Graduation Year


Document Type




Degree Name

Doctor of Philosophy (Ph.D.)

Degree Granting Department

Communication Sciences and Disorders

Major Professor

Michelle S. Bourgeois, Ph.D.

Committee Member

Jacqueline Hinckley, Ph.D.

Committee Member

Michael Barker, Ph.D.

Committee Member

Lisa Brown, Ph.D.


burnout, compassion fatigue, compassion satisfaction, emotion regulation


In the field of medicine, empathic providers have been found to bring numerous benefits to a clinical encounter as they are better able to elicit detailed and thorough case histories, build rapport and therapeutic alliance with patients, and foster greater compliance with treatment recommendations. Despite its multiple benefits, empathy has not been researched systematically within the field of speech-language pathology. In medical training, empathy has been found to decline by the time medical students are introduced to direct patient care. Currently, no information is available regarding the empathy trajectory of novice speech-language pathologists.

The goal of the current project was to determine the effect of one semester of clinical experience on the perceived and self-reported empathy of novice speech-language pathology clinicians during their first semester of graduate school. A convergent parallel mixed-method design was used in two stages (pre/post). Both quantitative and qualitative data were gathered concurrently during two distinct moments in time (i.e. pre-test: during the first week of exposure to clients in clinic; post-test: at the end of the first semester of clinic). Quantitative and qualitative data analyses were completed separately at the conclusion of each stage, with data integration taking place during final interpretation.

Quantitative findings revealed that novice speech-language pathology students were able to identify high vs. low levels of relational empathy as depicted in two video-recorded clinical interviews using a modified CARE measure (Mercer, Maxwell, Heaney, & Watt, 2004) even prior to exposure to clinical practice. In addition, these perceptions remained stable from pre-test to post-test. Qualitative comments written by novice clinicians regarding each video were analyzed using a-priori codes. Analysis of the qualitative data corroborated the quantitative findings except for mild nuances pertaining to observations about the caregiver in the video, which tended to occur more frequently at pre-test and less so at post-test. The significance of these qualitative findings was questionable, but it was hypothesized that clinicians may have become more “detached” from the caregiver’s perspective after they were exposed to direct work with clients in the clinic.

Novice clinicians’ levels of self-reported empathy were also observed to remain stable from pre-test to post-test, as evidenced by quantitative findings from the Empathy Assessment Index (EAI – Gerdes, Segal, & Lietz, 2012). Analysis of the subtests from the EAI showed that all clinicians tended to have lower scores for emotional regulation as compared with other components such as affective response, affective mentalizing, perspective taking, or self-other awareness. Qualitative analysis of an exit interview in which novice clinicians were asked to list the most frustrating and most rewarding aspects of their semester showed that aspects of the semester which were perceived as frustrating were often balanced by those which were perceived as rewarding. In addition, direct work with clients and caregivers was listed by far as one of the most rewarding experiences for novice clinicians, particularly as it pertained to client progress. Factors which could potentially lead into burnout were noted in the list of frustrating items, but these occurred more infrequently.

Further investigations into the empathy trajectory of novice speech-language pathology students are recommended especially using a cross-sectional or longitudinal design to determine if empathy remains stable over the course of training or whether it suffers a decline as academic, personal, and patient/caseload demands become more challenging and multifaceted. Possible investigations following clinicians after the completion of their clinical fellowship year would also be recommended as novice clinicians transition from trainees to full-fledged providers.