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Year : 2019  |  Volume : 22  |  Issue : 10  |  Page : 1403-1407

Are empathy and emotional intelligence missing in dental practitioner's toolkit in Saudi Arabia? A cross-sectional study

1 Department of Periodontics and Community Dental Sciences, College of Dentistry, King Khalid University, Abha, Kingdom of Saudi Arabia
2 Pediatric Dentistry and Orthodontic Sciences, College of Dentistry, King Khalid University, Abha, Kingdom of Saudi Arabia
3 Department of Dental Technology, College of Applied Medical Science, King Khalid University, Abha, Kingdom of Saudi Arabia

Date of Acceptance31-May-2019
Date of Web Publication14-Oct-2019

Correspondence Address:
Dr. R R Nagati
Department of Periodontics and Community Dental Sciences, College of Dentistry, King Khalid University, Abha-61471
Kingdom of Saudi Arabia
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/njcp.njcp_605_18

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Background: Empathy and emotional intelligence (EI) of a dentist are two factors vital for developing fruitful relations between clinicians and patients. Establishing a good relationship with patients may improve patients' outcomes. Data on empathy and EI in dental practitioners in the Kingdom of Saudi Arabia is scarce. Aims: Hence, we aimed to evaluate and compare empathy and EI among dental practitioners in Abha and Khamis Mushayat cities of Saudi Arabia. Methods: We conducted a cross-sectional survey study. A total of 183 dental practitioners who were reachable at survey time were included. A self-administered questionnaire on empathy and EI was structured based on Jefferson Scale of Physician Empathy (health professions version) and Schutte's Emotional Intelligence Scale, respectively. Statistical analysis was done using Mann–Whitney and Kruskal–Wallis tests. Results: No significant difference was observed between both genders regarding empathy and EI (P = 0.73 and 0.97, respectively). Similarly, no significant difference was observed between participants with different qualifications or different work settings (P > 0.05). However, a statistically significant positive correlation was observed between empathy and EI (r = 0.722). Conclusions: Irrespective of gender, qualification, or different work settings, dental practitioners in both cities showed adequate empathy and EI levels. Dentists with high empathy scores seem to show high EI levels. Clinical Significance: Evaluating and monitoring empathy and EI practice among dental practitioners have paramount importance to improve clinical practice and healing potential of patients. Low levels of empathy and EI practice would suggest modifications to training curriculum or healthcare policies.

Keywords: Emotional intelligence, empathy, Jefferson scale of physician empathy, Schutte's emotional intelligence scale

How to cite this article:
Gokhale S T, Al-Qahatani S M, Raj R S, Al-Qahatani B S, Vaddamanu S K, Jathmi A A, Alshehri W A, Nagati R R. Are empathy and emotional intelligence missing in dental practitioner's toolkit in Saudi Arabia? A cross-sectional study. Niger J Clin Pract 2019;22:1403-7

How to cite this URL:
Gokhale S T, Al-Qahatani S M, Raj R S, Al-Qahatani B S, Vaddamanu S K, Jathmi A A, Alshehri W A, Nagati R R. Are empathy and emotional intelligence missing in dental practitioner's toolkit in Saudi Arabia? A cross-sectional study. Niger J Clin Pract [serial online] 2019 [cited 2020 Sep 28];22:1403-7. Available from:

   Introduction Top

The relationship between a dentist and a patient is a core component of dental care. Empathy plays a significant role in building a strong doctor–patient relationship.[1] Indeed, clinicians who implement a warm, friendly reassuring manner are more effective than those who keep patient consultations strictly formal.[2] Understanding patient's complaint, previous experiences with doctors, and previous diseases or symptoms, and actually communicating this understanding efficiently to patients are the primary components of clinical empathy.[3] Although evidence of a direct relationship is lacking, clinical empathy may improve treatment quality. Many patients view treatment quality in the eye of empathy shown by the clinician.[4] According to current evidence, empathy is missing in modern-day health care and this may include dental care.[5] Empathy is a higher order emotion, and its degree differs between individuals.[1]

Emotional intelligence (EI) is the ability to perceive, connect, and manage others and your own emotions.[6],[7] Since some essential emotions play a significant role at workplace among dentist, patients, and hospital staff, EI should be incorporated in dentist training from student level. EI is a conjectural cognitive ability of a dentist and can be developed with time.[8],[9] Emotional intelligence may enhance clinical practice. Since dentists commonly face stress in several instances in their career, educational institutions like dental schools are recognizing the importance of developing students' empathy and EI. Providing adequate health care is the ultimate aim of any health care professional, which requires hard as well as soft skills. There has been tremendous research done in the field of hard skills, while the soft skills and their role are less explored.[10]

In this study, we focused on soft skills like empathy and EI. Several studies assess empathy and EI among nursing [5] and dental students [8],[11],[12],[13],[14],[15],[16],[17],[18],[19],[20] in different parts of the world. However, data regarding empathy and EI practice in dental practitioners particularly in the Kingdom of Saudi Arabia is scarce. Accordingly, we aimed to evaluate empathy and EI in dental practitioners in two major cities (Abha and Khamis Mushayat) in the Kingdom of Saudi Arabia. Furthermore, we aim to assess the relationship between empathy and EI with gender, qualification, and work settings of a dental practitioner.

   Materials and Methods Top

We conducted a descriptive cross-sectional observational study. Prior ethical committee approval was obtained from the institutional ethical committee board (Ethical committee number: SRC/ETH/2017-18/078) of the College of Dentistry, King Khalid University, Abha, Kingdom of Saudi Arabia. The study was conducted in Abha and Khamis Mushayat cities of Saudi Arabia between September 1, 2018 and September 30, 2018. Eligibility criteria included being an active dental practitioner, reachable during questionnaire distribution, and willing to participate in the survey. Included participants were involved in clinical practice or academic practice or both. Those who did not consent or failed to complete the questionnaire were excluded. A list of teaching faculty and Saudi board postgraduate students was obtained from College of Dentistry, King Khalid University, Abha and a list of practitioners in private practice was obtained from Saudi Health Commission of Abha and Khamis Mushayat cities.

A specially designed questionnaire was prepared to collect data, and printed in both Arabic and English languages. Participants were free to select their convenient language. Preceding giving off questionnaires, a brief explanation on study aims and confidentiality of participants' data was presented. The questionnaire had a provision for recording the sociodemographic details of participants which included the name (optional), age, gender, work settings [dental practitioners, academicians both (dental practitioners + academicians) postgraduate students in dentistry], work experience (number of years), socioeconomic status (annual income), phone number, and e-mail address.

We used the 20-item Jefferson Scale of Physician Empathy—Health Professions version (JSP-HP) and the Schutte's Emotional Intelligence Scale (SEIS,1998).[7],[13],[21] The first part included questions regarding empathy (20 questions) and the second included questions on EI (33 questions). The questionnaire was adapted for use by dentists by substituting the words “physician” and “doctor” with “dentist” and “medical” with “dental”. Questionnaire validity was tested by two preventive and community health dentists, and corrections were made according to their suggestions. Each item had a five-point Likert scale answer. For each question, five represents the highest score and one represents the lowest score. Total score for each participant ranged from 20 to 100 for empathy and 33 to165 for EI. Higher scores represent more empathetic and EI behavior of participant.

Statistical analysis

Data was entered in SPSS version 17. Intergroup comparisons were made using Mann–Whitney test and Kruskal–Wallis tests. Correlation between empathy and EI was estimated using Spearman's rank-order correlation test. P value <0.05 was considered statistically significant.

   Results Top

A total of 200 questionnaires were distributed and collected back from the respondents making the response rate of 100%. Fourteen questionnaires received were incomplete and hence were excluded. Among the 186 responses, 154 (83%) were males and 32 (17%) were females. There were no statistically significant differences in mean Empathy and EI scores between gender (P > 0.05) [Table 1].
Table 1: Comparison of empathy and emotional intelligence between both genders using the Mann–Whitney test

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According to educational levels of dentists, highest response was obtained from those having Bachelor's degree (113) followed by master's degree (54) and postgraduate students (19). There were no statistically significant differences in mean Empathy and EI scores among dentists with different educational qualifications (P > 0.05) [Table 2].
Table 2: Comparison of empathy and emotional intelligence based on qualification using the Kruskal–Wallis test

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According to work settings, highest response was from dentists in clinical practice (113), followed by those in academic practice (46), postgraduate students (19), and those working in both clinical and academic practice (8). However, there were no statistically significant differences in mean Empathy and Emotional Intelligence scores among dentists with different work settings (P > 0.05) [Table 3]. Emotional intelligence was found to have a strong positive correlation with empathy scores (r = 0.72) [Table 4].
Table 3: Comparison of empathy and emotional intelligence based on work settings using the Kruskal–Wallis test

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Table 4: Correlation between empathy and emotional intelligence using Spearman's rank-order correlation test

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   Discussion Top

In this cross-sectional study, we evaluated and compared empathy and emotional intelligence among all reachable dental practitioners in Abha and Khamis Mushayat cities of Saudi Arabia. Our study included those in clinical, academic, and both clinical and academic practice as well as postgraduate students. Unreachable practitioners were excluded from the study as well as those who filled questionnaires inadequately. Responders with higher scores seem to have better empathy and EI practice.

The word “empathy” was firstly introduced in the 1980s when a German psychologist coined the term “einfuhlung.”Although different definitions of empathy were proposed, empathy broadly means appreciating the emotions of others. Putting in mind our aim, we chose to use health professional version (HP) of Jefferson Scale of Empathy (JSPE) which was designed exclusively for the assessment of clinical empathy.[17]

Emotional intelligence (EI), though a recent concept, is also vital in upholding relations. According to Daniel Goleman, who has several studies on EI, EI is more important and powerful than intelligence quotient.[9] In this study, we adopted the Schutte's Emotional Intelligence Scale (SEIS) to assess EI as it has appropriate psychometric properties and consists of only 33 questions thus preventing questionnaire fatigue.[22] Due to the complexity of day to day practice in dentistry, empathy and EI are vital factors to be considered in order to achieve favorable healing both physically and mentally.[15],[23],[24]

Some recent studies by Diaz-Narvaez et al.,[12] Aggarwal et al.,[16] Shah and Thingujam,[25] Rastegar et al.,[21] and Di-Lillo et al.[26] Showed there was no difference between both genders among dental students in showing empathy toward patients. Contrarily, previous studies by Duarte et al.,[27] Sherman and Cramer,[17] Imran et al.,[28] and Ciarrochi et al.,[29] showed that females show empathy more than males. According to our study results, neither males nor females were significantly superior regarding empathy and EI.

Some researchers suggest empathy skills decline in dental students along their graduate curriculum from first to final year.[17] In a previous study by Anushka and Nagesh,[30] there was a significant difference regarding showing empathy between participants with different qualifications. Conversely, there is no significant difference observed in our current study in mean scores of empathy or EI among participants with different work setting practices and specialties. Also in contrary to the previous study,[30] although not statistically significant, postgraduate students showed relatively higher empathy and EI scores in our study. Both studies suggest there is no significant difference regarding empathy and EI among participants with different occupations.[30] Lack of studies evaluating empathy and EI in dental practitioners based on type of practice hinders more comparisons.

A statistically significant positive correlation was observed between empathy and EI in the current study. Also in previous studies by Anushka and Nagesh,[30] Rastegar et al.,[21] and Faye et al.,[31] empathetic practitioners showed more EI scores suggesting a positive correlation between empathy and EI. Long-term patient satisfaction and doctor–patient relationship depend on empathy and EI.[32] Based on our current study results, it is evident that Saudi Arabia is trying to train students to provide dental practitioners with equally important both cognitive and soft skills.

   Conclusion Top

According to current study results, empathy and emotional intelligence seem adequate and unaltered with gender, qualification/specialty of practice at different work settings. Furthermore, there is a positive correlation observed between empathy and EI among dental practitioners in Abha and Khamis Mushayat cities of the Kingdom of Saudi Arabia. Further longitudinal observational studies are recommended to observe changes in these two practices over time.


We would like to appreciate and acknowledge Dr. Vijay Apparaju and Dr. Shreyas Tikare for their constant support in literature search.

Financial support and sponsorship


Conflicts of interest

There are no conflicts of interest.

   References Top

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[PUBMED]  [Full text]  
Weng H-C, Steed JF, Yu S-W, Liu Y-T, Hsu C-C, Yu T-J, et al. The effect of surgeon empathy and emotional intelligence on patient satisfaction. Adv Health Sci Educ Theory Pract 2011;16:591-600.  Back to cited text no. 32


  [Table 1], [Table 2], [Table 3], [Table 4]


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