Emotional intelligence and stress in medical students performing surgical tasks

Emotional intelligence and LEGO-based communication assessments as indicators of peer evaluations

INTRODUCTION

Much attention and effort are devoted to general surgery residency applicant interview strategies and ranking. However, few interview strategies are positively associated with applicant communication performance. The purpose of this study was to assess the potential of a LEGO-based communication assessment and a standardized patient-based emotional intelligence assessment to serve as an indicator for communication and interpersonal skills among peers in residency.

METHODS

We examined general surgery residents who interviewed virtually at our institution in 2021-2022, then matriculated in 2022-2023. Residents' LEGO-based communication and emotional intelligence interview assessments were evaluated for associations with peer evaluations in intern year. A regression analysis was conducted testing the association between each assessment and peer-evaluation metrics, controlling for resident track (preliminary, categorical).

RESULTS

Performance on LEGO-based communication assessments was significantly associated with peer evaluation of cross-cover performance (B = 0.09, standard error 0.044, 95% confidence interval 0.001-0.187, P = .048), whereas emotional intelligence scores had no significant association (P = .155). In contrast, performance on the LEGO-based communication assessments were associated with peer evaluations for desirability as a coworker (B = 0.098, standard error 0.038, 95% confidence interval 0.017-0.178, P = .021), whereas emotional intelligence scores were negatively associated with desirability as a coworker (B = -0.255, standard error 0.107, 95% confidence interval -0.482 to -0.029], P = .029).

CONCLUSION

Although LEGO-based communication assessments before residency are associated with better resident peer evaluations 1 year into residency, our emotional intelligence applicant assessment during recruitment did not provide clear insight into resident performance. Future research should consider the ability of standardized assessments to predict performance.

Stress responses in surgical trainees during simulation-based training courses in laparoscopy

BACKGROUND

Simulation-based training courses in laparoscopy have become a fundamental part of surgical training programs. Surgical skills in laparoscopy are challenging to master, and training in these skills induces stress responses in trainees. There is limited data on trainees' stress levels, the stress responses related to training on different laparoscopic simulators, and how previous experiences influence trainees' stress response during a course. This study investigates physiologic, endocrine and self-reported stress responses during simulation-based surgical skills training in a course setting.

METHODS

We conducted a prospective observational study of trainees attending basic laparoscopic skills training courses at a national training centre. During the three-day course, participants trained on different laparoscopic simulators: Two box-trainers (the D-box and P.O.P. trainer) and a virtual reality simulator (LAPMentor™). Participants' stress responses were examined through heart rate variability (HRV), saliva cortisol, and the State Trait Anxiety Inventory-6 (STAI-6). The correlation between previous laparoscopic experiences and stress response measurements was explored.

RESULTS

Twenty-four surgical trainees were included in the study. Compared to resting conditions, stress measures were significantly higher during simulation-training activity (the D-box (SDNN = 58.5 ± 23.4; LF/HF-ratio = 4.58 ± 2.71; STAI-6 = 12.3 ± 3.9, P < 0.05), the P.O.P trainer (SDNN = 55.7 ± 7.4; RMSSD = 32.4 ± 17.1; STAI-6 = 12.1 ± 3.9, P < 0.05), and the LAPMentor™ (SDNN = 59.1 ± 18.5; RMSSD = 34.3 ± 19.7; LF/HF-ratio = 4.71 ± 2.64; STAI-6 = 9.9 ± 3.0, P < 0.05)). A significant difference in endocrine stress response was seen for the simulation-training activity on the D-box (saliva cortisol: 3.48 ± 1.92, P < 0.05), however, no significant differences were observed between the three simulators. A moderate correlation between surgical experience, and physiologic and endocrine stress response was observed (RMSSD: r=-0.31; SDNN: r=-0.42; SD2/SD1 ratio: r = 0.29; Saliva cortisol: r = 0.46; P < 0.05), and a negative moderate correlation to self-reported stress (r=-0.42, P < 0.05).

CONCLUSION

Trainees have a significant higher stress response during simulation-training compared to resting conditions, with no difference in stress response between the simulators. Significantly higher cortisol levels were observed on the D-box, indicating that simulation tasks with time pressure stress participants the most. Trainees with more surgical experience are associated with higher physiologic stress measures, but lower self-reported stress scores, demonstrating that surgical experience influences trainees' stress response during simulation-based skills training courses.

Measuring wellbeing: A scoping review of metrics and studies measuring medical student wellbeing across multiple timepoints

PURPOSE

Studies have demonstrated poor mental health in medical students. However, there is wide variation in study design and metric use, impairing comparability. The authors aimed to examine the metrics and methods used to measure medical student wellbeing across multiple timepoints and identify where guidance is necessary.

METHODS

Five databases were searched between May and June 2021 for studies using survey-based metrics among medical students at multiple timepoints. Screening and data extraction were done independently by two reviewers. Data regarding the manuscript, methodology, and metrics were analyzed.

RESULTS

221 studies were included, with 109 observational and 112 interventional studies. There were limited studies (15.4%) focused on clinical students. Stress management interventions were the most common (40.2%). Few (3.57%) interventional studies followed participants longer than 12 months, and 38.4% had no control group. There were 140 unique metrics measuring 13 constructs. 52.1% of metrics were used only once.

CONCLUSIONS

Unique guidance is needed to address gaps in study design as well as unique challenges surrounding medical student wellbeing surveys. Metric use is highly variable and future research is necessary to identify metrics specifically validated in medical student samples that reflect the diversity of today's students.

Emotional visual stimuli and simulated laparoscopic surgical performance: A pilot cohort study

BACKGROUND

Exposure to stress prior to or during surgery can negatively impact performance. Management of stress is an essential non-technical skill required for safe practice. The effects of exposure to emotional visual stressors on surgical performance are poorly understood. This study aims to develop a model to investigate effects of emotive visual stimuli on simulated laparoscopic performance.

METHODS AND MATERIALS

A single-centre cohort study. Thirty novice, simulator-naïve medical students were randomly allocated to view either positive, negative, or neutral emotional images (sourced from validated image registry). Participants focused for 5 s on the image before completing a peg-threading laparoscopic task. Time, instrument distance, speed, acceleration, motion smoothness, and ambidexterity were recorded automatically with instrument tracking software. 8 task cycles were completed; 3 control practices followed by 5 with the stimuli, according to group allocation.

RESULTS

The final performance metrics of students (time, distance, speed, and motion smoothness) were not significantly different when comparing positive and neutral stimuli groups to those shown negative stimuli. However, changes were seen in the rate of performance improvements (positive: p = 0.711, p = 0.837, p = 0.297, and p = 0.393) (neutral: p = 0.285, p = 0.918, p = 0.835, and p = 0.396). Participation improved performance metrics overall (p=<0.001, p=<0.001, p = 0.088, p = 0.025, p=<0.001).

CONCLUSION

Model systems may be valuable for investigating the impact of stress on surgeon performance. The effect of emotive visual stimuli on surgical performance is complex. This model may aid the further exploration of these relationships and ultimately can provide an environment in which surgeons can develop strategies to mitigate the adverse effect of stressors.

Emotional intelligence in military medical officers in the Defence Medical Services

BACKGROUND

Emotional intelligence (EI) is a concept describing an individual's ability to understand, process and act accordingly on others' and one's own emotions. It is a desirable quality for people working in teams and is beneficial to the individual in many ways. It is increasingly recognised that understanding and developing EI are important to working in the healthcare environment. It becomes especially pertinent in the deployed Defence Medical Services (DMS), where clinicians often fulfil a significant leadership role in a small team.

METHODS

This study was performed with the aim of exploring the role of EI in military doctors in the UK DMS. EI was measured in a cohort of 64 military doctors by way of a validated self-assessment questionnaire. Results were tested for differences in EI between different services and career stages.

RESULTS

The survey had an 83% return rate. There was roughly equal distribution between service, career groups and ages across the study population. There were more men than women. The population showed consistently high EI scores compared with control data. There were no statistical differences in EI scores between services or genders. Foundation doctors showed the highest EI scores and consultants the lowest (6.05 vs 5.3).

CONCLUSION

It was demonstrated that military doctors have consistently high EI score, especially at the most junior level. This suggests that traits deemed desirable by the single service selection processes also pertain to high EI without it being specifically measured for. The dangers of having too high EI and the benefits of having a range of EI within a team were discussed. There were limitations of being unable to obtain qualitative data and not including primary healthcare staff. Several recommendations were set out as to how the DMS may use or further investigate EI with regard to training and recruitment.

A scoping review of emotions and related constructs in simulation-based education research articles

BACKGROUND

While acknowledgement of emotions' importance in simulation-based education is emerging, there are concerns regarding how education researchers understand the concept of emotions for them to deliberately incorporate emotionally charged scenarios into simulation-based education. This concern is highlighted especially in the context of medical education often lacking strong theoretical integration. To map out how current simulation-based education literature conceptualises emotion, we conducted a scoping review on how emotions and closely related constructs (e.g. stress, and emotional intelligence) are conceptualised in simulation-based education articles that feature medical students, residents, and fellows.

METHODS

The scoping review was based on articles published in the last decade identified through database searches (EMBASE and Medline) and hand-searched articles. Data extraction included the constructs featured in the articles, their definitions, instruments used, and the types of emotions captured. Only empirical articles were included (e.g. no review or opinion articles). Data were charted via descriptive analyses.

RESULTS

A total of 141 articles were reviewed. Stress was featured in 88 of the articles, while emotions and emotional intelligence were highlighted in 45 and 34 articles respectively. Conceptualisations of emotions lacked integration of theory. Measurements of emotions mostly relied on self-reports while stress was often measured via physiological and self-report measurements. Negative emotions such as anxiety were sometimes seen as interchangeable with the term stress. No inferences were made about specific emotions of participants from their emotional intelligence.

CONCLUSIONS

Our scoping review illustrates that learners in simulation-based education are most often anxious and fearful. However, this is partially due to medical education prioritising measuring negative emotions. Further theoretical integration when examining emotions and stress may help broaden the scope towards other kinds of emotions and better conceptualisations of their impact. We call for simulation education researchers to reflect on how they understand emotions, and whether their understanding may neglect any specific aspect of affective experiences their simulation participants may have.

Unpacking the Broad Landscape of Intraoperative Stressors for Clinical Personnel: A Mixed-Methods Systematic Review

Purpose

The main goals of this mixed-methods systematic review are to identify what types of intraoperative stressors for operating room personnel have been reported in collected studies and examine the characteristics of each intraoperative stressor.

Methods

With a systematic literature search, we retrieved empirical studies examining intraoperative stress published between 2010 and 2020. To synthesize findings, we applied two approaches. First, a textual narrative synthesis was employed to summarize key study information of the selected studies by focusing on surgical platforms and study participants. Second, a thematic synthesis was employed to identify and characterize intraoperative stressors and their subtypes.

Results

Ninety-four studies were included in the review. Regarding the surgical platforms, the selected studies mainly focused on minimally invasive surgery and few studies examined issues around robotic surgery. Most studies examined intra-operative stress from surgeons' perspectives but rarely considered other clinical personnel such as nurses and anesthetists. Among seven identified stressors, technical factors were the most frequently examined followed by individual, operating room environmental, interpersonal, temporal, patient, and organizational factors.

Conclusion

By presenting stressors as multifaceted elements affecting collaboration and interaction between multidisciplinary team members in the operating room, we discuss the potential interactions between stressors which should be further investigated to build a safe and efficient environment for operating room personnel.

Evidence and Strategies for Including Emotional Intelligence in Pharmacy Education

Objective. This integrative review summarizes the literature addressing emotional intelligence among health care professionals and students to better define and incorporate it into the pharmacy curricula.Findings. Emotional intelligence is an essential attribute for relationship building, stress management, and self-regulation. Pharmacy students must develop and improve their emotional intelligence to support their development of successful relationships with patients, pharmacy colleagues, and other health care providers. In addition, awareness of one's own biases and emotions can help with behavioral regulation, which can facilitate enhanced communications with others. Increasing evidence suggests that emotional intelligence can influence academic success, the ability to provide compassionate and competent patient care, the ability to lead and influence others, and the ability to manage stress, all of which are important in pharmacy education. Educators can help learners develop emotional intelligence by designing activities that directly identify and target areas of weakness while leveraging areas of strength.Summary. This article discusses key background studies on emotional intelligence in the health professions literature and identifies specific methods and strategies to develop learners' emotional intelligence within the curriculum.

Stress in surgical educational environments: a systematic review

BACKGROUND

The effects of stress on surgical residents and how stress management training can prepare residents to effectively manage stressful situations is a relevant topic. This systematic review aimed to analyze the literature regarding (1) the current stress monitoring tools and their use in surgical environments, (2) the current methods in surgical stress management training, and (3) how stress affects surgical performance.

METHODS

A search strategy was implemented to retrieve relevant articles from Web of Science, Scopus, and PubMed. The 787 initially retrieved articles were reviewed for further evaluation according to the inclusion/exclusion criteria (Prospero registration number CRD42021252682).

RESULTS

Sixty-one articles were included in the review. The stress monitoring methods found in the articles showed heart rate analysis as the most used monitoring tool for physiological parameters while the STAI-6 scale was preferred for psychological parameters. The stress management methods found in the articles were mental-, simulation- and feedback-based training, with the mental-based training showing clear positive effects on participants. The studies analyzing the effects of stress on surgical performance showed both negative and positive effects on technical and non-technical performance.

CONCLUSIONS

The impact of stress responses presents an important factor in surgical environments, affecting residents' training and performance. This study identified the main methods used for monitoring stress parameters in surgical educational environments. The applied surgical stress management training methods were diverse and demonstrated positive effects on surgeons' stress levels and performance. There were negative and positive effects of stress on surgical performance, although a collective pattern on their effects was not clear.

Associations of trait emotional intelligence and stress with anxiety in Chinese medical students

Background

Medical students are vulnerable to anxiety. Identifying its key influencing factors can potentially benefit both students and their future patients. Trait emotional intelligence (EI) and perceived stress may play important roles in anxiety. The main objective of this study was to examine the associations between trait EI, perceived stress and anxiety among Chinese medical students.

Materials and methods

Self-report questionnaires, consisting of the Chinese versions of the Trait Emotional Intelligence Questionnaire-Short Form, the 10-item Perceived Stress Scale, the 7-item Generalized Anxiety Disorder Scale, and demographic section were distributed to 1500 students at three medical universities in China. Hierarchical regression analyses were performed to examine the associations between trait EI, perceived stress and anxiety. Asymptotic and resampling strategies were utilized to examine the mediating effect of perceived stress.

Results

A total number of 1388 medical students became final participants. After adjustment for demographics, while trait EI was strongly and negatively associated with anxiety, accounting for 21.1% of its variance, perceived stress was strongly and positively related to anxiety, explaining an additional 10.0% of the variance. Stress appeared to have a mediating effect on the association between trait EI and anxiety in students with high and moderate levels of stress, but not in low stress group.

Conclusions

Both constructs of trait EI and perceived stress could be of vital importance to understand anxiety in medical students. Evidence-based strategies to enhance trait EI and reduce perceived stress might be undertaken to prevent and treat anxiety in the students.

Trait Emotional Intelligence in Surgeons

Trait emotional intelligence (trait EI or trait emotional self-efficacy) concerns people's perceptions of their emotional functioning. Two studies investigated this construct in surgeons and comparison occupations. We hypothesized that trait EI profiles would differ both within surgical specialties as well as between them and other professions. Study 1 (N = 122) compared the trait EI profiles of four different surgical specialties (General, Orthopedic, Head and Neck, and Miscellaneous surgical specialties). There were no significant differences amongst these specialties or between consultant surgeons and trainees in these specialties. Accordingly, the surgical data were combined into a single target sample (N = 462) that was compared against samples of engineers, executives and senior managers, lawyers, junior military managers, nurses, and salespeople. Surgeons scored significantly higher on global trait EI than junior military managers, but lower than executives and senior managers, salespeople, and nurses. There were no significant differences vis-à-vis engineers or lawyers. A MANOVA confirmed a similar pattern of differences in the four trait EI factors (Wellbeing, Self-control, Sociability, and Emotionality). Global trait EI scores correlated strongly with single-question measures of job satisfaction (r = 0.47) and job performance (r = 0.46) in the surgical sample. These findings suggest that interventions to optimize the trait EI profiles of surgeons can be helpful in relation to job satisfaction, job performance, and overall psychological wellbeing.

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.

Measuring and Improving Emotional Intelligence in Surgery: A Systematic Review

OBJECTIVE

Evaluate how emotional intelligence (EI) has been measured among surgeons and to investigate interventions implemented for improving EI.

SUMMARY BACKGROUND

EI has relevant applications in surgery given its alignment with nontechnical skills. In recent years, EI has been measured in a surgical context to evaluate its relationship with measures such as surgeon burnout and the surgeon-patient relationship.

METHODS

A systematic review was conducted by searching MEDLINE, EMBASE, CINAHL, and PSYCINFO databases using Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. MeSH terms and keywords included "emotional intelligence," "surgery," and "surgeon." Eligible studies included an EI assessment of surgeons, surgical residents, and/or medical students within a surgical context.

RESULTS

The initial search yielded 4627 articles. After duplicate removal, 4435 articles were screened by title and abstract and 49 articles proceeded to a full-text read. Three additional articles were found via hand search. A total of 37 articles were included. Studies varied in surgical specialties, settings, and outcome measurements. Most occurred in general surgery, residency programs, and utilized self-report surveys to estimate EI. Notably, EI improved in all studies utilizing an intervention.

CONCLUSIONS

The literature entailing the intersection between EI and surgery is diverse but still limited. Generally, EI has been demonstrated to be beneficial in terms of overall well-being and job satisfaction while also protecting against burnout. EI skills may provide a promising modifiable target to achieve desirable outcomes for both the surgeon and the patient. Future studies may emphasize the relevance of EI in the context of surgical teamwork.

Do Psychological Resilience and Emotional Intelligence Vary Among Stress Profiles in University Students? A Latent Profile Analysis

The coronavirus/COVID-19 pandemic has brought about significant changes in the lifestyle of students. However, despite an extensive study of students’ life stress using a non-comprehensive scale and variable-centered approach, it has been little studied with a comprehensive scale and person-centered approach. Using the Student-Life Stress Inventory-revised (SSI-R), we analyzed students’ latent stress profiles and examined differences in psychological resilience and emotional intelligence by comparing stress profiles from a sample of 418 undergraduate and graduate students (aged 18–36) in various departments of eight universities in Turkey. We identified five distinct stress profiles, defined as an extremely low stress group (ELSG), a low stress group (LSG), a medium stress group (MSG), a high stress group (HSG), and an extremely high stress group (EHSG). We found that (1) MSG and HSG were similar in terms of emotional intelligence, resilience, and possession of high standards, and they reported higher levels of physiological, emotional, and behavioral reactions than ELSG and LSG; (2) MSG felt more pressure than HSG; (3) ELSG reported higher levels of emotional intelligence (wellbeing, self-control, and emotionality) than others. Also, EHSG reported lower levels of emotional intelligence (specifically self-control) than others; (4) whereas resilience was highly positively correlated to wellbeing, resilience and wellbeing were moderately negatively correlated to stress. Extremely low stress group and LSG reported higher levels of resilience than others. Medium stress group, HSG, and EHSG did not differ with regard to resilience and wellbeing. Our results suggest that, university students are able to maintain their functionality by coping up with stress in some ways, no matter how stressful they are. These findings are discussed in relation to the relevant literature.

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.

Validation of TMMS-24 in Three Spanish-Speaking Countries: Argentina, Ecuador, and Spain

Emotional intelligence (EI) is a fundamental skill related to different aspects of human life, such as psychological well-being or mood states. The present study has a triple objective: first, to explore the psychometric properties of the TMMS-24 in three Spanish-speaking countries (Argentina, Ecuador, and Spain); second, to examine the relation of EI with mood and avoidance of responsibility; and finally, to analyse the influence of sex, age and national differences on EI. The relevance of this study is given by the need for tools to assess EI in different cultures. A sample of 1048 adults (Mage = 21.11 years, SD = 5.84; 52.3% male) was selected by convenience sampling. The psychometric properties of the TMMS-24 were adequate, and the Spanish sample showed lower levels of EI than the Argentinian and Ecuadorian ones. EI was associated with mood and the avoidance of responsibility, with higher levels in women in all cases. Regarding the national and sex-specific differences, the Spanish sample showed significant differences in attention and repair, with men exhibiting higher scores in attention and women having higher scores in repair. In the Argentinean sample, no significant differences were found, and in the Ecuadorian one, women presented higher scores in attention than men. The TMMS-24 can be considered a useful, practical tool to assess EI in adults in different cultures and with different languages.

Associations among Stress, Anxiety, Depression, and Emotional Intelligence among Veterinary Medicine Students

Background: Veterinary students are faced with immense pressures and rigors during school. These pressures have contributed to elevated levels of stress, anxiety, and depression (SAD) among veterinary students relative to the general population. One proposed concept to help students combat SAD is that of emotional intelligence (EI). We explored the relationship between EI and SAD among veterinary students at a college in the Southeast United States. Methods: A cross-sectional study design was implemented among a convenience sample of 182 veterinary medical students. The survey instrument contained 56 items that elicited information about students’ demographics, perceived stress, anxiety, and depression, and emotional intelligence levels. Data analysis included univariate statistics, Pearson’s correlations, and multiple regression and independent samples t-tests. Results: The study revealed a statistically significant, negative correlation between EI levels and stress, anxiety, and depression. Additionally, a statistically significant, positive correlation was found between stress and anxiety as well as both stress and anxiety and depression. Multiple linear regression showed that EI was a statistically significant predictor of stress (b = −0.239, p < 0.001), anxiety (b = −0.044, p < 0.001), and depression (b = −0.063, p < 0.001), after controlling for sociodemographic variables. Students’ t-test results revealed a statistically significant mean difference in EI scores among students screening positive versus negative for depression, with students screening negative having a mean EI score of 10.81 points higher than students who screened positive for depression. Conclusion: There is a scientifically supported need for interventions in veterinary school to integrate EI into the veterinary medical curriculum and consider the EI levels of veterinary student candidates.

Analysis of Mirrored Psychophysiological Change of Cardiac Surgery Team Members During Open Surgery

OBJECTIVE

Mirrored psychophysiological change in cognitive workload indices may reflect shared mental models and effective healthcare team dynamics. In this exploratory analysis, we investigated the frequency of mirrored changes, defined as concurrent peaks in heart rate variability (HRV) across team members, during cardiac surgery.

DESIGN

Objective cognitive workload was evaluated via HRV collected from the primary surgical team during cardiac surgery cases (N = 15). Root mean square of the successive differences (RMSSD) was calculated as the primary HRV measure. Procedures were divided into consecutive nonoverlapping 5-minute segments, and RMSSD along with deviations from RMSSD were calculated for each segment. Segments with positive deflections represent above-average cognitive workload. Positive deflections and peaks across dyads within the same segment were counted.

SETTING

Data collection for this study took place in the cardiovascular operating room during live surgeries.

PARTICIPANTS

Physiological data were collected and analyzed from the attending surgeon, attending anesthesiologist, and primary perfusionist involved with the recorded cases.

RESULTS

Of the 641 five-minute segments analyzed, 325 (50.7%) were positive deflections above average, concurrently across at least 2 team members. Within the 325 positive deflections, 26 (8%) represented concurrent peaks in HRV across at least 2 active team members. Mirrored peaks across team members were observed most commonly during the coronary anastomoses or valve replacement phase (N = 12).

CONCLUSIONS

In this pilot study, mirrored physiological responses representing peaks in cognitive workload were observed uncommonly across dyads of cardiac surgery team members (1.73 peaks/case on average). Almost half of these occurred during the most technically demanding phases of cardiac surgery, which may underpin teamwork quality. Future work should investigate interactions between technical and nontechnical performance surrounding times of mirrored peaks and expand the sample size.

Associations between stress, anxiety, depression, and emotional intelligence among osteopathic medical students

Context

Stress, anxiety, and depression affect medical student populations at rates disproportionate to those of general student populations. Emotional intelligence (EI) has been suggested as a protective factor in association with psychological distress.

Objective

To explore the relationships between EI and stress, anxiety, and depression among a sample of US osteopathic medical students.

Methods

From February to March 2020, a convenience sample of medical students enrolled at an osteopathic medical school in the southeastern region of the United States were invited to complete a voluntary and anonymous 54-item online questionnaire that included sociodemographic items as well as validated and reliable scales assessing perceived stress, anxiety, depression, and EI. Univariate statistics were calculated to describe the participant characteristics and the study variables of interest. Pearson’s product-moment correlations were used to examine relationships between EI and study variables. Three multiple regression models were fitted to examine the relationship between EI and stress, anxiety, and depression, adjusting for sociodemographic factors exhibiting significant bivariate relationships with outcome variables. Dichotomous variables were created that were indicative of positive screens for potential depressive disorder or anxiety disorder. Independent-sample t-tests were used to determine the presence of a statistically significant difference in EI scores between positive screeners for depression and anxiety and their respective counterparts; an alpha level of 0.05 was set a priori to indicate statistical significance.

Results

In all, 268 medical students participated in this study, for a response rate of approximately 27%. Importantly, EI exhibited significant negative correlations with stress, anxiety, and depression (r=−0.384, p<0.001; r=−0.308, p<0.001; r=−0.286, p<0.001), respectively). Thus, high levels of stress, anxiety, and depression were observed in the sample. Significant relationships remained following covariate adjustment. Established cutoffs for anxiety and depression were used to classify positive and negative screens for these morbidities. Using these classifications, individuals screening positive for potential anxiety and depression exhibited significantly lower levels of EI than their counterparts showing subclinical symptoms (t=5.14, p<0.001 and t=3.58, p<0.001, respectively).

Conclusion

Our findings support the notion that higher levels of EI may potentially lead to increased well-being, limit psychological distress, improve patient care, and facilitate an ability to thrive in the medical field. We encourage continued study on the efficacy of EI training through intervention, measurement of EI in both academic and clinical settings as an indicator of those at risk for programmatic dropout or psychological distress, and consideration of EI training as an adjunct to the educational program curriculum.

Emotional Intelligence: Leadership Essentials for Chest Medicine Professionals

Emotional intelligence (EI) has become widely appreciated as an important leadership attribute, in business, education and, increasingly, in health care. Defined as "the capacity to understand your own and others' emotions and to motivate and develop yourself and others in service of improved work performance and enhanced organizational effectiveness," EI is correlated with a number of success attributes in several sectors; for example, in business, with enhanced business performance and enhanced personal career success, and in health care, with enhanced patient satisfaction, lower burnout, lower litigation risk, and enhanced leadership success. While multiple models of EI have evolved, perhaps the most popular model is framed around four general rubrics with component competencies. The general rubrics are: self-awareness, self-management, social awareness, and relationship management. EI can be measured by using available instruments, and it can be learned and taught. Indeed, teaching EI has become increasingly common in health-care organizations in service of improving health care and health-care leadership. Although more research is needed, ample evidence supports the notion that EI is a critical success element for success as a health-care leader, especially because EI competencies differ markedly from the clinical and scientific skills that are core to being a clinician and/or investigator. This review of EI presents evidence in support of the relevance of EI to health care and health-care leadership, discusses how and when EI can be developed among health-care providers, and considers remaining questions.

Review of emotional intelligence in health care: an introduction to emotional intelligence for surgeons

BACKGROUND

The aim of this review is to explain the components of emotional intelligence (EI) and explore the benefits within today's health care system with an emphasis on surgery. EI is a person's ability to understand their own emotions and those of the individuals they interact with. Higher individual EI has multiple proposed benefits, such as reducing stress, burnout and increasing work satisfaction. The business world recognizes EI as beneficial in terms of performance and outcomes. Could surgeons benefit from being more cognisant of EI and methods of assessing and improving EI to reap the aforementioned benefits?

METHODS

A search of Embase, Cochrane and Medline databases using the following search terms; emotional intelligen*, surg*, medic* yielded 95 articles. After review of all the literature 39 remaining articles and five text books were included.

RESULTS

To perform optimally, surgeons must be aware of their own emotions and others. EI differs from IQ and can be taught, learnt and improved upon. EI is measured via validated self-reporting questionnaires and 'multi-rater' assessments. High EI is positively associated with leadership skills in surgeons, non-technical skills, reduction in surgeon stress, burnout and increased job satisfaction, all of which translate to better patient relationships and care. Future implications of EI have been postulated as a measure of performance, a selection tool for training positions and a marker of burnout. EI should be an explicit part of contemporary surgical education and training.

Relationship of Emotional Intelligence, Intelligence Quotient, and Autonomic Reactivity Tests in Undergraduate Medical Students

BACKGROUND

Emotional intelligence is emerging as a determinant of success of an individual in their professions. Therefore, this study was designed to decipher the association of emotional intelligence, intelligence quotient, and autonomic stress reactivity tests in undergraduate medical students.

METHOD

Fifty-two undergraduate medical students were recruited in this study. Validated questionnaires for EI-self report and performance based-and IQ were filled by all the participants. Autonomic reactivity tests-lying to standing, deep breathing (DBT), Valsalva maneuver, cold pressor (CPT), and handgrip tests-were also performed. Correlational analysis was done using GraphPad Prism version 5.00.

RESULTS

Performance-based EI had a positive correlation with DBT responses and an inverse relation with CPT response. Additionally, sub-grouping on the basis of emotional quotient (EQ) and IQ and comparing their autonomic profile revealed an important pattern of parasympathetic reactivity-wherein it was higher in both high > EQ high IQ low > EQ low IQ high > both low .

CONCLUSIONS

Emotional intelligence is associated with autonomic reactivity responses. EQ has a positive relation to parasympathetic system while a negative relation to sympathetic system emphasizing the association of sympatho-vagal balance with the emotional intelligence of an individual. Also, parasympathetic responses in an individual differed significantly in groups based on EQ and IQ which again focuses on the strong relation between higher parasympathetic reactivity and emotional intelligence. This study highlights the probable role of emotional intelligence in medical students in deciphering not only their empathy towards patients, but also their physiological responses and cognitive capacity.

Emotional Intelligence Predicts Accurate Self-Assessment of Surgical Quality: A Pilot Study

BACKGROUND

Self-assessment is fundamental in surgical training. Accuracy of self-assessment is superior with greater age, experience, and the use of video playback. Presently, there is scarce evidence in the literature regarding predictors for a surgical trainee's aptitude for self-assessment. The objective of this study was to investigate whether emotional intelligence or visual-spatial aptitude can predict effective self-assessment among novice surgeons performing laparoscopic appendectomy (LA).

MATERIALS AND METHODS

Eighteen novice trainees performed a simulated LA, and two aptitude measures were evaluated: (1) emotional intelligence questionnaire and (2) visual spatial ability test. Self-assessment of their performance was conducted using the Objective Assessment of Surgical and Technical Skills global rating scale and ranking five subtasks of the procedure in order of quality of performance after watching a playback of their LA. Two blinded experts (senior consultant surgeons, performed >100 LAs) assessed surgical quality using the same scoring system. Candidates were ranked into higher and lower aptitude groups for the two aptitude measures. Spearman's rank correlation coefficient was calculated to identify if either of the two groups demonstrated greater agreement between self and expert assessment in relation to the two aptitude measures.

RESULTS

Participants with a higher degree of emotional intelligence demonstrated significant agreement with expert assessment (r = 0.73, P = 0.031).

CONCLUSIONS

Emotional intelligence can predict better self-assessment of surgical quality after performing a simulated LA. This may facilitate early identification of individuals who might require mentoring or guidance with self-assessment as well as contribute to selection criteria.

Does Emotional Intelligence Buffer the Effects of Acute Stress? A Systematic Review

People with higher levels of emotional intelligence (EI: adaptive emotional traits, skills, and abilities) typically achieve more positive life outcomes, such as psychological wellbeing, educational attainment, and job-related success. Although the underpinning mechanisms linking EI with those outcomes are largely unknown, it has been suggested that EI may work as a "stress buffer." Theoretically, when faced with a stressful situation, emotionally intelligent individuals should show a more adaptive response than those with low EI, such as reduced reactivity (less mood deterioration, less physiological arousal), and faster recovery once the threat has passed. A growing number of studies have begun to investigate that hypothesis in respect to EI measured as both an ability (AEI) and trait (TEI), but results are unclear. To test the "stress-buffering" function of EI, we systematically reviewed experimental studies that explored the relationship between both types of EI and acute stress reactivity or recovery. By searching four databases, we identified 45 eligible studies. Results indicated that EI was only adaptive in certain contexts, and that findings differed according to stressor type, and how EI was measured. In terms of stress reactivity, TEI related to less mood deterioration during sports-based stressors (e.g., competitions), physical discomfort (e.g., dental procedure), and cognitive stressors (e.g., memory tasks), but did not appear as helpful in other contexts (e.g., public speaking). Furthermore, effects of TEI on physiological stress responses, such as heart rate, were inconsistent. Effects of AEI on subjective and objective stress reactivity were often non-significant, with high levels detrimental in some cases. However, data suggest that both higher AEI and TEI relate to faster recovery from acute stress. In conclusion, results provide mixed support for the stress-buffering effect of EI. Limitations and quality of studies are also discussed. Findings could have implications for EI training programmes.

Perceived stress, coping strategies, and emotional intelligence: A cross-sectional study of university students in helping disciplines

BACKGROUND

Post-secondary students in training for helping profession disciplines, including nursing, may be at elevated risk for high stress levels. Stress among students has been linked with adverse physical and psychological health. In addition to the common stressors associated with post-secondary education, sources of stress for students in the helping professions include balancing academic and clinical demands. Previous research indicates perceived stress levels are correlated with emotional intelligence (EI) and with the coping strategies employed by students.

OBJECTIVES

The aim of this study was to examine (1) the relationship between EI and perceived stress, and (2) the potential mediating role of coping responses.

DESIGN

A cross-sectional survey design was employed.

SETTING

Participants were recruited from a public university in the United States.

PARTICIPANTS

A sample of 203 undergraduate and graduate students majoring in psychology, nursing, and social work was recruited.

METHOD

Participants were recruited on-campus and through campus online resources and completed an online survey or a paper-and-pencil version of the survey. Descriptive statistics and mediation analyses were used to test the study hypotheses.

RESULTS

Higher EI was associated with lower perceived stress, and this association was partially mediated by both adaptive and maladaptive coping responses. Higher EI was associated with greater use of adaptive coping and lower use of maladaptive coping, and these, in turn, were negatively and positively (respectively) associated with perceived stress.

CONCLUSION

The findings suggest that interventions aimed at increasing emotional intelligence may help to reduce perceived stress for students in the helping disciplines.

Emotional Intelligence and Burnout in Academic Radiation Oncology Chairs

EXECUTIVE SUMMARY

The importance of emotional intelligence (EI) in physicians has attracted attention as researchers begin to focus on the relationship of EI to retention, promotion, and productivity among academic physicians. However, to date, no formal evaluation of EI has been conducted among current department chairs. The objectives of this study were to assess the EI of current chairs of academic radiation oncology departments and to correlate EI with a self-reported assessment of burnout.The authors invited 95 chairs of academic radiation oncology departments to participate in a survey, approved by an institutional review board, consisting of the Trait Emotional Intelligence Questionnaire Short Form (TEIQue-SF) and the abbreviated Maslach Burnout Inventory (a-MBI). TEIQue-SF scores were evaluated for correlation with respondents' demographics and self-reported burnout scores on the a-MBI. Sixty chairs responded to the survey, for a response rate of 63.2%. The median (interquartile range) TEIQue-SF for the responding cohort was 172 (155-182) out of a maximum possible score of 210. The a-MBI emotional exhaustion and depersonalization subscores were low, with median (interquartile range) scores of 4 (2.25-6.75) and 1 (0-2.75) out of maximum possible scores of 18 and 30, respectively. Higher TEIQue-SF global scores were weakly correlated with decreased burnout. The study results show that academic radiation oncology chairs had a high EI and low rates of self-reported burnout. EI may be of increasing importance with respect to recruitment and retention of academic medical leaders.

Do doctors' attachment styles and emotional intelligence influence patients' emotional expressions in primary care consultations? An exploratory study using multilevel analysis

OBJECTIVE

To investigate whether and how doctors' attachment styles and emotional intelligence (EI) might influence patients' emotional expressions in general practice consultations.

METHODS

Video recordings of 26 junior doctors consulting with 173 patients were coded using the Verona Coding Definition of Emotional Sequences (VR-CoDES). Doctors' attachment style was scored across two dimensions, avoidance and anxiety, using the Experiences in Close Relationships: Short Form questionnaire. EI was assessed with the Mayer-Salovey-Caruso Emotional Intelligence Test. Multilevel Poisson regressions modelled the probability of patients' expressing emotional distress, considering doctors' attachment styles and EI and demographic and contextual factors.

RESULTS

Both attachment styles and EI were significantly associated with frequency of patients' cues, with patient- and doctor-level explanatory variables accounting for 42% of the variance in patients' cues. The relative contribution of attachment styles and EI varied depending on whether patients' presenting complaints were physical or psychosocial in nature.

CONCLUSION

Doctors' attachment styles and levels of EI are associated with patients' emotional expressions in primary care consultations. Further research is needed to investigate how these two variables interact and influence provider responses and patient outcomes.

PRACTICE IMPLICATIONS

Understanding how doctors' psychological characteristics influence PPC may help to optimise undergraduate and postgraduate medical education.

Conceptual model for measuring Saudi banking managers’ job performance based on their emotional intelligence (EI)

Purpose

The purpose of this paper is to develop and present a research model on various emotional intelligence (EI) constructs which have been found to influence job performance in the prior literature.

Design/methodology/approach

In addition to leadership and EI, the constructs are clustered under different categories: self-awareness includes self-confidence, emotional self-awareness and accurate self-assessment; self-management includes self-control, adaptability, conscientiousness, trustworthiness and optimism; social awareness includes empathy, organizational awareness and service orientation; and social skills groups’ communication, change catalyst, developing others and self-monitoring.

Findings

The paper proposes 17 hypotheses concerning significant relationships between these constructs and job performance.

Originality/value

The paper proposes a new approach toward studying the impact of various constructs of EI on job performance in Saudi banking sector.

Assessment of Surgery Residents' Interpersonal Communication Skills: Validation Evidence for the Communication Assessment Tool in a Simulation Environment

OBJECTIVES

Although development of trainees' competency in interpersonal communication is essential to high-quality patient-centered surgical care, nontechnical skills present assessment challenges for residency program directors. The Communication Assessment Tool (CAT) demonstrated internal reliability and content validity for general surgery residents, though the tool has not yet been applied in simulation. The study provides validation evidence for using the CAT to assess surgical residents' interpersonal communication skills in simulation scenarios.

DESIGN

Simulations of delivering bad news were completed by 21 general surgery residents during a mandatory communication curriculum. Upon completion of the 10-minute scenario, standardized participants (SPs) assessed performance using the 14-item CAT rating scale and individually provided feedback to residents. Discrete communication behaviors were recorded on video review by a trained blinded observer. The traits emotional intelligence questionnaire short form (TEIQue-SF) was completed by the residents 6 months later. SP-CAT ratings are evaluated with respect to learner characteristics, observed behaviors, and TEIQue results.

SETTING

Surgical simulation center in a 900-bed tertiary care hospital.

PARTICIPANTS

General surgery residents were targeted learners. Trauma survivors network volunteers served as SPs, acting as a family member of a patient who developed an intracerebral hemorrhage following a small bowel procedure.

RESULTS

Discrete communication behaviors were reliably assessed by the observer (interrater reliability with trainer: 89% agreement, κ = 0.77). SP-CAT ratings ranged from 34 to 61. Higher SP-CAT ratings were correlated with positive communication behaviors (Spearman ρ = 0.42, p = 0.056). Total TEIQue was positively related to SP-CAT ratings (ρ = 0.42, p = 0.061). The TEIQue emotionality factor was strongly correlated with SP-CAT ratings (ρ = 0.52, p = 0.016).

CONCLUSIONS

The CAT demonstrates content validity in a simulation environment with former patients acting as SPs. This study provides validation evidence relating the SP-CAT to discrete observations of communication behaviors by a trained, reliable observer as well as residents' self-reported emotional intelligence traits.

Psychometric properties of WLEIS as a measure of emotional intelligence in the Portuguese and Spanish medical students

The psychometric properties of Wong and Law's (2002) Emotional Intelligence Scale (WLEIS) were analyzed. Participants were 954 medical students: 481 from the University of Extremadura (Spain) and 473 from the University of Lisbon (Portugal). Following Messicks' validation framework, we analyzed the scale's response process, internal structure and relationship with other variables (i.e., engagement). Descriptive statistics, scale reliability, item characteristics, and exploratory and confirmatory analyses supported the distribution of the sixteen items across four factors. Convergent validity analyzed through the ρvc (η) index showed that all the factors were in the 50% criterion. The factors shared, on average, 23% of the variance showing adequate discriminant validity. Furthermore, the correlations among EI dimensions and engagement were all positive and significant. Overall, the WLEIS demonstrated good psychometric properties. Thus, this study ensures that WLEIS is a valid instrument in Portugal and Spain to evaluate EI in medical students.

Developments in Trait Emotional Intelligence Research

Trait emotional intelligence (“trait EI”) concerns our perceptions of our emotional abilities, that is, how good we believe we are in terms of understanding, regulating, and expressing emotions in order to adapt to our environment and maintain well-being. In this article, we present succinct summaries of selected findings from research on (a) the location of trait EI in personality factor space, (b) the biological underpinnings of the construct, (c) indicative applications in the areas of clinical, health, social, educational, organizational, and developmental psychology, and (d) trait EI training. Findings to date suggest that individual differences in trait EI are a consistent predictor of human behavior across the life span.

Emotional Intelligence as a Predictor of Resident Well-Being

BACKGROUND

There is increasing recognition that physician wellness is critical; it not only benefits the provider, but also influences quality and patient care outcomes. Despite this, resident physicians suffer from a high rate of burnout and personal distress. Individuals with higher emotional intelligence (EI) are thought to perceive, process, and regulate emotions more effectively, which can lead to enhanced well-being and less emotional disturbance. This study sought to understand the relationship between EI and wellness among surgical residents.

STUDY DESIGN

Residents in a single general surgery residency program were surveyed on a voluntary basis. Emotional intelligence was measured using the Trait Emotional Intelligence Questionnaire-Short Form. Resident wellness was assessed with the Dupuy Psychological General Well-Being Index, Maslach Burnout Inventory, and Beck Depression Inventory-Short Form. Emotional intelligence and wellness parameters were correlated using Pearson coefficients. Multivariate analysis was performed to identify factors predictive of well-being.

RESULTS

Seventy-three residents participated in the survey (response rate 63%). Emotional intelligence scores correlated positively with psychological well-being (r = 0.74; p < 0.001) and inversely with depression (r = -0.69, p < 0.001) and 2 burnout parameters, emotional exhaustion (r = -0.69; p < 0.001) and depersonalization (r = -0.59; p < 0.001). In regression analyses controlling for demographic factors such as sex, age, and relationship status, EI was strongly predictive of well-being (β = 0.76; p < 0.001), emotional exhaustion (β = -0.63; p < 0.001), depersonalization (β = -0.48; p = 0.002), and depression (β = -0.60; p < 0.001).

CONCLUSIONS

Emotional intelligence is a strong predictor of resident well-being. Prospectively measuring EI can identify those who are most likely to thrive in surgical residency. Interventions to increase EI can be effective at optimizing the wellness of residents.

Exploring personality dimensions that influence practice and performance of a simulated laparoscopic task in the objective structured clinical examination

BACKGROUND

Surgical educators have encouraged the investigation of individual differences in aptitude and personality in surgical performance. An individual personality difference that has been shown to influence laparoscopic performance under time pressure is movement specific reinvestment. Movement specific reinvestment has 2 dimensions, movement self-consciousness (MS-C) (i.e., the propensity to consciously monitor movements) and conscious motor processing (CMP) (i.e., the propensity to consciously control movements), which have been shown to differentially influence laparoscopic performance in practice but have yet to be investigated in the context of psychological stress (e.g., the objective structured clinical examination [OSCE]).

OBJECTIVE

This study investigated the role of individual differences in propensity for MS-C and CMP in practice of a fundamental laparoscopic skill and in laparoscopic performance during the OSCE. Furthermore, this study examined whether individual differences during practice of a fundamental laparoscopic skill were predictive of laparoscopic performance during the OSCE.

METHODS

Overall, 77 final-year undergraduate medical students completed the movement specific reinvestment scale, an assessment tool that quantifies the propensity for MS-C and CMP. Participants were trained to proficiency on a fundamental laparoscopic skill. The number of trials to reach proficiency was measured, and completion times were recorded during early practice, later practice, and the OSCE.

RESULTS

There was a trend for CMP to be negatively associated with the number of trials to reach proficiency (p = 0.064). A higher propensity for CMP was associated with fewer trials to reach proficiency (β = -0.70, p = 0.023). CMP and MS-C did not significantly predict completion times in the OSCE (p > 0.05). Completion times in early practice (β = 0.05, p = 0.016) and later practice (β = 0.47, p < 0.001) and number of trials to reach proficiency (β = 0.23, p = 0.003) significantly predicted completion times in the OSCE.

CONCLUSION

It appears that a higher propensity for CMP predicts faster rates of learning of a fundamental laparoscopic skill. Furthermore, laparoscopic performance during practice is indicative of laparoscopic performance in the challenging conditions of the OSCE. The lack of association between the 2 dimensions of movement specific reinvestment and performance during the OSCE is explained using the theory of reinvestment as a framework. Overall, consideration of personality differences and individual differences in ability during practice could help inform the development of individualized surgical training programs.

Emotional intelligence and recovering from induced negative emotional state

The aim of the present study was to examine the relationship between emotional intelligence (EI) and recovering from negative emotions induction, using a performance test to measure EI. Sixty seven undergraduates participated in the procedure, which lasted 75 min and was divided into three stages. At Time 1, subjects answered the State-Trait Anxiety Inventory (STAI)-S, Profile of Mood States (POMS)-A, and EI was assessed by Mayer–Salovey–Caruso Emotional Intelligence Test (MSCEIT). At Time 2, negative emotions were induced by nine pictures taken from the International Affective Picture System and participants were asked to complete a second STAI-S and POMS-B questionnaires. At Time 3 participants were allowed to rest doing a distracting task and participants were asked to complete a third STAI-S and POMS-A questionnaires. Results showed that the branches of the MSCEIT emotional facilitation and emotional understanding are related to previous mood states and mood recovery, but not to mood reactivity. This finding contrasts nicely with studies on which emotional recovery was assessed in relation to EI self-reported measures, highlighting the perception and emotional regulation.

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.

Conscious motor processing and movement self-consciousness: two dimensions of personality that influence laparoscopic training

BACKGROUND

Identifying personality factors that account for individual differences in surgical training and performance has practical implications for surgical education. Movement-specific reinvestment is a potentially relevant personality factor that has a moderating effect on laparoscopic performance under time pressure. Movement-specific reinvestment has 2 dimensions, which represent an individual's propensity to consciously control movements (conscious motor processing) or to consciously monitor their 'style' of movement (movement self-consciousness).

OBJECTIVE

This study aimed at investigating the moderating effects of the 2 dimensions of movement-specific reinvestment in the learning and updating (cross-handed technique) of laparoscopic skills.

METHODS

Medical students completed the Movement-Specific Reinvestment Scale, a psychometric assessment tool that evaluates the conscious motor processing and movement self-consciousness dimensions of movement-specific reinvestment. They were then trained to a criterion level of proficiency on a fundamental laparoscopic skills task and were tested on a novel cross-handed technique. Completion times were recorded for early-learning, late-learning, and cross-handed trials.

RESULTS

Propensity for movement self-consciousness but not conscious motor processing was a significant predictor of task completion times both early (p = 0.036) and late (p = 0.002) in learning, but completion times during the cross-handed trials were predicted by the propensity for conscious motor processing (p = 0.04) rather than movement self-consciousness (p = 0.21).

CONCLUSION

Higher propensity for movement self-consciousness is associated with slower performance times on novel and well-practiced laparoscopic tasks. For complex surgical techniques, however, conscious motor processing plays a more influential role in performance than movement self-consciousness. The findings imply that these 2 dimensions of movement-specific reinvestment have a differential influence in the learning and updating of laparoscopic skills.

Predicting anxiety in carers of people with dementia: the role of trait emotional intelligence

BACKGROUND

Trait emotional intelligence (trait EI) is a personality dimension related to affect that has been shown to predict psychopathology. The objective of the present study was to examine the predictive validity of trait EI in explaining anxiety symptoms in family carers of people with dementia.

METHODS

A cross-sectional survey was conducted with a convenience sample of 203 dementia family caregivers. We used the Trait Emotional Intelligence Questionnaire - Short Form (TEIQue-SF) to measure trait EI in carers. The predictive validity of the scale in explaining anxiety was tested via regression analysis.

RESULTS

Bivariate correlational analysis indicated that lower levels of trait EI were related to higher perceived burden, higher anxiety and depression, and poorer self-rated health in carers. Multiple regression analyses indicated that trait EI was a significant predictor of anxiety symptoms after accounting for known factors influencing outcomes for caregivers. Trait EI also showed strong predictive validity in relation to psychosocial outcomes in carers.

CONCLUSIONS

Trait EI plays an important role in predicting anxiety in dementia caregivers. Theoretical models and interventions aimed at carers of people with dementia should take into account aspects of personality.

Trait Emotional Intelligence, Anxiety Sensitivity, and Experiential Avoidance in Stress Reactivity and Their Improvement Through Psychological Methods

Stress pervades daily society, often with deleterious consequences for those prone to react intensely to it. Intervention techniques to attenuate stress reactivity are thus paramount. With that goal in mind, researchers have sought to identify and alter malleable psychological dispositional variables that influence stress reactivity. Trait emotional intelligence (TEI), anxiety sensitivity (AS), and experiential avoidance (EA) are increasingly receiving attention in these research efforts. The self-reported emotional component of stress reactivity has been emphasized in investigations and is our focus. Specifically, this paper overviews the role of TEI, AS, and EA in self-reported stress responses. We also discuss empirically supported psychological methods to adjust suboptimal levels of these variables in normal populations. Both psycho-educational (information, skills) and mindfulness-based interventions (specific mindfulness therapies or components) are covered. Findings include that (1) TEI, AS, and EA are each correlated with the emotional component of stress reactivity to both naturalistic and lab-based stressors; (2) preliminary support currently exists for psycho-educational intervention of TEI and AS but is lacking for EA; (3) adequate evidence supports mindfulness-based interventions to target EA, with very limited but encouraging findings suggesting mindfulness methods improve TEI and AS; and (4) although more research is needed, stress management approaches based on mindfulness may well target all three of these psychological variables and thus appear particularly promising. Encouragingly, some methods to modify dispositional variables (e.g., a mindfulness-based format of guided self-help) are easily disseminated and potentially applicable to the general public.

Emotional intelligence in medical education: a critical review

CONTEXT

Emotional intelligence (EI) is a term used to describe people's awareness of, and ability to respond to, emotions in themselves and other people. There is increasing research evidence that doctors' EI influences their ability to deliver safe and compassionate health care, a particularly pertinent issue in the current health care climate.

OBJECTIVES

This review set out to examine the value of EI as a theoretical platform on which to base selection for medicine, communication skills education and professionalism.

METHODS

We conducted a critical review with the aim of answering questions that clinical educators wishing to increase the focus on emotions in their curriculum might ask.

RESULTS

Although EI seems, intuitively, to be a construct that is relevant to educating safe and compassionate doctors, important questions about it remain to be answered. Research to date has not established whether EI is a trait, a learned ability or a combination of the two. Furthermore, there are methodological difficulties associated with measuring EI in a medical arena. If, as has been suggested, EI were to be used to select for medical school, there would be a real risk of including and excluding the wrong people.

CONCLUSIONS

Emotional intelligence-based education may be able to contribute to the teaching of professionalism and communication skills in medicine, but further research is needed before its wholesale adoption in any curriculum can be recommended.