Variation in the barriers to compassion across healthcare training and disciplines: A cross-sectional study of doctors, nurses, and medical students

Background: Despite the established importance of compassion in health, studies examining the specific barriers to compassionate care in healthcare are few. Recent work suggests that examining differences as a function of professional development and identifying variation in barriers to compassionate care across professions may highlight the origins of barriers and inform the development of compassion-enhancing interventions suited to the unique challenges of different professions and stages of training. Objectives: To explore whether the barriers to compassion vary (a) between physicians and nurses and (b) across samples of physicians and medical students (i.e., as a function of development and clinical experience). It was expected that medical students would report greater barriers than physicians and that nurses would generally report lower barriers to compassion, other than for external barriers. Methods: Registered nurses, physicians, and medical students were recruited using convenience sampling in New Zealand. Following consent, 1700 participants (801 nurses, 516 physicians, and 383 medical students) completed a survey including the Copenhagen Burnout Inventory and the Barriers to Physician Compassion questionnaire. Results: As expected, medical students reported greater barriers to compassion than physicians and nurses, with both professions generally reporting lower barriers. However, and also consistent with hypotheses, nurses reported greater work-environment-related barriers relative to physicians. Discussion: Students reported greater barriers than physicians. While nurses generally reported lower barriers than physicians, they specifically reported greater work environment-related barriers. For nurses, results highlight the importance of implementing interventions that reduce external barriers to compassion, specifically the need to alleviate the structural barriers and restrictions that nurses face. For medical students and younger healthcare professionals, the results highlight the importance of mentorship, support, and ongoing professional and emotional development. (C) 2018 Elsevier Ltd. All rights reserved.