Emotional intelligence in medicine: a systematic review through the context of the ACGME competencies

The mediating role of emotional empathy in the relationship between nursing students' emotional intelligence levels and their self-efficacy in pain management

BACKGROUND

In nursing care emotional intelligence and emotional empathy are important competencies, so determining their roles in pain management self-efficacy has become required for nursing students.

AIM

To determine the mediating role of emotional empathy in the relationship between nursing students' emotional intelligence levels and their pain management self-efficacy.

DESIGN

This is a cross-sectional and correlational study.

SETTINGS

The study was conducted at a nursing department of a state university in Turkey between 15 May-31 June 2024 in the spring semester of the 2023-2024 academic year.

PARTICIPANTS

The study population consisted of 2nd, 3rd, and 4th year nursing students with clinical practice experience (N = 326).

METHODS

Data were collected with personal information form, emotional intelligence trait scale short form, pain management self-efficacy scale, and multidimensional emotional empathy scale. Pearson r correlation, linear regression analysis and PROCESS Macro simple mediation analysis were used for advanced data analyses.

RESULTS

There were statistically significant and moderate positive correlation between emotional intelligence and pain management self-efficacy levels (r = 0.361, p < 0.01), emotional intelligence and emotional empathy levels (r = 0.343, p < 0.01), and pain management self-efficacy and emotional empathy levels (r = 0.358, p < 0.01) of the students. Emotional intelligence and emotional empathy were predictors of pain management self-efficacy (13 % and 12.8 %, respectively). Emotional empathy had a partial mediating role in the relationship between emotional intelligence and pain management self-efficacy (indirect effect = 0.1246, 95 % CI = [0.0667, 0.1987]).

CONCLUSIONS

Emotional intelligence, emotional empathy, and pain management self-efficacy were positively correlated. Emotional intelligence and emotional empathy can be predictors for pain management self-efficacy. Emotional empathy was a partial mediator that enables nursing students' emotional intelligence skills to reflect on their pain management self-efficacy.

A National Study of Emotional Intelligence Among Otolaryngology Residents and Fellows Using the TEIQue-Short Form

OBJECTIVE

Little is known about emotional intelligence (EI) among otolaryngology trainees and its assessment during training. We aim to assess EI levels and identify demographic and training-related factors associated with higher EI.

STUDY DESIGN

Cross-sectional study.

SETTING

Survey of otolaryngology trainees.

METHODS

Residents and fellows completed a national single-response survey from the Governing Council of the Section for Residents and Fellows-in-Training (November 7 to December 31, 2018). The Trait Emotional Intelligence Questionnaire-Short Form provided a global EI score and subscores for well-being, self-control, emotionality, and sociability. Associations between sociodemographic and training factors with higher scores were assessed.

RESULTS

The global EI score was high (5.2 ± 0.6). Fellows had higher global EI scores than residents (5.5 vs 5.23; P = .028). Fellows (6.33 vs 5.83; P = .024), trainees older than 35 years (6.17 vs 5.83; P = .021), and those in humanitarian efforts (P = .012) had higher well-being scores. Trainees older than 35 years had higher self-control scores (5.67 vs 5.17; P = .009). Fellows (5.88 vs 5.50; P = .002) and female trainees (5.62 vs 5.38; P = .001) had higher emotionality scores. Trainees with ≥4 publications had higher sociability scores (5.0 vs 4.83; P = .001).

CONCLUSION

Global EI scores were high in this national sample of otolaryngology trainees. Seniority, age, female gender, research experience, and humanitarian involvement were associated with higher scores in specific dimensions. Future studies should evaluate how training experiences or structured educational programs can enhance the development of EI.

Interactional competencies in medical student admission- what makes a "good medical doctor"?

Doctors' interactional competencies play a crucial role in patient satisfaction, well-being, and compliance. Accordingly, it is in medical schools' interest to select candidates with strong interactional abilities. While Multiple Mini Interviews (MMIs) provide a useful context to assess such abilities, the evaluation of candidate performance during MMIs is not always based on a solid theoretical framework. The newly developed selection procedure "Interactional Competencies - Medical Doctors (IC-MD)" uses an MMI circuit with five simulation patient scenarios and is rated based on the theoretically and empirically grounded construct of emotional availability. A first validation study with N = 70 first-semester medical students took place in 2021. In terms of convergent validity, IC-MD ratings showed strong correlations with simulation patients' satisfaction with the encounter (r =.57) but no association with emotional intelligence measures. IC-MD ratings were not related to high school performance or a cognitive student aptitude test, indicating divergent validity. Inter-rater reliability (ICC = 0.63) and generalizability (Eρ2 = 0.64) were satisfactory. The IC-MD proved to be fair regarding participants' age and gender. Participants with prior work experience in healthcare outperformed those without such experience. Participant acceptance of the procedure were good. The IC-MD is a promising selection procedure capable of assessing interactional competencies relevant to the medical setting. Measures of interactional competencies can complement the use of cognitive selection criteria in medical student admission. The predictive validity of the IC-MD needs to be addressed in future studies.

Beyond technical proficiency: A scoping review of the role of soft skills in medical radiation science

INTRODUCTION

Soft skills, including communication, empathy, and teamwork, are essential in medical radiation science (MRS) for delivering comprehensive patient care. Despite the emphasis on technical skills, integrating soft skills is crucial for improving patient outcomes and fostering a collaborative healthcare environment. This scoping review investigates the role, significance, and teaching strategies of soft skills in MRS practice and education.

METHOD

A scoping review was conducted across Scopus, PubMed, Web of Science, Emcare and CINAHL for studies published from 1st January 2014 to 31st December 2023. Twenty-five studies employing various designs were included. Data extraction was performed double-blindly by four authors and validated by two additional reviewers. The review synthesized findings on soft skills such as communication, empathy, patient care, emotional intelligence, teamwork, and compassion.

RESULTS

Communication was the most frequently reported soft skill, noted in 17 articles, followed by empathy in ten studies. Twelve studies highlighted training strategies, including workshops, video demonstrations, and simulation-based training. These strategies were effective in enhancing soft skills.

CONCLUSION

Soft skills play a crucial role in delivering holistic patient care in MRS. Diverse training approaches can improve medical radiation practitioners' competencies and promote a supportive work environment.

IMPLICATIONS FOR PRACTICE

The review highlights studies that demonstrate good practices and measurable improvements in patient interactions, interdisciplinary collaboration, and overall care quality. These findings may support training institutions that may need to improve their curricula in relation to soft skills integration.

The impact of affective and cognitive empathy on stress in medical students

OBJECTIVE

To analyze the relationship between empathy and its domains (i.e., affective and cognitive) and stress in medical students.

METHODS

An online cross-sectional study with 543 medical students as respondents divided in three groups: pre-clinical cycle (n = 173), clinical cycle (n = 197), and internship (n = 173). The participants completed the sociodemographic questionnaire, the Interpersonal Reactivity Index, and the Perceived stress scale.

RESULTS

The participants were mostly female (71.5%) with an average age of 23.54 (± 4.54) years old. Medical students in the clinical cycle, when compared to the ones in their pre-clinical cycle and internship, showed higher stress levels. Pre-clinical students presented higher levels of total empathy and its affective domain. The highest levels of empathy, especially affective empathy, were associated with higher stress levels in all three groups. Regarding cognitive empathy, there was no observed association with stress among the groups.

CONCLUSIONS

The levels of empathy and its affective domain correlated significantly with the stress indicators among students of different cycles (i.e., pre-clinical, clinical cycle, and internship).

A Practical Guide for Improving and Evaluating the Components of Emotional Intelligence in Healthcare Students

Emotional intelligence (EI) is essential for healthcare professionals as it can improve their overall performance at multiple levels. However, healthcare professionals do not adequately improve their EI during their university education. Therefore, in this perspective article, we present a practical guide for teaching and evaluating the components of EI in healthcare students, and the most common challenges/barriers for implementing EI to healthcare education curricula. The guide includes teaching methods and at least one validated questionnaire to improve and evaluate each of the five components of EI as described by Goleman: self-awareness, self-motivation, self-regulation, empathy, and social skill. In conclusion, this guide could help healthcare educators enhance the EI of their students.

Understanding resident wellness: A path analysis of the clinical learning environment at three institutions

PURPOSE

The clinical learning environment (CLE) affects resident physician well-being. This study assessed how aspects of the learning environment affected the level of resident job stress and burnout.

MATERIALS AND METHODS

Three institutions surveyed residents assessing aspects of the CLE and well-being via anonymous survey in fall of 2020 during COVID. Psychological safety (PS) and perceived organizational support (POS) were used to capture the CLE, and the Mini-Z Scale was used to assess resident job stress and burnout. A total of 2,196 residents received a survey link; 889 responded (40% response rate). Path analysis explored both direct and indirect relationships between PS, POS, resident stress, and resident burnout.

RESULTS

Both POS and PS had significant negative relationships with experiencing a great deal of job stress; the relationship between PS and stress was noticeably stronger than POS and stress (POS: B= -0.12, p=.025; PS: B= -0.37, p<.001). The relationship between stress and residents' level of burnout was also significant (B = 0.38, p<.001). The overall model explained 25% of the variance in resident burnout.

CONCLUSIONS

Organizational support and psychological safety of the learning environment is associated with resident burnout. It is important for educational leaders to recognize and mitigate these factors.

How Preceptor Behaviour Shapes the Future of Medical Professionals

Preceptors play an indispensable role in shaping the future of healthcare. They bridge theoretical learning and practical clinical expertise in a rapidly evolving medical education landscape. Their influence extends beyond knowledge transfer, embodying the values, attitudes, and professionalism essential to competent medical practice. Bandura's Social Learning Theory posits that individuals learn through observation and modelling. Applying this theory supports the assumption that trainees acquire skills and professional norms by observing preceptor behaviour, a process known as vicarious learning. They transmit clinical competencies, ethical standards, and interpersonal skills critical for patient-centred care. Despite their significance, challenges such as increasing workloads, diverse trainee needs, and the complexities of modern healthcare often impede their ability to mentor effectively. Preceptors shape trainees' professional identities and ethical standards, which are significantly influenced by the hidden curriculum, the set of unspoken or implicit lessons conveyed outside the formal curriculum. Globally, there is growing recognition of the need to support and enhance the role of preceptors in medical education. Due to several challenges, some factors might prevent preceptors from maintaining their role model status, including the need for experience, continuous learning, and adaptation to diverse trainee needs. Strategies such as engaging in reflective practices and implementing effective stress management techniques are crucial for preceptors to navigate these barriers and uphold their status. However, few studies have synthesised the various dimensions of preceptor influence, including role modelling, communication skills, and the hidden curriculum. This review aims to fill this gap by exploring the variable role of preceptors in shaping medical trainees' professional development. It highlights the theoretical underpinnings of preceptorship, discusses the challenges preceptors face, and proposes evidence-based strategies to enhance their impact on future healthcare professionals.

Emotional Intelligence as a Component of Surgical Coaching: A Scoping Review

OBJECTIVE

Surgical coaching has become more widespread and involves both technical and nontechnical skills. Emotional Intelligence (EI) is an important nontechnical skill and is associated with leadership skills, increased job satisfaction and superior nontechnical skills. This scoping review aimed to explore the use of EI as a component of surgical coaching.

DESIGN AND SETTING

A scoping review was conducted to map the existing literature. Medline was searched from inception to May 2023. Eligible studies included surgical coaching, which incorporated aspects of emotional intelligence into the non-technical skills component.

RESULTS

3206 studies were identified in the initial search. A total of 2117 articles remained after duplicates were removed. 2117 articles were screened by 2 authors (DA and MR). 32 studies were included in the full-text review, and 8 studies were included in the final analysis. Coaching was predominantly delivered by practicing surgeons, although 1 study used external professional coaches. Training methods for coaches vary widely, from short courses to extensive workshops, highlighting the lack of standardized training protocols within the field. The outcomes measured across studies were diverse, encompassing both technical and non-technical skills, as well as emotional intelligence constructs. Non-technical skills were predominantly assessed using the Non-Technical Skills for Surgeons (NOTSS) assessment tool, whereas other outcomes included burnout, resilience, and technical skills. Notably, none of the studies incorporated formal measurements of emotional intelligence, although aspects such as motivation, empathy, self-knowledge, and social skills were addressed in the coaching sessions.

CONCLUSIONS

Standardization of coaching protocols and incorporation of emotional intelligence principles represent critical avenues for advancing the field and maximizing the benefits of coaching interventions in surgical practice.

The relationship of emotional intelligence to burnout and related factors in healthcare profession students

BACKGROUND

High prevalence of burnout amongst healthcare profession students results in detrimental effects on academic performance, mental health, and quality of life. Emotional intelligence is a trainable skillset demonstrated to protect against burnout, improve psychological well-being, and decrease anxiety and stress, yet it lacks standardized inclusion in many healthcare profession program curricula.

OBJECTIVES

To explore the utility of emotional intelligence as a tool for burnout mitigation, this study aimed to determine the relationship between emotional intelligence and burnout in an interprofessional sample of healthcare profession students and identify related variables.

DESIGN

Cross-sectional survey study.

SETTINGS

Data was collected over 14 weeks in the fall of 2022 via a nationally distributed online survey.

PARTICIPANTS

147 healthcare profession students from the following professional or doctoral programs: Master of Science in Athletic Training (ATC), Doctor of Physical Therapy (DPT), Master of Science in or Doctor of Occupational Therapy (OT/OTD), Master of Science in Speech-Language Pathology (SLP), Doctor of Medicine (MD), Physician Assistant Studies (PA-S), Bachelor of Science in Nursing (RN), or Nurse Practitioner Studies (NP).

METHODS

Participants completed a demographics form (personal/school related variables including prior education and mindfulness habits), the Trait Emotional Intelligence Questionnaire-Short Form (TEIQue-SF), Oldenberg Burnout Inventory-Student (OLBI-S), and RU-SATED sleep health scale.

RESULTS

A large negative correlation was noted between emotional intelligence and burnout (r = -0.591, p < .001). Emotional intelligence and age were significant predictors of burnout. Previous emotional intelligence learning and mindfulness practice also demonstrated significant differences in emotional intelligence.

CONCLUSIONS

These findings suggest that greater emotional intelligence may have a positive impact on burnout and wellbeing in healthcare profession students. Educational interventions aimed to improve emotional intelligence should be explored for inclusion in healthcare profession educational program curricula.

Sustained Impact of an Emotional Intelligence and Resilience Curriculum for Medical Students

Purpose

The purpose of this study was to assess the effectiveness of an educational curriculum focused on Emotional Intelligence (EI) and Resilience among second-year medical students, with emphasis on evaluating the retention of EI skills one year following the curricular intervention.

Methods

Second-year medical students voluntarily participated in an EI-Resilience elective with a curriculum consisting of six sessions aimed at teaching EI and resilience skills. Participants underwent assessment before, immediately after, and one year following the intervention, utilizing the Bar-On Emotional Quotient Inventory 2.0 (EQ-i 2.0). Survey responses were averaged and compared between varying time points.

Results

Thirty students completed the EQ-i 2.0 assessments at three time points: prior to, immediately after, and one-year following the educational intervention. A comparison of mean EI scores pre- and immediate post-intervention showed a significant increase in most components of EI. No significant changes were detected between the immediate post-test and 1-year post-test on any EI components, except for a noteworthy increase in the mean Interpersonal Relationship score. Students demonstrated an average increase in their Interpersonal Relationship skills of 5.7 points (95% CI: 3.0, 8.4, p <0.001) at the one-year post-test compared to the post-test immediately following the intervention. Students reported continued satisfaction and usefulness one-year post-intervention as demonstrated by an internally developed survey. In the one-year post-intervention survey, most students used what they had learned in the elective during their third year (91%, 32/35) and all students found the elective to be applicable during their third year. In free-text responses, students reported improved coping and reflection skills in the third year of medical school following the intervention.

Conclusion

An EI-Resilience curriculum offered as an elective to second-year students continued to be well-received one year following the educational intervention. Data suggests that enhanced EI and resilience skills were sustained over a one-year period following the educational intervention.

Cultivating emotional intelligence in general surgery residents through a patient-centered experience

BACKGROUND

Emotional intelligence (EI) can decrease physician burnout. EI and burnout were assessed in surgical residents through participation in Patient-Centric Resident Conferences (PCRCs), which incorporated patients in resident education. We hypothesized PCRCs would improve EI and reduce burnout.

METHODS

This was a single institution study of General Surgery residents from 2018 to 2019. Residents participated in standard didactic conferences and PCRCs. The Trait Emotional Intelligence Questionnaire-Short Form (TEIQue-SF) survey and an ACGME burnout survey were administered at three time points.

RESULTS

Higher EI scores correlated with lower burnout scores over three survey distributions (R2 0.35, 0.39, and 0.68, respectively). EI and burnout scores did not change significantly over time. EI and burnout were not associated with conference attendance, meaning in work, or satisfaction with teaching.

CONCLUSIONS

General Surgery resident EI and burnout scores were inversely correlated. Previously, PCRCs were shown to be associated with increased resident meaning in work. The current study demonstrates PCRCs did not have a significant impact on measures of resident EI or burnout. Further research is needed for EI and burnout in surgery.

Intelligent play: How improv can improve clinician's emotional intelligence

BACKGROUND

Emotional intelligence (EI) of physicians significantly impacts their personal well-being and professional success with broad implications in health care. A focused training on EI is often lacking in medical curricula. We sought to understand the impact of improvisation training on clinicians' EI.

APPROACH

Four online medical improv workshops were offered to a diverse group of physicians with varied levels of practice experience including medicine-paediatric residents, paediatric educators, practising paediatricians and internal/family medicine clinicians. The improv training was thoughtfully curated and remained consistent for all four cohorts, lasting 2 h. Self-reported EI scales (pre and post) were captured using an online survey tool. The overall EI score and the scores of three EI components were compared before and after training.

EVALUATION

Out of 64 participants, 41 participants (64%) completed both the pre- and post-surveys and were included in the final analysis. Participant's pre-training score (mean:123.9, range: 121.1-126.7) was compared to their post-training score (mean:128.9, range: 126.3-131.3). The t tests comparing EI scores showed that compared to pre-intervention, participants on average scored 4.9 points higher (95% CI: 3.1-6.7; p < 0.01) on the overall scale, 2.2 points higher (95% CI: 1.2-3.2; p < 0.01) on the appraisal score, 1.4 points higher (95% CI: 0.8-2.0; p < 0.01) on the regulation score and 1.2 points higher (95% CI: 0.4-2.1; p = 0.01) on the utilisation score.

IMPLICATIONS

Improv training is an innovative method to fill the crucial gap in EI curricula. There was a statistically significant improvement in average score for clinicians' EI after a pilot improv training programme.

Professional psychological qualities of Chinese medical students: theoretical models, questionnaire development, and relationship with mental health

Introduction

Professional psychological qualities are crucial for individuals' career development and overall well-being, especially in clinical medical professions. Medical students often face significant work, academic, and doctor-patient communication pressures, which can challenge their mental and emotional health. Measuring and understanding the relationship between medical students' professional psychological qualities and their mental health is of significant practical importance.

Methods

This study developed a comprehensive professional psychological qualities scale through a series of qualitative and quantitative studies, consisting of three main components and thirteen secondary dimensions. The scale's reliability was assessed using Cronbach's α coefficients. In Study 2, the scale was administered to 972 medical students to explore their anxiety and depression levels. A simple mediation analysis was conducted to investigate the relationship between professional psychological qualities, anxiety, and depression.

Results

The professional psychological qualities scale demonstrated satisfactory reliability, with a total scale α coefficient of 0.947 and subscale α coefficients ranging from 0.895 to 0.933. The mediation analysis revealed that medical students' professional psychological qualities directly negatively impact depression levels and indirectly positively influence them via their effects on anxiety levels, exhibiting an overall masking effect unrelated to depression levels.

Discussion

This study addresses the gap in research on the professional psychological qualities of medical students by providing a reliable measurement tool. The findings shed light on the complex mechanisms through which these qualities impact the mental health process. The scale can be used by other researchers to assess medical students' professional psychological qualities and further investigate their relationship with mental health outcomes.

All You Need Is Music: Supporting Medical Students' Emotional Development With a Music-Based Pedagogy

PROBLEM

Although the practice of medicine is often emotionally challenging, medical curricula seldom systematically address the emotional development of medical students. To fill this gap, the authors developed and evaluated an innovative pedagogical activity based on music to nurture medical students' emotional development. The authors believe that the metaphoric nature of music offers an efficient venue for exploring emotion perception, expression, and regulation.

APPROACH

The pedagogical activity Emotions in Medicine was carried out throughout 2020 and 2021 and consisted of 4 encounters to explore: (1) emotion perception, (2) emotion expression, (3) emotion regulation, and (4) the role of emotions in medical practice. During all encounters, the authors used music to evoke students' emotions and focused the discussions on the relevance of emotions for meaningful medical practice. Emotional intelligence before and after the workshop was tested using the Schutte Self-Report Emotional Intelligence Test (SSEIT), a validated psychometric scale.

OUTCOMES

The workshop facilitated emotional connection among students and created a safe space to explore the role of emotions in medical practice. The mean total pretest SSEIT score was 110 (SD = 14.2); it increased to 116.8 (SD = 16.1) in the posttest ( P < .001). This increase was true across its 4 dimensions: (1) perception of emotions, (2) management of own emotions (3) management of others' emotions, and (4) use of emotions.

NEXT STEPS

Music can be an active tool to explore the role of emotions in medical practice. It fosters students' capacity to identify and reflect on emotions while exploring their role in patient care. Further (qualitative) research is needed to explore the mechanisms by which music facilitates learning emotion perception, expression, and regulation.

Higher degree of impostor characteristics relates to lower self-perceived teaching ability and emotional intelligence

BACKGROUND

Emotional intelligence (EI) has been previously associated with teaching ability and impostor phenomenon (IP) in medical education; however, studies have demonstrated mixed findings and have largely focused on trainees only. Therefore, we sought to explore the potential association between the degree of IP characteristics, EI and teaching ability in obstetrics and gynaecology (Ob/Gyn) faculty physicians.

METHODS

A cross-sectional, survey-based pilot study was completed at a single academic institution. Ob/Gyn attending (faculty) physicians were queried using surveys related to IP, EI and teaching ability. Resident (trainee) physicians also completed anonymous evaluations of faculty teaching ability.

FINDINGS

The degree of IP characteristics correlated negatively with self-perceived teaching ability, with no significant differences in resident assessment of faculty teaching. IP also correlated negatively with EI. Although there were no statistically significant differences in resident assessment of teaching ability based on EI, both EI and IP demonstrated inverse relationships to faculty assessment of teaching ability compared with resident assessment.

CONCLUSION

IP appears to relate to lower perceived teaching ability in Ob/Gyn faculty that does not correspond to resident evaluation of teaching performance. The demonstrated negative correlation between the degree of impostor characteristics and EI suggests that EI could potentially play a protective role in the development of IP and burnout, as well as influence teaching. This relationship may have implications for faculty willingness to continue in academic medicine.

How clinical decision tasks modulate emotional related EEG responses in nursing students

Healthcare professionals play a vital role in conveying sensitive information as patients undergo stressful, demanding situations. However, the underlying neurocognitive dynamics in routine clinical tasks remain underexplored, creating gaps in healthcare research and social cognition models. Here, we examined whether the type of clinical task may differentially affect the emotional processing of nursing students in response to the emotional reactions of patients. In a within-subjects design, 40 nursing students read clinical cases prompting them to make procedural decisions or to respond to a patient with a proper communicative decision. Afterward, participants read sentences about patients' emotional states; some semantically consistent and others inconsistent along with filler sentences. EEG recordings toward critical words (emotional stimuli) were used to capture ERP indices of emotional salience (EPN), attentional engagement (LPP) and semantic integration (N400). Results showed that the procedural decision task elicited larger EPN amplitudes, reflecting pre-attentive categorization of emotional stimuli. The communicative decision task elicited larger LPP components associated with later elaborative processing. Additionally, the classical N400 effect elicited by semantically inconsistent sentences was found. The psychophysiological measures were tied by self-report measures indexing the difficulty of the task. These results suggest that the requirements of clinical tasks modulate emotional-related EEG responses.

'Insight' in medical training: what, why, and how?

The term 'insight' is generically defined in English language as the ability to perceive deeper truths about people and situations. In clinical practice, patient insight is known to have important implications in treatment compliance and clinical outcomes, and can be assessed clinically by looking for the presence of illness awareness, correct attribution of symptoms to underlying condition, and acceptance of treatment. In this article, we suggest that cultivating insight is actually a highly important, yet often overlooked, component of medical training, which may explain why some consistently learn well, communicate effectively, and quickly attain clinical competency, while others struggle throughout their clinical training and may even be difficult to remediate. We herein define 'insight' in the context of medical training as having an astute perception of personal cognitive processes, motivations, emotions, and ability (strengths, weaknesses, and limitations) that should drive self-improvement and effective behavioural regulation. We then describe the utility of cultivating 'insight' in medical training through three lenses of (i) promoting self-regulated, lifelong clinical learning, (ii) improving clinical competencies and person-centred care, and (iii) enhancing physician mental health and well-being. In addition, we review educational pedagogies that are helpful to create a medical eco-system that promotes the cultivation of insight among its trainees and practitioners. Finally, we highlight several tell-tale signs of poor insight and discuss psychological and non-psychological interventions that may help those severely lacking in insight to become more amenable to change and remediation.

The mediating role of work-related perceptions in the relationship between empathy and self-perceived clinical performance of residents in China: A multi-center cross-sectional study

OBJECTIVE

This study aimed to describe the association between empathy and residents' clinical performance and investigate whether work-related perception mediates this relationship.

METHODS

A multi-center cross-sectional study was conducted, including 1160 residents from 10 cities in Liaoning Province between March and October 2020. The participants completed various self-reported questionnaires regarding demographic characteristics, work-related perceptions, self-perceived clinical performance, and empathy. The relationships among empathy, work-related perception, and self-perceived clinical performance were examined using a structural equation model (SEM).

RESULTS

Of the 1160 residents, 961 (82.8 %) completed the questionnaires. The SEM path analysis showed that the direct effect of empathy on self-perceived clinical performance was significant and positive (β = 0.34, P < 0.001). There existed significant effects of empathy on work-related perception (β = 0.26, P < 0.001) and work-related perception on performance (β = 0.31, P < 0.001). The path coefficients of empathy concerning self-perceived clinical performance decreased significantly (β = 0.26, P < 0.001) when work-related perception was modeled as a mediator. The bias-corrected and accelerated bootstrap test revealed that work-related perception significantly mediated the relationship between empathy and self-perceived clinical performance (a*b = 0.08, BCa 95 % CI: 0.05-0.13). However, the correlation between the sub-scales of empathy and the items of self-perceived clinical performance was not substantial, even if most of them were statistically significant. The final SEM produced a good fit to the sample data, with CMIN/DF = 2.07 (P < 0.001), CFI = 0.99, GFI = 0.99, AGFI = 0.98, TLI = 0.98, NFI = 0.97, RMSEA (90 % CI) = 0.033 (0.017, 0.049), and SRMR = 0.024.

CONCLUSION

Empathy might significantly affect self-perceived clinical performance both directly and indirectly through the mediating role of work-related perception.

PRACTICE IMPLICATIONS

Efforts to improve clinical performance among residents might benefit from interventions for cultivating empathy and practices for improving work-related perceptions of residents.

A systematic review of the adolescent-directed marketing strategies of transnational fast food companies in low- and middle-income countries

Introduction

Fast food consumption is associated with excessive intake of energy-dense foods; a major determinant of childhood obesity. The lack of data on the marketing strategies used to promote fast food to adolescents in low and middle-income countries (LMICs) acts as a barrier to global efforts to reduce the marketing of unhealthy foods to young people around the world.

Objectives

This systematic review aimed to identify the adolescent-directed marketing strategies of transnational fast food corporations in LMICs.

Methods

A systematic search of eight scientific databases (PubMed, CINAHL, Medline, Embase, ProQuest, PsycInfo, Scopus and Google Scholar) was conducted. Following PRISMA guidelines, primary research articles written in English were included if they were published between 1 January 2010 and 30 December 2022, and reported any adolescent-directed marketing activity undertaken by a transnational fast food company operating in a LMIC. Articles were excluded if they were not peer reviewed. The quality of the included articles was assessed using a condensed version of the Consolidated Criteria for Reporting Qualitative Research tool.

Results

Twelve articles met the eligibility criteria and were included in this review. A narrative synthesis of these articles revealed that the most documented strategies used to promote fast food to adolescents in LMICs were the use of incentives or premium offers, product appeals, promotional characters and brand familiarity. These strategies were mostly observed on social media, suggesting that there are serious concerns about adolescent exposure to fast food via social media in developing settings, especially as contextual differences in the nature of such marketing were identified.

Discussion

The promotion of fast food to adolescents in LMICs is contextual in nature, with the nature of marketing strategies employed by transnational fast food corporations varying greatly across cultural and socio-economic contexts. These findings are crucial for the development of guidelines and regulations restricting the marketing of fast food to adolescents in lower income settings, contributing to global efforts to reduce adolescent exposure to unhealthy food promotion.

Breast Cancer Survivors' Experiences of Managers' Actions During the Return to Work Process: A Scoping Review of Qualitative Studies

PURPOSE

Managers' actions can facilitate the return to work (RTW) process for breast cancer survivors (BCS). However, data on BCS' experiences of managers' actions regarding RTW are dispersed across multiple qualitative studies and do not offer useful insights for managers to support employees returning to work. This study aimed to summarize and map managers' actions experienced by BCS over three RTW phases (before, during, after) and categorize them as facilitating or hindering RTW.

METHODS

A scoping review of qualitative studies was conducted. Four databases (MEDLINE, PsycINFO, Cochrane Library, EMBASE) were systematically searched for articles published between 2000 and 2022. Studies and participant characteristics were extracted using an excel spreadsheet. A thematic analysis with a predominantly deductive and semantic approach was conducted.

RESULTS

Twenty-nine studies were included after screening 1042 records. Five themes were generated from the data. Two themes addressed the phase 'before RTW': 'managers' interpersonal skills' and 'preparing for RTW'; three in the 'during RTW' phase: 'managers' interpersonal skills', 'offering work flexibility', and 'offering work accommodations', and only one, 'paying attention to follow-up', was addressed in the 'after RTW' phase.

CONCLUSION

This review mapped managers' actions experienced by BCS in three phases of the RTW process. Results suggested that, according to BCS, managers need to mobilize specific skills to provide appropriate support during the RTW process. Further research is needed to better understand the skills underlying managers' actions facilitating the RTW process.

Emotional Intelligence and Resilience "PROGRAM" Improves Wellbeing and Stress Management Skills in Preclinical Medical Students

Purpose

The purpose of this study was to determine if implementation of a new educational curriculum focusing on Emotional Intelligence (EI) and Resilience improved second year medical student scores in these areas.

Methods

Our EI-Resilience curriculum was offered as an elective for second year medical students to voluntarily enroll in. The elective consisted of six 2-hour sessions taught by a single faculty member over eight months. Sessions focused on development of EI skills and teaching a Resilience "PROGRAM" (Positive thinking, Reframing, Optimism, Gratitude, Reflection, Altruism, Meaning). Participants' EI levels were assessed before and after the elective using the Bar-On Emotional Quotient Inventory 2.0 (EQ-i 2.0).

Results

Over a period of 2 years, 70 students participated in the elective. The overall mean EI score significantly improved after the educational elective (100.05 ± 12.94 versus 108.14 ±12.36, p < 0.001). Compared to the baseline scores, there was significant improvement in all EI components, including all five composite scales, all fifteen content subscales, and the well-being score (all p < 0.05). In a post-intervention survey assessing student perception of the elective, most students found the elective to be helpful (95%, 64/67), most students felt the elective should continue to be available for future students (95%, 64/67), and most would recommend the elective to other students (93%, 62/67).

Conclusion

An EI-Resilience curriculum offered as an elective to second year medical students was well received by students. Our outcomes showed significant improvement in students' EI scores and all sub-scores, including all components of the stress management composite and well-being score. Teaching EI skills and Resilience strategies in the preclinical setting might be an opportune time for this type of educational intervention.

Relationship Between Emotional Intelligence and Academic Performance Among Medical Students at University of Tabuk (2021)

BACKGROUND

There is a strong association between emotional intelligence (EI) and academic performance in medical students.

OBJECTIVE

This study aimed to explore the ‏ relationship between EI and academic performance among medical students at Tabuk University.

METHODS

This cross-sectional study was conducted among medical students in clinical years in the Faculty of Medicine, Tabuk University, Tabuk City, Kingdom of Saudi Arabia (KSA). Each study participant received a self-administered questionnaire composed of two parts: demographic data and the Schutte Self Report Emotional Intelligence Test (SSEIT).

RESULTS

The present study included 203 of the clinical-phase medical students. The academic achievement level was not associated with the students' gender (p = 0.194) or academic level (p = 0.278). Female students had a significantly higher total SSEIT score than male students (p < 0.001). The sixth-year students had a significantly higher perception of emotion than the fourth-year students (p = 0.029). Students with excellent academic achievement had higher mean scores for managing others' emotions (p = 0.004) and utilization of emotion compared to those with fair and very good levels (p = 0.042).

CONCLUSIONS

Some components of EI correlate with academic performance, gender, and academic level. Further research should be launched to assess the correlation between EI and academic performance among all medical students in all regions of KSA. Students can benefit by attending workshops and courses in universities to develop the students' EI because of its impact on their academic performance.

Outcomes of Emotional Intelligence Training for Surgeons in a Real-World Setting: a Mixed Methods Study

OBJECTIVE

The objective was to assess, improve and re-assess Emotional Intelligence (EI) in a group of junior and senior surgeons in a real-world setting.

DESIGN

This was a mixed methods study. An EI education program was delivered through a series of webinars. The program drew from the central concepts of emotional intelligence: Motivation, empathy, social skills, self-knowledge, and self-control. There was also a component of professional development. EI assessment was performed pre- and post-intervention using the Mayer-Salovey-Caruso Emotional Intelligence Test (MSCEIT) and a series of targeted questions. Qualitative assessment was performed by means of structured interviews examining uptake in techniques, understanding of EI, and its effect on personal and professional life.

SETTING

The Australia and New Zealand Training Board in Colorectal Surgery administers a 2-year bi-national training program in teaching hospitals in Australia and New Zealand and runs a series of educational webinars throughout the training program. The "EI series" was part of this educational program.

PARTICIPANTS

Webinars were attended by 35 junior surgeons and 8 senior surgeons RESULTS: Self-perceived knowledge and use of EI increased from a mean of 3.6 to 6.5 (p<0.0001). There was a significant difference between experiential (94) and strategic (101) scores (p=0.005). There was a nonsignificant improvement (98.04-100.6, p=0.16), in the pre-post MSCEIT among the junior surgeons and no change for senior surgeons. Seventy-eight percent (25/32) of surgeons interviewed reported using any new EI strategies. Seventy-five percent actively stopped and considered what other people in a clinical scenario may be thinking; 78% commenced metacognition; 81% practiced the process of self-regulation; 66% had begun to recognise and use emotions as data; and, 47% had actively practiced the process of self-distancing CONCLUSION: This study demonstrated the feasibility and utility of delivering EI training in an online format to a group of time-poor surgeons in a real-world setting.

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.

Using an Educational Intervention to Map our Surgical Teams' Function, Emotional Intelligence, Communication and Conflict Styles

OBJECTIVE

The leadership team invited surgical team members to participate in educational sessions that created self and other awareness as well as gathered baseline information about these topics: communication, conflict management, emotional intelligence, and teamwork.

DESIGN

Each educational session included an inventory that was completed to help participants understand their own characteristics and the characteristics of their team members. The results from these inventories were aggregated, relationships were identified, and the intervention was evaluated.

SETTING

A level 1 trauma center, Baylor Scott and White Health, in central Texas; a 636-bed tertiary care main hospital and an affiliated children's hospital.

PARTICIPANTS

An open invitation for all surgical team members yielded 551 interprofessional OR team members including anesthesia, attending physicians, nursing, physician assistants, residents, and administration.

RESULTS

Surgeons' communication styles were individual focused, while other team members were group focused. The most common conflict management mode for surgical team members on average was avoiding, and the least common was collaborating. Surgeons primarily used competing mode for conflict management, with avoiding coming in a close second. Finally, the 5 dysfunctions of a team inventory revealed low accountability scores, meaning the participants struggled with holding team members accountable.

CONCLUSIONS

Helping team members understand their own and others' strengths and blind spots will help create opportunity for more purposeful and clear communication. Additionally, this knowledge should improve efficiency and safety in the high-stakes environment of the operating room.

Emotional intelligence among medical students in Sweden - a questionnaire study

BACKGROUND

Emotional intelligence (EI), the ability to understand and regulate one's and other's emotions, has been linked to academic and clinical performance and stress management, making it an essential skill to develop during medical school. Nevertheless, uncertainty remains about the impact of medical education on EI, its association with sociodemographic factors, and the potential moderating role of gender. Therefore, this study aimed to explore levels of global EI among Swedish medical students based on their completed semesters while analyzing the potential moderator role of gender and identifying potential EI differences associated with age, gender, prior education, work experience, and previous experience working in a leadership position.

METHODS

The participants were medical students in semesters 1, 3, 5, 7, 9, and 11 at a Swedish University. Participants answered the self-report Trait Emotional Intelligence Questionnaire - Short Form (TEIQue-SF) and demographic questions. For each participant, the mean global trait EI was calculated (range 1-7), and differences were compared based on semesters and sociodemographic factors. In addition, we investigated the relationship between semester and EI scores with gender as a moderator.

RESULTS

Of the 663 invited medical students, 429 (65%) responded, including 269 women (62.7%), 157 men (36.6%), and 3 identifying as others (0.7%). The participants had a mean global trait EI score of 5.33. Final-year students demonstrated significantly higher global trait EI scores than first-year students, and gender did not have a moderating effect across semesters. Furthermore, students in the age group 25-29 years showed higher EI scores compared to those in the age group 21-24 years, while there were no significant differences in EI scores for older students (≥ 30 years) compared to other age groups. Higher EI scores were also positively associated with previous work-and leadership experiences. Gender and previous education did not significantly impact EI scores.

CONCLUSIONS

Our findings suggest that higher EI scores are associated with semesters of medical education, age, and previous work and leadership experience. Future longitudinal studies are needed to identify factors that could improve EI among medical students to design curricular activities aimed at supporting the EI of the next generation of physicians.

Emotional intelligence weakly predicts academic success in medical programs: a multilevel meta-analysis and systematic review

BACKGROUND

Emotional intelligence (EI) is a predictive factor of academic success in undergraduate Doctor of Medicine (MD) programs. Although some research suggests a positive association between EI and academic success in MD programs, other research reports neither an association nor a negative correlation between the two variables. The current study aimed to resolve these contradictory findings by conducting a systematic review and a meta-analysis using research from 2005 to 2022.

METHODS

Data were analyzed using a multilevel modeling approach to (a) estimate the overall relationship between EI and academic success in MD programs and (b) determine whether the mean effect size varies according to country (United States vs. non-United States countries), age, EI test, EI task nature (ability-based vs. trait-based), EI subscales, and academic performance criteria (grade point average vs. examinations).

RESULTS

Findings from 20 studies (m = 105; N = 4,227) indicated a positive correlation between EI and academic success (r = .13, 95% CI [.08, - .27], p < .01). Moderator analyses indicated that the mean effect size significantly varied according to EI tests and EI subscales. Moreover, three-level multiple regression analyses showed that between-study variance explained 29.5% of the variability in the mean effect size, whereas within-study variance explained 33.5% of the variability in the mean effect.

CONCLUSIONS

Overall, the current findings show that EI is significantly, albeit weakly, related to academic success in MD programs. Medical researchers and practitioners can therefore focus on integrating EI-related skills into the MD curriculum or target them through professional development training and programs.

The USMLE® STEP 1 Pass or Fail Era of the Vascular Surgery Residency Application Process: Implications for Structural Bias and Recommendations

MOTIVES BEHIND THE SHIFT

USMLE® STEP 1 score reporting has been changed to a binary pass/fail format since January 26, 2022. The motives behind this change were (1) the questionable validity of using USMLE® STEP 1 as a screening tool during the candidate selection process and (2) the negative impact of using standardized examination scores as an initial gatekeeping threshold for the underrepresented in medicine (URiM) candidates applying to GME programs, given their generally lower mean standardized exams scores compared to non-URiM students. The USMLE® administrators justified this change as a tactic to enhance the overall educational experience for all students and to increase the representation of URiM groups. Moreover, they advised the program directors (PDs) to give more attention to other important qualities and components such as the applicant's personality traits, leadership roles and other extracurricular accomplishments, as part of a holistic evaluation strategy. IMPACT OF USMLE® STEP 1 PASS/FAIL: At this early stage, it is unclear how this change will impact Vascular Surgery Integrated residency (VSIR) programs. Several questions are outstanding, most importantly, how VSIR PDs will evaluate applicants absent the variable which heretofore was the primary screening tool. Our previously published survey showed that VSIR PDs will move their attention to other measures such as USMLE® STEP 2CK and letters of recommendation during the VSIR selection process. Furthermore, more emphasis on subjective measures such as the applicant's medical school rank and extracurricular student activities is expected. Given the expected higher weight of USMLE® STEP 2CK in the selection process than ever, many anticipate that medical students will dedicate more of their limited time to its preparation at the expense of both clinical and non-clinical activities. Potentially leaving less time to explore specialty pathways and to determine whether VS is the appropriate career for them.

A FRAMEWORK FOR CANDIDATE EVALUATION

The critical juncture in the VSIR candidate evaluation paradigm presents an opportunity to thoughtfully transform the process via current (Standardized Letter of Recommendation, USMLE® STEP 2CK, and clinical research) and future (Emotional Intelligence, Structure Interview and Personality Assessment) measures which constitute a framework to follow in the USMLE® STEP 1 pass/fail era.

Personal Growth and Emotional Intelligence: Foundational Skills for the Leader

Emotional intelligence (EI) has gained popularity and is being seen as a necessity, spreading beyond the business world, and becoming universal. In that shift, medicine and medical education have started to see the importance. This is evident in mandatory curriculum and accreditation requirements. EI includes 4 primary domains with several subcompetencies under each domain. This article outlines several of the subcompetencies necessary for success as a physician, competencies that can be honed with targeted professional growth. Empathy, communication, conflict management, burnout, and leadership are discussed in an application way to help identify importance of and how to improve each.

Emotion recognition support system: Where physicians and psychiatrists meet linguists and data engineers

An important factor in the course of daily medical diagnosis and treatment is understanding patients’ emotional states by the caregiver physicians. However, patients usually avoid speaking out their emotions when expressing their somatic symptoms and complaints to their non-psychiatrist doctor. On the other hand, clinicians usually lack the required expertise (or time) and have a deficit in mining various verbal and non-verbal emotional signals of the patients. As a result, in many cases, there is an emotion recognition barrier between the clinician and the patients making all patients seem the same except for their different somatic symptoms. In particular, we aim to identify and combine three major disciplines (psychology, linguistics, and data science) approaches for detecting emotions from verbal communication and propose an integrated solution for emotion recognition support. Such a platform may give emotional guides and indices to the clinician based on verbal communication at the consultation time.

The Physician Leader: Teaching Leadership in Medicine

An integral part of a physician's practice includes being a leader, especially as there is a strong need for skilled leaders to advocate and navigate patient-centered and organizational outcomes. Nephrologists undertake multiple leadership roles, but dedicated leadership training is lacking in medical and postgraduate education. Given the growing need for physician leaders, practitioners in nephrology and beyond must become better equipped in understanding the role of leadership skills in medical practice. Nephrology and the medical community as a whole should focus on intentional and dedicated leadership in medical education training to better groom physicians for leadership roles. In this paper, we define and discuss the components and styles of leadership. We further propose cognitive models that allow one to apply leadership theory in common practice.

Perception of educational environment with an assessment of motivational learning strategies and emotional intelligence as factors affecting medical students' academic achievement

BACKGROUND

This study aimed to investigate how medical students perceive their educational environment, as well as the implications of motivation, learning strategies, and the factor of emotional intelligence on academic achievement.

MATERIALS AND METHODS

In a cross-sectional study, 3384 undergraduate students were recruited from randomly selected Egyptian medical colleges. Students from second to final year, taking fundamental and clinical courses and, at a minimum, three professional exams, were enrolled and subjected to the Dundee Ready Educational Environment Measure scale, the Motivated Strategies for Learning Questionnaire, and Emotional intelligence questionnaire.

RESULTS

The overall mean age of the studied students was 21.42 ± 1.61 years. Females represented 63.5%, rural residents were 52.2% and students with enough income represented 88.0%. The traditional system adopted 28.4% of the students versus 71.6% in the integrated system. Linear regression using path analysis was conducted to study the predictors of academic achievement, and it revealed that motivation was the highly significant predictor of academic achievement (β = 2.68, CI95%:2.35-3.05, P < 0.001), followed by learning (β = 1.09, CI95%:0.80-1.41, P < 0.001), emotional intelligence (β = 0.92, CI95%:0.87-0.97, P < 0.001), and the educational environment (β = 0.14, CI95%:0.13-0.15, P < 0.001).

CONCLUSION

The study's findings have implications for medical educators trying to understand the personal factors that influence learning and performance in medical school. Students' motivation was the highly significant predictor of academic achievement followed by learning, emotional intelligence, and educational environment. Perception of the learning environment had improved because of the integrated student-centered system, which fosters motivation and emotional intelligence. To improve learners' EI, optimal learning, and educational outcomes, the EI components can be taught and fostered.

Training in communication and emotion handling skills for students attending medical school: Relationship with empathy, emotional intelligence, and attachment style

OBJECTIVE

To describe the Emoty-Com training, its impact on medical students' attitudes towards doctors' emotions and to explore the association between students' empathy, emotional intelligence (EI), and attachment style (AS) with post-training performance scores.

METHODS

The 16-hour Emoty-Com training was delivered to all second-year medical students of Verona and Milan (Italy) Universities. At pre-training, students filled out three questionnaires assessing empathy, AS and EI and responded to three questions on attitudes towards doctors' emotions in the doctor-patient encounter. The same three questions and a final evaluation test were proposed at post-training.

RESULTS

264 students participated in the study. The training reduced students' worry about managing emotions during doctor-patient relationships. Gender was associated with specific subscales of empathy, EI, and AS. Final performance scores were associated with students' attitudes towards emotions but not with empathy, EI, and AS.

CONCLUSION

The Emoty-Com training increased students' self-efficacy in handling their own emotions during consultations. Students' performance scores were related to their attitude towards doctors' emotions in clinical encounters.

PRACTICE IMPLICATIONS

The Emoty-Com training suggests ways to teach and evaluate emotion-handling skills for medical students. Possible links between empathy, EI, AS, and the attitudes towards doctors' emotions during the years of education are highlighted.

Emotional intelligence as a mediator between attachment security and empathy in pre-clinical medical students: A multi-center cross-sectional study

OBJECTIVE

To explore the association of emotional intelligence (EI) and attachment security (AS) with empathy dimensions in medical students by examining the mediating role of EI.

METHODS

In a cross-sectional design, the Interpersonal Reactivity Index (IRI), the Emotional Quotient Inventory (EQ-i), the Attachment Style Questionnaire (ASQ), and demographic questions were administrated to second-year medical students of two medical schools in Northern Italy.

RESULTS

253 medical students (56.13% female), aged 19-29, participated in this study. AS positively correlated to Empathic Concern (r = 0.17, p = 0.008) and Perspective Taking (r = 0.24, p < 0.001), and negatively to Personal Distress (r = -0.33, p < 0.001). Individuals with the same level of AS and a higher score on EQ-i had a higher score (β = 0.072, p = 0.033) on empathy latent factor (at the basis of Empathic Concern and Perspective Taking) and a lower score (β = -0.290, p < 0.001) on Personal Distress than those with a lower EQ-i score.

CONCLUSION

This study shows that EI completely mediated the relationship between AS and empathy dimensions among medical students.

PRACTICE IMPLICATIONS

EI training and workshop should be considered when designing educational interventions and programs to enhance empathy and decrease interpersonal distress in medical students.

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.

Exploring the effective elements on the personal and professional development among health-care providers: A qualitative study

BACKGROUND

A new domain of "personal and professional development" was introduced as a core competency of health-care providers. This study aimed to explore the experiences of learners and faculty members about what competencies or skills were essential for the professional development and success of health-care providers.

MATERIALS AND METHODS

This is a qualitative study using an inductive content analysis approach in 2019-2020. In the present study, 58 academic faculty members participated by purposeful sampling including ten associate professors (17.24%) and 24 assistance professors (41.37%), in addition to 23-year medical residents (20.65%) and 4^th-year nursing students (20.65%). Individual and group interviews were conducted. Data were analyzed by the inductive content analysis approach introduced by Graneheim and Lundman.

RESULTS

The qualitative data were classified in 953 open codes and eight categories, which were further divided into four main categories: "socio-emotional skills," "life-long learning skills," "coping skills," and "well-being strategies."

CONCLUSIONS

The present results showed socioemotional and coping skills affect interpersonal and professional interactions that contributed to their improved health-care providers' capabilities. Participants also considered lifelong learning as influential in developing professional capabilities and keeping their knowledge and skills up-to-date for accountability to duties. Moreover, using well-being strategies protects the mental and physical health of health-care providers. These skills are synergistic, and their combination can have a significant role in improving the personal and professional capabilities.

The relationship between emotional intelligence, transformational leadership, and performance: a test of the mediating role of job satisfaction

Purpose

This paper examines the effect of job satisfaction on job performance among physicians in Iraq's public hospitals. It also determines the mediating role of job satisfaction on the relationship between emotional intelligence and job performance. It further unveils the mediating role of job satisfaction on the nexus between transformational leadership and job performance. As physicians form the bulk of health-care professionals, their performance at work is crucial in determining patient satisfaction regarding care quality.

Design/methodology/approach

A quantitative approach with structural equation modelling via partial least squares (PLS-SEM) and bootstrapping estimation was used to test the hypotheses developed. A total of 157 responses were utilized in the data analysis.

Findings

Evidence from the study indicates that job satisfaction has a positive relationship with job performance. The study also provides evidence that job satisfaction plays a positive mediating role in the relationship between emotional intelligence and job performance. Similarly, job satisfaction has a positive mediating effect on the nexus between transformational leadership and job performance among physicians in Iraq's public hospitals.

Originality/value

To the best of the authors' knowledge, this is the first study to investigate the relationship between physician job satisfaction and job performance in Iraqi public hospitals. Studies using Eastern samples are scarce, so the findings of this study will add to the body of knowledge from a cross-cultural standpoint.

The effect of transactional analysis training on emotional intelligence in health professions students

BACKGROUND

Emotional intelligence (EI) is considered to present a significant predictor of work performance whereas Transactional analysis (TA) is the relational perspective in communication in managing emotions. We evaluated the effect of psycho-educational training in EI and TA (TEITA) on EI among health professions undergraduates, with post-training, and at 1-month follow-up.

METHODS

A total of 34 participants participated in the study where 17 participants were in the TEITA group and another 17 were in the control group. A quasi-experimental non-randomised, controlled cohort study was conducted, in which participants in the TEITA group were introduced to EI and TA concepts on a weekly basis for four weeks, at 90 min each time, and provided with opportunities for experiential sharing of emotions and coping mechanisms experienced in the previous week. Both TEITA and control groups received weekly EI and TA reading materials. All completed the 16-item Wong and Law EI Scale at baseline and post-training. The training group also completed the questionnaire at a 1-month follow-up. Wilcoxon Signed Ranks and Mann Whitney tests were used to analyse within a group and between group changes in EI scores.

RESULTS

Baseline EI scores in the TEITA group were lower than the control group. On completion of TEITA, EI scores in the TEITA group increased, and differences were not detected between groups. Within the TEITA group, paired increases in all domains were statistically significant, whereas, in the control group, the paired increase was only detected in the domain addressing regulations of emotion (ROE). Pre to post-training increases in EI scores were statically significantly greater in TEITA compared to control groups. At the 1-month follow-up, EI scores were sustained.

CONCLUSION

The psycho-educational training based on EI and TA is effective in enhancing EI among health professions undergraduates. Future research should investigate the effect of such training on observable inter-personal and socio-economic behaviours.

Promoting a sense of belonging, engagement, and collegiality to reduce burnout: a mixed methods study among undergraduate medical students in a non-Western, Asian context

BACKGROUND

Burnout is a psychological condition induced by work-related chronic interpersonal stressors. Interventions creating a sense of belonging and collegiality have been proposed as approaches for alleviating burnout. The current study aimed to: (1) explore the relationships between burnout, sense of belonging (relatedness with others), and work engagement; and (2) identify the key elements perceived by undergraduate medical students as positively contributing to collegiality, engagement, and a sense of belonging, in an undergraduate medical training setting.

METHODS

An exploratory sequential mixed-methods design using questionnaires and semi-structured individual interviews collected quantitative and qualitative data among undergraduate medical students at Mahidol University, Thailand. The Maslach Burnout Inventory-Student Survey questionnaire was used to measure burnout. The Basic Psychological Need Satisfaction at Work Scale (BPNSS-21) and the Utrecht Work Engagement Scale-Student Version (UWESS-9) measured students' basic psychological needs satisfaction at work and work engagement, respectively. Descriptive statistical analysis and confirmatory factor analysis were performed on BPNSS-21 and UWESS-9 data. Spearman's correlation coefficient was used to identify the correlation between burnout and other factors. Twenty undergraduate medical students participated in the qualitative study. Qualitative analysis was conducted iteratively using constant comparison and the standard principles of primary, secondary, and tertiary coding for thematic analysis.

RESULTS

Thai versions of the BPNSS-21 and UWESS-9 showed an acceptable fit for the Thai cultural context. Burnout had significant weak inverse associations with engagement (r = - 0.39, p < 0.005) and basic psychological needs satisfaction (r = - 0.37, p < 0.005). Sense of belonging had a significant weak inverse relationship with burnout (r = - 0.25, p < 0.005). The main themes emerging from qualitative analysis were relevant tasks and learning activities, safety in the learning environment, peer interaction, program design factors, dynamics of collegiality while progressing through medical school, and personal stance and social skills.

CONCLUSIONS

Sense of belonging, engagement, and collegiality were related to burnout. The key features for promoting collegiality, the sense of belonging, and engagement were relevant tasks and learning activities, safety in the learning environment, peer interaction, program design factors, dynamics of collegiality while progressing through medical school, and personal stance and social skills.

WLEIS as a Measure of Emotional Intelligence of Healthcare Professionals: A Confirmatory Factor Analysis

Emotional intelligence has been extensively studied in healthcare practices worldwide. It is requisite for a reliable and valid instrument to measure the emotional intelligence of healthcare professionals in India. The Wong and Law emotional intelligence scale (WLEIS) has been a widely used tool to measure trait emotional intelligence. This study examines the validity of this scale in the healthcare context. The original 16 items WLEIS scale has been administered to 98 doctors of the Ahmedabad region of Gujarat. Two competing models, single factor and four factors have been tested against each other. Fit indices of four-factor model ( χ2 (98) = 111.61, ( p > 0.001), CMIN/df = 1.139, CFI = 0.987, SRMR = 0.059, RMSEA = 0.038 and PClose = 0.714) has excellent goodness of fit. Results of confirmatory factor analysis support the original four-factor model. The model also has acceptable reliability, convergent and discriminant validity. Further, in order to establish EI construct underneath four factors, secondary factor analysis has been performed. Standardized regression weight of only one dimension, that is, ‘Regulation of emotion’ is acceptable. All fit indices of the second-order model have an excellent fit. WLEIS is a valid instrument to measure the emotional intelligence of health professionals.

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 and Good Medical Practice: Is There a Relationship?

Emotional intelligence (EI) is defined as the ability to perceive and manage the emotions of oneself and others. Despite being one of the most highly used psychological terms in popular nomenclature, its understanding in the context of clinicians remains poor. There is a dearth of literature on this topic, and this submission examines the relationship between a clinicians' EI and the key domains of "Good Medical Practice" guidelines from the General Medical Council, United Kingdom. It aims to review and critically analyse the existing literature on EI and Good Medical Practice while attempting to establish a relationship between the two. This submission thus examines the relationship between emotional intelligence and a clinician's on-the-job performance. The findings demonstrate how emotional intelligence can aid the clinician in all aspects of their working life in the context of practising in line with General Medical Council (GMC) guidance. The authors also recommend exploring the possibility of inclusion of EI within a modern medical curriculum, as it may lead to improved practice in clinicians.

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.

Personality traits and quality of life among Lebanese medical students: any mediating effect of emotional intelligence? A path analysis approach

BACKGROUND

Medicine is an incredibly demanding career that appears to leave many medical students at risk of fatigue, anxiety, depression and burnout. Since adaptation and lifestyle changes are important, quality of life (QOL) of students during medical school could be impaired. Personality traits and emotional intelligence (EI) facets may be both linked to medical student's QOL. To our knowledge, no studies have been done on the concurrent and prospective relationship between QOL-related personality traits and EI in Lebanese medical students. This study aimed to investigate the role of EI as a mediator between personality traits and QOL among a sample of Lebanese medical students.

METHODS

This research is a descriptive cross-sectional survey study involving 293 Lebanese medical students recruited from all 7 Faculties of Medicine in Lebanon (June-December 2019). Structural equation modeling (SEM) was performed using SPSS AMOS v.24 to examine the structural relationship between each personality trait taken as independent variables, QOL as the dependent variable, and emotional intelligence as the mediator, among university students. The relative Chi-square (χ²/df), root mean square error of approximation (RMSEA) statistic, Tucker Lewis Index (TFI) and the comparative fit index (CFI) were used to evaluate the goodness-of-fit of the model.

RESULTS

Higher conscientiousness was significantly associated with more EI (Beta = 0.38; p < 0.001) and lower QOL (Beta = - 0.14; p = 0.025). The indirect relationships between conscientiousness, EI and QOL showed that EI mediated the association between conscientiousness and QOL (Beta = 0.17; 95% CI - 0.73 to - 0.004; p = 0.037). The fit indices of this model were adequate for χ²/df, RMSEA and CFI but not TLI. Higher openness to experience was significantly associated with more EI (Beta = 0.48; p < 0.001) and lower QOL (Beta = - 0.38; p < 0.001). The indirect relationships between openness to experience, EI and QOL showed that EI mediated the association between openness to experience and QOL (Beta = 0.30; 95% CI - 1.11 to - 0.03; p = 0.04). The fit indices were adequate for χ²/df and CFI but not RMSEA and TLI. EI did not mediate the association between the other three personality traits (extroversion, agreeableness and neuroticism) and QOL.

CONCLUSION

This current research has shed considerable light on the nexus of associations between EI, personality traits and well-being, nonetheless, led to the creation of more puzzling questions. On the whole, it seems that EI and its components can be used as an evaluation instrument in relates with Lebanese medical students' personality profile as a means of future training to improve quality of life during medical education.