Patient Perceptions of Empathy in Medical Student Encounters: Comparing Electronic and Handwritten Notetaking Methods

Authors

• Harish Karthikeyan, University of Missouri–Kansas City School of MedicineFollow
• Asad H. Siddiqui, University of Missouri–Kansas City School of MedicineFollow
• Stacey Algren, University of Missouri–Kansas City School of MedicineFollow
• Angellar Manguvo, University of Missouri–Kansas City School of MedicineFollow

ORCID (Optional)

Karthikeyan: https://orcid.org/0009-0007-1851-528X

Siddiqui: https://orcid.org/0009-0006-8851-4920

Algren: https://orcid.org/0009-0000-8055-9397

Publication Date

4-10-2026

Abstract

Objectives: Patient interviews are central to clinical practice, serving as both an information-gathering tool and a foundation for rapport and empathy. With the increased use of electronic documentation during clinic visits, concerns have been raised about technology detracting from the patient-clinician connection. This study examined whether medical students’ notetaking modality (electronic vs handwritten) influenced patient perceptions of empathy during clinical encounters.

Study Design: This study employed a causal-comparative approach, as student groups occurred naturally, combined with a survey design to collect data from patients.

Methods: A total of 135 student–patient encounters were analyzed at the University of Missouri–Kansas City School of Medicine, an accelerated six-year BA/MD program. Patient perceptions of empathy were assessed using an adapted Consultation and Relational Empathy (CARE) Measure. Independent-samples t tests, ANOVAs, and regression analyses evaluated differences in perceived empathy by notetaking modality, patient demographics (age, gender, ethnicity), student training level, and interview duration.

Results: Patients rated empathy consistently high across encounters. No significant differences were observed between electronic and handwritten notetaking. Senior students more frequently used handwritten notes, but modality preference was not associated with empathy ratings or interview duration. Patient demographics also did not significantly influence empathy perceptions or moderate the relationship between modality and empathy.

Conclusions: Empathy appears to be conveyed primarily through relational and communicative behaviors rather than documentation style. For medical education, these findings underscore the importance of longitudinal training in patient-centered communication and support the integration of electronic documentation skills without compromising empathic engagement.

DOI

doi:10.32873/unmc.dc.ihsej.0077

Creative Commons License

This work is licensed under a Creative Commons Attribution 4.0 License.

Recommended Citation

Karthikeyan, Harish; Siddiqui, Asad H.; Algren, Stacey; and Manguvo, Angellar (2026) "Patient Perceptions of Empathy in Medical Student Encounters: Comparing Electronic and Handwritten Notetaking Methods," Innovations in Health Sciences Education Journal: Vol. 3 : Iss. 1 , Article 3.
Available at: https://doi.org/doi:10.32873/unmc.dc.ihsej.0077