The Jefferson Scale of Empathy (JSE) is a 20-item questionnaire designed to measure empathy specifically in healthcare settings. Developed at Thomas Jefferson University, it has become the most widely used tool for assessing how well doctors, nurses, and other health professionals understand and connect with their patients’ experiences. Each item is scored on a 7-point scale, from “Strongly Disagree” to “Strongly Agree,” producing a total score that reflects a clinician’s or student’s empathic orientation toward patient care.
What the Scale Measures
The JSE doesn’t measure empathy as a single, broad trait. Research consistently identifies three distinct dimensions within the scale. The first and most prominent is perspective-taking, which captures how willing and able a clinician is to see a situation through the patient’s eyes. The second is compassionate care, reflecting emotional engagement with patients’ concerns and wellbeing. The third, sometimes described as “walking in the patient’s shoes,” measures the ability to think about experiences from the patient’s point of view during clinical encounters.
This three-factor structure has been replicated across studies in multiple countries, which gives researchers confidence that the scale is capturing something real and consistent rather than just producing a single vague number. Perspective-taking tends to carry the most weight in the overall score, reflecting the scale’s emphasis on cognitive empathy (understanding what a patient feels) rather than purely emotional empathy (feeling what a patient feels).
How the Scale Works
The questionnaire presents 20 statements, and respondents rate their agreement with each on that 1-to-7 scale. Some items are positively worded (agreeing reflects higher empathy) while others are reverse-scored, meaning disagreement signals greater empathy. This mix helps prevent people from simply selecting the “right” answer down the line.
Total scores can range from 20 to 140, with higher scores indicating stronger empathic tendencies in clinical contexts. The scale takes only a few minutes to complete, which makes it practical for use with large groups of students or during busy clinical training periods.
Who Takes It
The JSE was originally created for physicians but has been adapted into versions for different groups. One version is designed for practicing physicians and other healthcare professionals. A student version uses slightly adjusted language appropriate for people still in training. A third version covers students and practitioners across health professions more broadly, including nursing, pharmacy, and allied health fields.
Medical schools are the most common setting for the JSE. Programs use it to track empathy levels across years of training, identify students who might benefit from additional communication skills work, and evaluate whether curriculum changes actually shift how students relate to patients. It has been translated into dozens of languages and used in studies spanning countries across every continent.
Why Empathy Scores Matter Clinically
The JSE would be an academic curiosity if higher scores didn’t connect to anything meaningful in patient care. But research has linked physicians’ scores on the scale to tangible health outcomes. Studies in both the United States and Italy have found significant associations between higher JSE scores and better results for diabetic patients, including improved blood sugar control and fewer complications. These findings suggest that empathic physicians don’t just make patients feel better emotionally; they may also produce measurably better clinical results, likely because patients are more open, more adherent to treatment plans, and more willing to share important information with doctors they feel understood by.
Strengths and Limitations
The JSE’s main strength is its specificity. Unlike general empathy questionnaires borrowed from psychology, it was built from the ground up for healthcare contexts. The language, scenarios, and dimensions it measures all reflect the particular kind of empathy that matters when someone is sick, scared, or navigating a complex diagnosis. Its consistent three-factor structure across diverse populations adds to its credibility as a measurement tool.
The most significant limitation is that it relies on self-reporting. People rate their own empathic tendencies, which means scores can be influenced by how respondents want to be perceived rather than how they actually behave with patients. Someone might genuinely believe they take the patient’s perspective while their patients experience something very different. Researchers are aware of this gap, and some studies pair JSE scores with patient-reported measures or observed clinical behaviors to get a fuller picture.
Another consideration is that the scale measures orientation toward empathy rather than empathic skill. A high score indicates that someone values and prioritizes understanding patients, but it doesn’t directly assess whether they can effectively communicate that understanding during a tense clinical moment.
How To Access the Scale
The JSE is administered through Thomas Jefferson University. Researchers, educators, and institutions looking to use the scale in studies or training programs typically need to request access through the university’s Center for Research in Medical Education and Health Care. The scale is not freely available for download, as controlled distribution helps maintain the instrument’s integrity and ensures users receive the correct version with proper scoring instructions.