When I say… empathic dissonance.

As I entered the OSCE station, I ran through my mental checklist: smile and shake my examiner's hand, warmly greet the patient, obtain a detailed history, and make an empathic statement. The station was going well, I gathered a comprehensive history and established a strong rapport. However, when I made my pre-rehearsed statement of empathy, "I'm sorry to hear that", I felt like a fraud. I didn't really empathise with this patient; the statement was wholly untruthful. I made the statement to tick a box on the mark sheet.