a two - way process of exchanging or shaping ideas , feelings , and information between dentist and patient has created keen interest in dental society . the best way to achieve effectively exchanging and shaping ideas depend on the credibility of the dentist that is how he defines empathy practically . empathy is to see with the eyes of other , to hear with the ears of another , and to feel with the heart of another ( alfred adler ) . empathy was derived from two greek terms ,  em  and  pathos ,  meaning  feeling into  and has its origin from the german word  einfulung . the basic difference between empathy and sympathy is that empathy means intellectual understanding , while sympathy means sharing sentiments . the american dental education association always emphasized on including empathy as a part of the dental curriculum as it plays an important role in healthy dentist and patient relationship . sherman and cramer reported a similar decline in empathy levels among the dental students during the 2 year of dental training , but in contrary some studies reported vice - versa . in view of such varying empathy findings from different countries , it is the need of the hour to understand empathy levels among dental students in the indian context . the present study is the first of its kind in india and few among the world to explore the empathy level among dental students . 
 to measure the self - reported empathy levels among dental undergraduate and postgraduate students of the dental program ( bds , mds)to review the trend of changes in empathy level with experience , age , and gender among dental undergraduate and postgraduate students . 
  to measure the self - reported empathy levels among dental undergraduate and postgraduate students of the dental program ( bds , mds ) to review the trend of changes in empathy level with experience , age , and gender among dental undergraduate and postgraduate students to measure the self - reported empathy levels among dental undergraduate and postgraduate students of the dental program ( bds , mds)to review the trend of changes in empathy level with experience , age , and gender among dental undergraduate and postgraduate students . 
  to measure the self - reported empathy levels among dental undergraduate and postgraduate students of the dental program ( bds , mds ) to review the trend of changes in empathy level with experience , age , and gender among dental undergraduate and postgraduate students a cross - sectional institutional and self - reporting questionnaire based study was conducted among students pursuing their graduation and postgraduation in two private dental institutions located in the north west part of the country , rajasthan , india . the curriculum in india pertaining dental education offers 5 years course during graduation and 3 years of course during postgraduation . the present study was cleared by the ethical committee of the sdcri and maharaja ganga singh dental college . this research has been conducted in full accordance with the world medical association declaration of helsinki . data were obtained from the 1 to final ( 4 ) year students , interns , and postgraduate students enrolled in bachelor of dental surgery and master of dental surgery program , respectively , in these two institutions from january to april 2015 . the students were briefly explained about the nature of the study , and their written consent was taken . the inclusion criterion for the present study was that students must have completed 6 months following admission . those students who were either unable to provide the required information or incomplete questionnaire form were excluded . the initial sample consisted of 1041 students but after applying the inclusion and exclusion criteria , the final sample comprised 978 students . health profession students ( jspe - hps ) version questionnaire ( already validated ) was administered to assess the empathy level . the questionnaire consists of twenty components using 7-point likert scale ( for every single component ) and score ranges from 20 to 140 with upper values representing greater empathy . along with jspe - hps questionnaire , there are four subcategories measuring different dimensions of empathy such as  perspective taking ,   compassionate care ,   standing in patient 's shoes ,  and  personal distress . confirmatory factor analysis was used to recognize the dimensionality of the jspe - hps version using ( a ) kaiser 's criteria , ( b ) an eigenvalue ( > 1.25 was used ) , and ( c ) only retaining items if coefficients were 0.30 . after evaluation of results , 3-factor pathway was selected , i.e. ,  perspective taking ,   compassionate care ,  as well as  standing in patient 's shoes . the above outcome resulted in approximately 37% of the overall described variance . among the components , ( armonk , ny : ibm corp ) for generation of descriptive , as well as inferential statistics . the statistical significant difference among groups the female : male ratio in the present study was 2.7:1 [ table 1 ] . there was a statistically significant difference reported when empathy was tested in relation to gender ( between males and females ) , as well as for age ( p < 0.05 ) . the lowest and highest mean empathy score was found in postgraduate ( mean = 108.77 , standard deviation [ sd ] = 9.12 ) and 1 year ( mean = 117.23 , sd = 14.19 ) dental students , respectively . empathy score when tested according to experience using anova and post hoc test was found to be statistically substantial ( p < 0.05 ) . different variables retorts on the jefferson scale of physician empathy health profession student 's ten components were computed on subscale-1 and components value arraying between 0.697 and 0.518 describing 22.85% of the variability . the most important component was  health - care providers  understanding of the emotional status of the patients , as well as that of their families ' . five components were computed on subscale-2 and components value arraying between 0.207 and 0.023 describing 10.18% of the variability . five components were computed on subscale-3 and components value arraying between  0.572 and  0.327 describing 9.34% of the variability . two components were common among subscale 2 and subscale 3 , i.e. , component 14 (  i believe that emotion has no place in the treatment of medical illness  ) and component 11 (  patients ' illnesses can be cured only by targeted treatment ; therefore , health - care providers ' emotional ties with their patients do not have a significant influence in treatment outcomes  ) . the required cronbach 's alpha value for satisfactory internal consistency should be above 0.70 and in the present study cronbach 's value for subscale 1 , 2 , and 3 were 0.79 , 0.76 , and 0.48 , respectively [ table 2 ] . component analyses and adjusted score correlations of the jefferson scale of physician empathy health profession student 's few components brought out eminent mean values :  patients feel better when their health - care providers understand their feelings i believe that empathy is an important factor in patients ' treatment  brought out a mean value of 5.27 ( sd = 1.31 ) . the aim of the contemporary study was to define the properties of jse - hps , as well as to measure the empathy among students of dental colleges in sri ganganagar , rajasthan , india . the present study reported that postgraduate students had statistically lower empathy score as compared to all other years of students . this difference may be due to the fact that during the initiation of the dental course , students believe in idealism , i.e. , sharing the feeling of the patients but with the progression of the dental course these feelings vanish , i.e. , idealism gives way to the realization ( means to get through the various level of dental degree meritoriously , requisite is to acquire enormous dimensions of facts ) . hence , significant perspectives such as sharing the thoughts and feelings of the patients are put aside and emphasis swings on facts - based examinations . the mean empathy score of the present study ranges from 103 to 117 which is similar with the other studies among dental and medical students , while in contrary , other studies reported 7890 mean empathy score . while analyzing the empathy among male and female in the present study , females showed higher empathy level than males which is similar with the other studies , but this was against the studies done by rose et al . and babar et al . this might be due to the fact that women 's brains probably show more empathy than men 's brains . when females were probed to recognize other human 's feeling , female 's brain action showed that they themselves feel the same sentiments as well while in contrary male 's brain action showed noetic assessment  a more objective position . in the present study , it was found that empathy score differs by age while the same was not reported by babar et al . subscale-1 , 2 , and 3 are parallel with the studies described previously . as empathy is an essential component of maintaining healthy rapport between the dentist and patient , thus amending empathy is the vital chore of health training . recently , bonvicini et al . conducted a study regarding communication skills exercise to find whether it will result in rise of the empathy level or not . the conclusion of the study was that communication skill exercise led to increase in empathy among the students . the present study showed that empathy levels were dropping with the progression of dental course . therefore , the need is to introduce exercise regarding empathy among dental students at the initiation of and during their dental course . however , there is an argument regarding the introduction of training in empathy as newton et al . the author proposes to introduce administrative modifications which motivate students scholastically and sensitively during their dental course . this will result in interprofessional education , growth of team effort principle , as well as alterations in judgment method . hence , results of the present study can be implemented among other dental institutions also . the limitation of the present study is that valuation of empathy was constructed on subjective evaluation of a validated questionnaire ; therefore , observational approaches such as the history - taking rating scale could be used with jse - hps to measure empathy level in dental students . cross - sectional studies make it impossible to understand the process of changes in empathy level through the years of dental course . dental health educators should consider this fall in empathy seriously as early as possible during the dental course . empathy - related teaching exercises must be implemented among the dental students to endorse the growth of empathy so that fall in empathy should be prevented . more longitudinal research is required to investigate the outcome of communication exercise in cultivating empathy among dental students . the authors of this manuscript declare that they have no conflicts of interest , real or perceived , financial or nonfinancial in this article . the authors of this manuscript declare that they have no conflicts of interest , real or perceived , financial or nonfinancial in this article .