EMPATHICA - Developing an Empathy and Optimism training tool for Healthcare Practitioners

Talk Code: 
Kirsten A. Smith
Felicity Bishop, Hazel Everitt, Leanne Morrison, Jeremy Howick, Kirsten A. Smith, Stephanie Hughes, Jane Vennik, Emily Lyness, Mohana Ratnapalan, Hajira Dambha-Miller, Christian Mallen, Paul Little, Lucy Yardley
Author institutions: 
University of Southampton, University of Oxford, Keele University, University of Bristol


Osteoarthritis (OA) pain is common, costly, and challenging to manage in busy primary care settings. Recent research suggests that patients experience less pain after consulting practitioners who show empathy and encourage optimism about treatment.


We are developing an online training tool using the Person-based Approach to teach practitioners (GPs, physiotherapists, and nurses) how to show more empathy and encourage patients to have positive yet realistic expectations. To do this, we first explored the literature on practitioner communication skills, conducting: 1. A content analysis on interventions to increase empathic communication among practitioners ; 2. A content analysis on interventions to evoke positive expectations of treatment outcomes among patients; 3. A meta-ethnography to synthesize evidence on patients’ and practitioners’ perspectives on communication in primary care OA consultations. We then conducted interviews with practitioners to explore the barriers and facilitators to online training in empathy and optimism.


We brought this evidence together with a behavioural analysis to develop guiding principles and a logic model to inform our intervention development. We then developed the training tool, using think-aloud interviews to iteratively refine the content to improve its acceptability to practitioners. We filmed consultations using the guidance in our training tool and collected patient views to ensure the messages of our training tool were acceptable to patients.

In 2020 we will conduct a feasibility trial in 10 GP practices with up to 280 patients to explore the feasibility of the training and how to trial it most efficiently.



We hypothesize that our training tool will increase perceived empathy, improve patient optimism about the outcome of their treatment and reduce pain in OA patients; it may also lead to improved consultation and health outcomes for patients consulting with other conditions in primary care.

Submitted by: 
Kirsten Smith
Funding acknowledgement: 
The EMPATHICA project is supported by a National Institute for Health Research (NIHR) School for Primary Care Research grant (project number 389). The Primary Care Department is a member of the NIHR School for Primary Care Research and supported by NIHR Research funds. The research programme of LM and LY is partly supported by the NIHR Southampton Biomedical Research Centre (BRC). HDM is funded through an NIHR Clinical Lectureship. CM is funded by the National Institute for Health Research (NIHR) Collaborations for Leadership in Applied Health Research and Care West Midlands, the NIHR School for Primary Care Research and an NIHR Research Professorship in General Practice (NIHR-RP-2014-04-026).