Toward a Model of Burnout in Medical Professionals: The Role of Empathy, Compassion Satisfaction, and Secondary Traumatic Stress — A Structural Equation Modeling Study
Elissa Dawkins, PhD1*, Pearl Seo, MD MPH2
1Senior Project Manager in the Clinical Research Services Education and Training Department at the Sylvester Comprehensive Cancer Center at the University of Miami Miller School of Medicine, University of Miami, USA.
2Assistant Professor, Division of Medical Oncology, Department of Medicine, Miller School of Medicine, University of Miami, USA.
*Corresponding Author: Elissa Dawkins, Senior Project Manager in the Clinical Research Services Education and Training Department at the Sylvester Comprehensive Cancer Center at the University of Miami Miller School of Medicine. She is also Part-time Faculty at Capella University in the School of Public Service and Leadership; Adjunct Faculty at American College of Education; and Contributing Faculty at Walden University, USA.
https://doi.org/10.58624/SVOAMR.2025.03.014
Received: November 22, 2024
Published: July 08, 2025
Citation: Dawkins E, Seo P. Toward a Model of Burnout in Medical Professionals: The Role of Empathy, Compassion Satisfaction, and Secondary Traumatic Stress — A Structural Equation Modeling Study. SVOA Medical Research 2025, 3:4, 106-137. doi: 10.58624/SVOAMR.2025.03.014
Abstract
Purpose: This study was designed to provide a better understanding of the potential direct and indirect effects that cognitive and affective empathy had on burnout (BO), and whether the effects, if any, were mediated by secondary traumatic stress (STS) and compassion satisfaction (CS). There is a paucity of research in the literature detailing the potential direct and indirect effects these constructs may have on a population of medical professionals spanning multiple specialties, centers, and geographical regions.
Methods: This study sought to gather this information using the Jefferson Scale of Empathy for Health Professionals (JSE-HP), the Interpersonal Reactivity Index (IRI), and the Professional Quality of Life (ProQOL-5) via an anonymous survey on the Survey Monkey platform. Statistical analyses were employed using Structural Equation Modeling (SEM) with covariances to assess the direct and indirect effects of the variables presented in the path analysis model on a sample of medical professionals (N = 165).
Results: The total effects (TE) between affective empathy and BO (TE = .133, SE = .062, p = .015), and STS and burnout (TE = .491, SE = .065, p = .005) were significant. CS (DE = -.792, SE = .051, p = .003) and affective empathy had a direct effect on BO (DE = -.116, SE = .054, p = .020); lower 95% CI = -.226, upper 95% CI = -.010); affective empathy also had an indirect effect (IE) on BO (IE = .249, SE = .047, p = .005). While the TE between cognitive empathy and burnout was not significant (TE = -.350, SE = .080, p = .171), nor was the direct effect (DE) (DE = -.063, SE = .048, p = .238), cognitive empathy did have an IE on BO (IE = -.287, SE = .065, p = .003) As well as STS (IE = .105, SE = .051, p = .050). Although gender was not a moderating variable between cognitive empathy and STS (F (1, 163) = 1.472, p = .233), it was between cognitive empathy and CS (p < .0001), affective empathy and BO (p < .0001), affective empathy and STS (p = 049), and affective empathy and CS (p < .0001). As affective empathy increased in females, BO decreased; whereas in males as affective empathy increased, BO also increased. In addition, the results showed in both males and females, the higher the affective empathy score, the more STS caregivers will experience. However, STS was higher in males who exuded more affective empathy.
Conclusions: Empathy should be introduced early on in medical education curricula to reduce the probability of developing burnout later in one’s medical career. Empathy-focused interventions should be incorporated within the medical environment where empathy can be taught and cultivated to improve workplace and organizational outcomes. Participating in Balint groups, empathy training, and learning stress-coping measures are all important to lowering the risk of developing burnout. Future research should not only explore the direct and indirect effects of empathy in a large sample of medical professionals, but why and how empathy decreases, and if alexithymia might play an integral role in these changes over time.
Keywords: Model of Burnout, Medical Professionals, Secondary Traumatic Stress (STS)