Changes in medical students' emotional intelligence: an exploratory study

The impact of empathy on medical students: an integrative review

INTRODUCTION

Empathy is considered the ability to understand or feel others emotions or experiences. As an important part of medical education, empathy can affect medical students in many ways. It is still lacking a comprehensive evaluation of the existing articles on empathy's impact on medical students, despite the existence of many articles on the topic.

OBJECTIVES

To summarize the impact of empathy on medical students during medical education from four perspectives: mental health, academic performance, clinical competence, and specialty preference.

METHODS

The search terms used for retrieval were "empathy", "medical student", "mental health", "depression", "anxiety", "burnout", "examinations", "academic performance", "clinical competence", "specialty preference" on PubMed, EBSCO, and Web of Science before January 2024. The search was carried out by two reviewers. Titles and abstracts were screened independently and reviewed based on inclusion/exclusion criteria. A consensus was drawn on which articles were included.

RESULTS

Our results indicated that high empathy was a positive factor for mental health, However, students with high affective empathy were more likely to suffer from depression, anxiety, and burnout. Empathy was found to be unrelated to academic performance, but positively correlated with clinical competence, particularly in terms of communication skills. Medical students with high levels of empathy tended to prefer people-oriented majors.

CONCLUSIONS

Medical students who score higher on the self-reported empathy scales often have better mental health, better communication skills, and tend to choose people-oriented specialties. But empathy is not related to academic performance. Additionally, the different dimensions of empathy have different impacts on medical students. It is necessary to design targeted courses and training for medical students to enhance their empathy.

Empathy, emotional intelligence and interprofessional skills in healthcare education

According to the World Health Organization (WHO), health professionals maintain the health of citizens through evidence-based medicine and caring. Students enroled in health professional programmes are required to have successfully attained all core learning outcomes by reaching key milestones throughout the course of their studies, demonstrating they have developed the required graduate skills and attributes upon completion of the programme. While some of the knowledge, skills and competencies that make up these learning outcomes are very discipline specific, there are more general professional skills across all disciplines which are difficult to define, such as empathy, emotional intelligence and interprofessional skills. These are at the heart of all health professional programmes that once defined, can be mapped through curricula and further evaluated. Literature will be presented on these three professional skills: empathy, emotional intelligence, and interprofessional skills, based on studies that focussed primarily in health professional programmes and highlight some of the key findings and issues at undergraduate and postgraduate levels. The paper will present the need for these skills to be defined and then mapped through curricula so that students are better supported in their professional development. Empathy, emotional intelligence and interprofessional skills transcend the discipline specific skills and as such it is important that all educators consider how best these may be fostered. Efforts should also be made to further the integration of these professional skills within curricula to produce health professionals with an enhanced focus on person-centred care.

The development of empathy in the healthcare setting: a qualitative approach

BACKGROUND

Healthcare professionals' empathetic behaviors have been known to lead to higher satisfaction levels and produce better health outcomes for patients. However, empathy could decrease over time especially during training and clinical practice. This study explored factors that contributed to the development of empathy in the healthcare setting. Findings could be used to improve the effectiveness and sustainability of empathy training.

METHOD

A qualitative approach, informed by aspects of grounded theory, was utilized to identify factors that enabled the development of empathy from the perspectives of doctors, nurses, allied healthcare workers and students. Twelve sessions of focus group discussions were conducted with 60 participants from two hospitals, a medical school, and a nursing school. Data was analyzed independently by three investigators who later corroborated to refine the codes, subthemes, and themes. Factors which influence the development of empathy were identified and categorized. This formed the basis of the creation of a tentative theory of empathy development for the healthcare setting.

RESULTS

The authors identified various personal (e.g. inherent characteristics, physiological and mental states, professional identity) and external (e.g. work environment, life experience, situational stressors) factors that affected the development of empathy. These could be further categorized into three groups based on the stability of their impact on the individuals' empathy state, contributed by high, medium, or low stability factors. Findings suggest empathy is more trait-like and stable in nature but is also susceptible to fluctuation depending on the circumstances faced by healthcare professionals. Interventions targeting medium and low stability factors could potentially promote the development of empathy in the clinical setting.

CONCLUSIONS

Understanding factors that impact the development of empathy allows us to develop measures that could be implemented during training or at the workplace leading to improve the quality of care and higher clinical work satisfaction.

Emotional intelligence in undergraduate medical students: a scoping review

PURPOSE

To perform a scoping review to determine what is known about emotional intelligence (EI) in undergraduate medical education (UME). Two main questions were asked: A. What medical student characteristics are associated with EI? Are there correlations with demographic or other factors? B. What research studies have been done on EI in UME? For example, is there evidence EI changes over time as a result of personal experiences? Should EI be used as an admission criterion? Can EI improve as a result of experiences or deliberate interventions?

METHOD

The authors searched four databases (PubMed, PsycInfo, Education Resources Information Center, and Web of Science) for all papers published up to and including December 2020. Two reviewers independently screened articles to determine if they met inclusion criteria. All authors extracted and analyzed data.

RESULTS

A set of 1520 papers on the topic of emotional intelligence was identified, with 119 papers meeting inclusion criteria. Most studies were done at international locations with only 17 done at US medical schools. Seventy-five were cohort or cross-sectional studies. Study populations were mixed among the studies, with year of medical study, inclusion of other healthcare students, and participation rates among the inter-study differences noted.

CONCLUSIONS

Numerous gaps in the literature on EI exist with several points being clear: (1) there is disagreement on the definition of EI, (2) it is undetermined whether EI is a trait or an ability, and (3) there is marked variability among the instruments used to measure EI. It is also becoming apparent that using EI determination may be helpful as a component of the admission process, higher EI is likely related to improved clinical reasoning, and higher EI contributes to more effective stress management.

Importance of communication in medical practice and medical education: An emphasis on empathy and attitudes and their possible influences

BACKGROUND

Healthcare professionals need to be prepared to promote healthy lifestyles and care for patients. By focusing on what students should be able to perform one day as clinicians, we can bridge the gap between mere theoretical knowledge and its practical application. Gender aspects in clinical medicine also have to be considered when speaking of personalized medicine and learning curricula.

AIM

To determine sets of intellectual, personal, social, and emotional abilities that comprise core qualifications in medicine for performing well in anamnesis-taking, in order to identify training needs.

METHODS

An analysis of training clinicians’ conceptions with respect to optimal medical history taking was performed. The chosen study design also aimed to assess gender effects. Structured interviews with supervising clinicians were carried out in a descriptive study at the Medical University of Vienna. Results were analyzed by conducting a qualitative computer-assisted content analysis of the interviews. Inductive category formation was applied. The main questions posed to the supervisors dealt with (1) Observed competencies of students in medical history taking; and (2) The supervisor’s own conceptions of "ideal medical history taking".

RESULTS

A total of 33 training clinicians (n = 33), engaged in supervising medical students according to the MedUni Vienna’s curriculum standards, agreed to be enrolled in the study and met inclusion criteria. The qualitative content analysis revealed the following themes relevant to taking an anamnesis: (1) Knowledge; (2) Soft skills (relationship-building abilities, trust, and attitude); (3) Methodical skills (structuring, precision, and completeness of information gathering); and (4) Environmental/contextual factors (language barrier, time pressure, interruptions). Overall, health care professionals consider empathy and attitude as critical features concerning the quality of medical history taking. When looking at physicians’ theoretical conceptions, more general practitioners and psychiatrists mentioned attitude and empathy in the context of "ideal medical history taking", with a higher percentage of females. With respect to observations of students’ history taking, a positive impact from attitude and empathy was mainly described by male health care professionals, whereas no predominance of specialty was found. Representatives of general medicine and internal medicine, when observing medical students, more often emphasized a negative impact on history taking when students lacked attitude or showed non-empathetic behavior; no gender-specific difference was detected for this finding.

CONCLUSION

The analysis reveals that for clinicians engaged in medical student education, only a combination of skills, including adequate knowledge and methodical implementations, is supposed to guarantee acceptable performance. This study’s findings support the importance of concepts like relationship building, attitude, and empathy. However, there may be contextual factors in play as well, and transference of theoretical concepts into the clinical setting might prove challenging.

Stability and Differences in Empathy Between Men and Women Medical Students: a Panel Design Study

PHENOMENON

Empathy is central to the physician-patient relationship, and affects clinical outcomes. There is uncertainty about the stability of empathy in medical students over the course of medical school, as well as differences in empathy between men and women.

APPROACH

A panel study design was used to follow first year through fourth year medical students (MS1-4) during the 2018-2019 school year. Empathy was measured using the interpersonal reactivity index (IRI), a self-report scale that separates empathy into a cognitive perspective taking (PT) and affective empathic concern (EC) component.

FINDINGS

A total of 631 (359 women and 272 men) from 970 students (65% response rate) responded to a baseline survey, and a total of 536 students (300 women and 236 men) from 970 students (55% response rate) responded to surveys throughout the year. At baseline, women had significantly higher EC scores than men (p < 0.0001), with no significant PT difference between men and women (p > 0.05). These differences were stable for all MS cohorts.

INSIGHTS

Women had self-reported higher affective empathy (EC component) than men, while there were no differences in cognitive empathy (PT component). We discuss these data in the context of defining gender vs. sex, socialized gender stereotypes, and implications for future research.

Evaluating and Comparing Emotional Intelligence and Improvement Mindset of Plastic Surgery Residents

BACKGROUND

Emotional Intelligence (EI) has been linked to burnout, job satisfaction, and work performance among resident physicians. Individuals with a growth mindset believe intelligence and ability are traits that can be increased or improved upon through learning. EI and mindset have yet to be studied among plastic surgeons in the United States.

MATERIALS AND METHODS

An online survey was distributed to plastic surgery residents and general surgery residents at a single institution containing a validated EI survey tool (TEIQue-SF). Second, a survey was sent to all plastic surgery residents in the United States containing the TEIQue-SF and a validated survey tool to assess mindset (ITIS).

RESULTS

The response rate for the local study was 82% (plastic surgery) and 75% (general surgery). Only 7.8% of plastic surgery residents had any prior formal EI training or education. Mean global EI scores of local plastic surgery residents were higher than the normative population sample (P <0.0001). Plastic surgery and general surgery residents had similar EI scores. Integrated residents and junior plastic surgery residents had higher Well-Being scores compared to independent (P = 0.04) and senior residents (P = 0.04). Sixty-four plastic surgery residents completed the national survey. No correlation was found between EI and ITIS scores among the national plastic surgery resident cohort.

CONCLUSION

Despite different work profiles, general surgery and plastic surgery residents may have similar EI profiles. Mindset does not appear to correlate to EI domains. Future studies will focus on how EI and mindset may develop over the course of residency training and their relationship to overall resident wellness.

Compassion Fatigue: Understanding Empathy

In clinical medicine, empathy is considered a central feature of holistic caretaking and successful patient interaction. It is unclear whether characteristics of empathy are innate, learned, or a combination of both. The means to evaluate clinical empathy are ill-defined, but perception of empathy has been shown to influence patient outcomes as well as professional well-being. This article reviews what is known about empathy in a medical setting and how it relates to negative mental health outcomes, such as compassion fatigue.

Emotional Intelligence and its Association with Academic Success and Performance in Medical Students

Background

Emotional intelligence (EI) is potentially associated with higher academic performance. However, no study from the Gulf region has previously assessed if EI affects academic success and academic performance in medical students.

Objectives

To examine the relationship between EI and academic success and academic performance in a sample of Saudi Arabian medical students.

Methods

This cross-sectional, questionnaire study included all 4^th-6^th year medical students enrolled at King Saud bin Abdulaziz University for Health Sciences (KSAU-HS), Riyadh, Saudi Arabia, in the academic year 2017-18. Eligible students were invited to complete the self-administered Schutte Self-Report Emotional Intelligence Test and the Academic Success Inventory for College Students (ASICS) along with a questionnaire eliciting demographic information between January and April 2018. Academic achievement was assessed based on each student's self-reported grade point average in the most recent examination.

Results

Of 377 eligible students, 296 (78%) completed the questionnaires. A significant association was identified between overall EI and ASICS scores (r = 0.197; P < 0.001). EI scores were constant in males and females and the year of study. No statistically significant association was observed between EI and academic success across gender and academic years (P > 0.05 for all values). However, in terms of external motivation and career decidedness by level of study, final-year students had higher scores compared with students in the other two study years (P = 0.02 and P = 0.01, respectively).

Conclusion

This study offers primary data on the impact of EI scores on academic success in medical education, and it identified several factors associated with EI and academic success. The findings of this study suggest that EI and academic success are linked, and that both are vital for increasing academic performance.

Cultivating emotional intelligence in child welfare professionals: A systematic scoping review

Emotional intelligence (EI) refers to the ability to recognize and appropriately respond to emotions in oneself and others; these competencies include, but are not limited to, empathy, emotion regulation, reflective ability, self-awareness, and psychological flexibility. Such abilities are crucial to meaningful and effective child welfare work. Further, they are part of resilience and healthy coping mechanisms, which are important for those working in child welfare if compassion fatigue and burnout are to be combated. However, little is known about how to cultivate these competencies in child welfare professionals. The present study had two goals: 1) To conduct a systematic scoping review of the literature on interventions purporting to develop and/or enhance EI-related competencies in this population, whether those interventions be at the caseworker, supervisor, or organizational level; 2) To consider future directions for the teaching and enhancement of EI competencies for child welfare professionals. A total of 18 studies met inclusion criteria, with the majority focused on developing mindfulness and/or empathy skills. However, no studies focused on child welfare professionals, and instead focused on social work students or professionals, with a few including other helping professionals. Additionally, none were focused on a supervisory or organizational level. Future directions for research are discussed, including the use of experiential or simulation-based training in order to elicit emotions within a safe and supportive learning context, the use of reflective supervision to help develop self-reflection and emotion regulation skills, and system-wide interventions that enhance the development of emotional intelligence competencies in public child welfare organizations.

Empathy, well-being and stressful experiences in the clinical learning environment

OBJECTIVE

This study examines whether students in the clinical phase show reduced well-being and lower empathy scores compared to preclinical students. Furthermore, it explores students' most stressful experiences.

METHODS

A cross-sectional mixed-methods study was conducted among medical students of the revised patient- and student-centred curriculum at Witten/Herdecke University (Germany). An online survey included questions regarding empathy (JSPE-S), well-being (WHO-5), distressing factors in the learning and clinical environments, mistreatment and thoughts of dropping out.

RESULTS

176 (34 %) of 517 medical students completed the questionnaire, 73 being preclinical and 103 clinical students. Despite lower well-being, clinical student did not demonstrate lower empathy levels. Main stressors during the clinical phase were negative physician role models and financially focussed care rather than challenging patient encounters. Compared to preclinical students, clinical students showed more mistreatment experiences and higher ratings towards thoughts of dropping out.

CONCLUSION

Our results illustrate contemporary challenges to establishing a learner-centred clinical environment that nurtures well-being and empathy of medical students. The sustainment of empathy despite more stressful experiences and lower well-being may be due to protective factors.

PRACTICE IMPLICATIONS

The paper suggests activities to support clinical students to find ways to adapt the clinical learning environment to students' needs.

Predictors of information literacy self-efficacy among medical students: PLS-SEM analysis

Purpose

The study was designed to examine the predictors of information literacy self-efficacy skills (IL skills) of medical students.

Design/methodology/approach

The study was quantitative in nature and was carried out by using survey research method. Wong and Law Emotional Intelligence Scale (WLEIS) and Information Literacy Self-Efficacy Scale for medical students (ILSES-M) were used to collect the data. Data was collected randomly from 223 out of 526 undergraduate medical students on proportionally random basis according to the number of students available in each year. PLS-SEM analysis was run with the help of SmartPLS 3.2.

Findings

The findings of the study revealed that three subconstructs for emotional intelligence (EI), that is, self-emotions appraisal, others-emotion appraisal, use of emotions, had a statistically significant positive impact (p < 0.05) on information literacy (IL) self-efficacy of the medical students. The findings further confirm that English language proficiency and frequency of attended IL instruction sessions also have a significant positive impact on IL self-efficacy of medical students.

Originality/value

The exploration of EI in relation to IL is comparatively a novel area. The study observed the influence of EI level on IL self-efficacy of medical students. The study will be a significant contribution to the IL literature. The results may help the information professionals/librarians, particularly those who are engaged in teaching and designing IL programs.

The Evolution of Social Beliefs 1960-2016 in the United States and Its Influence on Empathy and Prosocial Expression in Medicine

This perspective surveys healthcare's response to the increased prominence of racial, ethnic, religious and sexual minorities as well as females in American culture. It argues for understanding physicians both as products of the broader society and its changes. Starting in the 1960s, empiric evidence for the rise of reactionary viewpoints in response to major social movements is outlined. Structural reasons for the prevalence of such ideologies within medicine are highlighted. Its negative consequences for minority health are addressed. Finally, the author turns to compensatory strategies to improve the social environment within healthcare. Alternative selection strategies for medical school are proposed, with a stronger focus on empathetic candidates.

Relationship between Mentalizing and Working Conditions in Health Care

Mentalizing describes the human ability to comprehend one's own and others' mental states and is seen as one of the core competencies of psychotherapists. Current research has emphasized the importance of both early dyadic attachment as well as broader sociocultural environmental input on the development of mentalizing. This study investigates whether mentalizing skills, operationalized via reflective functioning (RF), might be influenced by training and working conditions. This study was a matched case-control comparison, cross-sectional study. RF was assessed in a total of 10 psychotherapy trainees working in private practice at the beginning (group A; n = 5) and end (group B; n = 5) of their psychotherapy training (training association: Gestalt Therapy, Institute of Integrative Gestalttherapy Vienna) and in a total of 40 health professionals (institution: General Hospital Vienna-Social Medical Center South, Vienna, Department of Psychiatry, acute psychiatric ward) at the beginning of (group C; n = 20) and without (group D; n = 20) mentalization based therapy training. The participants differed from each other regarding their training, but participants of the same institution were matched. RF scores were significantly higher in group A and B than in group C and D (A,C: p = 0.0065, Odds Ratio (OR): 0.0294; A,D: p = 0.0019, OR: 0.0132; B,C: p = 0.0065, OR: 0.0294, B,D: p = 0.0019, OR: 0.0132). RF scores were not significantly different among groups A and group B (A,B: p > 0.9999) or between groups C and D (C,D: p = 0.6050). The current study suggests that mentalizing skills might be rather slow to improve by training, but that they might be influenced by the context.

'What I Wish My Surgeon Knew': A Novel Approach to Promote Empathic Curiosity in Surgery

OBJECTIVE

Physician empathy is associated with a variety of superior patient and physician outcomes. Teaching physicians to practice empathic curiosity is challenging however, and relatively few efficient and effective methods have been proposed toward this end. The goal of this study was to evaluate the impact and feasibility of a novel approach to foster empathic curiosity during surgical training.

DESIGN

We used an exploratory qualitative approach for our study. Postoperative patients at a single hospital were invited to participate in brief semistructured interviews to better understand their unmet needs. The interview began with the question, "What do you wish your surgeon knew about you?" We audio recorded and transcribed each patient interview. We then iteratively read the transcripts, applied an inductive approach to coding, and used qualitative content analysis to identify themes.

SETTING

Veterans Affairs Ann Arbor Healthcare System, an academic-affiliated tertiary care facility.

PARTICIPANTS

Patients who underwent general surgery procedures (n = 23) between July and August 2017.

RESULTS

Of those who provided demographic information (n = 21), all were male and 95% were white with a mean age of 63.9 (34-77) years. Of these, 33% (n = 7) of patients experienced a postoperative complication. Patients described 3 broad categories of unmet need in the perioperative setting including: (i) being treated holistically and with dignity; (ii) using clear communication and delineating provider roles; and (iii) setting specific and realistic expectations.

CONCLUSIONS

Promoting the use of empathically curious questions, such as "What do you wish your surgeon knew about you?" may help surgical trainees to identify unmet needs that are crucial for optimizing surgical care.

The Positive Association Between Empathy and Self-Esteem in Chinese Medical Students: A Multi-Institutional Study

Background

Empathy is an important element of the physician-patient relationship and is a critical personality trait for medical students. However, research has shown that it declines during undergraduate medical education. It is still unclear how empathy interrelates with the psychological elements of medical students, in particular, self-esteem. This study examined the relationship between empathy and self-esteem to explore other possible methods to improve medical students’ empathy.

Methods

A stratified sampling strategy was used to select 1690 medical students from 3 medical institutions in Shanghai as study participants. The questionnaires used to collect data included the Jefferson Scale of Physician Empathy-Student Version (JSPE-S), the Rosenberg Self-esteem Scale (RSES), and a self-made inventory on personal information. Descriptive analysis, independent t-test, One-Way ANOVA, and linear regression were used to analyze the data.

Results

The mean empathy score among medical students was 102.73 with SD = 12.64. Multiple regression analysis revealed that, “age,” “perception of the importance of empathy,” “academic pressure,” “desire to be a doctor after graduation,” and “self-esteem” were significant predictors of empathy (P < 0.05) and the adjusted R² was 0.462. The correlation matrix between empathy and self-esteem was significant (r = 0.510, P < 0.01). Self-esteem explained 15.5% of the variation of empathy in the final regression model.

Conclusion

There was a positive association between self-esteem and empathy. Self-esteem is one of many factors which contribute to medical students’ empathy. Age, academic pressure, attitude toward empathy and future career also play a critical role in medical student empathy. Enhancing medical students’ self-esteem may be an efficacious way to improve medical students’ empathy.

Is empathy change in medical school geo-socioculturally influenced?

CONTEXT

There is convincing evidence that physician empathy leads to better patient care. As a result, there has been considerable research interest in investigating how empathy changes during undergraduate medical studies. Early (generally North American) studies raised concerns that medical training causes a decline in empathy. More recent studies (conducted around the world) have begun to suggest that either a slight increase or decrease in empathy occurs during undergraduate medical training, which has led some to argue that empathy changes indiscriminately (with no discernible pattern). This paper explores whether there is evidence to suggest that empathy changes indiscriminately or with a discernible geo-sociocultural pattern during undergraduate medical training.

METHODS

Literature that investigated change in empathy during undergraduate medical training was reviewed. Cross-sectional and longitudinal studies were tabulated separately according to their respective geographical locations. The tabulated results were analysed to investigate whether empathy changed similarly or differently within different geographical locations.

RESULTS

The studies reviewed indicate similar patterns of empathy change within approximate geo-sociocultural clusters. Whereas US studies predominantly show small but significant decreases in empathy, Far Eastern studies mostly show small but significant increases in empathy as undergraduates progress through the medical course.

CONCLUSIONS

These results suggest that change in empathy during undergraduate medical education is not as indiscriminate (patternless) as once thought. Additionally, these results support the notion that empathy is a locally construed global construct.

The Evaluation of Emotional Intelligence among Medical Students and Its Links with Non-cognitive Acceptance Measures to Medical School

BACKGROUND

The importance of emotional intelligence (EI) to the success of health professionals has been increasingly acknowledged. Concurrently, medical schools have begun integrating non-cognitive measures in candidate selection processes. The question remains whether these newly added processes correctly assess EI skills.

OBJECTIVES

Measuring EI levels among medical students; examining the correlations between participants' EI levels and their scores on the non-cognitive MOR test; and exploring students' attitudes regarding the importance of EI in medical practice.

METHODS

The study included 111 first-year and sixth-year students at the Faculty of Medicine at the Technion, Haifa, Israel. Emotional intelligence was assessed by the Bar-On EQ-i 2.0, and MOR evaluation scores were provided by the faculty. An additional questionnaire was designed to rate students' attitudes toward the importance of EI to the success of medical doctors (MDs).

RESULTS

No significant correlations were found between MOR test scores and EI evaluation scores. Of the 15 EI competencies evaluated, mean scores for flexibility, problem-solving, and independence were lowest for both the first-year and the sixth-year study groups. No differences in EI levels between first-year and sixth-year students were found. Both groups of students considered EI to be highly important to their success as MDs.

CONCLUSIONS

While further studies of the links between MOR tests and EI are required, the current findings indicate that MOR test scores may not be predictive of medical students' EI levels and vice versa. As previous evidence suggests that EI contributes to professional success and to better outcomes in the field of medicine, integrating it into selection processes for medical students and into the curricula in medical schools is recommended.

The relationship between emotional intelligence and happiness in medical students

PURPOSE

Emotional intelligence is a factor affecting the health of individuals, and happiness is another factor affecting it. Medical students' health can greatly affect a community's health due to the important role of medical students in maintaining and improving it. Accordingly, we aimed to study the relationship between emotional intelligence and happiness among the students of the Shiraz Medical School.

METHODS

This study is an analytical, cross-sectional study. The target population of this study was the medical students who began studying in the medical school and the international branch of Shiraz University of Medical Sciences from September 2014 to September 2017. The sample size was 300 students who were selected by a systematic sampling method. The instruments for collecting information in this study were Oxford Happiness Inventory and Siberia Schering's Emotional Intelligence Questionnaire. The significance level of the tests was set at 0.05.

RESULTS

The mean age of 292 responded participants were 20.73 with standard deviation of ±1.81 emotional intelligence (p&lt;0.001), level of stress (p&lt;0.001), and grade (p=0.03) and type of personality (p&lt;0.001) can explain the changes in the happiness level and they were significant effective factors in the regression modeling.

CONCLUSION

Emotional intelligence was a predictive factor for happiness in medical students. Students with higher emotional intelligence felt healthier. And happiness in extroverted students was higher than introverted ones. It is suggested that the results of this study should be confirmed with prospective studies.

Hypothesis: the hospital learning environment impedes students' acquisition of reflectivity and medical professionalism

Undergraduate clinical education follows the "bedside" tradition that exposes students to inpatients. However, the hospital learning environment has two main limitations. First, most inpatients require acute care, and students may complete their training without seeing patients with frequent non-emergent and chronic diseases that are managed in outpatient settings. Second, students rarely cope with diagnostic problems, because most inpatients are diagnosed in the community or the emergency room. These limitations have led some medical schools to offer longitudinal integrated clerkships in community settings instead of hospital block clerkship rotations. In this paper, I propose the hypothesis that the hospital learning environment has a third limitation: it causes students' distress and delays their development of reflectivity and medical professionalism. This hypothesis is supported by evidence that (a) the clinical learning environment, rather than students' personality traits, is the major driver of students' distress, and (b) the development of attributes, such as moral reasoning, empathy, emotional intelligence and tolerance of uncertainty that are included in the definitions of both reflectivity and medical professionalism, is arrested during undergraduate medical training. Future research may test the proposed hypothesis by comparing students' development of these attributes during clerkships in hospital wards with that during longitudinal clerkships in community settings.

An Epidemiological Study on Empathy and its Correlates: A Cross-sectional Assessment among Medical Students of a Government Medical College of India

BACKGROUND

Empathy is a desirable quality in every clinician. It is a crucial determinant of patient-physician communication and relation. There are very few existent Indian studies on empathy of medical students and its correlates.

AIM

The aim of the study was to assess empathy level of medical students and its correlates.

METHODOLOGY

It was a cross-sectional, hospital-based, analytical observational study conducted from July to November 2017. In total, 249 undergraduate medical students of a medical college of Kolkata were interviewed with a structured schedule. The schedule comprised of the sociodemographic questionnaire, career satisfaction, future career choice, and Jefferson Scale of Empathy.

RESULTS

The mean empathy score was 98.5 ± 12.5. Third-semester students had higher empathy scores (102.4 ± 12.4) compared to fifth (97.2 ± 12.9) and seventh semester (95.0 ± 10.9) students. The difference between the mean scores of different semesters was statistically significant. Female students were more empathic than male students. In the multivariable linear regression model, sex, semester, residence, career satisfaction, future career choice, and current place of living were significant predictors of empathy scores.

CONCLUSION

Empathy level of medical students of our study was quite low compared to other studies conducted outside India. Empathy eroded with semester, which supports earlier pieces of evidence in this regard.

Associations between emotional intelligence, empathy and personality in Japanese medical students

BACKGROUND

It is known that empathic communication is important for physicians to achieve higher patient satisfaction and health outcomes. Emotional intelligence (EI), empathy and personality in medical students predict students' individual disposition and their emotional and empathic perceptions. This study aimed to investigate: 1) The association between empathy, EI and personality, and 2) Gender differences in the association between empathy, EI and personality.

METHOD

Participants were 357 1st year medical students from 2008 to 2011 at one medical school in Japan. Students completed self-report questionnaires comprising three validated instruments measuring EI: Trait Emotional Intelligence Questionnaire-Short Form (TEIQue-SF), empathy: Jefferson Scale of Physician Empathy- student version (JSPE) and personality: NEO-Five-Factor Inventory (NEO-FFI), which explores 5 dimensions of personality Neuroticism (N), Extraversion (E), Openness to experience (O), Agreeableness (A), and Conscientiousness (C).

RESULTS

Pearson Correlations showed weak association between TEIQue-SF and JSPE. TEIQue-SF and NEO-FFI showed positive correlation for E and C, and strong negative correlation for N and weak positive correlation for A and O. Weak positive correlation between JSPE and the NEO-FFI were observed for E and A. Although effect sizes were small, N, A and empathy were significantly higher in females (unpaired t-test). However, hierarchical multiple-regression analysis when controlling for gender and personality showed no association between EI, empathy and gender. A, TEIQue-SF and N were found to make small contributions in respect of predictions for JSPE. Personality contributed significantly to the prediction of TEIQue-SF. N had the largest independent negative contribution (β = - 0,38).

CONCLUSION

In our study population of 1st year medical students, females had significantly higher N, A and empathy scores than males. Medical students' N score was strongly negatively associated with EI. Empathy was weakly associated with EI and A. However, when controlling gender and personality in regression analysis, gender did not affect EI and empathy, rather personality is the most important factor. Our findings indicate that N is a major factor that negatively affects EI. It is important to mitigate N using thoughtful training, taking into account students' personalities, to reduce N. In future studies, we will assess how communication trainings for students might enhance EI.

Virtual morality in the helping professions: Simulated action and resilience

Recent advances in virtual technologies have allowed the investigation of simulated moral actions in aversive moral dilemmas. Previous studies have employed diverse populations to explore these actions, with little research considering the significance of occupation on moral decision-making. For the first time, in this study we have investigated simulated moral actions in virtual reality made by professionally trained paramedics and fire service incident commanders who are frequently faced with and must respond to moral dilemmas. We found that specially trained individuals showed distinct empathic and related personality trait scores and that these declined with years of experience working in the profession. Supporting the theory that these professionals develop resilience in moral conflict, reduced emotional arousal was observed during virtual simulations of a distressing dilemma. Furthermore, trained professionals demonstrated less regret following the execution of a moral action in virtual reality when compared to untrained control populations. We showed that, contrary to previous research, trained individuals made the same moral judgements and moral actions as untrained individuals, though showing less arousal and regret. In the face of increasing concerns regarding empathy decline in health care professionals, we suggest that the nature of this decline is complex and likely reflects the development of a necessary emotional resilience to distressing events.

Strategies for interprofessional facilitators and clinical supervisors that may enhance the emotional intelligence of therapy students

Emotional intelligence (EI) is a critical skill for occupational therapy, physiotherapy, and speech pathology students (therapy students). This article reports the findings from an analysis of interviews with therapy students (n = 24) to determine the aspects of clinical placements that therapy students perceived as influencing the changes in EI scores. This article reports the findings of the qualitative phase of a longitudinal, retrospective mixed methods design. Interviewees were selected using purposive sampling. Of those interviewed, 95% agreed that clinical placements had a significant impact on a range of EI skills with changes being both positive and negative. Content analysis showed that students perceived their EI skills had changed because of the following aspects of clinical placements: student-supervisor interactions, student interactions with patients in emotional distress and being encouraged to reflect and hear feedback on their EI skills. To support and enhance student's EI skills, interprofessional facilitators and profession-specific supervisors are recommended to utilise the following strategies with interprofessional cohorts. Supervisors and facilitators should be emotionally in-tune with students and trust students to work autonomously with patients experiencing emotional distress, pain and loss, especially those with complex needs. Importantly, interprofessional facilitators and direct supervisors should encourage students to reflect on their EI skills both individually and as a group. Supervisors should frequently evaluate and provide feedback to students on their EI skills, at the same time as providing feedback on their practical and clinical reasoning skills.

A new admission method may select applicants with a distinct personality profile

BACKGROUND

There is little data to suggest that a specific admission method can select students with a distinct personality profile. We have recently introduced a new admission process that combines a computerized personality test, with a single interview. The purpose of the current study was to find whether the new method selects applicants with a different personality profile and attitudes compared with the previous method.

METHOD

Using a validated personality questionnaire (HEXACO) and attitudes questionnair, that were filled anonymously between November 2014 and May 2015, the authors compared two groups of students: group A comprising students accepted with the new method (first and second year) with group B comprising students accepted with the previous method (third to sixth year).

RESULTS

In group A, 157 responded out of 250 (63%), while in group B 194 out of 352 (55%). Group A students ranked significantly higher in honesty-humility, extraversion, agreeableness and openness to experience, and lower in emotionality. Physicians' role in society was perceived to be more meaningful among Group A students (M = 4.19, SD = 0.50, N = 152) compared to Group B students (M = 3.86, SD = 0.57, N = 184).

CONCLUSIONS

The new method may select applicants with a distinct personality profile and different attitudes toward the physicians' role in the society.

International study of medical school learning environments and their relationship with student well-being and empathy

OBJECTIVE

To assess whether favourable perceptions of the learning environment (LE) were associated with better quality of life, less burnout and more empathy across three undergraduate medical education programmes in Israel, Malaysia and China.

METHODS

Cross-sectional surveys were administered at the end of the 2013-2014 academic year at three medical schools: Technion American Medical Students Program (TAMS) in Israel, Perdana University-Royal College of Surgeons in Ireland School of Medicine (PURCSI) in Malaysia and Peking Union Medical College (PUMC) in China. LE perceptions were assessed using the Johns Hopkins Learning Environment Scale (JHLES). Well-being was assessed using validated items for quality of life and the depersonalisation and emotional exhaustion domains of burnout. The 20-item Jefferson Empathy Scale assessed empathy. Statistical analyses included bivariate regressions and multivariate regressions that adjusted for gender, school, class year and perceived academic rank.

RESULTS

Overall, 400/622 (64.3%) students responded, with the following rates by site: TAMS 92/121 (76.0%), PURCSI 160/198 (80.1%) and PUMC 148/303 (48.8%). In multivariate models, favourable overall LE perceptions were associated with higher odds of good quality of life (odds ratio [OR], 3.2; 95% confidence interval [CI], 1.8-5.8; p < 0.001) and lower odds of emotional exhaustion (OR, 0.34; 95% CI, 0.24-0.50; p < 0.001) and depersonaliation (OR, 0.30; 95% CI, 0.24-0.37; p = 0.001). 'Community of Peers', one of seven factors in the JHLES, was the only one to be independently associated with better quality of life and less emotional exhaustion and depersonalisation. After adjusting for covariates, there was not a statistically significant association between overall LE and empathy (OR, 1.4; 95% CI, 0.91-2.2; p = 0.12).

CONCLUSIONS

Students' LE perceptions are closely associated with their well-being, and fostering peer community may hold promise for enhancing quality of life and protecting against burnout. Across these three settings, LE and empathy were not closely related, suggesting that any influence of learning environment on empathy would be modest.

A Study of Emotional Intelligence Among Postgraduate Medical Students in Delhi

Context: The importance of emotional intelligence (EI) in the successful practice of medicine has been well established. However, efforts to study the same in India, especially in doctors and medical students, are lacking. This study has measured the emotional intelligence of postgraduate medical students in Delhi and aimed to identify some of the factors affecting it.

Methods: A cross-sectional analytical study, using the Schutte's Self-Report Emotional Intelligence Test, to measure the EI of 200 postgraduate medical students of two medical colleges in Delhi. Students working in clinical specialties were selected randomly and contacted by the first author. Data was collected by a self-administered questionnaire.

Results: The mean scores of EI among the study participants was 124.4 with a standard deviation of 12.8. The total scores possible in the scale range from 33 to 165, with higher scores representing higher EI. The age of the participants was positively associated with emotional intelligence (r = 0.187, p = 0.008). EI was also found to decrease with the increase in total workload (p=0.013), having night duty hours (p = 0.019), and having emergency duty (p = 0.037).  

Conclusions: More studies to measure the EI of doctors, the factors affecting it, and possible measures to improve it, are needed. The workload of the resident doctors needs to be assessed with appropriate changes made in the total work done and the quality of work done. 

Changes in Affective and Cognitive Empathy among Veterinary Practitioners

Clinical empathy is a multi-dimensional concept characterized by four dimensions: (1) affective-the ability to experience patients' or clients' emotions and perspectives, (2) moral-the internal motivation to empathize, (3) cognitive-the intellectual ability to identify and comprehend others' perspective and emotions, and (4) behavioral-the ability to convey understanding of those emotions and perspectives back to the patient or client. The Davis Interpersonal Reactivity Index (IRI) was used to examine the affective and cognitive facets of empathy in veterinary practitioners. The IRI consists of four subscales that measure cognitive (perspective taking and fantasy) and affective (emphatic concern and personal distress) components of empathy. Data from a cross-sectional sample of practicing veterinarians (n=434) were collected. Veterinarians' fantasy scores were lowest for those with the most clinical experience. Personal distress scores were highest among new veterinarians and lowest for those with 26 or more years in practice. High levels of personal distress in the early years of practice are concerning for the professional wellness of veterinarians. To combat this trend, the implementation of resilience-building interventions should be considered to support veterinary practitioners.

The stories they tell: How third year medical students portray patients, family members, physicians, and themselves in difficult encounters

BACKGROUND

Physicians have long had patients whom they have labeled "difficult", but little is known about how medical students perceive difficult encounters with patients.

METHODS

In this study, we analyzed 134 third year medical students' reflective essays written over an 18-month period about difficult student-patient encounters. We used a qualitative computerized software program, Atlas.ti to analyze students' observations and reflections.

RESULTS

Main findings include that students described patients who were angry and upset; noncompliant with treatment plans; discussed "nonmedical" problems; fearful, worried, withdrawn, or "disinterested" in their health. Students often described themselves as anxious, uncertain, confused, and frustrated. Nevertheless, they saw themselves behaving in empathic and patient-centered ways while also taking refuge in "standard" behaviors not necessarily appropriate to the circumstances. Students rarely mentioned receiving guidance from attendings regarding how to manage these challenging interactions.

CONCLUSIONS

These third-year medical students recognized the importance of behaving empathically in difficult situations and often did so. However, they often felt overwhelmed and frustrated, resorting to more reductive behaviors that did not match the needs of the patient. Students need more guidance from attending physicians in order to approach difficult interactions with specific problem-solving skills while maintaining an empathic, patient-centered context.

Medical students' creative projects on a third year pediatrics clerkship: a qualitative analysis of patient-centeredness and emotional connection

BACKGROUND

Increasingly, medical educators are incorporating reflective writing and original creative work into educational practices with the goals of stimulating student self-awareness, appreciation of multiple perspectives, and comfort with ambiguity and uncertainty. This study investigated students' creative projects to assess the extent to which they adopted a patient/relationship-centered, emotionally connected position toward patients and families.

METHODS

Over a 10 year period, students on a required third year pediatrics clerkship individually or in groups completed either a reflection or an education project using a creative medium. 520 projects (representing 595 students, 74.7 % of total eligible students) were qualitatively analyzed according to various thematic and emotion-based dimensions.

RESULTS

The majority of projects were personal narrative essays and poetry. The largest number of project themes related to the importance of patient/relationship-centered medicine with patients. The next largest number of projects focused on health education of parents, patients, or classmates. In telling their stories, students were more likely to use a personal voice representing either their or the patient's perspective than an objective, impersonal one. In terms of emotional tone, projects were more likely to be serious than humorous. The largest number of students' emotions expressed an empathic tone. Students identified a large number and wide range of both negative and positive feelings in themselves and their patients. The majority of student emotions were positive, while the majority of patient and family emotions were negative.

CONCLUSIONS

Students' preference for patient-centered, relational themes, as well as their tendency to favor the first voice, empathic tone, and willingness to express a range of positive and negative emotions in presenting their projects, suggests that they valued emotional connection with patients and families during the pediatrics clerkship experience.

Empathy among undergraduate medical students: A multi-centre cross-sectional comparison of students beginning and approaching the end of their course

BACKGROUND

Although a core element in patient care the trajectory of empathy during undergraduate medical education remains unclear. Empathy is generally regarded as comprising an affective capacity: the ability to be sensitive to and concerned for, another and a cognitive capacity: the ability to understand and appreciate the other person's perspective. The authors investigated whether final year undergraduate students recorded lower levels of empathy than their first year counterparts, and whether male and female students differed in this respect.

METHODS

Between September 2013 and June 2014 an online questionnaire survey was administered to 15 UK, and 2 international medical schools. Participating schools provided both 5-6 year standard courses and 4 year accelerated graduate entry courses. The survey incorporated the Jefferson Scale of Empathy-Student Version (JSE-S) and Davis's Interpersonal Reactivity Index (IRI), both widely used to measure medical student empathy. Participation was voluntary. Chi squared tests were used to test for differences in biographical characteristics of student groups. Multiple linear regression analyses, in which predictor variables were year of course (first/final); sex; type of course and broad socio-economic group were used to compare empathy scores.

RESULTS

Five medical schools (4 in the UK, 1 in New Zealand) achieved average response rates of 55 % (n = 652) among students starting their course and 48 % (n = 487) among final year students. These schools formed the High Response Rate Group. The remaining 12 medical schools recorded lower response rates of 24.0 % and 15.2 % among first and final year students respectively. These schools formed the Lower Response Rate Group. For both male and female students in both groups of schools no significant differences in any empathy scores were found between students starting and approaching the end of their course. Gender was found to significantly predict empathy scores, with females scoring higher than males.

CONCLUSIONS

Participant male and female medical students approaching the end of their undergraduate education, did not record lower levels of empathy, compared to those at the beginning of their course. Questions remain concerning the trajectory of empathy after qualification and how best to support it through the pressures of starting out in medical practice.

Assessing empathy development in medical education: a systematic review

CONTEXT

Empathy in doctor-patient relationships is a familiar topic for medical scholars and a crucial goal for medical educators. Nonetheless, there are persistent disagreements in the research literature concerning how best to evaluate empathy among physicians, and whether empathy declines or increases across medical education. Some researchers have argued that the instruments used to study 'empathy' may not measure anything meaningful to clinical practice or patient satisfaction.

METHODS

We performed a systematic review to learn how empathy is conceptualised in medical education research. We examined how researchers define the central construct of empathy and what they choose to measure, and investigated how well definitions and operationalisations match.

RESULTS

Among the 109 studies that met our search criteria, 20% failed to define the central construct of empathy at all and only 13% used an operationalisation that was well matched to the definition provided. The majority of studies were characterised by internal inconsistencies and vagueness in both the conceptualisation and operationalisation of empathy, constraining the validity and usefulness of the research. The methods most commonly used to measure empathy relied heavily on self-report and cognition divorced from action, and may therefore have limited power to predict the presence or absence of empathy in clinical settings. Finally, the large majority of studies treated empathy itself as a 'black box', using global construct measurements that are unable to shed light on the underlying processes that produce an empathic response.

CONCLUSIONS

We suggest that future research should follow the lead of basic scientific research that conceptualises empathy as relational - an engagement between a subject and an object - rather than as a personal quality that may be modified wholesale through appropriate training.

A Methodological Review of the Assessment of Humanism in Medical Students

BACKGROUND

Humanism is a complex construct that defies simplistic measurement. How educators measure humanism shapes understanding and implications for learners. This systematic review sought to address the following questions: How do medical educators assess humanism in medical students, and how does the measurement impact the understanding of humanism in undergraduate medical education (UME)?

METHOD

Using the IECARES (integrity, excellence, compassion, altruism, respect, empathy, and service) Gold Foundation framework, a search of English literature databases from 2000 to 2013 on assessment of humanism in medical students revealed more than 900 articles, of which 155 met criteria for analysis. Using descriptive statistics, articles and assessments were analyzed for construct measured, study design, assessment method, instrument type, perspective/source of assessment, student level, validity evidence, and national context.

RESULTS

Of 202 assessments reported in 155 articles, 162 (80%) used surveys; 164 (81%) used student self-reports. One hundred nine articles (70%) included only one humanism construct. Empathy was the most prevalent construct present in 96 (62%); 49 (51%) of those used a single instrument. One hundred fifteen (74%) used exclusively quantitative data; only 48 (31%) used a longitudinal design. Construct underrepresentation was identified as a threat to validity in half of the assessments. Articles included 34 countries; 87 (56%) were from North America.

CONCLUSIONS

Assessment of humanism in UME incorporates a limited scope of a complex construct, often relying on single quantitative measures from self-reported survey instruments. This highlights the need for multiple methods, perspectives, and longitudinal designs to strengthen the validity of humanism assessments.

Healthcare providers' accuracy in assessing patients' pain: A systematic review

OBJECTIVE

Healthcare providers satisfy an important role in providing appropriate care in the prevention and management of acute and chronic pain, highlighting the importance of providers' abilities to accurately assess patients' pain. We systematically reviewed the literature on healthcare providers' pain assessment accuracy.

METHODS

A systematic literature search was conducted in PubMed and PsycINFO to identify studies addressing providers' pain assessment accuracy, or studies that compared patients' self-report of pain with providers' assessment of pain.

RESULTS

60 studies met the inclusion criteria. Healthcare providers had moderate to good pain assessment accuracy. Physicians and nurses showed similar pain assessment accuracy. Differences in pain assessment accuracy were found according to providers' clinical experience, the timing of the pain assessment, vulnerable patient populations and patients' pain intensity.

CONCLUSION

Education and training aimed at improving providers with poor pain assessment accuracy is discussed especially in relation to those with limited clinical experience (<4 years) or a great deal of clinical experience (>10 years) and those providing care for vulnerable patient populations.

PRACTICE IMPLICATIONS

More research on characteristics that influence providers' pain assessment accuracy and trainings to improve pain assessment accuracy in medical and continuing education may improve pain treatment for patients.

Educational Research Report: Changes in Students' Levels of Empathy during the Didactic Portion of a Veterinary Program

Empathy can be defined as the ability to understand and connect with the emotional state and frame of mind of another. Establishing connections with others is a crucial skill for veterinarians who must earn the trust and compliance of their clients to provide quality care for their patients. This is a longitudinal study using the Davis Interpersonal Reactivity Index (IRI) to assess changes in veterinary students' self-reported empathy as they progressed through the didactic portion of the DVM program at Colorado State University. The IRI consists of four subscales that measure cognitive and affective components of empathy: Perspective Taking, Fantasy, Emphatic Concern, and Personal Distress. Data were collected at three time points, corresponding to the start of the first year, the fourth semester (second year), and the fifth semester (third year). Results showed an overall decline in Perspective Taking scores, with a significant decrease between first and second year. There was an overall increase in students' levels of Personal Distress as they progressed through the program. The significant difference was found between years 1 and 3. This is especially concerning because the enhanced unease in interpersonal interactions coincides with students entering clinical rotations in the third year-the very time when these traits are necessary for quality client and patient care. Veterinary educators are urged to use this information as a basis for investigating novel curricular and programmatic interventions to counteract these changes in student empathy.

Do empathy, perspective-taking, sense of power and personality differ across undergraduate education and are they inter-related?

Empathy is desirable in all health care professionals in their interactions with patients and each other. Empathy in its cognitive (perspective-taking) and affective forms has been well-studied in the literature and in fact, is shown in most studies to decline during undergraduate and graduate medical education. Empathy has also been shown to be inversely proportional to one's sense of power (SOP) in the business literature. In addition, the relationship of empathy to personality traits has not been examined. This cross-sectional study of four cohorts of undergraduate medical students at a private mid-Atlantic medical school compares the empathy of first, second, third and fourth year medical students to see if there is a decline across the medical school experience. It also examines the relationship among empathy, SOP and personality type across the 4 years of medical school. Unlike in many previous studies, we found no decline in student empathy. We found no significant relationship between SOP and empathy. Finally, there were no significant differences in power perception and personality measures across all educational years surveyed.

The relationship between the social management of emotional intelligence and academic performance among medical students

Positive social interaction with peers was said to facilitate cognitive and intellectual development leading to good academic performance. There was paucity of published data on the effect of social management (SM) emotional intelligence (EI) on academic performance. We conducted this study to examine their relationship in the undergraduate medical students in a public medical school in Malaysia. This was a cross-sectional study using the Mayer-Salovey-Caruso Emotional Intelligence Test (MSCEIT) to measure the SM. The first and final year medical students were invited to participate. Students answered a paper-based demography questionnaire and completed the online MSCEIT in privacy. Independent predictors were identified using multivariate analyses. A total of 163 (84 first year and 79 final year) medical students completed the study (at a response rate of 66.0%). SM score (B = -.10 95% CI -.175 to -.015, p = .021) was significantly related to the continuous assessment (CA) marks (adjusted R(2) = .45, F13,137 = 10.26, p < .0001), and was a predictor of poor result in the overall CA (adjusted OR 1.06 95% CI 1.011-1.105). Negative relationships might exist between emotional social intelligence and academic success in undergraduate medical students. A different collection of social skills and SM EI could be constructive towards academic achievement in medical schools.

Are there gender differences in the emotional intelligence of resident physicians?

BACKGROUND

Because academic literature indicates that emotional intelligence (EI) is tied to work performance, job satisfaction, burnout, and client satisfaction, there is great interest in understanding physician EI.

OBJECTIVE

To determine whether gender differences in resident EI profiles mirror EI gender differences in the general population.

STUDY DESIGN (INCLUDE PARTICIPANTS AND SETTING)

A total of 325 residents in 3 types of residency programs (pathology, pediatrics, and general surgery) at 3 large academic institutions were invited electronically to complete the validated Trait Emotional Intelligence Questionnaire (TEIQue), a tool consisting of 153 items that cluster to 15 independent facets, 4 composite factors, and 1 global EI score.

RESULTS

The response rate was 42.8% (n = 139, women = 84). Global EI was not significantly different between men and women resident physicians (p = 0.74). Women scored higher than men in the TEIQue facets impulse control (p = 0.004) and relationships (p = 0.004). Men scored higher than women in 2 facets, stress management (p = 0.008) and emotion management (p = 0.023). Within surgery (n = 85, women = 46), women scored higher than men in impulse control (p = 0.006), whereas men scored higher in stress management (p = 0.008).

CONCLUSIONS

Men and women residents across 3 specialties demonstrated near-identical global EI scores. However, gender differences in specific TEIQue facets suggest that similar to the general population, men and women residents may benefit from specific training of different EI domains to enhance well-rounded development. The lack of significant gender differences within surgery may indicate that surgery attracts individuals with particular EI profiles regardless of gender. Future research should focus on the functional relationship between educational interventions that promote targeted EI development and enhanced clinical performance.

Changes in wellbeing and professional values among medical undergraduate students: a narrative review of the literature

BACKGROUND

Educators are concerned by the high prevalence of emotional distress among medical students, and by the alleged decline in their humanitarian values.

OBJECTIVE

To re-examine these concerns by reviewing studies of medical students' wellbeing and development.

METHOD

Narrative review of the literature.

MAIN FINDINGS

(a) Medical students' emotional distress increases during their undergraduate training. However, although higher than in the general population, the prevalence of distress among medical students is similar to that among other university students. (b) Medical students' distress is independently related to endogenous factors (personality traits and life events) and to their perception of the medical learning environment. (c) Medical students do not display a measurable increase in moral reasoning, empathy and tolerance of uncertainty. (d) Students' wellbeing, moral development, reflectivity and tolerance of uncertainty have been shown to be interrelated, and associated with clinical performance.

CONCLUSIONS

The findings of this review endorse the concerns about the wellbeing and development of undergraduate medical students. The design of the reviewed studies does not permit inferences about causality. Yet, these findings are consistent with the hypothesis that medical training causes emotional distress that delays students' development and affects their clinical performance.

Correlates and changes in empathy and attitudes toward interprofessional collaboration in osteopathic medical students

CONTEXT

Many studies have reported a decline in empathy as allopathic medical students progress through medical school. Data are needed to compare the pattern of changes in empathy in osteopathic and allopathic medical students. Also, it is important to investigate the associations between measures of empathy and attitudes toward interprofessional collaboration, which are among major elements of professionalism in medicine.

OBJECTIVES

(1) To investigate correlations between empathy and interprofessional collaboration in osteopathic medical students; (2) to examine differences in empathy and interprofessional collaboration scores by sex, class year, and specialty interest; and (3) to compare empathy scores by class year between osteopathic and allopathic medical students.

DESIGN

Correlational and comparative study.

SETTING

Ohio University Heritage College of Osteopathic Medicine.

PARTICIPANTS

Osteopathic medical students enrolled in academic year 2011-2012.

MAIN OUTCOME MEASURES

The Jefferson Scale of Empathy (JSE) and the Jefferson Scale of Attitudes toward Physician-Nurse Collaboration (JSAPNC) scores.

RESULTS

Student respondents (N=373) included 197 women (53%) and 176 men (47%). Significant correlation was found between scores on the JSE and JSAPNC (r=0.42, P<.01). Women scored higher than men on the JSE (mean scores, 117.1 and 111.9, respectively; F1,371=19.6, P<.01) and the JSAPNC (mean scores, 50.1 and 48.7, respectively; F1,371=6.5, P<.01). No statistically significant difference on the scores of the 2 scales was observed among students who planned to pursue "people-oriented" specialties (150 [40%]) compared with those interested in "technology/procedure-oriented" specialties (170 [45%]). No statistically significant change in empathy scores was found in different class years of the osteopathic medical students. Comparisons of empathy scores with allopathic medical students showed no significant difference in the first and second years, but osteopathic medical students had a higher mean empathy score (M=114.4) than their allopathic counterparts (M=110.9) in the third year (t158=2.31, P<.05), and their empathy scores remained high, although not statistically significant, in the fourth year of osteopathic medical school.

CONCLUSION

The decline in empathy that is often reported among allopathic medical students was not observed. The present study can serve as a step toward further longitudinal research on the development of empathy and attitudes toward teamwork among osteopathic medical students.

Empathy among medical students: is there a relation with quality of life and burnout?

Background

We aimed to assess medical students' empathy and its associations with gender, stage of medical school, quality of life and burnout.

Method

A cross-sectional, multi-centric (22 medical schools) study that employed online, validated, self-reported questionnaires on empathy (Interpersonal Reactivity Index), quality of life (The World Health Organization Quality of Life Assessment) and burnout (the Maslach Burnout Inventory) in a random sample of medical students.

Results

Out of a total of 1,650 randomly selected students, 1,350 (81.8%) completed all of the questionnaires. Female students exhibited higher dispositional empathic concern and experienced more personal distress than their male counterparts (p<0.05; d≥0.5). There were minor differences in the empathic dispositions of students in different stages of their medical training (p<0.05; f<0.25). Female students had slightly lower scores for physical and psychological quality of life than male students (p<0.05; d<0.5). Female students scored higher on emotional exhaustion and lower on depersonalization than male students (p<0.001; d<0.5). Students in their final stage of medical school had slightly higher scores for emotional exhaustion, depersonalization and personal accomplishment (p<0.05; f<0.25). Gender (β = 0.27; p<0.001) and perspective taking (β = 0.30; p<0.001) were significant predictors of empathic concern scores. Depersonalization was associated with lower empathic concern (β = −0.18) and perspective taking (β = −0.14) (p<0.001). Personal accomplishment was associated with higher perspective taking (β = 0.21; p<0.001) and lower personal distress (β = −0.26; p<0.001) scores.

Conclusions

Female students had higher empathic concern and personal distress dispositions. The differences in the empathy scores of students in different stages of medical school were small. Among all of the studied variables, personal accomplishment held the most important association with decreasing personal distress and was also a predicting variable for perspective taking.

A systematic review of physician leadership and emotional intelligence

OBJECTIVE

This review evaluates the current understanding of emotional intelligence (EI) and physician leadership, exploring key themes and areas for future research.

LITERATURE SEARCH

We searched the literature using PubMed, Google Scholar, and Business Source Complete for articles published between 1990 and 2012. Search terms included physician and leadership, emotional intelligence, organizational behavior, and organizational development. All abstracts were reviewed. Full articles were evaluated if they addressed the connection between EI and physician leadership. Articles were included if they focused on physicians or physicians-in-training and discussed interventions or recommendations.

APPRAISAL AND SYNTHESIS

We assessed articles for conceptual rigor, study design, and measurement quality. A thematic analysis categorized the main themes and findings of the articles.

RESULTS

The search produced 3713 abstracts, of which 437 full articles were read and 144 were included in this review. Three themes were identified: (1) EI is broadly endorsed as a leadership development strategy across providers and settings; (2) models of EI and leadership development practices vary widely; and (3) EI is considered relevant throughout medical education and practice. Limitations of the literature were that most reports were expert opinion or observational and studies used several different tools for measuring EI.

CONCLUSIONS

EI is widely endorsed as a component of curricula for developing physician leaders. Research comparing practice models and measurement tools will critically advance understanding about how to develop and nurture EI to enhance leadership skills in physicians throughout their careers.

Educating tomorrow's doctors: A cross sectional survey of emotional intelligence and empathy in medical students of Lahore

OBJECTIVE

Medical education in Pakistan traditionally emphasizes physician's biomedical knowledge with less emphasis on interpersonal skills and ability to relate to the patients. This study explored the emotional intelligence & empathy of undergraduate medical students and investigated its relationship with various factors to act as baseline for future work in this area.

METHODOLOGY

The Schutte Emotional Intelligence scale and Davis' Interpersonal Reactivity Index in addition to socio demographic questionnaire were administered to first year and final year medical undergraduates of two medical Institutions in Lahore, Pakistan. Data was analyzed by using SPSS 17 version.

RESULTS

The overall mean scores for medical students both on emotional intelligence and empathy is significantly lower than that found in previous literature, highlighting that medical students do not appear to fare better than average people in EQ. Women showed statistically significant higher scores on Appraisal of emotions , Regulation of emotions, Empathic concern Scale & Personal distress scale. Comparison of EI & IRI of students according to medical college year did not show any statistical significance.

CONCLUSION

Current medical curriculum and training in Pakistan does not appear to increase EI abilities which are building blocks that may allow students and residents to develop competence. Medical educators in Pakistan should look for ways to incorporate emotional intelligence in medical curriculum which will ultimately contribute towards patient centered practice, patient satisfaction as well as effective communication skills.

Prioritizing emotional intelligence training needs using optimal globalization grey relational analysis

Purpose

– The aim of this paper is to demonstrate the application of optimal globalization grey relational analysis (GGRA) as a workable decision-making tool to prioritize emotional intelligence (EI) training needs of specific groups of academic leaders.

Design/methodology/approach

– The study involved administrating the emotional skills assessment process to 50 academic leaders in the USA and 50 in Taiwan. Optimal GGRA was utilized to prioritize EI training needs of the two distinct groups of academic leaders.

Findings

– Results of the optimal GGRA suggest that context-specific EI interventions focusing on enhancing weak areas of emotional competency are made possible through optimal globalization grey analysis.

Practical implications

– Optimal GGRA is introduced as a valid decision-making technique for planning effective EI interventions. The results have implications for designing training courses targeting on enhancing weak areas of emotional competency.

Originality/value

– The utility of optimal GGRA as a decision-making tool to prioritizing training needs for the two cultural groups of academic leaders in the study aims at going beyond the narrow psychometric perspectives of measurements on leadership potentials and reaching out to practical approaches to leadership development and training.