within this cultural context can therefore contribute to a more nuanced understanding of medical education processes[ 20 – 22 ]. Study aims and contributions Against this backdrop, the present study investigates the relationships among emotional intelligence, self-efficacy, and empathy in a cohort of Chinese undergraduate clinical medicine students using a two-wave design spanning the early and later stages of training. Specifically, this study aims to: 2. Subjects and Methods 2.1 Research Subjects The questionnaires were distributed twice to the same cohort of students: first in March-April 2021 (freshmen) and again in March 2024 (senior four). Online surveys were administered to 2020 undergraduate clinical medical students at our university via the Questionnaire Star platform. The first survey collected 378 responses, with 345 valid after excluding those exceeding 120 seconds (91.27% validity rate). The second survey collected 459 responses, with 361 valid (78.65% validity rate). 2.2 Survey Design The electronic questionnaire included demographic information (gender, age, family economic status, hometown, student leadership roles, only-child status) and three subscales: the Empathy Scale, Self-Efficacy Scale, and Emotional Intelligence Scale. Empathy Scale[23]: 20 items, 7-point Likert scale, total score 140. Higher scores indicate higher empathy. Self-Efficacy Scale[24]: 10 items, 4-point Likert scale (From 'completely incorrect' to 'completely correct', they are counted as 1 point, 2 points, 3 points, and 4 points respectively,), total score 40. Higher scores indicate stronger self-efficacy. Emotional Intelligence Scale[25]: 16 items across four dimensions (emotional perception, emotional control, emotional regulation, emotional application), 7-point Likert scale, total score 112. Higher scores indicate higher emotional intelligence. 2.3 Statistical Methods Data were analyzed using SPSS 26.0. Descriptive statistics and Pearson correlation analysis were performed (α = 0.05). Kaiser-Meyer-Olkin (KMO) tests were conducted: Empathy Scale KMO = 0.904 (both surveys), Self-Efficacy Scale KMO = 0.910/0.916, Emotional Intelligence Scale KMO = 0.889/0.897. Bartlett’s sphericity tests were significant (p = 0.000).See Table -1 Scale Reliability Analysis. Table -1 Scale Reliability Analysis N=345 N=365 Scale name items Kaiser-MeyerOlkin Kaiser-MeyerOlkin empathy ability 20 0.904 0.904 Self efficacy Scale 10 0.910 0.916 emotional intelligence 16 0.889 0.897 (Note: N=345 is the first questionnaire scale, N=365 is the second questionnaire scale) 3. Results and Analysis 3.1 Validity and Reliability of Scales The consistency reliability test method Cronbach's α coefficient was used to analyze the validity and reliability of two questionnaire scales. The Cronbach's α coefficients of the Empathy Scale were 0.773 and 0.626, the Cronbach's α coefficients of the Self Efficacy Scale were 0.859 and 0.919, and the Cronbach's α coefficients of the Emotional Intelligence Scale were 0.893 and 0.916, respectively. The above results indicate that the questionnaire scale 1 of this study has very good validity and reliability, and the questionnaire scale design is reasonable.See Table -2 Scale Reliability Analysis. Table -2 Scale Reliability Analysis N=345 N=365 Scale name items Cronbach′s α Cronbach’s α empathy ability 20 0.773 0.626 Self efficacy Scale 10 0.859 0.919 emotional intelligence 16 0.893 0.916 (Note: N=345 is the first questionnaire scale, N=365 is the second questionnaire scale) 3.2 Basic information of undergraduate students of clinical medicine Among the 345 undergraduate students of clinical medicine, there are 160 male students (46.4%) and 185 female students (53.6%); aged 17-22 (18.64±0.69) years old; 182 only children (52.8%) and 163 non-only children (47.2%); 196 urban residents (56.8%) and 149 township residents (43.2%); 37 poor families (10.7%), 264 well-off families (76.5%) and 44 wealthy families (12.8%); 160 student cadres (46.4%) and 185 non-student cadres (53.6%). Among the 365 clinical medicine undergraduate students, there were 78 males (21.37%) and 286 females (78.63%); aged 20-25 (18.64±0.69) years old; 145 were only children (39.73%) and 220 were not only children (60.27%); 172 were urban residents (47.12%) and 193 were township residents (52.88%); the family economic situation was poor for 74 (20.27%), moderately well-off for 280 (76.71%) and wealthy for 11 (3.02%); there were 155 student cadres (42.47%) and 210 were non-student cadres (57.53%). 3.3 Scores of Empathy, Self-Efficacy, and Emotional Intelligence The empathy ability score results showed that the average score of the freshman was 4.46 (total score 89.12), which increased to 5.30 (89.72) in the senior year, but the total score increase was not significant (p=0.12), indicating that clinical practice has not effectively improved empathy ability, which is consistent with Hojat's "empathy decline" phenomenon. The self-efficacy score results dropped from 2.62 in the freshman year to 2.41 in the senior year (p<0.01), which may be due to the accumulation of academic pressure and clinical frustration (Artino et al., 2011). The emotional intelligence score results showed that the emotion application dimension increased significantly (4.88→5.20, p<0.05), reflecting that senior students are better at strategic emotion management, but their emotion control ability stagnated (4.60→4.76, p=0.21). The correlation between self-efficacy and empathy ability was weakly correlated only in the lower grades (r=0.139, p<0.05), and was not significant in the higher grades, indicating that the effect of self-efficacy on empathy is mediated by the situation. When students face complex doctor-patient conflicts, self-confidence alone is not enough to drive empathic behavior. Emotional intelligence affects empathy. Emotional perception (β=0.325, p<0.01) and emotion regulation (β=0.344, p<0.01) are key predictors of empathy, supporting Salovey's (1997) "emotion-cognition dual channel" theory.See Table -3 Scoring of Empathy Ability, Self Efficacy, Emotional Intelligence, and Emotional Intelligence in Four Dimensions . Table -3 Scoring of Empathy Ability, Self Efficacy, Emotional Intelligence, and Emotional Intelligence in Four Dimensions (N=345) (N=365) project Total score Average score（χ±s） Total score Average score（χ±s） empathy ability 89.12±13.08 4.46±0.65 89.72±8.36 5.3±0.44 Self efficacy 26.18±5.64 2.62±0.56 24.07±5.19 2.41±0.27 emotional intelligence 77.78±13.97 4.86±0.87 81.78±11.86 4.86±0.62 Emotional perception 20.4±4.59 5.1±1.15 22.08±3.46 5.52±0.18 emotion control 18.36±4.65 4.6±1.16 19.02±4.3 4.76±0.22 Emotional regulation 19.52±4.21 4.88±1.05 19.88±3.86 4.97±0.2 Emotional Application 19.49±4.4 4.88±1.1 20.8±3.81 5.2±0.2 (Note: N=345 is the first questionnaire scale, N=365 is the second questionnaire scale) 3.4 Correlation between self-efficacy, emotional intelligence, and the four dimensions of emotional intelligence and empathy in different demographic characteristics The results show that there is a significant statistical correlation between self-efficacy, emotional intelligence, as well as emotion perception, emotion control, emotion regulation, and emotion application and empathy (p < 0.01). From the perspective of gender, except for the insignificant correlation between the emotion regulation dimension and empathy, self-efficacy, emotional intelligence, emotion perception, emotion control, and emotion application all show significant correlations for men (p < 0.01). For women, except for the insignificant correlation between self-efficacy and emotion perception and empathy, emotional intelligence, emotion control, emotion regulation, and emotion application all show significant correlations (p < 0.01). From the perspective of whether or not they are only children, except for the correlation between emotion perception and empathy, self-efficacy, emotional intelligence, emotion control, emotion regulation, and emotion application all show significant correlations (p < 0.01). From the perspective of non-only children, except for the correlation between self-efficacy and empathy, emotional intelligence and the four dimensions of emotional intelligence all show significant correlations (p < 0.01). From the perspective of whether or not to be a student leader, except for the correlation between self-efficacy and emotion perception dimensions and empathy, emotional intelligence, emotion control, emotion regulation, and emotion application all showed significant correlations with empathy (p < 0.01). Self-efficacy, emotional intelligence, and the four dimensions of emotional intelligence all showed significant correlations with empathy for non-student leaders (p < 0.01). From the overall perspective of the students' place of origin, except for the insignificant correlation between self-efficacy and empathy, emotional intelligence and the four dimensions of emotional intelligence all showed significant correlations with empathy. It is worth noting that the emotional intelligence and the correlation between the four dimensions of emotional intelligence and empathy of rural students are generally higher than those of urban students (p < 0.01). From the perspective of gender, females have higher empathy (Δ=0.68, p<0.01), but weaker emotional control than males (Δ=-0.24, p<0.05), which may be related to the discipline of "emotional expression" in the process of gender socialization (Eagly, 2013); from the perspective of urban and rural areas, the correlation between emotional intelligence and empathy of rural students is stronger (r=0.478 vs. 0.325), which may be because the rural environment emphasizes collective emotional interaction. See Table-4 Correlation between four dimensions of self-efficacy, emotional intelligence, and emotional intelligence with empathy ability based on different demographic characteristics. Table - 4 Correlation between four dimensions of self-efficacy, emotional intelligence, and emotional intelligence with empathy ability based on different demographic characteristics N=345 Self efficacy emotional intelligence Emotional perception emotion control Emotional regulation Emotional Application category 0.139** 0.395** 0.325** 0.261** 0.344** 0.311** empathy ability gender Male N=160 0.281** 0.385** 0.350** 0.245** 0.332 0.240** Female N=185 0.015 0.413** 0.818 0.274** 0.356** 0.381** the only child onlyN=182 0.193** 0.322** 0.269 0.195** 0.270** 0.275** not merely N=163 0.04 0.497** 0.409** 0.345** 0.442** 0.366** student cadres Yes N=160 0.118 0.343** 0.301 0.251** 0.348** 0.204** No N=185 0.168* 0.450** 0.350** 0.276** 0.343** 0.402** Students Town N=196 0.13 0.325** 0.263** 0.192** 0.328** 0.244** rural area N=149 0.126 0.478** 0.413** 0.337** 0.357** 0.382** Note:* P<0.05，**P<0.01； N=345 is the first questionnaire scale, and N=365 is the second questionnaire scale. 3.5 Correlation between self-efficacy, emotional intelligence and its four dimensions and empathy Conduct correlation analysis on the total scores of self-efficacy, emotional intelligence, emotional intelligence dimensions, and empathy ability. The total scores of self-efficacy, emotional intelligence, and various dimensions are positively correlated with the total score of empathy ability, and all have statistical significance (P<0.01). See Table-5 and Table-6 Correlation between Self Efficacy, Emotional Intelligence, and Four Dimensions with Empathy Ability. Tabl -5 Correlation between Self Efficacy, Emotional Intelligence, and Four Dimensions with Empathy Ability N=345 Empathy Self efficacy emotional intelligence Emotional perception emotion control Emotional regulation Emotional Application Empathy 1 Self efficacy 0.139 ** 1 emotional intelligence 0.395 ** 0.448 ** 1 Emotional perception 0.325 ** 0.205 ** 0.801 ** 1 emotion control 0.261 ** 0.403 ** 0.778 ** 0.476 ** 1 Emotional regulation 0.344 ** 0.429 ** 0.806 ** 0.570 ** 0.510 ** 1 Emotional Application 0.311 ** 0.372 ** 0.748 ** 0.452 ** 0.431 ** 0.470 ** 1 Note:* P<0.05，**P<0.01； N=345 is the first questionnaire scale, and N=365 is the second questionnaire scale. Table-6 Correlation between Self Efficacy, Emotional Intelligence, and Four Dimensions with Empathy Ability N=365 Empathy Self efficacy emotional intelligence Emotional perception emotion control Emotional regulation Emotional Application Empathy 1 Self efficacy 0.177 ** 1 emotional intelligence 0.248 ** 0.578 ** 1 Emotional perception 0.231 ** 0.335 ** 0.780 ** 1 emotion control 0.174 ** 0.466 ** 0.772 ** 0.526 ** 1 Emotional regulation 0.165 ** 0.568 ** 0.805 ** 0.470 ** 0.510 ** 1 Emotional Application 0.396 ** 0.396 ** 0.719 ** 0.459 ** 0.333 ** 0.443 ** 1 Note:* P<0.05，**P<0.01； N=345 is the first questionnaire scale, and N=365 is the second questionnaire scale. 3.6 Regression Analysis of Empathy Influencing Factors This study uses the total score of empathy as the dependent variable, and self-efficacy, emotional intelligence, the four dimensions of emotional intelligence, gender, whether or not to be an only child, whether or not to be a class leader, and place of origin as independent variables. Through the multivariate linear regression method, the factors that may affect empathy are explored. In the regression model, self-efficacy, emotional intelligence, emotion regulation, emotion regulation, emotion application, gender and other factors are included in the equation. The results show that self-efficacy has a weak effect on empathy, only 13.9% (R2=0.019, F=6.785). After reaching the senior grades, the effect increases, but it is weak, only 17.7% (R2=0.031, F=11.748). However, when self-efficacy and emotional intelligence jointly affect empathy, the effect of self-efficacy is not significant, while the effect of emotional intelligence on empathy is significant, accounting for 41.6% of the influencing factors (R2=0.158, F=32.077). After reaching the senior grades, the effect decreases, accounting for 21.9% (R2=0.063, F=12.35). When self-efficacy, emotional intelligence, and the four dimensions of emotional intelligence affect empathy together, only emotional intelligence as a whole has a significant effect on empathy, and its influencing factors account for 16.4% (R2=0.164, F=13.294). In addition, when self-efficacy, emotional intelligence, emotional regulation, emotional regulation, emotional application, and gender affect empathy together, only emotional intelligence and gender have a significant impact on empathy, accounting for 17.7% of the influencing factors (R2=0.177, F=12.078). See Table-7and Table-8 Regression Analysis of Factors Influencing Empathy Ability. Table-7 Regression Analysis of Factors Influencing Empathy Ability N=345 M0del1 M0del2 M0del3 M0del4 Self efficacy 0.139 * -0.047 -0.049 -0.059 emotional intelligence 0.416 *** 0.397 * 0.432 * Emotional perception emotion control -0.078 -0.093 Emotional regulation 0.069 0.054 Emotional Application 0.034 0.024 gender -0.113 * Is it an only child Growing regions R 2 0.019 * 0.158 *** 0.164 *** 0.177 *** F 6.785 32.077 13.294 12.078 Note：*P<0.05，**P<0.01，***P<0.001;N=345 is the first questionnaire scale Table-8 Regression Analysis of Factors Influencing Empathy Ability N=365 M0del1 M0del2 M0del3 M0del4 Self efficacy 0.177 * 0.05 0.080 0.071 emotional intelligence 0.219 *** 0.081 0.05 Emotional perception 0.127 0.137 emotion control -0.034 -0.014 Emotional regulation Emotional Application 0.069 0.086 gender -0.054 Is it an only child Growing regions R 2 0.031 * 0.063 *** 0.072 0074 F 11.748 12.350 1.061 1.068 Note：*P<0.05，**P<0.01，***P<0.001; N=365 is the second questionnaire scale 4. Conclusions and Recommendations This study examined empathy development among Chinese undergraduate clinical medicine students and explored the roles of emotional intelligence and self-efficacy using a two-wave cohort design. Three main findings emerged. First, empathy levels showed only modest improvement from the early to later stages of training, supporting prior reports of empathy stagnation during medical education. Second, emotional intelligence consistently demonstrated a significant and robust association with empathy, whereas self-efficacy exhibited weak and inconsistent effects. Third, demographic factors—particularly gender and rural–urban background—moderated the strength of the relationships between emotional intelligence and empathy. 4.1 Emotional intelligence as a proximal predictor of empathy The most salient finding of this study is that emotional intelligence, rather than self-efficacy, serves as the primary predictor of empathy among medical students[ 26 – 27 ]. Across both waves, EI showed stable and meaningful associations with empathy, with emotional perception and emotional regulation emerging as particularly important dimensions. These results support emotion-centered theories of empathy, which posit that effective empathic engagement depends on the ability to accurately process and regulate emotional information[ 28 – 29 ]. From a developmental perspective, EI may function as a proximal psychological resource that directly enables students to translate emotional awareness into empathic behavior[ 30 ]. As students progress into clinical environments characterized by emotional complexity and interpersonal stress, EI-related competencies become increasingly salient. This may explain why EI retained its predictive power even as self-efficacy declined in later stages of training[ 31 ]. 4.2 Boundary conditions of self-efficacy in empathy development In contrast to emotional intelligence, self-efficacy demonstrated only weak associations with empathy, and its predictive effect diminished when EI was included in multivariate models. This finding suggests that self-efficacy alone is insufficient to elicit empathic engagement in emotionally demanding clinical contexts. While confidence in one’s abilities may facilitate task performance and learning persistence, it does not necessarily translate into sensitivity toward others’ emotional experiences[ 32 ]. This pattern highlights an important boundary condition for efficacy-based models in medical education. In contexts where emotional understanding and interpersonal attunement are required, emotion-related competencies may override the influence of generalized confidence beliefs. Conceptualizing self-efficacy as a distal and context-dependent factor helps reconcile inconsistent findings in the literature and underscores the need to integrate emotional competence into models of professional development[ 33 ]. 4.3 Demographic and contextual influences The study also revealed meaningful demographic differences in empathy and its psychological correlates. Female students demonstrated higher empathy levels, consistent with prior research on gender socialization and emotional expressiveness. Additionally, the association between emotional intelligence and empathy was stronger among students from rural backgrounds than those from urban areas. One possible explanation is that rural social environments emphasize collective interaction and emotional interdependence, fostering greater sensitivity to others’ emotions[ 34 – 35 ]. These findings suggest that empathy development is shaped not only by individual psychological resources but also by broader social and cultural contexts. Medical education programs should therefore consider students’ diverse backgrounds when designing humanistic and emotional training interventions[ 36 – 37 ]. 4.4 Implications for medical education The findings of this study have several practical implications for medical education. First, they highlight the importance of integrating emotional intelligence training early in medical curricula, rather than relying solely on clinical exposure to foster empathy. Structured interventions focusing on emotional perception, regulation, and reflective practice may be particularly effective[ 38 – 40 ]. Second, while self-efficacy remains important for academic and clinical performance, educators should be cautious in assuming that confidence-building alone will enhance empathic capacity. Emotional competence training should complement, rather than be replaced by, efficacy-oriented educational strategies[ 41 – 42 ]. Finally, the observed demographic differences underscore the value of tailored educational approaches. Incorporating scenario-based learning, guided reflection, and culturally sensitive communication training may help address diverse developmental needs among medical students[ 43 – 44 ]. 5. Limitations and future directions Several limitations should be acknowledged. The sample was drawn from a single medical university, which may limit generalizability. Although the study employed a two-wave design, future research using fully longitudinal modeling techniques could provide deeper insight into individual developmental trajectories. Additionally, qualitative or intervention-based studies may further elucidate how emotional intelligence training translates into sustained empathic practice. Despite these limitations, this study provides robust evidence that emotional intelligence plays a central role in empathy development among medical students and offers actionable insights for advancing humanistic medical education. Declarations Acknowledgements We thank all the participants in this study. Author contributions Conceived and designed the research: Z-q J, T-t Z. Wrote the paper: Z-q J. Analyzed the data: Z-q J, T-t Z. Revised the paper: Z-q J, T-t Z,All authors reviewed the manuscript. Funding Southwest Medical University-level research project, No.: 58-00260406. Data availability The datasets generated and/or analyzed during the current study are not publicly available due privacy protection and ethical obligations but are available (in deidentified form) from the corresponding author on reasonable request. Human Ethics and Consent to Participate declarations This study adhered to the Declaration of Helsinki.Approved by the Ethics Committee of Southwest Medical University,No.SWMUIRBTX-202412-0040;Considering the privacy and security of the respondents, the questionnaires were filled out anonymously. The respondents were informed of the privacy, confidentiality and voluntary participation consent before filling out the questionnaires. The questionnaire was filled after obtaining informed consent from all participants of the study.All data were used for academic purposes only. Consent for publication Not applicable. Competing interests The authors declare no competing interests. References Wei H. Jean Watson.Healthcare interprofessional team members' perspectives on human caring: A directed content analysis study. Int J Nurs Sci. 2019;6(1):17–23. https://doi.org/10.1016/j.ijnss.2018.12.001 . Brett W. Nicole Verbeck,Curt Walker &Daniel M Clinchot.Burnout, perceived stress, and empathic concern: differences in female and male Millennial medical students.Psychology. Health Med. 2019;24(4):429–38. https://doi.org/10.1080/13548506.2018.1529329 . Mohammed RAL, Btousha,Malakeh Z, Malak,Shaher H. Hamaideh &Ahmed H. Shuhaiber.The relationship between emotional intelligence, self-efficacy, and clinical decision-making among critical care nurses in Jordan. J Hum Behav Social Environ. 2024;35(3):454–68. https://doi.org/10.1080/10911359.2024.2310261 . Sushma Prabhath U, Kulkarni, Vani Lakshmi R, Patra B. Divya Arvind Prabhu & Kirtana R. Nayak.Visual hermeneutics as a tool to introduce empathy and core physician attributes in doctor-patient relationship for first-year medical undergraduate students. BMC Med Educ. 2025;25(145). https://doi.org/10.1186/s12909-025-06742-6 . Sandra H, Sulzer, Noah W, Feinstein,Claire LW. Assessing Empathy Development in Medical Education: A Systematic Review. Med Educ. 2016;50(3):300–10. .https://doi/10.1111/medu.12806 . Mi-Kyoung Cho ,Mi Young Kim. Effectiveness of simulation-based interventions on empathy enhancement among nursing students: a systematic literature review and meta-analysis. BMC Nurs.2024;23(319). https://doi.org/10.1186/s12912-024-01944-7 Bandura A, Sebastian Wessels. &. Self-efficacy . Vol. 4. na, 1994. ABoissy A, Windover AK, Bokar D et al. Communication skills training for physicians improves patient satisfaction. Journal of general internal medicine .2016;31(7):755–761. .https://doi.org/10.1007/s11606-016-3597-2 Woods JL, Pasold TL, Boateng BA et al. Medical student self-efficacy, knowledge and communication in adolescent medicine. International Journal of Medical Education . 2014;5:165–172.https://doi.10.5116/ijme.53d3.7b30. Klassen RM, Klassen JRL. Self-efficacy beliefs of medical students: a critical review. Perspect Med Educ. 2018;7(2):76–82. https://doi.org/10.1007/s40037-018-0411-3 . Wang J, Zheng Q, Song W, et al. The effect of nursing students' self-efficacy on patient-centered communication during the COVID-19 pandemic: The mediating effect of learning burnout. Front Psychiatry. 2021;12:787819doi. 10.3389/fpsyt.2021.787819 . Zou L, Xie Z, Tan M, et al. The effect of professional identity on nursing academic achievement: the chain mediating effect of general self-efficacy and learning engagement. BMC Med Educ. 2024;24(1):1014. https://doi.org/10.1186/s12909-024-05995-x . Monteiro M. Doctor-patient relationship and its influence on the outcomes: what is the importance of emotional intelligence when approaching the patient? MS thesis. 2023. Sharp G, Bourke L, Rickard MJFX. Review of emotional intelligence in health care: an introduction to emotional intelligence for surgeons. ANZ J Surg. 2020;90(4):433–40. https://doi.org/10.1111/ans.15671 . Pichert JW, Miller CS, Hollo AH et al. What health professionals can do to identify and resolve patient dissatisfaction. The Joint Commission journal on quality improvement .1998;24(6): 303–312. https://doi.org/10.1016/S1070-3241(16)30382-0 Isbell LM, Boudreaux ED, Chimowitz H, et al. What do emergency department physicians and nurses feel? A qualitative study of emotions, triggers, regulation strategies, and effects on patient care. BMJ Qual Saf. 2020;29(10):1–2. https://doi.org/10.1136/bmjqs-2019-010179 . Kasemy ZA, Kabbash I, Desouky D et al. Perception of educational environment with an assessment of motivational learning strategies and emotional intelligence as factors affecting medical students’ academic achievement. Journal of education and health promotion. 2022;11(1): 303.https://doi.org10.4103/jehp.jehp_1772_21. Kanesan P, Fauzan N. Models of emotional intelligence: A review. e-BANGI Journal .2019;16(7). Pérez-Fuentes MC, Jurado MMM, Gázquez Linares JJ. Explanatory value of general self-efficacy, empathy and emotional intelligence in overall self-esteem of healthcare professionals. Social work in public health .2019;34(4): 318–329. https://doi.org/10.1080/19371918.2019.1606752 Ousager J, Johannessen H. Humanities in undergraduate medical education: a literature review. Acad Med. 2010;85(6):988–98. https://doi.org/10.1097/ACM.0b013e3181dd226b . Chen Guangyi Z, Cuihong L. Investigation and analysis of the current status of humanistic care ability and its influencing factors among 407 higher vocational nursing students. Chin J Nurs Manage. 2015;15(04):409–12. https://doi:CNKI:SUN:GLHL . 0.2015-04-014. Taylor A, Lehmann S, Chisolm M. Integrating humanities curricula in medical education: a literature review. MedEd Publish. 2018;6:90. https://doi:10.15694/mep.2017.000090.2 . Jiang Tian W, Xiaoyan L, Yuanyuan L. Reliability and validity of the Chinese version of the Jefferson Empathy Scale (Medical Student Version). J Sichuan Univ (Medical Edition). 2015;46(04):602–5. https://doi:10.13464/j.scuxbyxb.2015.04.021 . Wang Caikang H, Zhongfeng LY. Reliability and validity of the general self-efficacy scale. Appl Psychol.2001;(01):37–40. https://doi: CNKI:SUN:YXNX.0.2001-01-006. Huang Y, Aiqin Lü, Lei W. Validity test of emotional intelligence scale for college students. J Peking Univ (Natural Sci Edition). 2008;06970–6. .https://doi:10.13209/j.0479-8023.2008.151 . Zhang H. Relationship between empathy level, emotional health and prosocial behavior. Sports Social Psychol. 2024;4(1). https://doi.org/10.37420/J.SSP.2024.001 . Preston SD. The origins of altruism in offspring care. Psychol Bull. 2013;139(6):1305–41. https://doi.org/10.1037/a0031755 . Song P, Tang W. Emphasizing humanities in medical education: Promoting the integration of medical scientific spirit and medical humanistic spirit. Biosci Trends. 2017;11(2):128–33. https://doi.org/10.5582/bst.2017.01092 . Cairns P, Isham AE, Zachariae R. The association between empathy and burnout in medical students: a systematic review and meta-analysis. BMC Med Educ. 2024;24(1):640. https://doi.org/10.1186/s12909-024-05625-6 . Hou J, Michaud C, Li Z, et al. Transformation of the education of health professionals in China: progress and challenges. Lancet. 2014;384(9945):819–27. Song P, Tang W. Emphasizing humanities in medical education: Promoting the integration of medical scientific spirit and medical humanistic spirit. BioScience Trends. 2017;11(2):128–133.https://doi.10.5582/bst.2017.01092. Xiqian Ca. Qingliang Fan b, Congying Yuan c. The impact of only child peers on students’ cognitive and non-cognitive outcomes .2022;78: 02231.https://doi.org/10.1016/j.labeco.2022.102231 Xu Q, Wu J, Peng H. Chinese EFL university students’ self-efficacy for online self-regulated learning: Dynamic features and influencing factors. Front Psychol. 2022;13. 912970.https://doi.org/10.3389/fpsyg.2022.912970 . Yu Fei G, Huimin H, Hui, Qian Cong. Study on the relationship between emotional intelligence and coping effectiveness of medical students. J China Med Univ. 2012;41(02):169–71. Zhao M, Abdul Kadir NB, Abd Razak MA. The relationship between family functioning, emotional intelligence, loneliness, social support, and depressive symptoms among undergraduate students. Behav Sci. 2024;14(9):819. https://doi.org/10.3390/bs14090819 . Stoller JK, Taylor CA, Farver CF. Emotional intelligence competencies provide a developmental curriculum for medical training. Med Teach. 2013;35(3):243–7. https://doi.org/10.3109/0142159X.2012.737964 . Fu ZW, Wang KL, Du NY, et al. Comparative study on emotional behavior and parental job stress of only-child and non-only-child preschool children. World J Clin Cases. 2024;12(21):4642. ttps://doi.org/10.12998/wjcc.v12.i21.4642 . Luszczynska A, Scholz U, Schwarzer R. The general self-efficacy scale: multicultural validation studies. J Psychol. 2005;139(5):439–57. https://doi.org/10.3200/JRLP.139.5.439-457 . Culbertson SS, Fullagar CJ, Mills MJ. Feeling good and doing great: the relationship between psychological capital and well-being. J Occup Health Psychol. 2010;15(4):421–33. https://doi.org/10.1037/a0020720 . Strobel M, Tumasjan A, Spörrle M. Be yourself, believe in yourself, and be happy: Self-efficacy as a mediator between personality factors and subjective well‐being. Scandinavian Journal of psychology .2011;52(1): 43–48. https://doi.org/10.1111/j.1467-9450.2010.00826.x Mangione S, Chakraborti C, Staltari G et al. Medical students’ exposure to the humanities correlates with positive personal qualities and reduced burnout: a multi-institutional US survey. Journal of general internal medicine .2018;33(5): 628–634. https://doi.org/10.1007/s11606-017-4275-8 Hsu WC, Fuh LJ, Liao SC. Tickling the heart: integrating social emotional learning into medical education to cultivate empathetic, resilient, and holistically developed physicians. Front Med. 2024;11. 1368858.https://doi.org/10.3389/fmed.2024.1368858 . El Tarhouny S, Hassouna A, Mansour T. Emotional intelligence in medical education: Its role in professional identity formation: AMEE Guide No. 186. Medical Teacher. 2025;1–15. https://doi.org/10.1080/0142159X.2025.2501257 Yang Y, Wang C. The chain mediating effect of empathy and communication ability on emotional intelligence and caring ability of nursing students. Front Psychol. 2024;14. 1339194.ttps://doi.org/10.3389/fpsyg.2023.1339194 . Additional Declarations No competing interests reported. Cite Share Download PDF Status: Posted Version 1 posted You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-8697656","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":598495957,"identity":"79132c8f-6a05-4c27-83d1-1d974b1d0d6c","order_by":0,"name":"JIANG ZHIQIANG","email":"","orcid":"","institution":"西南医科大学","correspondingAuthor":false,"prefix":"","firstName":"JIANG","middleName":"","lastName":"ZHIQIANG","suffix":""},{"id":598495958,"identity":"3fd23d7e-34d9-4fd8-82a2-2cac70e19ebc","order_by":1,"name":"ZHU TINGTING","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAAz0lEQVRIiWNgGAWjYBACxvnnHxz+U2HDw9jeQKQW5hk8jA94zqTJMfccIFIL+wweZgPetsPG7DMSiNTCO7v3mIRkG3Ni78zHG28w1NhEE9QiOedcmoTBObbEmbPTii0YjqXlNhDSYtiQYCaRUMaTuHF2jpkEY8NhwlrsDwC1HGCTSNx/8wyRWhhn5BgbNrQZGDPO4CFWS8+xxMcMZxLkGHuAfkkgxi+M7c0HDjNU/AdG5eGNNz7U2BDWggwMJBJIUQ7RQqqOUTAKRsEoGBkAAO+qQ+9PGd6nAAAAAElFTkSuQmCC","orcid":"","institution":"Affiliated Hospital of Southwest Medical University","correspondingAuthor":true,"prefix":"","firstName":"ZHU","middleName":"","lastName":"TINGTING","suffix":""}],"badges":[],"createdAt":"2026-01-26 07:40:11","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-8697656/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-8697656/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":104882021,"identity":"1a0922c2-e835-47f7-be3f-3e38d576ec39","added_by":"auto","created_at":"2026-03-18 09:28:21","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":835630,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-8697656/v1/bcc51b7f-ded8-4196-8a34-cf0fd56b8647.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"Factors Influencing Empathy in Clinical Medical Education","fulltext":[{"header":"1. Background","content":"\u003cp\u003eEmpathy is widely recognized as a core professional competency in medical education, playing a crucial role in doctor\u0026ndash;patient communication, clinical decision-making, and patient satisfaction. Empirical evidence consistently shows that higher physician empathy is associated with improved treatment adherence, better clinical outcomes, and reduced medical disputes[\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e]. Despite sustained reforms in medical curricula and increasing attention to medical humanities, numerous studies have reported stagnation or even decline in empathy as students progress through clinical training, a phenomenon often referred to as the \u0026ldquo;empathy erosion\u0026rdquo; effect[\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eUnderstanding the psychological mechanisms underlying empathy development in medical students has therefore become a central concern in contemporary medical education research. Among the individual-level factors examined, emotional intelligence (EI) and self-efficacy (SE) have received particular attention. However, existing findings remain fragmented, and the relative roles of these constructs in shaping empathy\u0026mdash;especially across different stages of medical training\u0026mdash;are not yet fully understood.\u003c/p\u003e \u003cp\u003e \u003cb\u003eEmotional intelligence and empathy\u003c/b\u003e \u003c/p\u003e \u003cp\u003eEmotional intelligence refers to the capacity to perceive, understand, regulate, and utilize emotions in oneself and others. In clinical contexts, EI enables medical students to recognize patients\u0026rsquo; emotional cues, manage their own emotional responses, and engage in emotionally appropriate communication[\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e]. Prior research has consistently demonstrated positive associations between EI and empathy among healthcare students and professionals, suggesting that EI may function as a proximal psychological resource that directly supports empathic engagement[\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eTheoretical models of EI emphasize emotion-related information processing as a core mechanism linking EI to social functioning. From this perspective, empathy is not merely an attitudinal disposition but an emotionally grounded capability that depends on effective emotional perception and regulation. Accordingly, EI\u0026mdash;particularly its components related to emotional perception and regulation\u0026mdash;may serve as a key driver of empathy development during medical training [\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e].\u003c/p\u003e \u003cp\u003e \u003cb\u003eSelf-efficacy and its boundary conditions\u003c/b\u003e \u003c/p\u003e \u003cp\u003eSelf-efficacy, defined as individuals\u0026rsquo; beliefs in their capability to organize and execute actions required to manage prospective situations, has been shown to predict academic performance, learning engagement, and professional identity in medical education[\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e]. High self-efficacy may increase students\u0026rsquo; confidence in handling clinical tasks and interpersonal challenges. However, evidence regarding its role in fostering empathy is mixed[\u003cspan additionalcitationids=\"CR9 CR10\" citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eUnlike EI, which is intrinsically emotion-oriented, self-efficacy is primarily task- and performance-oriented. In emotionally complex clinical encounters\u0026mdash;such as those involving patient suffering, uncertainty, or conflict\u0026mdash;confidence in one\u0026rsquo;s abilities alone may be insufficient to elicit empathic understanding[\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e]. This suggests that self-efficacy may function as a distal and context-dependent factor in empathy development, exerting its influence only under certain emotional or situational conditions[\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e].\u003c/p\u003e \u003cp\u003e \u003cb\u003eDevelopmental perspective and cultural context\u003c/b\u003e \u003c/p\u003e \u003cp\u003eMost prior studies have examined EI, self-efficacy, and empathy using cross-sectional designs, limiting insight into how these constructs evolve across different stages of medical education[\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e]. A developmental perspective is particularly important in medical training, where students transition from classroom-based learning to emotionally demanding clinical practice [\u003cspan additionalcitationids=\"CR18\" citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eFurthermore, cultural and contextual factors may shape the ways in which psychological resources translate into empathic behavior. In collectivist societies such as China, emotional socialization, family structure (e.g., only-child status), and rural\u0026ndash;urban background may influence emotional learning and interpersonal sensitivity. Examining empathy development within this cultural context can therefore contribute to a more nuanced understanding of medical education processes[\u003cspan additionalcitationids=\"CR21\" citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eStudy aims and contributions\u003c/p\u003e \u003cp\u003eAgainst this backdrop, the present study investigates the relationships among emotional intelligence, self-efficacy, and empathy in a cohort of Chinese undergraduate clinical medicine students using a two-wave design spanning the early and later stages of training. Specifically, this study aims to:\u003c/p\u003e"},{"header":"2. Subjects and Methods","content":"\u003cp\u003e2.1 Research Subjects\u003c/p\u003e\n\u003cp\u003eThe questionnaires were distributed twice to the same cohort of students: first in March-April 2021 (freshmen) and again in March 2024 (senior four). Online surveys were administered to 2020 undergraduate clinical medical students at our university via the Questionnaire Star platform. The first survey collected 378 responses, with 345 valid after excluding those exceeding 120 seconds (91.27% validity rate). The second survey collected 459 responses, with 361 valid (78.65% validity rate).\u003c/p\u003e\n\u003cp\u003e2.2 Survey Design\u003c/p\u003e\n\u003cp\u003eThe electronic questionnaire included demographic information (gender, age, family economic status, hometown, student leadership roles, only-child status) and three subscales: the Empathy Scale, Self-Efficacy Scale, and Emotional Intelligence Scale.\u003c/p\u003e\n\u003cp\u003eEmpathy Scale[23]: 20 items, 7-point Likert scale, total score 140. Higher scores indicate higher empathy.\u003c/p\u003e\n\u003cp\u003eSelf-Efficacy Scale[24]: 10 items, 4-point Likert scale (From 'completely incorrect' to 'completely correct', they are counted as 1 point, 2 points, 3 points, and 4 points respectively,), total score 40. Higher scores indicate stronger self-efficacy.\u003c/p\u003e\n\u003cp\u003eEmotional Intelligence Scale[25]: 16 items across four dimensions (emotional perception, emotional control, emotional regulation, emotional application), 7-point Likert scale, total score 112. Higher scores indicate higher emotional intelligence.\u003c/p\u003e\n\u003cp\u003e2.3 Statistical Methods\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eData were analyzed using SPSS 26.0. Descriptive statistics and Pearson correlation analysis were performed (α = 0.05). Kaiser-Meyer-Olkin (KMO) tests were conducted: Empathy Scale KMO = 0.904 (both surveys), Self-Efficacy Scale KMO = 0.910/0.916, Emotional Intelligence Scale KMO = 0.889/0.897. Bartlett’s sphericity tests were significant (p = 0.000).See Table -1 Scale Reliability Analysis.\u003c/p\u003e\n\u003cp\u003eTable -1 Scale Reliability Analysis\u003c/p\u003e\n\u003ctable border=\"0\" cellspacing=\"0\" cellpadding=\"0\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003eN=345\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003eN=365\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003eScale name\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003eitems\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003eKaiser-MeyerOlkin\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003eKaiser-MeyerOlkin\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003eempathy ability\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e20\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0.904\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0.904\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003eSelf efficacy Scale\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e10\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0.910\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0.916\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003eemotional intelligence\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e16\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0.889\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0.897\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e(Note: N=345 is the first questionnaire scale, N=365 is the second questionnaire scale)\u003c/p\u003e\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n \n\n\n \n\n"},{"header":"3. Results and Analysis","content":"\u003cp\u003e3.1 Validity and Reliability of Scales\u003c/p\u003e\u003cp\u003eThe consistency reliability test method Cronbach's α coefficient was used to analyze the validity and reliability of two questionnaire scales. The Cronbach's α coefficients of the Empathy Scale were 0.773 and 0.626, the Cronbach's α coefficients of the Self Efficacy Scale were 0.859 and 0.919, and the Cronbach's α coefficients of the Emotional Intelligence Scale were 0.893 and 0.916, respectively. The above results indicate that the questionnaire scale 1 of this study has very good validity and reliability, and the questionnaire scale design is reasonable.See Table -2 Scale Reliability Analysis.\u003c/p\u003e\u003cp\u003eTable -2 Scale Reliability Analysis\u003c/p\u003e\u003ctable border=\"0\" cellspacing=\"0\" cellpadding=\"0\" width=\"420\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"3\" style=\"width: 191px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 114px;\"\u003e\n \u003cp\u003eN=345\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 115px;\"\u003e\n \u003cp\u003eN=365\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 143px;\"\u003e\n \u003cp\u003eScale name\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 47px;\"\u003e\n \u003cp\u003eitems\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 114px;\"\u003e\n \u003cp\u003eCronbach′s α\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 115px;\"\u003e\n \u003cp\u003eCronbach’s α\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 143px;\"\u003e\n \u003cp\u003eempathy ability\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 47px;\"\u003e\n \u003cp\u003e20\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 114px;\"\u003e\n \u003cp\u003e0.773\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 115px;\"\u003e\n \u003cp\u003e0.626\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 143px;\"\u003e\n \u003cp\u003eSelf efficacy Scale\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 47px;\"\u003e\n \u003cp\u003e10\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 114px;\"\u003e\n \u003cp\u003e0.859\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 115px;\"\u003e\n \u003cp\u003e0.919\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 143px;\"\u003e\n \u003cp\u003eemotional intelligence\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 47px;\"\u003e\n \u003cp\u003e16\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 114px;\"\u003e\n \u003cp\u003e0.893\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 115px;\"\u003e\n \u003cp\u003e0.916\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 143px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 47px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 1px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 114px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 115px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\u003cp\u003e(Note: N=345 is the first questionnaire scale, N=365 is the second questionnaire scale)\u003c/p\u003e\u003cp\u003e3.2 Basic information of undergraduate students of clinical medicine\u003c/p\u003e\u003cp\u003eAmong the 345 undergraduate students of clinical medicine, there are 160 male students (46.4%) and 185 female students (53.6%); aged 17-22 (18.64±0.69) years old; 182 only children (52.8%) and 163 non-only children (47.2%); 196 urban residents (56.8%) and 149 township residents (43.2%); 37 poor families (10.7%), 264 well-off families (76.5%) and 44 wealthy families (12.8%); 160 student cadres (46.4%) and 185 non-student cadres (53.6%).\u003c/p\u003e\u003cp\u003eAmong the 365 clinical medicine undergraduate students, there were 78 males (21.37%) and 286 females (78.63%); aged 20-25 (18.64±0.69) years old; 145 were only children (39.73%) and 220 were not only children (60.27%); 172 were urban residents (47.12%) and 193 were township residents (52.88%); the family economic situation was poor for 74 (20.27%), moderately well-off for 280 (76.71%) and wealthy for 11 (3.02%); there were 155 student cadres (42.47%) and 210 were non-student cadres (57.53%).\u003c/p\u003e\u003cp\u003e3.3 Scores of Empathy, Self-Efficacy, and Emotional Intelligence\u003c/p\u003e\u003cp\u003eThe empathy ability score results showed that the average score of the freshman was 4.46 (total score 89.12), which increased to 5.30 (89.72) in the senior year, but the total score increase was not significant (p=0.12), indicating that clinical practice has not effectively improved empathy ability, which is consistent with Hojat's \"empathy decline\" phenomenon. The self-efficacy score results dropped from 2.62 in the freshman year to 2.41 in the senior year (p\u0026lt;0.01), which may be due to the accumulation of academic pressure and clinical frustration (Artino et al., 2011). The emotional intelligence score results showed that the emotion application dimension increased significantly (4.88→5.20, p\u0026lt;0.05), reflecting that senior students are better at strategic emotion management, but their emotion control ability stagnated (4.60→4.76, p=0.21). The correlation between self-efficacy and empathy ability was weakly correlated only in the lower grades (r=0.139, p\u0026lt;0.05), and was not significant in the higher grades, indicating that the effect of self-efficacy on empathy is mediated by the situation. When students face complex doctor-patient conflicts, self-confidence alone is not enough to drive empathic behavior. Emotional intelligence affects empathy. Emotional perception (β=0.325, p\u0026lt;0.01) and emotion regulation (β=0.344, p\u0026lt;0.01) are key predictors of empathy, supporting Salovey's (1997) \"emotion-cognition dual channel\" theory.See\u0026nbsp;Table -3 Scoring of Empathy Ability, Self Efficacy, Emotional Intelligence, and Emotional Intelligence in Four Dimensions .\u003c/p\u003e\u003cp\u003eTable -3 Scoring of Empathy Ability, Self Efficacy, Emotional Intelligence, and Emotional Intelligence in Four Dimensions\u003c/p\u003e\u003ctable border=\"0\" cellspacing=\"0\" cellpadding=\"0\" width=\"687\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 158px;\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"bottom\" style=\"width: 264px;\"\u003e\n \u003cp\u003e(N=345)\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"bottom\" style=\"width: 264px;\"\u003e\n \u003cp\u003e(N=365) \u0026nbsp;\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 158px;\"\u003e\n \u003cp\u003eproject\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 132px;\"\u003e\n \u003cp\u003eTotal score\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 132px;\"\u003e\n \u003cp\u003eAverage score（χ±s）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 132px;\"\u003e\n \u003cp\u003eTotal score\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 132px;\"\u003e\n \u003cp\u003eAverage score（χ±s）\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 158px;\"\u003e\n \u003cp\u003eempathy ability\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 132px;\"\u003e\n \u003cp\u003e89.12±13.08\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 132px;\"\u003e\n \u003cp\u003e4.46±0.65\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 132px;\"\u003e\n \u003cp\u003e89.72±8.36\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 132px;\"\u003e\n \u003cp\u003e5.3±0.44\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 158px;\"\u003e\n \u003cp\u003eSelf efficacy\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 132px;\"\u003e\n \u003cp\u003e26.18±5.64\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 132px;\"\u003e\n \u003cp\u003e2.62±0.56\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 132px;\"\u003e\n \u003cp\u003e24.07±5.19\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 132px;\"\u003e\n \u003cp\u003e2.41±0.27\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 158px;\"\u003e\n \u003cp\u003eemotional intelligence\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 132px;\"\u003e\n \u003cp\u003e77.78±13.97\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 132px;\"\u003e\n \u003cp\u003e4.86±0.87\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 132px;\"\u003e\n \u003cp\u003e81.78±11.86\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 132px;\"\u003e\n \u003cp\u003e4.86±0.62\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 158px;\"\u003e\n \u003cp\u003eEmotional perception\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 132px;\"\u003e\n \u003cp\u003e20.4±4.59\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 132px;\"\u003e\n \u003cp\u003e5.1±1.15\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 132px;\"\u003e\n \u003cp\u003e22.08±3.46\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 132px;\"\u003e\n \u003cp\u003e5.52±0.18\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 158px;\"\u003e\n \u003cp\u003eemotion control\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 132px;\"\u003e\n \u003cp\u003e18.36±4.65\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 132px;\"\u003e\n \u003cp\u003e4.6±1.16\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 132px;\"\u003e\n \u003cp\u003e19.02±4.3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 132px;\"\u003e\n \u003cp\u003e4.76±0.22\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 158px;\"\u003e\n \u003cp\u003eEmotional regulation\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 132px;\"\u003e\n \u003cp\u003e19.52±4.21\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 132px;\"\u003e\n \u003cp\u003e4.88±1.05\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 132px;\"\u003e\n \u003cp\u003e19.88±3.86\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 132px;\"\u003e\n \u003cp\u003e4.97±0.2\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 158px;\"\u003e\n \u003cp\u003eEmotional Application\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 132px;\"\u003e\n \u003cp\u003e19.49±4.4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 132px;\"\u003e\n \u003cp\u003e4.88±1.1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 132px;\"\u003e\n \u003cp\u003e20.8±3.81\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 132px;\"\u003e\n \u003cp\u003e5.2±0.2\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\u003cp\u003e(Note: N=345 is the first questionnaire scale, N=365 is the second questionnaire scale)\u003c/p\u003e\u003cp\u003e3.4 Correlation between self-efficacy, emotional intelligence, and the four dimensions of emotional intelligence and empathy in different demographic characteristics\u003c/p\u003e\u003cp\u003eThe results show that there is a significant statistical correlation between self-efficacy, emotional intelligence, as well as emotion perception, emotion control, emotion regulation, and emotion application and empathy (p \u0026lt; 0.01). From the perspective of gender, except for the insignificant correlation between the emotion regulation dimension and empathy, self-efficacy, emotional intelligence, emotion perception, emotion control, and emotion application all show significant correlations for men (p \u0026lt; 0.01). For women, except for the insignificant correlation between self-efficacy and emotion perception and empathy, emotional intelligence, emotion control, emotion regulation, and emotion application all show significant correlations (p \u0026lt; 0.01). From the perspective of whether or not they are only children, except for the correlation between emotion perception and empathy, self-efficacy, emotional intelligence, emotion control, emotion regulation, and emotion application all show significant correlations (p \u0026lt; 0.01). From the perspective of non-only children, except for the correlation between self-efficacy and empathy, emotional intelligence and the four dimensions of emotional intelligence all show significant correlations (p \u0026lt; 0.01). From the perspective of whether or not to be a student leader, except for the correlation between self-efficacy and emotion perception dimensions and empathy, emotional intelligence, emotion control, emotion regulation, and emotion application all showed significant correlations with empathy (p \u0026lt; 0.01). Self-efficacy, emotional intelligence, and the four dimensions of emotional intelligence all showed significant correlations with empathy for non-student leaders (p \u0026lt; 0.01). From the overall perspective of the students' place of origin, except for the insignificant correlation between self-efficacy and empathy, emotional intelligence and the four dimensions of emotional intelligence all showed significant correlations with empathy. It is worth noting that the emotional intelligence and the correlation between the four dimensions of emotional intelligence and empathy of rural students are generally higher than those of urban students (p \u0026lt; 0.01). From the perspective of gender, females have higher empathy (Δ=0.68, p\u0026lt;0.01), but weaker emotional control than males (Δ=-0.24, p\u0026lt;0.05), which may be related to the discipline of \"emotional expression\" in the process of gender socialization (Eagly, 2013); from the perspective of urban and rural areas, the correlation between emotional intelligence and empathy of rural students is stronger (r=0.478 vs. 0.325), which may be because the rural environment emphasizes collective emotional interaction. See Table-4 Correlation between four dimensions of self-efficacy, emotional intelligence, and emotional intelligence with empathy ability based on different demographic characteristics.\u003c/p\u003e\u003cp\u003eTable - 4 Correlation between four dimensions of self-efficacy, emotional intelligence, and emotional intelligence with empathy ability based on different demographic characteristics N=345\u003c/p\u003e\u003ctable border=\"0\" cellspacing=\"0\" cellpadding=\"0\" width=\"615\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 83px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 74px;\"\u003e\n \u003cp\u003eSelf efficacy\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 74px;\"\u003e\n \u003cp\u003eemotional intelligence\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 76px;\"\u003e\n \u003cp\u003eEmotional perception\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 77px;\"\u003e\n \u003cp\u003eemotion control\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 75px;\"\u003e\n \u003cp\u003eEmotional regulation\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 75px;\"\u003e\n \u003cp\u003eEmotional Application\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 80px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 83px;\"\u003e\n \u003cp\u003ecategory\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 74px;\"\u003e\n \u003cp\u003e0.139**\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 74px;\"\u003e\n \u003cp\u003e0.395**\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 76px;\"\u003e\n \u003cp\u003e0.325**\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 77px;\"\u003e\n \u003cp\u003e0.261**\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 75px;\"\u003e\n \u003cp\u003e0.344**\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 75px;\"\u003e\n \u003cp\u003e0.311**\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"13\" style=\"width: 80px;\"\u003e\n \u003cp\u003eempathy ability\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 83px;\"\u003e\n \u003cp\u003egender\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 74px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 74px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 76px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 77px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 75px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 75px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 83px;\"\u003e\n \u003cp\u003eMale N=160\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 74px;\"\u003e\n \u003cp\u003e0.281**\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 74px;\"\u003e\n \u003cp\u003e0.385**\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 76px;\"\u003e\n \u003cp\u003e0.350**\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 77px;\"\u003e\n \u003cp\u003e0.245**\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 75px;\"\u003e\n \u003cp\u003e0.332\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 75px;\"\u003e\n \u003cp\u003e0.240**\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 83px;\"\u003e\n \u003cp\u003eFemale N=185\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 74px;\"\u003e\n \u003cp\u003e0.015\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 74px;\"\u003e\n \u003cp\u003e0.413**\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 76px;\"\u003e\n \u003cp\u003e0.818\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 77px;\"\u003e\n \u003cp\u003e0.274**\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 75px;\"\u003e\n \u003cp\u003e0.356**\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 75px;\"\u003e\n \u003cp\u003e0.381**\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 83px;\"\u003e\n \u003cp\u003ethe only child\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 74px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 74px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 76px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 77px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 75px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 75px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 83px;\"\u003e\n \u003cp\u003eonlyN=182\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 74px;\"\u003e\n \u003cp\u003e0.193**\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 74px;\"\u003e\n \u003cp\u003e0.322**\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 76px;\"\u003e\n \u003cp\u003e0.269\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 77px;\"\u003e\n \u003cp\u003e0.195**\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 75px;\"\u003e\n \u003cp\u003e0.270**\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 75px;\"\u003e\n \u003cp\u003e0.275**\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 83px;\"\u003e\n \u003cp\u003enot merely N=163\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 74px;\"\u003e\n \u003cp\u003e0.04\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 74px;\"\u003e\n \u003cp\u003e0.497**\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 76px;\"\u003e\n \u003cp\u003e0.409**\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 77px;\"\u003e\n \u003cp\u003e0.345**\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 75px;\"\u003e\n \u003cp\u003e0.442**\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 75px;\"\u003e\n \u003cp\u003e0.366**\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 83px;\"\u003e\n \u003cp\u003estudent cadres\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 74px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 74px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 76px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 77px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 75px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 75px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 83px;\"\u003e\n \u003cp\u003eYes N=160\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 74px;\"\u003e\n \u003cp\u003e0.118\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 74px;\"\u003e\n \u003cp\u003e0.343**\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 76px;\"\u003e\n \u003cp\u003e0.301\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 77px;\"\u003e\n \u003cp\u003e0.251**\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 75px;\"\u003e\n \u003cp\u003e0.348**\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 75px;\"\u003e\n \u003cp\u003e0.204**\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 83px;\"\u003e\n \u003cp\u003eNo N=185\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 74px;\"\u003e\n \u003cp\u003e0.168*\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 74px;\"\u003e\n \u003cp\u003e0.450**\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 76px;\"\u003e\n \u003cp\u003e0.350**\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 77px;\"\u003e\n \u003cp\u003e0.276**\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 75px;\"\u003e\n \u003cp\u003e0.343**\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 75px;\"\u003e\n \u003cp\u003e0.402**\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 83px;\"\u003e\n \u003cp\u003eStudents\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 74px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 74px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 76px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 77px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 75px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 75px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 83px;\"\u003e\n \u003cp\u003eTown N=196\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 74px;\"\u003e\n \u003cp\u003e0.13\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 74px;\"\u003e\n \u003cp\u003e0.325**\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 76px;\"\u003e\n \u003cp\u003e0.263**\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 77px;\"\u003e\n \u003cp\u003e0.192**\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 75px;\"\u003e\n \u003cp\u003e0.328**\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 75px;\"\u003e\n \u003cp\u003e0.244**\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 83px;\"\u003e\n \u003cp\u003erural area N=149\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 74px;\"\u003e\n \u003cp\u003e0.126\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 74px;\"\u003e\n \u003cp\u003e0.478**\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 76px;\"\u003e\n \u003cp\u003e0.413**\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 77px;\"\u003e\n \u003cp\u003e0.337**\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 75px;\"\u003e\n \u003cp\u003e0.357**\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 75px;\"\u003e\n \u003cp\u003e0.382**\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\u003cp\u003eNote:* P\u0026lt;0.05，**P\u0026lt;0.01；\u0026nbsp;N=345 is the first questionnaire scale, and N=365 is the second questionnaire scale.\u003c/p\u003e\u003cp\u003e3.5 Correlation between self-efficacy, emotional intelligence and its four dimensions and empathy\u003c/p\u003e\u003cp\u003eConduct correlation analysis on the total scores of self-efficacy, emotional intelligence, emotional intelligence dimensions, and empathy ability. The total scores of self-efficacy, emotional intelligence, and various dimensions are positively correlated with the total score of empathy ability, and all have statistical significance (P\u0026lt;0.01). See Table-5 and Table-6\u0026nbsp;Correlation between Self Efficacy, Emotional Intelligence, and Four Dimensions with Empathy Ability.\u003c/p\u003e\u003ctable border=\"0\" cellspacing=\"0\" cellpadding=\"0\" width=\"608\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"8\" valign=\"bottom\" style=\"width: 608px;\"\u003e\n \u003cp\u003eTabl -5 Correlation between Self Efficacy, Emotional Intelligence, and Four Dimensions with Empathy Ability \u0026nbsp; \u0026nbsp; \u0026nbsp;N=345\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 95px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 61px;\"\u003e\n \u003cp\u003eEmpathy\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 74px;\"\u003e\n \u003cp\u003eSelf efficacy\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 74px;\"\u003e\n \u003cp\u003eemotional intelligence\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 74px;\"\u003e\n \u003cp\u003eEmotional perception\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 74px;\"\u003e\n \u003cp\u003eemotion control\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 74px;\"\u003e\n \u003cp\u003eEmotional regulation\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 80px;\"\u003e\n \u003cp\u003eEmotional Application\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 95px;\"\u003e\n \u003cp\u003eEmpathy\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 61px;\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 74px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 74px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 74px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 74px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 74px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 80px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 95px;\"\u003e\n \u003cp\u003eSelf efficacy\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 61px;\"\u003e\n \u003cp\u003e0.139\u003csup\u003e**\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 74px;\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 74px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 74px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 74px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 74px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 80px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 95px;\"\u003e\n \u003cp\u003eemotional intelligence\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 61px;\"\u003e\n \u003cp\u003e0.395\u003csup\u003e**\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 74px;\"\u003e\n \u003cp\u003e0.448\u003csup\u003e**\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 74px;\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 74px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 74px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 74px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 80px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 95px;\"\u003e\n \u003cp\u003eEmotional perception\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 61px;\"\u003e\n \u003cp\u003e0.325\u003csup\u003e**\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 74px;\"\u003e\n \u003cp\u003e0.205\u003csup\u003e**\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 74px;\"\u003e\n \u003cp\u003e0.801\u003csup\u003e**\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 74px;\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 74px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 74px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 80px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 95px;\"\u003e\n \u003cp\u003eemotion control\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 61px;\"\u003e\n \u003cp\u003e0.261\u003csup\u003e**\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 74px;\"\u003e\n \u003cp\u003e0.403\u003csup\u003e**\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 74px;\"\u003e\n \u003cp\u003e0.778\u003csup\u003e**\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 74px;\"\u003e\n \u003cp\u003e0.476\u003csup\u003e**\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 74px;\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 74px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 80px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 95px;\"\u003e\n \u003cp\u003eEmotional regulation\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 61px;\"\u003e\n \u003cp\u003e0.344\u003csup\u003e**\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 74px;\"\u003e\n \u003cp\u003e0.429\u003csup\u003e**\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 74px;\"\u003e\n \u003cp\u003e0.806\u003csup\u003e**\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 74px;\"\u003e\n \u003cp\u003e0.570\u003csup\u003e**\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 74px;\"\u003e\n \u003cp\u003e0.510\u003csup\u003e**\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 74px;\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 80px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 95px;\"\u003e\n \u003cp\u003eEmotional Application\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 61px;\"\u003e\n \u003cp\u003e0.311\u003csup\u003e**\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 74px;\"\u003e\n \u003cp\u003e0.372\u003csup\u003e**\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 74px;\"\u003e\n \u003cp\u003e0.748\u003csup\u003e**\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 74px;\"\u003e\n \u003cp\u003e0.452\u003csup\u003e**\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 74px;\"\u003e\n \u003cp\u003e0.431\u003csup\u003e**\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 74px;\"\u003e\n \u003cp\u003e0.470\u003csup\u003e**\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 80px;\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\u003cp\u003eNote:* P\u0026lt;0.05，**P\u0026lt;0.01；\u0026nbsp;N=345 is the first questionnaire scale, and N=365 is the second questionnaire scale.\u003c/p\u003e\u003ctable border=\"0\" cellspacing=\"0\" cellpadding=\"0\" width=\"680\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"8\" valign=\"bottom\" style=\"width: 680px;\"\u003e\n \u003cp\u003eTable-6 Correlation between Self Efficacy, Emotional Intelligence, and Four Dimensions with Empathy Ability N=365\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 102px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 66px;\"\u003e\n \u003cp\u003eEmpathy\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 73px;\"\u003e\n \u003cp\u003eSelf\u0026nbsp;\u003c/p\u003e\n \u003cp\u003eefficacy\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 102px;\"\u003e\n \u003cp\u003eemotional\u0026nbsp;\u003c/p\u003e\n \u003cp\u003eintelligence\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 88px;\"\u003e\n \u003cp\u003eEmotional\u0026nbsp;\u003c/p\u003e\n \u003cp\u003eperception\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 66px;\"\u003e\n \u003cp\u003eemotion\u0026nbsp;\u003c/p\u003e\n \u003cp\u003econtrol\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 88px;\"\u003e\n \u003cp\u003eEmotional regulation\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 95px;\"\u003e\n \u003cp\u003eEmotional Application\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 102px;\"\u003e\n \u003cp\u003eEmpathy\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 66px;\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 73px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 102px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 88px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 66px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 88px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 95px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 102px;\"\u003e\n \u003cp\u003eSelf\u0026nbsp;\u003c/p\u003e\n \u003cp\u003eefficacy\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 66px;\"\u003e\n \u003cp\u003e0.177\u003csup\u003e**\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 73px;\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 102px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 88px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 66px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 88px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 95px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 102px;\"\u003e\n \u003cp\u003eemotional\u0026nbsp;\u003c/p\u003e\n \u003cp\u003eintelligence\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 66px;\"\u003e\n \u003cp\u003e0.248\u003csup\u003e**\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 73px;\"\u003e\n \u003cp\u003e0.578\u003csup\u003e**\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 102px;\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 88px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 66px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 88px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 95px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 102px;\"\u003e\n \u003cp\u003eEmotional\u0026nbsp;\u003c/p\u003e\n \u003cp\u003eperception\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 66px;\"\u003e\n \u003cp\u003e0.231\u003csup\u003e**\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 73px;\"\u003e\n \u003cp\u003e0.335\u003csup\u003e**\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 102px;\"\u003e\n \u003cp\u003e0.780\u003csup\u003e**\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 88px;\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 66px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 88px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 95px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 102px;\"\u003e\n \u003cp\u003eemotion\u0026nbsp;\u003c/p\u003e\n \u003cp\u003econtrol\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 66px;\"\u003e\n \u003cp\u003e0.174\u003csup\u003e**\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 73px;\"\u003e\n \u003cp\u003e0.466\u003csup\u003e**\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 102px;\"\u003e\n \u003cp\u003e0.772\u003csup\u003e**\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 88px;\"\u003e\n \u003cp\u003e0.526\u003csup\u003e**\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 66px;\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 88px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 95px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 102px;\"\u003e\n \u003cp\u003eEmotional regulation\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 66px;\"\u003e\n \u003cp\u003e0.165\u003csup\u003e**\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 73px;\"\u003e\n \u003cp\u003e0.568\u003csup\u003e**\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 102px;\"\u003e\n \u003cp\u003e0.805\u003csup\u003e**\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 88px;\"\u003e\n \u003cp\u003e0.470\u003csup\u003e**\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 66px;\"\u003e\n \u003cp\u003e0.510\u003csup\u003e**\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 88px;\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 95px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 102px;\"\u003e\n \u003cp\u003eEmotional Application\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 66px;\"\u003e\n \u003cp\u003e0.396\u003csup\u003e**\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 73px;\"\u003e\n \u003cp\u003e0.396\u003csup\u003e**\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 102px;\"\u003e\n \u003cp\u003e0.719\u003csup\u003e**\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 88px;\"\u003e\n \u003cp\u003e0.459\u003csup\u003e**\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 66px;\"\u003e\n \u003cp\u003e0.333\u003csup\u003e**\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 88px;\"\u003e\n \u003cp\u003e0.443\u003csup\u003e**\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 95px;\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\u003cp\u003eNote:* P\u0026lt;0.05，**P\u0026lt;0.01；\u0026nbsp;N=345 is the first questionnaire scale, and N=365 is the second questionnaire scale.\u003c/p\u003e\u003cp\u003e3.6 Regression Analysis of Empathy Influencing Factors\u003c/p\u003e\u003cp\u003eThis study uses the total score of empathy as the dependent variable, and self-efficacy, emotional intelligence, the four dimensions of emotional intelligence, gender, whether or not to be an only child, whether or not to be a class leader, and place of origin as independent variables. Through the multivariate linear regression method, the factors that may affect empathy are explored. In the regression model, self-efficacy, emotional intelligence, emotion regulation, emotion regulation, emotion application, gender and other factors are included in the equation. The results show that self-efficacy has a weak effect on empathy, only 13.9% (R2=0.019, F=6.785). After reaching the senior grades, the effect increases, but it is weak, only 17.7% (R2=0.031, F=11.748). However, when self-efficacy and emotional intelligence jointly affect empathy, the effect of self-efficacy is not significant, while the effect of emotional intelligence on empathy is significant, accounting for 41.6% of the influencing factors (R2=0.158, F=32.077). After reaching the senior grades, the effect decreases, accounting for 21.9% (R2=0.063, F=12.35). When self-efficacy, emotional intelligence, and the four dimensions of emotional intelligence affect empathy together, only emotional intelligence as a whole has a significant effect on empathy, and its influencing factors account for 16.4% (R2=0.164, F=13.294). In addition, when self-efficacy, emotional intelligence, emotional regulation, emotional regulation, emotional application, and gender affect empathy together, only emotional intelligence and gender have a significant impact on empathy, accounting for 17.7% of the influencing factors (R2=0.177, F=12.078). See Table-7and Table-8 Regression Analysis of Factors Influencing Empathy Ability.\u003c/p\u003e\u003cp\u003eTable-7 Regression Analysis of Factors Influencing Empathy Ability N=345\u003c/p\u003e\u003ctable border=\"0\" cellspacing=\"0\" cellpadding=\"0\" width=\"360\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 72px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 72px;\"\u003e\n \u003cp\u003eM0del1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 72px;\"\u003e\n \u003cp\u003eM0del2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 72px;\"\u003e\n \u003cp\u003eM0del3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 72px;\"\u003e\n \u003cp\u003eM0del4\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\"\u003e\n \u003cp\u003eSelf efficacy\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\"\u003e\n \u003cp\u003e0.139\u003csup\u003e*\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\"\u003e\n \u003cp\u003e-0.047\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\"\u003e\n \u003cp\u003e-0.049\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\"\u003e\n \u003cp\u003e-0.059\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\"\u003e\n \u003cp\u003eemotional intelligence\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\"\u003e\n \u003cp\u003e0.416\u003csup\u003e***\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\"\u003e\n \u003cp\u003e0.397\u003csup\u003e*\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\"\u003e\n \u003cp\u003e0.432\u003csup\u003e*\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\"\u003e\n \u003cp\u003eEmotional perception\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\"\u003e\n \u003cp\u003eemotion control\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\"\u003e\n \u003cp\u003e-0.078\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\"\u003e\n \u003cp\u003e-0.093\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\"\u003e\n \u003cp\u003eEmotional regulation\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\"\u003e\n \u003cp\u003e0.069\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\"\u003e\n \u003cp\u003e0.054\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\"\u003e\n \u003cp\u003eEmotional Application\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\"\u003e\n \u003cp\u003e0.034\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\"\u003e\n \u003cp\u003e0.024\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\"\u003e\n \u003cp\u003egender\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\"\u003e\n \u003cp\u003e-0.113\u003csup\u003e*\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\"\u003e\n \u003cp\u003eIs it an only child\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\"\u003e\n \u003cp\u003eGrowing regions\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\"\u003e\n \u003cp\u003eR\u003csup\u003e2\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\"\u003e\n \u003cp\u003e0.019\u003csup\u003e*\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\"\u003e\n \u003cp\u003e0.158\u003csup\u003e***\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\"\u003e\n \u003cp\u003e0.164\u003csup\u003e***\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\"\u003e\n \u003cp\u003e0.177\u003csup\u003e***\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\"\u003e\n \u003cp\u003eF\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\"\u003e\n \u003cp\u003e6.785\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\"\u003e\n \u003cp\u003e32.077\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\"\u003e\n \u003cp\u003e13.294\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\"\u003e\n \u003cp\u003e12.078\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n \u003c/table\u003e\u003cp\u003eNote：*P\u0026lt;0.05，**P\u0026lt;0.01，***P\u0026lt;0.001;N=345 is the first questionnaire scale\u003c/p\u003e\u003cp\u003eTable-8 Regression Analysis of Factors Influencing Empathy Ability N=365\u003c/p\u003e\u003ctable border=\"0\" cellspacing=\"0\" cellpadding=\"0\" width=\"360\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 72px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 72px;\"\u003e\n \u003cp\u003eM0del1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 72px;\"\u003e\n \u003cp\u003eM0del2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 72px;\"\u003e\n \u003cp\u003eM0del3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 72px;\"\u003e\n \u003cp\u003eM0del4\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\"\u003e\n \u003cp\u003eSelf efficacy\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\"\u003e\n \u003cp\u003e0.177\u003csup\u003e*\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\"\u003e\n \u003cp\u003e0.05\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\"\u003e\n \u003cp\u003e0.080\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\"\u003e\n \u003cp\u003e0.071\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\"\u003e\n \u003cp\u003eemotional intelligence\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\"\u003e\n \u003cp\u003e0.219\u003csup\u003e***\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\"\u003e\n \u003cp\u003e0.081\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\"\u003e\n \u003cp\u003e0.05\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\"\u003e\n \u003cp\u003eEmotional perception\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\"\u003e\n \u003cp\u003e0.127\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\"\u003e\n \u003cp\u003e0.137\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\"\u003e\n \u003cp\u003eemotion control\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\"\u003e\n \u003cp\u003e-0.034\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\"\u003e\n \u003cp\u003e-0.014\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\"\u003e\n \u003cp\u003eEmotional regulation\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\"\u003e\n \u003cp\u003eEmotional Application\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\"\u003e\n \u003cp\u003e0.069\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\"\u003e\n \u003cp\u003e0.086\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\"\u003e\n \u003cp\u003egender\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\"\u003e\n \u003cp\u003e-0.054\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\"\u003e\n \u003cp\u003eIs it an only child\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\"\u003e\n \u003cp\u003eGrowing regions\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\"\u003e\n \u003cp\u003eR\u003csup\u003e2\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\"\u003e\n \u003cp\u003e0.031\u003csup\u003e*\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\"\u003e\n \u003cp\u003e0.063\u003csup\u003e***\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\"\u003e\n \u003cp\u003e0.072\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\"\u003e\n \u003cp\u003e0074\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\"\u003e\n \u003cp\u003eF\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\"\u003e\n \u003cp\u003e11.748\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\"\u003e\n \u003cp\u003e12.350\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\"\u003e\n \u003cp\u003e1.061\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\"\u003e\n \u003cp\u003e1.068\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n \u003c/table\u003e\u003cp\u003eNote：*P\u0026lt;0.05，**P\u0026lt;0.01，***P\u0026lt;0.001; N=365 is the second questionnaire scale\u003c/p\u003e"},{"header":"4. Conclusions and Recommendations","content":"\u003cp\u003eThis study examined empathy development among Chinese undergraduate clinical medicine students and explored the roles of emotional intelligence and self-efficacy using a two-wave cohort design. Three main findings emerged. First, empathy levels showed only modest improvement from the early to later stages of training, supporting prior reports of empathy stagnation during medical education. Second, emotional intelligence consistently demonstrated a significant and robust association with empathy, whereas self-efficacy exhibited weak and inconsistent effects. Third, demographic factors\u0026mdash;particularly gender and rural\u0026ndash;urban background\u0026mdash;moderated the strength of the relationships between emotional intelligence and empathy.\u003c/p\u003e \u003cdiv id=\"Sec16\" class=\"Section2\"\u003e \u003ch2\u003e4.1 Emotional intelligence as a proximal predictor of empathy\u003c/h2\u003e \u003cp\u003eThe most salient finding of this study is that emotional intelligence, rather than self-efficacy, serves as the primary predictor of empathy among medical students[\u003cspan citationid=\"CR26\" class=\"CitationRef\"\u003e26\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR27\" class=\"CitationRef\"\u003e27\u003c/span\u003e]. Across both waves, EI showed stable and meaningful associations with empathy, with emotional perception and emotional regulation emerging as particularly important dimensions. These results support emotion-centered theories of empathy, which posit that effective empathic engagement depends on the ability to accurately process and regulate emotional information[\u003cspan citationid=\"CR28\" class=\"CitationRef\"\u003e28\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR29\" class=\"CitationRef\"\u003e29\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eFrom a developmental perspective, EI may function as a proximal psychological resource that directly enables students to translate emotional awareness into empathic behavior[\u003cspan citationid=\"CR30\" class=\"CitationRef\"\u003e30\u003c/span\u003e]. As students progress into clinical environments characterized by emotional complexity and interpersonal stress, EI-related competencies become increasingly salient. This may explain why EI retained its predictive power even as self-efficacy declined in later stages of training[\u003cspan citationid=\"CR31\" class=\"CitationRef\"\u003e31\u003c/span\u003e].\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec17\" class=\"Section2\"\u003e \u003ch2\u003e4.2 Boundary conditions of self-efficacy in empathy development\u003c/h2\u003e \u003cp\u003eIn contrast to emotional intelligence, self-efficacy demonstrated only weak associations with empathy, and its predictive effect diminished when EI was included in multivariate models. This finding suggests that self-efficacy alone is insufficient to elicit empathic engagement in emotionally demanding clinical contexts. While confidence in one\u0026rsquo;s abilities may facilitate task performance and learning persistence, it does not necessarily translate into sensitivity toward others\u0026rsquo; emotional experiences[\u003cspan citationid=\"CR32\" class=\"CitationRef\"\u003e32\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eThis pattern highlights an important boundary condition for efficacy-based models in medical education. In contexts where emotional understanding and interpersonal attunement are required, emotion-related competencies may override the influence of generalized confidence beliefs. Conceptualizing self-efficacy as a distal and context-dependent factor helps reconcile inconsistent findings in the literature and underscores the need to integrate emotional competence into models of professional development[\u003cspan citationid=\"CR33\" class=\"CitationRef\"\u003e33\u003c/span\u003e].\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec18\" class=\"Section2\"\u003e \u003ch2\u003e4.3 Demographic and contextual influences\u003c/h2\u003e \u003cp\u003eThe study also revealed meaningful demographic differences in empathy and its psychological correlates. Female students demonstrated higher empathy levels, consistent with prior research on gender socialization and emotional expressiveness. Additionally, the association between emotional intelligence and empathy was stronger among students from rural backgrounds than those from urban areas. One possible explanation is that rural social environments emphasize collective interaction and emotional interdependence, fostering greater sensitivity to others\u0026rsquo; emotions[\u003cspan citationid=\"CR34\" class=\"CitationRef\"\u003e34\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR35\" class=\"CitationRef\"\u003e35\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eThese findings suggest that empathy development is shaped not only by individual psychological resources but also by broader social and cultural contexts. Medical education programs should therefore consider students\u0026rsquo; diverse backgrounds when designing humanistic and emotional training interventions[\u003cspan citationid=\"CR36\" class=\"CitationRef\"\u003e36\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR37\" class=\"CitationRef\"\u003e37\u003c/span\u003e].\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec19\" class=\"Section2\"\u003e \u003ch2\u003e4.4 Implications for medical education\u003c/h2\u003e \u003cp\u003eThe findings of this study have several practical implications for medical education. First, they highlight the importance of integrating emotional intelligence training early in medical curricula, rather than relying solely on clinical exposure to foster empathy. Structured interventions focusing on emotional perception, regulation, and reflective practice may be particularly effective[\u003cspan additionalcitationids=\"CR39\" citationid=\"CR38\" class=\"CitationRef\"\u003e38\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR40\" class=\"CitationRef\"\u003e40\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eSecond, while self-efficacy remains important for academic and clinical performance, educators should be cautious in assuming that confidence-building alone will enhance empathic capacity. Emotional competence training should complement, rather than be replaced by, efficacy-oriented educational strategies[\u003cspan citationid=\"CR41\" class=\"CitationRef\"\u003e41\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR42\" class=\"CitationRef\"\u003e42\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eFinally, the observed demographic differences underscore the value of tailored educational approaches. Incorporating scenario-based learning, guided reflection, and culturally sensitive communication training may help address diverse developmental needs among medical students[\u003cspan citationid=\"CR43\" class=\"CitationRef\"\u003e43\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR44\" class=\"CitationRef\"\u003e44\u003c/span\u003e].\u003c/p\u003e \u003c/div\u003e"},{"header":"5. Limitations and future directions","content":"\u003cp\u003eSeveral limitations should be acknowledged. The sample was drawn from a single medical university, which may limit generalizability. Although the study employed a two-wave design, future research using fully longitudinal modeling techniques could provide deeper insight into individual developmental trajectories. Additionally, qualitative or intervention-based studies may further elucidate how emotional intelligence training translates into sustained empathic practice.\u003c/p\u003e \u003cp\u003eDespite these limitations, this study provides robust evidence that emotional intelligence plays a central role in empathy development among medical students and offers actionable insights for advancing humanistic medical education.\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eAcknowledgements\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eWe thank all the participants in this study.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthor contributions\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eConceived and designed the research: Z-q J, T-t Z. Wrote the paper: Z-q J. Analyzed the data: Z-q J, T-t Z. Revised the paper: Z-q J, T-t Z,All authors reviewed the manuscript.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFunding\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eSouthwest Medical University-level research project, No.: 58-00260406.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eData availability\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe datasets generated and/or analyzed during the current study are not publicly available due privacy protection and ethical obligations but are available (in deidentified form) from the corresponding author on reasonable request.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eHuman Ethics and Consent to Participate declarations\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis study adhered to the Declaration of Helsinki.Approved by the Ethics Committee of Southwest Medical University,No.SWMUIRBTX-202412-0040;Considering the privacy and security of the respondents, the questionnaires were filled out anonymously. The respondents were informed of the privacy, confidentiality and voluntary participation consent before filling out the questionnaires. The questionnaire was filled after obtaining informed consent from all participants of the study.All data were used for academic purposes only.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConsent for publication\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNot applicable.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCompeting interests\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors declare no competing interests.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\u003cli\u003e\u003cspan\u003eWei H. Jean Watson.Healthcare interprofessional team members' perspectives on human caring: A directed content analysis study. Int J Nurs Sci. 2019;6(1):17\u0026ndash;23. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.1016/j.ijnss.2018.12.001\u003c/span\u003e\u003cspan address=\"10.1016/j.ijnss.2018.12.001\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eBrett W. Nicole Verbeck,Curt Walker \u0026amp;Daniel M Clinchot.Burnout, perceived stress, and empathic concern: differences in female and male Millennial medical students.Psychology. Health Med. 2019;24(4):429\u0026ndash;38. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.1080/13548506.2018.1529329\u003c/span\u003e\u003cspan address=\"10.1080/13548506.2018.1529329\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eMohammed RAL, Btousha,Malakeh Z, Malak,Shaher H. Hamaideh \u0026amp;Ahmed H. Shuhaiber.The relationship between emotional intelligence, self-efficacy, and clinical decision-making among critical care nurses in Jordan. J Hum Behav Social Environ. 2024;35(3):454\u0026ndash;68. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.1080/10911359.2024.2310261\u003c/span\u003e\u003cspan address=\"10.1080/10911359.2024.2310261\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eSushma Prabhath U, Kulkarni, Vani Lakshmi R, Patra B. Divya Arvind Prabhu \u0026amp; Kirtana R. Nayak.Visual hermeneutics as a tool to introduce empathy and core physician attributes in doctor-patient relationship for first-year medical undergraduate students. BMC Med Educ. 2025;25(145). \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.1186/s12909-025-06742-6\u003c/span\u003e\u003cspan address=\"10.1186/s12909-025-06742-6\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eSandra H, Sulzer, Noah W, Feinstein,Claire LW. Assessing Empathy Development in Medical Education: A Systematic Review. Med Educ. 2016;50(3):300\u0026ndash;10. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e.https://doi/10.1111/medu.12806\u003c/span\u003e\u003cspan address=\".https://doi/10.1111/medu.12806\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eMi-Kyoung Cho ,Mi Young Kim. Effectiveness of simulation-based interventions on empathy enhancement among nursing students: a systematic literature review and meta-analysis. BMC Nurs.2024;23(319).\u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.1186/s12912-024-01944-7\u003c/span\u003e\u003cspan address=\"10.1186/s12912-024-01944-7\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eBandura A, Sebastian Wessels. \u0026amp;. \u003cem\u003eSelf-efficacy\u003c/em\u003e. Vol. 4. na, 1994.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eABoissy A, Windover AK, Bokar D et al. Communication skills training for physicians improves patient satisfaction. \u003cem\u003eJournal of general internal medicine\u003c/em\u003e.2016;31(7):755\u0026ndash;761.\u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e.https://doi.org/10.1007/s11606-016-3597-2\u003c/span\u003e\u003cspan address=\".10.1007/s11606-016-3597-2\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eWoods JL, Pasold TL, Boateng BA et al. Medical student self-efficacy, knowledge and communication in adolescent medicine. \u003cem\u003eInternational Journal of Medical Education\u003c/em\u003e. 2014;5:165\u0026ndash;172.https://doi.10.5116/ijme.53d3.7b30.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eKlassen RM, Klassen JRL. Self-efficacy beliefs of medical students: a critical review. Perspect Med Educ. 2018;7(2):76\u0026ndash;82. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.1007/s40037-018-0411-3\u003c/span\u003e\u003cspan address=\"10.1007/s40037-018-0411-3\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eWang J, Zheng Q, Song W, et al. The effect of nursing students' self-efficacy on patient-centered communication during the COVID-19 pandemic: The mediating effect of learning burnout. Front Psychiatry. 2021;12:787819doi. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.3389/fpsyt.2021.787819\u003c/span\u003e\u003cspan address=\"10.3389/fpsyt.2021.787819\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eZou L, Xie Z, Tan M, et al. The effect of professional identity on nursing academic achievement: the chain mediating effect of general self-efficacy and learning engagement. BMC Med Educ. 2024;24(1):1014. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.1186/s12909-024-05995-x\u003c/span\u003e\u003cspan address=\"10.1186/s12909-024-05995-x\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eMonteiro M. Doctor-patient relationship and its influence on the outcomes: what is the importance of emotional intelligence when approaching the patient? \u003cem\u003eMS thesis.\u003c/em\u003e 2023.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eSharp G, Bourke L, Rickard MJFX. Review of emotional intelligence in health care: an introduction to emotional intelligence for surgeons. ANZ J Surg. 2020;90(4):433\u0026ndash;40. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.1111/ans.15671\u003c/span\u003e\u003cspan address=\"10.1111/ans.15671\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003ePichert JW, Miller CS, Hollo AH et al. What health professionals can do to identify and resolve patient dissatisfaction. \u003cem\u003eThe Joint Commission journal on quality improvement\u003c/em\u003e.1998;24(6): 303\u0026ndash;312.\u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.1016/S1070-3241(16)30382-0\u003c/span\u003e\u003cspan address=\"10.1016/S1070-3241(16)30382-0\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eIsbell LM, Boudreaux ED, Chimowitz H, et al. What do emergency department physicians and nurses feel? A qualitative study of emotions, triggers, regulation strategies, and effects on patient care. BMJ Qual Saf. 2020;29(10):1\u0026ndash;2. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.1136/bmjqs-2019-010179\u003c/span\u003e\u003cspan address=\"10.1136/bmjqs-2019-010179\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eKasemy ZA, Kabbash I, Desouky D et al. Perception of educational environment with an assessment of motivational learning strategies and emotional intelligence as factors affecting medical students\u0026rsquo; academic achievement.\u003cem\u003eJournal of education and health promotion.\u003c/em\u003e2022;11(1): 303.https://doi.org10.4103/jehp.jehp_1772_21.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eKanesan P, Fauzan N. Models of emotional intelligence: A review. \u003cem\u003ee-BANGI Journal\u003c/em\u003e.2019;16(7).\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eP\u0026eacute;rez-Fuentes MC, Jurado MMM, G\u0026aacute;zquez Linares JJ. Explanatory value of general self-efficacy, empathy and emotional intelligence in overall self-esteem of healthcare professionals.\u003cem\u003eSocial work in public health\u003c/em\u003e.2019;34(4): 318\u0026ndash;329.\u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.1080/19371918.2019.1606752\u003c/span\u003e\u003cspan address=\"10.1080/19371918.2019.1606752\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eOusager J, Johannessen H. Humanities in undergraduate medical education: a literature review. Acad Med. 2010;85(6):988\u0026ndash;98. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.1097/ACM.0b013e3181dd226b\u003c/span\u003e\u003cspan address=\"10.1097/ACM.0b013e3181dd226b\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eChen Guangyi Z, Cuihong L. Investigation and analysis of the current status of humanistic care ability and its influencing factors among 407 higher vocational nursing students. Chin J Nurs Manage. 2015;15(04):409\u0026ndash;12. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi:CNKI:SUN:GLHL\u003c/span\u003e\u003cspan address=\"https://doi:CNKI:SUN:GLHL\" targettype=\"URL\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e. 0.2015-04-014.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eTaylor A, Lehmann S, Chisolm M. Integrating humanities curricula in medical education: a literature review. MedEd Publish. 2018;6:90. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi:10.15694/mep.2017.000090.2\u003c/span\u003e\u003cspan address=\"https://doi:10.15694/mep.2017.000090.2\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eJiang Tian W, Xiaoyan L, Yuanyuan L. Reliability and validity of the Chinese version of the Jefferson Empathy Scale (Medical Student Version). J Sichuan Univ (Medical Edition). 2015;46(04):602\u0026ndash;5. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi:10.13464/j.scuxbyxb.2015.04.021\u003c/span\u003e\u003cspan address=\"https://doi:10.13464/j.scuxbyxb.2015.04.021\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eWang Caikang H, Zhongfeng LY. Reliability and validity of the general self-efficacy scale. Appl Psychol.2001;(01):37\u0026ndash;40. https://doi: CNKI:SUN:YXNX.0.2001-01-006.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eHuang Y, Aiqin L\u0026uuml;, Lei W. Validity test of emotional intelligence scale for college students. J Peking Univ (Natural Sci Edition). 2008;06970\u0026ndash;6. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e.https://doi:10.13209/j.0479-8023.2008.151\u003c/span\u003e\u003cspan address=\".https://doi:10.13209/j.0479-8023.2008.151\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eZhang H. Relationship between empathy level, emotional health and prosocial behavior. Sports Social Psychol. 2024;4(1). \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.37420/J.SSP.2024.001\u003c/span\u003e\u003cspan address=\"10.37420/J.SSP.2024.001\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003ePreston SD. The origins of altruism in offspring care. Psychol Bull. 2013;139(6):1305\u0026ndash;41. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.1037/a0031755\u003c/span\u003e\u003cspan address=\"10.1037/a0031755\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eSong P, Tang W. Emphasizing humanities in medical education: Promoting the integration of medical scientific spirit and medical humanistic spirit. Biosci Trends. 2017;11(2):128\u0026ndash;33. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.5582/bst.2017.01092\u003c/span\u003e\u003cspan address=\"10.5582/bst.2017.01092\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eCairns P, Isham AE, Zachariae R. The association between empathy and burnout in medical students: a systematic review and meta-analysis. BMC Med Educ. 2024;24(1):640. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.1186/s12909-024-05625-6\u003c/span\u003e\u003cspan address=\"10.1186/s12909-024-05625-6\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eHou J, Michaud C, Li Z, et al. Transformation of the education of health professionals in China: progress and challenges. Lancet. 2014;384(9945):819\u0026ndash;27.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eSong P, Tang W. Emphasizing humanities in medical education: Promoting the integration of medical scientific spirit and medical humanistic spirit.\u003cem\u003eBioScience Trends.\u003c/em\u003e2017;11(2):128\u0026ndash;133.https://doi.10.5582/bst.2017.01092.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eXiqian Ca. Qingliang Fan b, Congying Yuan c.\u003cem\u003eThe impact of only child peers on students\u0026rsquo; cognitive and non-cognitive outcomes\u003c/em\u003e.2022;78:\u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e02231.https://doi.org/10.1016/j.labeco.2022.102231\u003c/span\u003e\u003cspan address=\"02231.10.1016/j.labeco.2022.102231\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eXu Q, Wu J, Peng H. Chinese EFL university students\u0026rsquo; self-efficacy for online self-regulated learning: Dynamic features and influencing factors. Front Psychol. 2022;13. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e912970.https://doi.org/10.3389/fpsyg.2022.912970\u003c/span\u003e\u003cspan address=\"912970.10.3389/fpsyg.2022.912970\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eYu Fei G, Huimin H, Hui, Qian Cong. Study on the relationship between emotional intelligence and coping effectiveness of medical students. J China Med Univ. 2012;41(02):169\u0026ndash;71.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eZhao M, Abdul Kadir NB, Abd Razak MA. The relationship between family functioning, emotional intelligence, loneliness, social support, and depressive symptoms among undergraduate students. Behav Sci. 2024;14(9):819. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.3390/bs14090819\u003c/span\u003e\u003cspan address=\"10.3390/bs14090819\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eStoller JK, Taylor CA, Farver CF. Emotional intelligence competencies provide a developmental curriculum for medical training. Med Teach. 2013;35(3):243\u0026ndash;7. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.3109/0142159X.2012.737964\u003c/span\u003e\u003cspan address=\"10.3109/0142159X.2012.737964\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eFu ZW, Wang KL, Du NY, et al. Comparative study on emotional behavior and parental job stress of only-child and non-only-child preschool children. World J Clin Cases. 2024;12(21):4642. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ettps://doi.org/10.12998/wjcc.v12.i21.4642\u003c/span\u003e\u003cspan address=\"ttps://10.12998/wjcc.v12.i21.4642\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eLuszczynska A, Scholz U, Schwarzer R. The general self-efficacy scale: multicultural validation studies. J Psychol. 2005;139(5):439\u0026ndash;57. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.3200/JRLP.139.5.439-457\u003c/span\u003e\u003cspan address=\"10.3200/JRLP.139.5.439-457\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eCulbertson SS, Fullagar CJ, Mills MJ. Feeling good and doing great: the relationship between psychological capital and well-being. J Occup Health Psychol. 2010;15(4):421\u0026ndash;33. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.1037/a0020720\u003c/span\u003e\u003cspan address=\"10.1037/a0020720\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eStrobel M, Tumasjan A, Sp\u0026ouml;rrle M. Be yourself, believe in yourself, and be happy: Self-efficacy as a mediator between personality factors and subjective well‐being.\u003cem\u003eScandinavian Journal of psychology\u003c/em\u003e.2011;52(1): 43\u0026ndash;48.\u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.1111/j.1467-9450.2010.00826.x\u003c/span\u003e\u003cspan address=\"10.1111/j.1467-9450.2010.00826.x\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eMangione S, Chakraborti C, Staltari G et al. Medical students\u0026rsquo; exposure to the humanities correlates with positive personal qualities and reduced burnout: a multi-institutional US survey.\u003cem\u003eJournal of general internal medicine\u003c/em\u003e.2018;33(5): 628\u0026ndash;634.\u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.1007/s11606-017-4275-8\u003c/span\u003e\u003cspan address=\"10.1007/s11606-017-4275-8\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eHsu WC, Fuh LJ, Liao SC. Tickling the heart: integrating social emotional learning into medical education to cultivate empathetic, resilient, and holistically developed physicians. Front Med. 2024;11. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e1368858.https://doi.org/10.3389/fmed.2024.1368858\u003c/span\u003e\u003cspan address=\"1368858.10.3389/fmed.2024.1368858\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eEl Tarhouny S, Hassouna A, Mansour T. Emotional intelligence in medical education: Its role in professional identity formation: AMEE Guide No. 186.\u003cem\u003eMedical Teacher.\u003c/em\u003e2025;1\u0026ndash;15.\u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.1080/0142159X.2025.2501257\u003c/span\u003e\u003cspan address=\"10.1080/0142159X.2025.2501257\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eYang Y, Wang C. The chain mediating effect of empathy and communication ability on emotional intelligence and caring ability of nursing students. Front Psychol. 2024;14. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e1339194.ttps://doi.org/10.3389/fpsyg.2023.1339194\u003c/span\u003e\u003cspan address=\"1339194.ttps://10.3389/fpsyg.2023.1339194\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":true,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"Empathy, Emotional intelligence, Self-efficacy, Clinical medical education, Medical students, Humanistic education, Gender differences, Emotional regulation, Doctor–patient relationship","lastPublishedDoi":"10.21203/rs.3.rs-8697656/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-8697656/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003e\u003cstrong\u003eBackground:\u003c/strong\u003e Empathy is a fundamental professional competence in medical education, yet evidence suggests that empathy development may stagnate during medical training. Emotional intelligence and self-efficacy have been proposed as important psychological predictors of empathy; however, their relative roles across different stages of medical education remain unclear.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eMethods: \u003c/strong\u003eThis study employed a two-wave cohort design to investigate empathy development among undergraduate clinical medicine students in China. Participants completed validated measures of empathy, emotional intelligence, and self-efficacy during the early stage of training and again in the later stage. Descriptive analyses, group comparisons, and multivariate regression models were used to examine developmental changes and the relative contributions of emotional intelligence and self-efficacy to empathy.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eResults: \u003c/strong\u003eEmpathy levels showed only modest improvement across training stages. Emotional intelligence demonstrated a stable and significant positive association with empathy at both time points, whereas self-efficacy showed weak and inconsistent effects after controlling for emotional intelligence. Among emotional intelligence dimensions, emotional perception and emotional regulation emerged as the strongest predictors of empathy. In addition, gender and rural–urban background were associated with differences in empathy levels and the strength of these relationships.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConclusions:\u003c/strong\u003e The findings indicate that emotional intelligence, rather than self-efficacy, plays a central role in empathy development among medical students. These results suggest that confidence-based educational approaches alone may be insufficient to foster empathic competence in emotionally complex clinical contexts. Integrating emotional intelligence–focused training into early medical curricula may provide a more effective pathway for supporting sustainable empathy development in medical education.\u003c/p\u003e","manuscriptTitle":"Factors Influencing Empathy in Clinical Medical Education","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2026-03-03 16:56:02","doi":"10.21203/rs.3.rs-8697656/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"c701d8a9-8818-4538-8d6a-916ab5bc019e","owner":[],"postedDate":"March 3rd, 2026","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[],"tags":[],"updatedAt":"2026-03-18T09:26:09+00:00","versionOfRecord":[],"versionCreatedAt":"2026-03-03 16:56:02","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-8697656","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-8697656","identity":"rs-8697656","version":["v1"]},"buildId":"XKTyCvWXoU3ODBz1xrDgd","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}