Context: Health care practitioners face increasing expectations to provide patient-centered care. Communication skills, specifically empathy, are critical in the provision of patient-centered care. Past work correlates empathy with improved patient satisfaction, compliance, and treatment outcomes. In particular, a predictive relationship exists between clients' ratings of their clinician's empathy and treatment outcomes. There is a dearth of studies examining empathy using qualitative methodology and factors of empathy in athletic training. Objective: To gain an understanding of athletes' perceptions of empathy in the patient-clinician relationship. Design: Qualitative interviews were completed using grounded-theory techniques. Setting: A quiet office. Participants: A typical, purposeful sample of 15 college-age Division I student-athletes (8 female, 7 male; 19.3 +/- 1.2 y) from a variety of sports (football, wrestling, volleyball, baseball, etc) participated. Data Collection and Analysis: Researchers utilized an interview protocol designed to understand the factors of empathy related to athletic training. The interview protocol established a concept of empathy to help facilitate discussion of ideas. Data were transcribed, coded, and analyzed for themes and patterns using grounded-theory techniques. Trustworthiness of the data was ensured using an external auditor, member checks, and methods triangulation. Results: Five themes described empathy: advocacy, communication, approachability, access, and competence. Advocacy was described as the athletic trainer (AT) representing the patient. Communication was the ability to listen reflectively; approachability emerged as the comfort and personal connection the patient felt with the AT. Access and technical competence were bridges required for the development of empathy. Conclusions: Providing patient-centered care facilitated by developing good patient-clinician relationships is critical in enabling the best treatment outcomes. ATs portray empathy through advocacy, communication, and approachability. Empathy improves the patient-clinician relationship and is critical for patient-centered care delivered by ATs.
