The development, delivery, and evaluation of novel longitudinal empathy-focused communication skills training at a UK medical school

Background:
Empathy benefits patients and clinicians, yet medical students' empathy often declines during training. A key factor is that communication skills teaching is rarely empathy-focused, evidence-based, or longitudinal.

Aim:
To establish principles of best practice for training and curriculum design based on existing literature; audit our existing curriculum; and design and pilot elements of a longitudinal curriculum based on existing evidence and our experience.

Methods:
We audited the existing curriculum to identify gaps in empathy-focused communication training and compared our findings with systematic review evidence. Students, educators, and patient representatives developed and refined a preliminary curriculum as equal partners in co-production workshops.

Results:
The audit showed that empathy training was concentrated in the early years, focusing on active listening and rapport-building, with little evidence-based content or longitudinal reinforcement. Co-production workshops generated recommendations, including formative workplace-based assessments with patient feedback, structured home visits during early training, and patient advocacy experiences. A new longitudinal curriculum was developed, embedding advanced empathy skills, evidence-based positive messaging strategies, and integrated assessments throughout the clinical years. Pilot sessions using role-play with “difficult” patients showed that students and tutors better understood empathy in challenging consultations.

Discussion and conclusion:
We identified and addressed key gaps in empathy training using a systematic, evidence-based, co-produced approach. The resulting curriculum offers a practical, adaptable model for developing lasting empathic communication skills across medical education.

Innovation:
We developed a replicable model that combines longitudinal home visits, workplace-based empathy assessments with patient feedback, and integration of evidence-based communication strategies throughout the medical curriculum.