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Lobkovich AM, Mohammad I, Ouahab W, Wilhelm SM. Evaluating the impact of a decision-making game on empathy development in pharmacy students from the dual perspectives of the patient and pharmacist. CURRENTS IN PHARMACY TEACHING & LEARNING 2024; 16:102187. [PMID: 39236449 DOI: 10.1016/j.cptl.2024.102187] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/29/2024] [Revised: 08/09/2024] [Accepted: 08/20/2024] [Indexed: 09/07/2024]
Abstract
INTRODUCTION Doctor of Pharmacy programs are charged with developing students' empathy by the 2016 Accreditation Council for Pharmacy Education (ACPE) Standard 3 and the 2022 Curriculum Outcomes and Entrustable Professional Activities (COEPA). Although empathy is essential to optimal patient care, its subjective nature makes it challenging to teach and therefore literature is lacking on best teaching practices. The authors of this paper describe a novel simulated approach to elicit and assess empathy in a pharmacy classroom. This study evaluated the impact of a decision-making game in a pharmacy skills lab course on the development of students' empathy using a validated empathy scale. METHODS This is a cohort-based quality improvement project in which third year pharmacy students participated in a 3-h classroom empathy game experience that simulated a month in a patient's life including issues related to the cycle of poverty. Prior to the game, students completed a voluntary, anonymous baseline demographics survey. They also completed a pre- and post-survey of the validated empathy tool, the Kiersma-Chen Empathy Scale (KCES-R), to assess change in the empathy score following the decision-making game. Students also provided narrative comments in the post-survey. Statistical tests used included descriptive statistics for demographic data, Shapiro-Wilk test of normality, and Wilcoxon Signed-Rank test for survey scores (SPSS Version 29). RESULTS Pharmacy students (n = 37) showed an overall increase in composite KCES-R scores after participating in the empathy game class session (z = -5.071, p < 0.001). The scores of each of the 14 KCES-R items also increased after the learning experience (p < 0.05). Students' narrative comments were all positive and indicated that the activity offered new insights on self-perceived empathy development. CONCLUSION The empathy game simulation was a successful approach to increase empathy scores in third-year pharmacy students.
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Affiliation(s)
- Alison M Lobkovich
- Assistant Professor (Clinical), Department of Pharmacy Practice, Eugene Applebaum College of Pharmacy and Health Sciences, Wayne State University, 259 Mack Ave, Detroit, MI 48201, United States of America; Ambulatory Care Clinical Pharmacy Specialist, Henry Ford Health, Detroit, MI, United States of America.
| | - Insaf Mohammad
- Assistant Professor (Clinical), Department of Pharmacy Practice, Eugene Applebaum College of Pharmacy and Health Sciences, Wayne State University, 259 Mack Ave, Detroit, MI 48201, United States of America; Ambulatory Care Clinical Pharmacy Specialist, Corewell Health Dearborn Hospital, Dearborn, MI, United States of America.
| | - Wiam Ouahab
- Eugene Applebaum College of Pharmacy and Health Sciences, Wayne State University, 259 Mack Avenue, Detroit, MI 48201, United States of America.
| | - Sheila M Wilhelm
- Professor (Clinical), Patient Care Skills Laboratory Coordinator, Department of Pharmacy Practice, Eugene Applebaum College of Pharmacy and Health Sciences, Wayne State University, 259 Mack Avenue, Detroit, MI 48201, United States of America.
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de Graaff E, Bennett C, Dart J. Empathy in Nutrition and Dietetics: A Scoping Review. J Acad Nutr Diet 2024; 124:1181-1205. [PMID: 38677364 DOI: 10.1016/j.jand.2024.04.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2023] [Revised: 04/12/2024] [Accepted: 04/22/2024] [Indexed: 04/29/2024]
Abstract
BACKGROUND Empathy is fundamental to the provision of efficacious patient-centered health care. Currently, there is no comprehensive synthesis of peer-reviewed empirical research related to empathy in the nutrition and dietetics profession. Understanding empathy in the context of nutrition and dietetics care may lead to improved teaching practices that support nutrition and dietetics students and practitioners to provide high-quality, empathic, patient-centered care. OBJECTIVE This scoping review aimed to understand the approaches through which empathy is conceptualized, measured, and taught in the field of nutrition and dietetics. METHODS Using the Preferred Reporting Items for Systematic reviews and Meta-Analyses-Scoping Reviews Statement and Checklist, a scoping review process was undertaken. Five databases were searched in February 2023: Cumulative Index to Nursing and Allied Health, Embase, Medline, PsycInfo, and Scopus, with no date limits. Eligible studies were English language-based, peer-reviewed, empirical research exploring or measuring empathy as an outcome in primary data stratified to nutrition and dietetics. Extracted qualitative data were synthesized and analyzed thematically with an inductive, interpretivist approach applied to conceptualize the interrelationship between empathy and dietetic practice. Quantitative data were extracted and summarized in a table. RESULTS Twenty-six studies were included in the scoping review. Analysis identified 2 overarching themes underpinning the current literature on empathy in nutrition and dietetics that described empathy as a key skill in the application of patient-centered care, which was supported by approaches to lifelong cultivation of empathy in the nutrition and dietetics profession. A range of tools has measured empathy in nutrition and dietetics students and practitioners with no clear consensus in findings across studies. CONCLUSIONS This review identified the extent and nature of empathy within nutrition and dietetics, from both practitioner and patient perspectives, and the vast array of approaches used to teach and quantify empathy in students and practitioners. Insights from this review inform the need for future studies. The results of this review suggest that future research include exploring implications of empathic dietetics care on patient outcomes and identification of best practice, evidence-based curricula and strategies to support sustainable cultivation and maintenance of empathic care across the career span of nutrition and dietetics practitioners.
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Affiliation(s)
- Emma de Graaff
- Department of Nutrition, Dietetics, and Food, School of Clinical Sciences, Faculty of Medicine, Nursing and Health Sciences, Monash University, Clayton, Victoria, Australia
| | - Christie Bennett
- Department of Nutrition, Dietetics, and Food, School of Clinical Sciences, Faculty of Medicine, Nursing and Health Sciences, Monash University, Clayton, Victoria, Australia.
| | - Janeane Dart
- Department of Nutrition, Dietetics, and Food, School of Clinical Sciences, Faculty of Medicine, Nursing and Health Sciences, Monash University, Clayton, Victoria, Australia
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Ulutas Deniz E, Ceylan C, Eren R, Memiş OB. Advancing empathy and emotional intelligence among pharmacy students: A comparative mixed-methods study with peer role-play simulation intervention. CURRENTS IN PHARMACY TEACHING & LEARNING 2024; 16:102112. [PMID: 38795610 DOI: 10.1016/j.cptl.2024.102112] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/17/2024] [Revised: 05/14/2024] [Accepted: 05/16/2024] [Indexed: 05/28/2024]
Abstract
INTRODUCTION Due to the significance of interpersonal empathy and emotional intelligence in pharmaceutical practices, it has become essential to emphasize its importance in pharmacy education. The aim of this study is to provide pharmacy students, who require proper communication skills throughout their professional careers, with a simulation-based intervention focusing on empathy and emotional intelligence, and to evaluate the influence of this educational intervention on emotional intelligence and empathy levels. METHODS The methodological approach adopted in this study aims to integrate both qualitative and quantitative data for a comprehensive analysis, that is, the mixed method, and to provide in-depth answers to the research questions. RESULTS There was a difference observed in the change in empathy and emotional intelligence scores between the control and intervention groups. When the pre-test and mid-test results with the intervention group were analyzed, there was a difference in the values for emotional intelligence when only education was offered. Conversely, no difference was found in empathy scores under the same conditions. In the intervention group, after the implementation of both training and simulation practice resulted in a difference in the scores for emotional intelligence and empathy when comparing the results before and after the test. Gender and the interaction between gender and group had small effect sizes on both empathy and emotional intelligence. The comprehensive data collected from these interviews enabled a rigorous thematic analysis, culminating in the identification of three primary themes accompanied by respective categories: the contribution of theoretical education to simulation, perceptions of simulation practice, the significance of debriefing sessions. Students highlighted the development of various communication skills, such as improving patient-provider relationships, conveying empathy to patients, being aware of and managing their emotions, and building self-confidence through simulated encounters and debriefing sessions. CONCLUSION Based on these findings, it is recommended that simulation methods be made mandatory in pharmacy school curricula and be disseminated nationwide.
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Affiliation(s)
- Elif Ulutas Deniz
- Department of Pharmacy Management, Faculty of Pharmacy, Atatürk University, 25240 Yakutiye-Erzurum, Türkiye.
| | - Ceren Ceylan
- Faculty of Pharmacy, Atatürk University, Türkiye
| | - Rumeysa Eren
- Department of Pharmacy Management, Faculty of Pharmacy, Atatürk University, Türkiye
| | - Olcay Besnili Memiş
- Department of Labor Economics and Industrial Relations, Faculty of Economics and Administrative Sciences, Atatürk University, Türkiye.
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Moura AT, Coriolano AM, Kobayasi R, Pessanha S, Cruz HL, Melo SM, Pecly IM, Tempski P, Martins MA. Is there an association among spirituality, resilience and empathy in medical students? BMC MEDICAL EDUCATION 2024; 24:704. [PMID: 38943145 PMCID: PMC11214230 DOI: 10.1186/s12909-024-05687-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Received: 03/05/2024] [Accepted: 06/20/2024] [Indexed: 07/01/2024]
Abstract
BACKGROUND Spirituality has religious and nonreligious dimensions and is often linked to well-being, positive emotions, connection and meaning in life. Both empathy and resilience are important in medical training and future professional practice since they are considered core skills related to professionalism and patient care. Our study aimed to understand the relationships among spirituality, resilience, and empathy in medical students. We also aimed to determine whether there are differences by gender and between medical students in different years of a medical program. METHODS Medical students (n = 1370) of the first to fourth years of a six-year medical program, from six medical schools, completed questionnaires to assess empathy (Jefferson Empathy Scale and Davis Multidimensional Interpersonal Reactivity Scale) and resilience (Wagnild & Young Scale) and to rate their spirituality. RESULTS Medical students with high spirituality showed higher scores for both resilience and empathy (p < 0.001). In addition, we observed higher levels of both spirituality and empathy, but not resilience, in female medical students than in male medical students. In contrast, we did not detect significant differences in spirituality, empathy, or resilience between students in different years of medical school. CONCLUSION Medical students with high levels of spirituality have also higher scores for both empathy and resilience. Spirituality, empathy and resilience have similar values for students in different years of a medical program.
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Affiliation(s)
- Anna Tms Moura
- Faculdade de Ciências Médicas, Universidade Estadual do Rio de Janeiro, Rio de Janeiro, Brazil
- Centro de Desenvolvimento de Educação Médica, Faculdade de Medicina, Universidade de São Paulo, Avenida Dr. Arnaldo 455 sala 1210, Sao Paulo, Brazil
| | - Andreia M Coriolano
- Centro de Desenvolvimento de Educação Médica, Faculdade de Medicina, Universidade de São Paulo, Avenida Dr. Arnaldo 455 sala 1210, Sao Paulo, Brazil
| | - Renata Kobayasi
- Centro de Desenvolvimento de Educação Médica, Faculdade de Medicina, Universidade de São Paulo, Avenida Dr. Arnaldo 455 sala 1210, Sao Paulo, Brazil
| | - Silvio Pessanha
- Instituto de Educação Médica, IDOMED, Rio de Janeiro, Brazil
| | - Hellen Lmc Cruz
- Instituto de Educação Médica, IDOMED, Rio de Janeiro, Brazil
| | - Suely M Melo
- Instituto de Educação Médica, IDOMED, Rio de Janeiro, Brazil
| | - Inah Md Pecly
- Instituto de Educação Médica, IDOMED, Rio de Janeiro, Brazil
| | - Patricia Tempski
- Centro de Desenvolvimento de Educação Médica, Faculdade de Medicina, Universidade de São Paulo, Avenida Dr. Arnaldo 455 sala 1210, Sao Paulo, Brazil
| | - Milton A Martins
- Centro de Desenvolvimento de Educação Médica, Faculdade de Medicina, Universidade de São Paulo, Avenida Dr. Arnaldo 455 sala 1210, Sao Paulo, Brazil.
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Gómez-Polo C, Montero J, Portillo Muñoz M, Lobato Carreño M, Pardal-Peláez B, Zubizarreta-Macho Á, Martín Casado AM. Emotional Intelligence and Personality Traits of University Students in Dentistry, Medicine and Pharmacy Degrees. Eur J Investig Health Psychol Educ 2024; 14:1757-1768. [PMID: 38921082 PMCID: PMC11203328 DOI: 10.3390/ejihpe14060116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2024] [Revised: 06/07/2024] [Accepted: 06/08/2024] [Indexed: 06/27/2024] Open
Abstract
BACKGROUND This study aimed to characterize dentistry, medicine and pharmacy students in terms of emotional intelligence (EI) and personality traits (PTs). It also sought to identify whether differences existed according to gender and degree program and the relationship between them. METHODS Students enrolled in dentistry (115), medicine (85) and pharmacy (57) degree programs participated voluntarily in the research, including 59 men and 198 women. The following questionnaires were used: (1) the Trait Meta-Mood Scale (TMMS-24) to evaluate EI; (2) the NEO Five-Factor Inventory (NEO-FFI) to assess PT. The Qualtrics XM platform was used for data collection. RESULTS There were no statistically significant differences between three components of EI, either according to gender or degree program. The only difference in PTs was found in neuroticism, where women scored higher than men. There were statistically significant differences between students on different degree programs in openness to experience and responsibility. The five PTs correlated significantly with the three components of EI, except responsibility and emotional attention. The strongest associations were found between neuroticism and emotional repair (-0.439). CONCLUSIONS High percentages of the student population were observed to have weaknesses in emotional clarity and emotional repair. Neuroticism is a personality trait that seems to occur more frequently in women.
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Affiliation(s)
- Cristina Gómez-Polo
- Department of Surgery, Faculty of Medicine and Dentistry, University of Salamanca, 37008 Salamanca, Spain; (C.G.-P.); (J.M.); (M.L.C.); (B.P.-P.); (Á.Z.-M.)
| | - Javier Montero
- Department of Surgery, Faculty of Medicine and Dentistry, University of Salamanca, 37008 Salamanca, Spain; (C.G.-P.); (J.M.); (M.L.C.); (B.P.-P.); (Á.Z.-M.)
| | - María Portillo Muñoz
- Department of Surgery, Faculty of Medicine and Dentistry, University of Salamanca, 37008 Salamanca, Spain; (C.G.-P.); (J.M.); (M.L.C.); (B.P.-P.); (Á.Z.-M.)
| | - Maria Lobato Carreño
- Department of Surgery, Faculty of Medicine and Dentistry, University of Salamanca, 37008 Salamanca, Spain; (C.G.-P.); (J.M.); (M.L.C.); (B.P.-P.); (Á.Z.-M.)
| | - Beatriz Pardal-Peláez
- Department of Surgery, Faculty of Medicine and Dentistry, University of Salamanca, 37008 Salamanca, Spain; (C.G.-P.); (J.M.); (M.L.C.); (B.P.-P.); (Á.Z.-M.)
| | - Álvaro Zubizarreta-Macho
- Department of Surgery, Faculty of Medicine and Dentistry, University of Salamanca, 37008 Salamanca, Spain; (C.G.-P.); (J.M.); (M.L.C.); (B.P.-P.); (Á.Z.-M.)
| | - Ana María Martín Casado
- Department of Statistics, Faculty of Medicine and Dentistry, University of Salamanca, 37008 Salamanca, Spain;
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Chen H, Xuan H, Cai J, Liu M, Shi L. The impact of empathy on medical students: an integrative review. BMC MEDICAL EDUCATION 2024; 24:455. [PMID: 38664799 PMCID: PMC11047033 DOI: 10.1186/s12909-024-05448-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/04/2023] [Accepted: 04/19/2024] [Indexed: 04/28/2024]
Abstract
INTRODUCTION Empathy is considered the ability to understand or feel others emotions or experiences. As an important part of medical education, empathy can affect medical students in many ways. It is still lacking a comprehensive evaluation of the existing articles on empathy's impact on medical students, despite the existence of many articles on the topic. OBJECTIVES To summarize the impact of empathy on medical students during medical education from four perspectives: mental health, academic performance, clinical competence, and specialty preference. METHODS The search terms used for retrieval were "empathy", "medical student", "mental health", "depression", "anxiety", "burnout", "examinations", "academic performance", "clinical competence", "specialty preference" on PubMed, EBSCO, and Web of Science before January 2024. The search was carried out by two reviewers. Titles and abstracts were screened independently and reviewed based on inclusion/exclusion criteria. A consensus was drawn on which articles were included. RESULTS Our results indicated that high empathy was a positive factor for mental health, However, students with high affective empathy were more likely to suffer from depression, anxiety, and burnout. Empathy was found to be unrelated to academic performance, but positively correlated with clinical competence, particularly in terms of communication skills. Medical students with high levels of empathy tended to prefer people-oriented majors. CONCLUSIONS Medical students who score higher on the self-reported empathy scales often have better mental health, better communication skills, and tend to choose people-oriented specialties. But empathy is not related to academic performance. Additionally, the different dimensions of empathy have different impacts on medical students. It is necessary to design targeted courses and training for medical students to enhance their empathy.
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Affiliation(s)
- Hao Chen
- Department of Neurosurgery, the Second Affiliated Hospital of Harbin Medical University, Harbin, 150086, China
| | - Hanwen Xuan
- Department of Neurosurgery, the Second Affiliated Hospital of Harbin Medical University, Harbin, 150086, China
| | - Jinquan Cai
- Department of Neurosurgery, the Second Affiliated Hospital of Harbin Medical University, Harbin, 150086, China.
| | - Meichen Liu
- Modern Educational Technology Center, Harbin Medical University, Harbin, 150086, China.
| | - Lei Shi
- School of Health Management, Guangzhou Medical University, Guangzhou, 511436, China.
- School of Health Management, Southern Medical University, Guangzhou, 510515, China.
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De Brochowski V, Rubin GJ, Webster RK. The effect of nocebo explanation and empathy on side-effect expectations of medication use following a fictional GP consultation. PSYCHOL HEALTH MED 2024; 29:809-821. [PMID: 37491019 DOI: 10.1080/13548506.2023.2240072] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/29/2021] [Accepted: 07/18/2023] [Indexed: 07/27/2023]
Abstract
The simple act of informing patients about side-effects increases the likelihood they will experience them (i.e. the nocebo effect). Explaining this psychological phenomenon could help to reduce side-effect experience, however, it is yet to be explored if this can be applied to clinical settings where new medication is prescribed. In addition, the degree to which a health-care provider empathetically communicates this to patients may have an impact. To investigate this, we carried out 2 × 2 factorial trial to assess the effect of nocebo explanation and empathy (plus their interaction) on side-effect expectations following a fictional GP consultation prescribing a new medication. Overall, 208 participants were randomised to watch one of the four fictive GP consultations and play the role of the patient. In all videos, participants received information about the reason for the consultation, the recommendation of a new fictive medicine, how to take it, benefits and side-effects. The videos differed in whether the GP provided an explanation of the nocebo effect (yes/no) and whether they communicated in an empathetic style (yes/no). After watching the video, participants were asked about their side-effect expectations and rated the quality of the GP's communication. Two-way ANOVAs revealed no main effect of nocebo explanation on expectation of side-effects warned or not warned about in the consultation. However, there was a main effect of empathy, with participants watching the empathetic consultations having significantly lower expectations of non-warned-about side-effects. There was no significant interaction. Findings suggest that explaining the nocebo effect and GP empathy did little to allay expectations of side-effects that were specifically mentioned in the consultation. However, GP empathy had an effect by helping to reduce additional side-effect expectations participants still had. Future work should extend these findings to real GP consultations where the full dimensions of empathy can be explored.
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Affiliation(s)
- Valentine De Brochowski
- Health Psychology Section, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, United Kingdom
| | - G James Rubin
- Health Protection Research Unit in Emergency Preparedness and Response at, King's College London, London, United Kingdom
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Mostafapour M, Fortier JH, Garber G. Exploring the dynamics of physician-patient relationships: Factors affecting patient satisfaction and complaints. J Healthc Risk Manag 2024; 43:16-25. [PMID: 38706117 DOI: 10.1002/jhrm.21567] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2023] [Accepted: 03/25/2024] [Indexed: 05/07/2024]
Abstract
This review identifes the factors influencing the relationship between physicians and patients that can lead to patients' dissatisfaction and medical complaints. Utilizing a systemic approach 92 studies were retrieved which included quantitative, qualitative, and mixed method studies. Through a thematic analysis of the literature, we identified three interrelated main themes that can influence the relationship between physicians and patients, patients' satisfaction, and the decision to file a medico-legal complaint. The main themes include patient and physician characteristics; the interpersonal relationship between physicians and patients; and the health care system and policies, with relevant subthemes. These themes are demonstrated in a descriptive model. The review suggests areas of focus for physicians who may wish to increase their awareness around the potential sources of relational problems with their patients. Identifying these issues may assist in improvements in the therapeutic relationship with patients, can reduce their medico-legal risk, and enhance the quality of their clinical practice. The findings can also be utilized to support andragogical principles for medical learners. The article can serve as a structured framework to identify potential problems and gaps to design and test effective interventions to mitigate these potential relational problems between physician-patient.
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Affiliation(s)
- Mehrnaz Mostafapour
- Department of Safe Medical Care Research, Canadian Medical Protective Association, Ottawa, Canada
| | - Jacqueline H Fortier
- Department of Safe Medical Care Research, Canadian Medical Protective Association, Ottawa, Canada
| | - Gary Garber
- Department of Safe Medical Care Research, Canadian Medical Protective Association, Ottawa, Canada
- Department of Medicine and the School of Epidemiology and Public Health at, University of Ottawa, Ottawa, Canada
- Department of Medicine, University of Toronto, Toronto, Canada
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van der Merwe A, van Vuuren CJ. Creating transformational learning experiences for 21 st century healthcare students through preclinical skills training at a South African university. BMC MEDICAL EDUCATION 2024; 24:198. [PMID: 38413950 PMCID: PMC10900705 DOI: 10.1186/s12909-024-05177-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/08/2023] [Accepted: 02/13/2024] [Indexed: 02/29/2024]
Abstract
BACKGROUND Creating an inclusive interprofessional teaching and learning community can enhance student engagement and ultimately develop essential graduate attributes (GA) (also known as generic, transferable, core, soft, work-ready or nontechnical skills). The early practical development of GA within a diverse space is essential in health profession education, as students experience the transition to clinical training as challenging. AIM This paper describes the conceptualization and implementation of an inclusive interprofessional curriculum focused on GA development in the preclinical years. METHODS A phased multimethod research design was applied. Phase 1 focused on the conceptualization of a preclinical GA development curriculum through a consensus-seeking process among all staff in the School of Health and Rehabilitation Sciences (N = 36). Subsequently, in Phase 2, quantitative and qualitative data were gathered from participating first-year students (N = 135) as an early curricular implementation review. Descriptive statistical analyses for quantitative and thematic analyses for qualitative data were performed. RESULTS During Phase 1, five themes were identified (Ethics, Professionalism, General principles for interventions, Organizations and institutions, Management) informing preclinical curriculum development. Forty-one first-year students (30%) participated in Phase 2. The majority of participants (87%) indicated that they had a positive learning experience during Phase 2. Students expressed that engagement was encouraged (83%) within a space of mutual respect (83%), with interprofessional groups assisting in building "a trusting environment and a supportive one". Students indicated they "liked that it [module] wasn't just about one topic", as it concretized that "there is more to being a healthcare professional that just treating people". CONCLUSION GA development provides an invaluable opportunity for interprofessional engagement. Creating a diverse and inclusive curricular space through multimodal and interprofessional training, GA training was transformed to be more practical and future-focused, creating a positive learning experience. Future research should focus on the longer-term impact of this practical, preclinical GA development during the transition of these students into the clinical training space.
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Affiliation(s)
- Anke van der Merwe
- School of Health and Rehabilitation Sciences, Faculty of Health Sciences, University of the Free State, 205 Nelson Mandela Drive, Park West, 9301, Bloemfontein, Free State, South Africa.
| | - Corlia Janse van Vuuren
- School of Health and Rehabilitation Sciences, Faculty of Health Sciences, University of the Free State, 205 Nelson Mandela Drive, Park West, 9301, Bloemfontein, Free State, South Africa
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Byrne M, Campos C, Daly S, Lok B, Miles A. The current state of empathy, compassion and person-centred communication training in healthcare: An umbrella review. PATIENT EDUCATION AND COUNSELING 2024; 119:108063. [PMID: 38008647 DOI: 10.1016/j.pec.2023.108063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/26/2023] [Revised: 10/18/2023] [Accepted: 11/08/2023] [Indexed: 11/28/2023]
Abstract
OBJECTIVES This umbrella review consolidates evidence available on empathy training, its effectiveness and design mechanisms that contribute to effectiveness. METHODS We conducted an umbrella review (review of reviews) of empathy, compassion and person-centred communication training in healthcare published between 2018 and 2022. One reviewer screened titles, abstracts and full-text articles, with a second reviewer at full-text stage. Quality appraisal was done in duplicate. Data extraction was piloted by two reviewers and conducted by one reviewer with a quality check of all extracted data. All reviewers provided input into synthesis of results and analysis. RESULTS Twenty-five reviews were included. We provide an overview of the definitions of empathy, compassion and person-centred communication, outcome measures used, a synthesis of findings on the mechanisms and effectiveness of training and a summary of review recommendations. CONCLUSIONS For policy and practice, we advise the inclusion of empathic communication into the curriculum; longitudinal and sequenced learning; debriefing, targeted feedback, enabling self-reflection, deliberate practice, experiential learning; improving motivation by teaching the benefits of empathy and teaching sustainable empathy. Future research should involve patients in training and research and study the effect of targeting interventions at healthcare practitioners and patients.
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Affiliation(s)
- Monika Byrne
- School of Psychology, University of Auckland, New Zealand.
| | - Carlos Campos
- Centre for Medical and Health Sciences Education, School of Medicine, University of Auckland, New Zealand
| | - Svetlana Daly
- School of Psychology, University of Auckland, New Zealand
| | - Benjamin Lok
- Virtual Experiences Research Group, University of Florida, USA
| | - Anna Miles
- School of Psychology, University of Auckland, New Zealand
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Choi A, Murtha TD, Morrison LJ, Talwalkar JS. A Comparison Between In-Person and Virtual Communication Skills OSCE for Medical Students. JOURNAL OF MEDICAL EDUCATION AND CURRICULAR DEVELOPMENT 2024; 11:23821205241241375. [PMID: 38532857 PMCID: PMC10964456 DOI: 10.1177/23821205241241375] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/03/2023] [Accepted: 03/05/2024] [Indexed: 03/28/2024]
Abstract
Objectives This study investigates the effectiveness of a virtual format of an advanced communication skills observed structured clinical examination (OSCE) for senior medical students in comparison to an in-person format. The study also examines the emotional support students experience in the virtual setting. Our analysis was based on quantitative data collected through objective checklists and post-OSCE survey results. Methods The virtual OSCE was a revision of an earlier in-person formative advanced communication skills OSCE for fourth-year medical students. Student performances were assessed by self and peers using objective checklists-the modified Master Interview Rating Scale (mMIRS) and Communication Behavior Checklist (CBC). The mMIRS measured interview process such as avoiding jargon and demonstrating empathy. The CBC examined interview content which included tasks specific to the content of the case. The OSCE was followed by a faculty-led debrief and quantitative survey. The virtual OSCE was conducted in 2021, and the results of the checklists and survey were compared with those collected from two earlier in-person OSCEs. Results Eighty-three students participated in the virtual OSCE. There was no difference in mMIRS scores between the virtual and in-person OSCE. Overall CBC scores were lower in the virtual OSCE compared to in-person (p < 0.05). Sixty-seven out of 83 (80.7%) students completed the post-OSCE survey. There were no differences between the virtual and in-person OSCE in terms of educational value, whether the OSCE would change the way participants talk to patients, and preparedness to have serious conversations with patients. All respondents somewhat or strongly agreed with feeling emotionally supported during the virtual OSCE. Conclusion The virtual format was a suitable alternative to an in-person, formative, advanced communication skills OSCE for medical students. The virtual OSCE was educationally effective and was met with student satisfaction and a sense of emotional support. Future virtual iterations must ensure adequate instruction on interview content.
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Affiliation(s)
- Alex Choi
- Department of Medicine, Yale School of Medicine, New Haven, CT, USA
| | - Tanya D. Murtha
- Department of Pediatrics, Warren Alpert Medical School of Brown University, Providence, RI, USA
| | | | - Jaideep S. Talwalkar
- Departments of Internal Medicine and Pediatrics, Yale School of Medicine, New Haven, CT, USA
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Shaheen MY, Basudan AM, Almubarak AM, Alzawawi AS, Al-Ahmari FM, Aldulaijan HA, Almoharib H, Ashri NY. Dental Students' Perceptions Towards E-learning in Comparison With Traditional Classroom Learning. Cureus 2023; 15:e51129. [PMID: 38274909 PMCID: PMC10810565 DOI: 10.7759/cureus.51129] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/18/2023] [Indexed: 01/27/2024] Open
Abstract
INTRODUCTION Electronic learning (e-learning) has evolved into a popular educational approach since the coronavirus disease 2019 (COVID-19) pandemic. While this represents an additional model for teaching, traditional classroom learning fosters the development of interpersonal skills and enables students to share and discuss specific topics. However, existing research on the comparison of both these modes of learning in the field of dental education is inadequate. This study aimed to evaluate the perceptions of dental students towards both electronic and classroom learning. METHODS A cross-sectional questionnaire-based survey was conducted between November 2022 and January 2023 among dental students in Saudi Arabia. Students were questioned on their comparative perceptions of e-learning and classroom learning before, during, and after the COVID-19 pandemic. Questionnaire responses, including demographic data, were collected and tabulated, using electronic data management software. The tabulated data were analyzed to provide descriptive statistics and compare electronic and classroom learning with demographic variables and previous experience with e-learning. RESULTS Most respondents reported possessing average information technology (IT) skills and prior experience with e-learning. Blackboard Learning Management System (LMS) (Reston, VA: Blackboard Inc.), Zoom (San Jose, CA: Zoom Video Communications Inc.), and Microsoft Teams (Redmond, WA: Microsoft Corporation) were the most commonly used and advantageous e-learning platforms. While the majority of participants found both methods acceptable for problem-based learning sessions and theoretical lectures, they reported e-learning to be less effective than classroom learning for clinical and practical sessions. Regarding e-learning as a preferred method over classroom learning, most responses were "neutral" or "uncertain." Comparing the mean ranks of the ordinal responses for the different teaching methodologies and the nominal responses for e-learning as the preferred method, no statistically significant interactions were observed for demographic characteristics, IT-skill levels, or prior experience with e-learning. CONCLUSION Although enhanced performance and learning capacity are enabled through e-learning, the advantages of personal interactions and the feasibility of practical and clinical dental sessions are achieved only through classroom learning.
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Affiliation(s)
- Marwa Y Shaheen
- Department of Periodontics and Community Dentistry, College of Dentistry, King Saud University, Riyadh, SAU
| | - Amani M Basudan
- Department of Periodontics and Community Dentistry, College of Dentistry, King Saud University, Riyadh, SAU
| | - Abdulrahman M Almubarak
- Department of Periodontics and Community Dentistry, College of Dentistry, King Saud University, Riyadh, SAU
| | - Abeer S Alzawawi
- Department of Periodontics and Community Dentistry, College of Dentistry, King Saud University, Riyadh, SAU
| | - Fatemah M Al-Ahmari
- Department of Periodontics and Community Dentistry, College of Dentistry, King Saud University, Riyadh, SAU
| | - Hajer A Aldulaijan
- Department of Periodontics and Community Dentistry, College of Dentistry, King Saud University, Riyadh, SAU
| | - Hani Almoharib
- Department of Periodontics and Community Dentistry, College of Dentistry, King Saud University, Riyadh, SAU
| | - Nahed Y Ashri
- Department of Periodontics and Community Dentistry, College of Dentistry, King Saud University, Riyadh, SAU
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Lallier S, Hourantier C, Gilles de la Londe J, Billon G, Cadwallader JS, Piot MA. General practitioners' perceptions of dealing with patients with pressured speech: a qualitative study. Fam Pract 2023; 40:575-581. [PMID: 37656918 DOI: 10.1093/fampra/cmad088] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/03/2023] Open
Abstract
BACKGROUND Empathetic listening can be particularly challenging with patients presenting pressured speech, while time pressure and costs limit practitioners' availability. We aimed to explore general practitioners' (GPs') experiences when encountering a patient with pressured speech without pathological syndrome. METHODS Using a thematic analysis method, 19 semi-structured interviews were conducted with GPs purposively sampled in Ile-de-France region. RESULTS Three themes emerged. First, misgivings were aroused when meeting a patient with pressured speech, including frustration, displeasure, and a struggle to maintain focus. Second, huge efforts were needed to adhere to the appropriate clinical reasoning and care for these patients who need more time and energy. The very definition of this condition varies from one clinician to another, and for some, psychiatric conditions were systematically associated. Third, implementation of specific strategies was required to adjust to these patients: trying to create distance with the patient, to organize a framework in which the patient with pressured speech can express him or herself, and even strategies to increase GPs' availability. CONCLUSION The time and energy required to provide adequate care for patients presenting with pressured speech make it quite challenging, and this builds up pressure in the waiting room. But when medical demands take this form, there is a risk that clinicians will reject the patient or refer early to mental health services, leading to growing feelings of abandonment, the neglect of organic issues, and medical nomadism. Initial and continuing medical training focussing on advanced communication skills and multifocal approaches can foster long-term follow-up.
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Affiliation(s)
- Stéphanie Lallier
- Department of Medical Practice, Université de Paris-Cité, Epernon, Paris, France
| | - Christelle Hourantier
- Department of Child, Adolescent and Young Adult Psychiatry, Institut Mutualiste Montsouris, Paris, France
| | - Julie Gilles de la Londe
- Department of General Practice, University of Paris-Cité, Health Faculty, School of Medicine, Paris, France
| | - Grégoire Billon
- Maudsley Simulation, South London and Maudsley National Health Service (NHS) Foundation Trust, London, United Kingdom
| | - Jean-Sébastien Cadwallader
- Department of General Practice, Sorbonne University, Paris, France
- Institut Pierre Louis d'Épidémiologie Et de Santé Publique, INSERM, Sorbonne University, Paris, France
| | - Marie-Aude Piot
- Department of Child and Adolescent Psychiatry, Necker-Enfants Malades Hospital-APHP, Paris, France
- School of Medicine, Université de Paris-Cité- Health Faculty, Paris, France
- Université Paris-Saclay, UVSQ, INSERM, CESP, Team DevPsy, Paris, France
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Washmuth NB, Stephens R, McAfee B, McAfee AD, Bise CG, Durham J. Using expletives to enhance therapeutic outcomes: A case report. Health Psychol Res 2023; 11:89726. [PMID: 37953825 PMCID: PMC10638054 DOI: 10.52965/001c.89726] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2023] Open
Abstract
Background Swearing deserves attention in the physical therapy setting due to its potential positive effects on pain, physical performance, and therapeutic alliance. The purpose of this case report is to describe the strategic use of swearing in the clinical setting. Case Presentation A 44-year-old female completed an episode of physical therapy after undergoing patellofemoral arthroplasty. Swearing was formally included into the plan of care, and the patient swore out loud during the most challenging and painful interventions. Results The patient reported that repeating a swear word was funny, distracted the patient, and made the patient feel more confident. The patient and physical therapist self-reported a strong therapeutic alliance. Conclusion There is evidence repeating a swear word out loud can strengthen the therapeutic alliance, improve physical performance, and decrease pain. This is, to our knowledge, the first report of a patient swearing during an episode of physical therapy care.
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Guariglia P, Palmiero M, Giannini AM, Piccardi L. The Key Role of Empathy in the Relationship between Age and Social Support. Healthcare (Basel) 2023; 11:2464. [PMID: 37685497 PMCID: PMC10487866 DOI: 10.3390/healthcare11172464] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Revised: 08/25/2023] [Accepted: 08/28/2023] [Indexed: 09/10/2023] Open
Abstract
Aging involves several changes depending on genetic and behavioral factors, such as lifestyle and the number and quality of social relationships, which in turn can be influenced by empathy. Here, the change in the perceived social support across the lifespan as a function of empathy was investigated, considering the mediating role of empathy after controlling for gender and education. In total, 441 people (18-91 years old) filled in the Italian short version of the Interpersonal Support Evaluation List (ISEL-12), the Social Support Questionnaire (SSQ6), as well as the Empathy Questionnaire (EQ), and the Reading the Mind in the Eyes test (RMET). The mediation analyses with ISEL-12 showed that age and the EQ fully mediated the relationship between age and appraisal, belonging, and tangible scores. Further, the EQ fully mediated only the relationship between age and SSQ6-People. These results showed that empathic skills are key in the relationships between age and social support. This suggests that empathy can trigger social support and, ultimately, well-being if stimulated across the lifespan, especially from a young age; this would help to form the socio-emotional competence across the years as a sort of cushion that can be useful in the older to fulfill active aging.
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Affiliation(s)
- Paola Guariglia
- Faculty of Human and Social Sciences, UKE-Kore University of Enna, 94100 Enna, Italy
| | | | | | - Laura Piccardi
- Department of Psychology, Sapienza University of Rome, 00158 Rome, Italy
- San Raffaele Cassino Hospital, 03043 Cassino, Italy
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Malik Z, Ahn J, Schwartz A, Blackie M. Narrative medicine workshops for emergency medicine residents: Effects on empathy and burnout. AEM EDUCATION AND TRAINING 2023; 7:e10895. [PMID: 37485471 PMCID: PMC10357272 DOI: 10.1002/aet2.10895] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/23/2023] [Revised: 05/30/2023] [Accepted: 06/20/2023] [Indexed: 07/25/2023]
Abstract
Background Emergency medicine (EM) residents face unique affective challenges and barriers to interpersonal connection in their clinical environment which may contribute to decreased empathy and increased burnout. Narrative medicine (NM) might address these barriers and has had beneficial impacts in various populations but has never been studied in EM residents. In this study, we sought to evaluate the effect of NM workshops on burnout and empathy and to assess resident perceptions of the workshops. Methods We performed a quasi-experimental study at two EM residencies from June to October 2020. Residents at the intervention site participated in two NM workshops led by EM faculty that were composed of a close reading of a literary text, reflective writing, and group discussion. Residents were asked to complete the abbreviated Interpersonal Reactivity Index (IRI) and a single-item burnout measure pre- and postintervention. We fitted linear regression models to IRI subscores; we treated burnout as an ordinal variable and fitted a conditional logistic regression model. Residents completed a postintervention survey that we analyzed using summary statistics. Results A total of 46.7% of control (28/60) and 100% of intervention (48/48) residents responded (n = 76). While all respondents demonstrated worsening burnout with time (p = 0.001), residents at the intervention site exhibited less severe increases (interaction p < 0.001). Empathy remained unchanged. A total of 50% of intervention residents (24/48) responded to the postintervention survey; most (n = 20, 83.3%) agreed that the workshops should be a standard part of EM didactics. Conclusions These findings establish the feasibility and desirability of NM in residency education and offers a model for EM-centered narrative workshops. Additionally, while our outcomes are limited, we found that exposure to an NM curriculum may be protective against worsening burnout.
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Affiliation(s)
- Zayir Malik
- Department of Emergency MedicineBoston University School of MedicineBostonMassachusettsUSA
| | - James Ahn
- Section of Emergency Medicine in the Department of MedicineUniversity of ChicagoChicagoIllinoisUSA
| | - Alan Schwartz
- Department of Medical EducationUniversity of Illinois at ChicagoChicagoIllinoisUSA
| | - Michael Blackie
- Department of Medical EducationUniversity of Illinois at ChicagoChicagoIllinoisUSA
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Zou L, Su J, Li J, Wang J, Kang J, Yin A, Ren H, Jiang X, Ding Y, An P. Application of bilingual simulated patients in the medical history collection for international medical students in China. BMC MEDICAL EDUCATION 2023; 23:525. [PMID: 37479971 PMCID: PMC10362765 DOI: 10.1186/s12909-023-04480-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Accepted: 06/28/2023] [Indexed: 07/23/2023]
Abstract
BACKGROUND In all international medical student (IMS) programs in China, language barriers between IMSs and Chinese patients greatly reduced the learning in clinical practice and brought great challenges to IMSs in their transition from preclinical to clinical practice. This study aimed to investigate the role of bilingual simulated patients (B-SPs) in IMSs learning of medical history collection in China. METHODS 48 IMSs of grade 4 between October 2020 to Jan 2021 were enrolled in this study. During the training of medical history collection, students were randomly arranged into two groups trained with either B-SPs (B-SP group) or English-speaking SP (E-SP group). All SPs in Objective Structured Clinical Exam station (OSCE) were trained in the Affiliated Hospital of Wuhan University. Clinical skills in medical history collection were assessed by instructors during pre-clinical, post-clinical OSCE and clinical rotations. RESULTS The scores of IMSs in each group were analyzed in terms of medical history collection including the ability to effectively consult for information and key communication skills related to patient care. Our results indicated that IMS in B-SP group obtained similar scores in preclinical training for history collection (67.3 ± 8.46 vs 67.69 ± 8.86, P < 0.05) compared to E-SP group, while obtaining significantly higher score improvements between pre- and post-OSCE (17.22 (95% CI 12.74 to 21.70) vs 10.84 (95% CI 3.53 to 18.15), P = 0.0007). CONCLUSION B-SPs are more conducive to doctor-patient communication and actually improve IMSs learning in medical history collection in China.
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Affiliation(s)
- Liping Zou
- The Clinical Skill Center, Teaching Office of the First School of Clinical Medicine, Renmin Hospital of Wuhan University, 9 Zhangzhidong Road, Wuhan, 430060, Hubei Province, China
| | - Juan Su
- Department of Gastroenterology, Renmin Hospital of Wuhan University, 99 Zhangzhidong Road, Wuhan, 430060, Hubei Province, China
- Key Laboratory of Hubei Province for Digestive System Disease, Renmin Hospital of Wuhan University, Wuhan, China
- Hubei Provincial Clinical Research Center for Digestive Disease Minimally Invasive Incision, Renmin Hospital of Wuhan University, Wuhan, China
| | - Jiao Li
- Department of Gastroenterology, Renmin Hospital of Wuhan University, 99 Zhangzhidong Road, Wuhan, 430060, Hubei Province, China
- Key Laboratory of Hubei Province for Digestive System Disease, Renmin Hospital of Wuhan University, Wuhan, China
- Hubei Provincial Clinical Research Center for Digestive Disease Minimally Invasive Incision, Renmin Hospital of Wuhan University, Wuhan, China
| | - Jing Wang
- Department of Gastroenterology, Renmin Hospital of Wuhan University, 99 Zhangzhidong Road, Wuhan, 430060, Hubei Province, China
- Key Laboratory of Hubei Province for Digestive System Disease, Renmin Hospital of Wuhan University, Wuhan, China
- Hubei Provincial Clinical Research Center for Digestive Disease Minimally Invasive Incision, Renmin Hospital of Wuhan University, Wuhan, China
| | - Jian Kang
- Department of Gastroenterology, Renmin Hospital of Wuhan University, 99 Zhangzhidong Road, Wuhan, 430060, Hubei Province, China
- Key Laboratory of Hubei Province for Digestive System Disease, Renmin Hospital of Wuhan University, Wuhan, China
- Hubei Provincial Clinical Research Center for Digestive Disease Minimally Invasive Incision, Renmin Hospital of Wuhan University, Wuhan, China
| | - Anning Yin
- Department of Gastroenterology, Renmin Hospital of Wuhan University, 99 Zhangzhidong Road, Wuhan, 430060, Hubei Province, China
- Key Laboratory of Hubei Province for Digestive System Disease, Renmin Hospital of Wuhan University, Wuhan, China
- Hubei Provincial Clinical Research Center for Digestive Disease Minimally Invasive Incision, Renmin Hospital of Wuhan University, Wuhan, China
| | - Haixia Ren
- Department of Gastroenterology, Renmin Hospital of Wuhan University, 99 Zhangzhidong Road, Wuhan, 430060, Hubei Province, China
- Key Laboratory of Hubei Province for Digestive System Disease, Renmin Hospital of Wuhan University, Wuhan, China
- Hubei Provincial Clinical Research Center for Digestive Disease Minimally Invasive Incision, Renmin Hospital of Wuhan University, Wuhan, China
| | - Xiaoda Jiang
- Department of Gastroenterology, Renmin Hospital of Wuhan University, 99 Zhangzhidong Road, Wuhan, 430060, Hubei Province, China
- Key Laboratory of Hubei Province for Digestive System Disease, Renmin Hospital of Wuhan University, Wuhan, China
- Hubei Provincial Clinical Research Center for Digestive Disease Minimally Invasive Incision, Renmin Hospital of Wuhan University, Wuhan, China
| | - Yijuan Ding
- Department of Gastroenterology, Renmin Hospital of Wuhan University, 99 Zhangzhidong Road, Wuhan, 430060, Hubei Province, China
- Key Laboratory of Hubei Province for Digestive System Disease, Renmin Hospital of Wuhan University, Wuhan, China
- Hubei Provincial Clinical Research Center for Digestive Disease Minimally Invasive Incision, Renmin Hospital of Wuhan University, Wuhan, China
| | - Ping An
- Department of Gastroenterology, Renmin Hospital of Wuhan University, 99 Zhangzhidong Road, Wuhan, 430060, Hubei Province, China.
- Key Laboratory of Hubei Province for Digestive System Disease, Renmin Hospital of Wuhan University, Wuhan, China.
- Hubei Provincial Clinical Research Center for Digestive Disease Minimally Invasive Incision, Renmin Hospital of Wuhan University, Wuhan, China.
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Roberts-West L, Gravatt A, Guest N, Hunt A, Siddique L, Serbic D. A Comparison of Social Exclusion Towards People with Depression or Chronic Back Pain. Br J Pain 2023; 17:267-280. [PMID: 37342396 PMCID: PMC10278445 DOI: 10.1177/20494637221148337] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/20/2023] Open
Abstract
Objectives Research comparing mental and physical health stigma is scarce. The aim of this study was to compare social exclusion towards hypothetical males and females with depression or chronic back pain. Furthermore, the study investigated whether social exclusion is associated with participant's empathy and personality traits, while controlling for their sex, age and personal exposure to mental/physical chronic health conditions. Design This study employed a cross-sectional questionnaire design. Methods Participants (N = 253) completed an online vignette-based questionnaire and were randomly allocated to either a depression or chronic back pain study condition. Measures of social exclusion through respondents' willingness to interact with hypothetical individuals, empathy and the Big Five personality traits were completed. Results Willingness to interact scores did not significantly differ depending on the diagnosis or sex of the hypothetical person in the vignette. For depression, higher levels of conscientiousness significantly predicted less willingness to interact. Whilst being a female participant and having higher empathy significantly predicted greater willingness to interact. For chronic back pain, higher empathy significantly predicted greater willingness to interact, with no significant predictors found from the Big Five personality traits. Conclusion Findings indicate that females and males with depression or chronic back pain face similar levels of social exclusion, with empathy being a core variable driving social exclusion behaviours. These findings enhance our understanding of potential variables driving social exclusion, in-turn informing campaign development to reduce public stigma towards depression and chronic back pain.
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Affiliation(s)
- Lucy Roberts-West
- Department of Psychology, Royal Holloway University of London, Egham, SRY, UK
| | - Amy Gravatt
- Department of Psychology, Royal Holloway University of London, Egham, SRY, UK
| | - Natasha Guest
- Department of Psychology, Royal Holloway University of London, Egham, SRY, UK
| | - Ashley Hunt
- Department of Psychology, Royal Holloway University of London, Egham, SRY, UK
| | - Laraib Siddique
- Department of Psychology, Royal Holloway University of London, Egham, SRY, UK
| | - Danijela Serbic
- Department of Psychology, Royal Holloway University of London, Egham, SRY, UK
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Tajirian M, Juarez B, Martinez T. Adapting a Dental Anxiety Measure to Encourage Empathy. Int J Dent 2023; 2023:4909993. [PMID: 37261033 PMCID: PMC10228219 DOI: 10.1155/2023/4909993] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Revised: 04/14/2023] [Accepted: 05/06/2023] [Indexed: 06/02/2023] Open
Abstract
Introduction The aim of this study was to improve upon the Modified Dental Anxiety Scale (MDAS) by developing the empathy-based International-Modified Dental Anxiety Scale (I-MDAS). This new measure was then utilized to compare the dental anxiety of patients cross-culturally. Methodology. This study was a descriptive cross-sectional study adapting the MDAS into the I-MDAS by adding the International scale. The study surveyed 465 participants from a dental clinic, SurveySwap, and distributed flyers. Data was collected through Qualtrics through the self-administered I-MDAS and analyzed through the SPSS computer software version 28. Participants were categorized into two subgroups where 41.3% received dental care only within the United States and are termed the domestic population, and 58.7% received dental care outside of the United States and are labeled the nondomestic population. Information about demographics, past negative dental experiences, and current dental anxiety was collected. The conducted analyses utilized an independent sample t-test to compare the subgroups' anxiety levels, a bivariate correlation to find the Pearson correlation, a Cronbach's coefficient α, and a one way ANOVA test to compare the genders' I-MDAS scores. Results There was no significant difference in dental anxiety levels between the domestic population (M = 12.73, SD = 5.13) and the nondomestic population (M = 12.76, SD = 5.06); t (463) = -0.58, p = 0.95). The I-MDAS shows evidence of validity and reliability. There was a significant and positive relationship between the International scale items and the MDAS scale items (r (463) = 0.60, p < 0.001), indicating the criterion validity of the I-MDAS. Content validity was strengthened by expanding the inquired topics in the new measure. The Cronbach's α value of 0.85 shows that the I-MDAS is reliable for clinical applications. Conclusions The I-MDAS improves upon the MDAS by providing dentists with a tool for encouraging empathy. Dental clinicians across nations can use the I-MDAS to combat the vicious cycle of dental anxiety.
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Detsomboonrat P, Theppanich S, Banyen S, Hongviphat S, Khamnil Y, Lapauthaya K, Somboonsavatdee A, Min SN. Empathy level towards patients among thai dental students: a cross-sectional study. BMC Oral Health 2023; 23:184. [PMID: 36997938 PMCID: PMC10061995 DOI: 10.1186/s12903-023-02891-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2022] [Accepted: 03/15/2023] [Indexed: 04/01/2023] Open
Abstract
BACKGROUND This study aimed to develop the Jefferson scale of Empathy - Health Professions student version (JSE-HPS) for the dental student in the Thai version and assess the empathy level in students across gender, universities, and year of dental education. METHODS JSE-HPS original version was translated to develop the draft Thai JSE-HPS version and was administered to 5 dental students for a pilot test. The final questionnaires (JSE-HPS) were completed by 439 dental students from five public universities and one private in Thailand in the 2021-2022 academic year. The internal consistency and reliability (test-retest) of the questionnaires were tested by using Cronbach's alpha and intraclass correlation coefficient (ICC). Factor analysis was used to examine the underlying factors of the JSE-HPS (Thai language). RESULTS The JSE-HPS represented good internal consistency (Cronbach's α = 0.83). Factor analysis revealed, "Compassionate Care", "Perspective Taking" and "Ability to stand in Patients' Shoes" as the first, second, and third factors, respectively. The mean empathy score of dental students was 114.30 (SD = 13.06) from the total score of 140. There were no significant differences in the empathy levels among genders, study programs, grades, universities, regions, types of universities, and years of study. CONCLUSION The findings confirm the reliability and validity of the JSE-HPS (Thai version) to measure the empathy level among dental students. Integrating empathic elements into the dental curriculum will help student learning to be more effective and improve treatment outcomes.
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Affiliation(s)
- Palinee Detsomboonrat
- Department of Community Dentistry, Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand
| | - Sudthida Theppanich
- Undergraduate dental student, Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand
| | - Suttida Banyen
- Undergraduate dental student, Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand
| | - Sansern Hongviphat
- Undergraduate dental student, Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand
| | | | - Komsun Lapauthaya
- Department of Community Dentistry, Faculty of Dentistry, Mahidol University, Bangkok, Thailand
| | - Anupap Somboonsavatdee
- Department of Statistics, Chulalongkorn Business School, Chulalongkorn University, Bangkok, Thailand
| | - Saw Nay Min
- Department of Community Dentistry, Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand.
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Hamer K, McFarland S. The role of early intergroup experiences for identification with all humanity in adulthood. Front Psychol 2023; 14:1042602. [PMID: 37008867 PMCID: PMC10050495 DOI: 10.3389/fpsyg.2023.1042602] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2022] [Accepted: 02/27/2023] [Indexed: 03/17/2023] Open
Abstract
Identification with all humanity (IWAH), defined as a bond with and concern for people all over the world, predicts concern for global problems, commitment to human rights, and prosocial activities. However, it is still unknown how such a broad social identification develops and if early experiences play any role. Two studies explored the role of diverse childhood and adolescence intergroup experiences in predicting IWAH in adulthood. We focused on experiences such as being raised in diversity and having intergroup friends, helping or being helped by various others, and having experiences leading to re- or de-categorization, and introduced a new Childhood/Adolescent Intergroup Experiences (CAIE) scale. Study 1 (N = 313 U.S. students, M age = 21) and Study 2 (N = 1,000, a representative Polish sample, M age = 47) found that this kind of intergroup experiences during childhood and adolescence predicted IWAH beyond the effects of its other known predictors, such as empathy, openness to experience, universalism, right-wing authoritarianism, social dominance orientation or ethnocentrism. These results, obtained on various samples and in countries with different ethno-cultural contexts, point to potential ways of enlarging IWAH during childhood and adolescence.
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Affiliation(s)
- Katarzyna Hamer
- Institute of Psychology of Polish Academy of Sciences, Warsaw, Poland
| | - Sam McFarland
- Western Kentucky University, Bowling Green, KY, United States
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22
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Olszewski AE, Bogetz J, Mercer A, Bradford MC, Scott M, Fields B, Williams K, Rosenberg AR, Trowbridge A. Empathy Expression in Interpreted and Noninterpreted Care Conferences of Seriously Ill Children. Pediatrics 2023; 151:e2022059447. [PMID: 36785992 PMCID: PMC9986854 DOI: 10.1542/peds.2022-059447] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/21/2022] [Indexed: 02/15/2023] Open
Abstract
BACKGROUND AND OBJECTIVES Clinician empathy is associated with improved communication and clinical outcomes. We hypothesized that, when clinicians express empathy, families are more likely to deepen discussions, and that clinicians express less empathy in care conferences with language interpretation. METHODS Prospective, mixed methods cohort study of English and interpreted audio-recorded transcripts of care conferences for pediatric patients with serious illness hospitalized at a single urban, quaternary medical institution between January 2018 and January 2021. Directed content analysis identified empathic opportunities, clinician empathetic statements or missed opportunities, and family responses. Clinician empathic statements were "buried" if immediately followed by more clinician medical talk. Descriptive analyses summarized demographics and codes. χ2 analyses summarized differences among language interpretation and family responses. RESULTS Twenty-nine patient-family dyads participated. Twenty-two (81%) family members were female. Eleven (39%) used language interpretation (8 Spanish, 2 Vietnamese, 1 Somali). Families created 210 empathic opportunities. Clinicians responded with unburied empathy 80 times (38%, no differences for English versus interpreted care conferences, P = .88). When clinicians buried empathy or missed empathic opportunities, families responded with alliance (agreement, gratitude, or emotional deepening) 14% and 15% of the time, respectively. When clinicians responded with unburied empathy, families responded with alliance 83% of the time (P < .01). CONCLUSIONS Our study suggests that clinician empathic expression does not differ when language interpretation is used in pediatric care conferences. Clinicians often miss opportunities to express empathy, or they bury it by medical talk. Although unburied empathy created opportunities for relationship-building and family-sharing, buried empathy negatively impacted these domains similarly to no empathic expression.
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Affiliation(s)
- Aleksandra E. Olszewski
- Divisions of Bioethics and Palliative Care
- Division of Critical Care Medicine, Department of Pediatrics, Lurie Children’s Hospital and Northwestern University, Chicago, Illinois
| | - Jori Bogetz
- Divisions of Bioethics and Palliative Care
- Palliative Care and Resilience Program
| | | | - Miranda C. Bradford
- Palliative Care and Resilience Program
- Core for Biostatistics, Epidemiology and Analytics in Research, Seattle Children’s Research Institute, Seattle, Washington
| | - Maya Scott
- Divisions of Bioethics and Palliative Care
- Center for Diversity and Health Equity
| | | | - Kelli Williams
- Parent Advisory Council, Seattle Children’s Hospital, Seattle, Washington
| | - Abby R. Rosenberg
- Hematology and Oncology, Department of Pediatrics, University of Washington and Seattle Children’s Hospital, Seattle, Washington
- Palliative Care and Resilience Program
| | - Amy Trowbridge
- Divisions of Bioethics and Palliative Care
- Palliative Care and Resilience Program
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Malbois E, Hurst-Majno S. Empathy is not so perfect! -For a descriptive and wide conception of empathy. MEDICINE, HEALTH CARE, AND PHILOSOPHY 2023; 26:85-97. [PMID: 36380157 PMCID: PMC9984513 DOI: 10.1007/s11019-022-10124-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 10/21/2022] [Indexed: 06/16/2023]
Abstract
Physician empathy is considered essential for good clinical care. Empirical evidence shows that it correlates with better patient satisfaction, compliance, and clinical outcomes. These data have nevertheless been criticized because of a lack of consistency and reliability. In this paper, we claim that these issues partly stem from the widespread idealization of empathy: we mistakenly assume that physician empathy always contributes to good care. This has prevented us from agreeing on a definition of empathy, from understanding the effects of its different components and from exploring its limits. This is problematic because physicians' ignorance of the risks of empathy and of strategies to manage them can impact their work and wellbeing negatively. To address this problem, we explore the effects of the potential components of empathy and argue that it should be conceived as a purely descriptive and wide term. We end by discussing implications for medical education.
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Affiliation(s)
- Elodie Malbois
- Institute for Ethics, History, and the Humanities, University of Geneva, Geneva, Switzerland.
| | - S Hurst-Majno
- Institute for Ethics, History, and the Humanities, University of Geneva, Geneva, Switzerland
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24
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Erlich D, Lee A, Duggan A, Walec K. Preparing for the End of Life: Medical Students Completing Their Own Advance Directives Described Increased Empathy for Patients. Fam Med 2023; 55:195-198. [PMID: 36888675 PMCID: PMC10622001 DOI: 10.22454/fammed.2023.183324] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
BACKGROUND AND OBJECTIVES Family medicine offers the opportunity to integrate advance care planning into routine primary care, connecting relationship-centered orientation with thoughtful action before a terminal diagnosis. However, physicians are undertrained in end-of-life counseling and care. To address this educational gap, we had clerkship students complete their own advance directives and submit a written reflection about the experience. The aim of this study was to learn about how students report on the value of completing their own advance directives, according to their written reflections. We hypothesized that self-described empathy, previously defined as understanding patients' emotions and communicating that understanding back to patients, would increase, as reported by students in their reflections. METHODS We analyzed 548 written reflections over 3 academic years using a qualitative content analysis approach. An iterative process included open coding, building of themes, and verification with the text by four professionally diverse researchers. RESULTS After completing their own advance directives, students reported increased empathy for patients facing end-of-life decisions and discussed the intention to change their future clinical practice regarding helping patients plan for the end of life. CONCLUSIONS Using experiential empathy, an approach to teaching and cultivating empathy in which the participants experience the topic first-hand, we directed medical students to consider their own end-of-life wishes. Upon reflection, many noted this process changed their attitudes and clinical approaches to patients' death. This learning experience could be one meaningful component of a longitudinal and comprehensive curriculum to prepare medical school graduates to help patients plan for and face the end of life.
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Affiliation(s)
| | - Amy Lee
- Tufts University School of MedicineBoston, MA
| | - Ashley Duggan
- Tufts University School of MedicineBoston, MA
- Boston CollegeBoston, MA
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25
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Bedir D, Agduman F, Bedir F, Erhan SE. The mediator role of communication skill in the relationship between empathy, team cohesion, and competition performance in curlers. Front Psychol 2023; 14:1115402. [PMID: 36874810 PMCID: PMC9978815 DOI: 10.3389/fpsyg.2023.1115402] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2022] [Accepted: 01/25/2023] [Indexed: 02/18/2023] Open
Abstract
Understanding the psycho-social factors such as communication, empathy, cohesion, etc., that affect successful athletic performance is a high priority and primary focus for applied sports psychology. Detailed examination of the athletes' psycho-social characteristics is essential in revealing which processes play an active role in achieving optimum performance. Developing these features of the athlete can contribute to coordinating the team, sharing tasks, increasing motivation, preparing team members for a change, and improving performance. For this purpose, the mediating role of communication skills in the relationship between empathy, team cohesion, and competition performance was examined in a sample of 241 curlers competing in 69 teams in the Turkish Curling League in the 2021-2022 season. During the data collection process, Personal Information Form, Empathic Tendency Scale, Scale for Effective Communication in Team Sport, and Group Environment Questionnaire were used. Competition performance was calculated by giving 1 point for each match won by the teams in the competitions in which the single-circuit round-robin system is applied. Structural equation modeling was used in data analysis to determine the direct and indirect predictive effects between variables. The study showed that empathy and team cohesion predict competition performance through communication skills, and communication skills fully mediate this relationship. Based on the research results, it was evaluated that communication skills have a substantial effect on the competitive performance of athletes, and this finding was discussed in the context of the literature.
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Affiliation(s)
- Deniz Bedir
- Faculty of Sport Sciences, Erzurum Technical University, Erzurum, Türkiye
| | - Fatih Agduman
- Faculty of Sport Sciences, Ataturk University, Erzurum, Türkiye
| | - Fatih Bedir
- Faculty of Sport Sciences, Ataturk University, Erzurum, Türkiye
| | - Suleyman Erim Erhan
- College of Physical Education and Sports, Tekirdag Namik Kemal University, Tekirdag, Türkiye
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McNally G, Haque E, Sharp S, Thampy H. Teaching empathy to medical students. CLINICAL TEACHER 2023; 20:e13557. [PMID: 36560858 PMCID: PMC10107542 DOI: 10.1111/tct.13557] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2021] [Accepted: 12/02/2022] [Indexed: 12/24/2022]
Abstract
BACKGROUND Empathy is a core skill essential to patient-centred care. Yet a decline in empathy throughout undergraduate medical education is well recognised. The mainstay of existing teaching approaches to foster medical students' empathic ability has largely focused on the cognitive domain of empathy within the context of communication skills learning. However, there is growing evidence for educational initiatives that better evoke students' affective emotional responses. APPROACH A student-led educational initiative was created to enhance medical students' understanding of empathy through undertaking different experiential approaches. Eight medical students were invited to participate in an empathy workshop that involved two experiential approaches: personal simulation, and patient narrative, selected given their expected focus on the affective domain. EVALUATION A subsequent focus group discussion explored students' reactions, learning, and intended future change in practice. Discussions were coded and analysed for descriptive themes. Both initiatives were reported to generate students' empathic responses. Personal simulation evoked more affective domains whilst patient narratives additionally created cognitive empathic insight into the impact of the patient's condition. Students also reported intended changes to their future consulting practices. CONCLUSIONS Although this is a small-scale exploration of medical students' experiences of empathy-related teaching initiatives, it offers insight into how each initiative could target different aspects of empathy. Data support the use of even brief experiential teaching to improve medical students' empathy during their undergraduate training. We provide recommendations for clinical educators who are considering designing similar initiatives within their undergraduate medical curricula.
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Affiliation(s)
- Gemma McNally
- University of Manchester Medical School, Manchester, UK
| | - Enam Haque
- University of Manchester Medical School, Manchester, UK
| | - Sarah Sharp
- University of Manchester Medical School, Manchester, UK
| | - Harish Thampy
- University of Manchester Medical School, Manchester, UK
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27
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Yuen JK, See C, Cheung JTK, Lum CM, Lee JS, Wong WT. Can teaching serious illness communication skills foster multidimensional empathy? A mixed-methods study. BMC MEDICAL EDUCATION 2023; 23:20. [PMID: 36631787 PMCID: PMC9835381 DOI: 10.1186/s12909-023-04010-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/22/2022] [Accepted: 01/06/2023] [Indexed: 06/17/2023]
Abstract
BACKGROUND To investigate the impact of a serious illness communication skills training course on medical students' attitudes regarding clinical empathy, self-efficacy in empathic communication, and learning on different dimensions of empathy. METHODS A mixed-methods design was used. A blended learning Serious Illness Communication Skills Training (SI-CST) course was delivered to sixth-year medical students. Students (n=185) completed questionnaires with the 20-item Jefferson Scale of Empathy (JSE) and self-rated preparedness level for five empathic communication tasks at baseline (T1), six weeks (T2), and three-to-six months post-training (T3). Written reflections on key lessons learned were analyzed using inductive thematic analysis. RESULTS Total JSE scores significantly improved from T1 to T2 (111.4 vs 113.9, P=.01) and from T1 to T3 (111.4 vs 113.9, P=.01). There was an increase in Standing in Patient's Shoes subscale of the JSE with an effect size of 0.56 whereas the Perspective-Taking and Compassionate Care subscales showed no significant changes. Self-rated preparedness for all five empathic communication tasks significantly improved from T1 to T2 (P ≤ .001) and from T1 to T3 (P ≤ .001) with large effect sizes (1.09-1.41). Four key themes emerged from the qualitative analysis. They were appreciating the important role of empathy in clinical care (moral empathy), learning skills in detecting and understanding patient emotions (cognitive empathy), learning skills in responding to emotion with empathy (behavioral empathy), and appreciating that communication skills can be improved with continual practice and self-reflection. CONCLUSIONS Our results revealed that SI-CST improved medical students' empathic attitudes and self-efficacy in empathic communication. Qualitative results found learning on the cognitive, behavioral and moral dimensions of empathy.
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Affiliation(s)
- Jacqueline K Yuen
- Department of Medicine, The University of Hong Kong, Queen Mary Hospital, 4/F Professorial Block, 102 Pokfulam Road, Pokfulam, Hong Kong SAR, China.
| | - Christopher See
- School of Biomedical Sciences, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Johnny T K Cheung
- Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Chor Ming Lum
- Department of Medical and Geriatrics, Shatin Hospital, Hong Kong SAR, China
| | - Jenny Sw Lee
- Department of Medicine, Alice Ho Miu Ling Nethersole Hospital, Hong Kong SAR, China
| | - Wai Tat Wong
- Department of Anaesthesia & Intensive Care, The Chinese University of Hong Kong, Hong Kong SAR, China
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28
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The New Renaissance of Family Medicine: Myth or Reality. Zdr Varst 2022; 62:1-4. [PMID: 36694794 PMCID: PMC9837810 DOI: 10.2478/sjph-2023-0001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2022] [Accepted: 11/28/2022] [Indexed: 12/30/2022] Open
Abstract
Renaissance is the term used for the societal movement that marked the end of the Middle Ages. With the development of science came the rediscovery of the works and values of ancient scholars. This brought enormous development in all areas of society, including education. Man became the measure of all things, humanism became important again, and there was a blossoming of science and art. The 'renaissance of family medicine' took place approximately 50 years ago as a response to over-technical (even inhumane) medicine. Family medicine focused on the patient and was, as such, rediscovered and developed as a scientific discipline. In 2022 Wonca Europe launched a new document that set out the core values of family medicine, initiating a discussion about the 'new' renaissance of family medicine. The idea implies that, due to the changes brought about by rapid technical advances and recent global events, family medicine will develop further. However, the really intriguing question is whether these rapid and dramatic changes will actually result in a new renaissance of family medicine or whether they will result in its decline.
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29
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Lorenz FJ, Darok MC, Ho L, Holstrom-Mercader MS, Freiberg AS, Dellasega CA. The Impact of an Unconventional Elective in Narrative Medicine and Pediatric Psycho-oncology on Humanism in Medical Students. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2022; 37:1798-1805. [PMID: 34057696 DOI: 10.1007/s13187-021-02029-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 05/21/2021] [Indexed: 06/12/2023]
Abstract
Over the course of medical school, students' optimism and hopefulness often devolve into a cynical view of medicine that continues throughout clinical rotations and beyond (Neumann et al., Acad Med 86(8):996-1009, 2011). Here, we present a qualitative evaluation of a novel immersive elective in pediatric psycho-oncology coupled with narrative medicine and its impact on students. Participants were third- and fourth-year medical students who were relieved of traditional clinical duties. Alternatively, they shadowed pediatric cancer patients, keeping narrative journals of their observations and insights. A trained team of pre-clinical medical students and faculty conducted a retrospective analysis of 120 journals written between 2008 and 2019. They compared recurring concepts to assess how blending experiential learning and reflective writing influenced the attitudes and behaviors of students. Consistent themes emerged related to developing a rich understanding of patient experiences, a humanistic appreciation of the context of illness, the ability to meaningfully reflect on insights to critically ill children, and an appreciation for the unique learning opportunity. Additionally, families expressed gratitude for the students' attentiveness to their emotional needs. By the conclusion of the elective, most students discovered that they had reignited their intrinsic empathic behaviors and were provided with beneficial insights that they believed would continue into future rotations. Experiential teaching methods paired with narrative reflection may be a valuable and therapeutic tool to learn the intricacies of the patient perspective, with the potential to enhance humanism in students during a critical time in their medical training when empathy tends to drift. Longitudinal and quantitative studies are warranted to better understand the degree and duration of specific benefits.
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Affiliation(s)
- F Jeffrey Lorenz
- Penn State College of Medicine, 500 University Drive, Hershey, PA, USA.
| | - Matthew C Darok
- Penn State College of Medicine, 500 University Drive, Hershey, PA, USA
| | - Lisa Ho
- Penn State College of Medicine, 500 University Drive, Hershey, PA, USA
| | | | - Andrew S Freiberg
- Department of Pediatrics, Division of Hematology and Oncology, Penn State College of Medicine, 500 University Drive, Hershey, PA, USA
| | - Cheryl A Dellasega
- Department of Humanities, Penn State College of Medicine, 500 University Drive, Hershey, PA, USA
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30
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Zdun-Ryżewska A, Sobczak K, Rudnik A. Fatigue, Pro-Social Attitude and Quality of Life as Predictors of Empathy in Medical and Social-Oriented Students. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:15853. [PMID: 36497926 PMCID: PMC9735796 DOI: 10.3390/ijerph192315853] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/09/2022] [Revised: 11/24/2022] [Accepted: 11/25/2022] [Indexed: 06/17/2023]
Abstract
Empathy is significant in professions that require establishing proper contact as a condition for providing help. Identifying factors related to empathy is important for understanding how to teach empathic behavior. The main goal of this study was to find variables related to empathy in a group of students from two universities: medical and social oriented (N = 1701). The study group consisted of female (81%) and male (19%) participants, aged between 18-20 (37%), 21-23 (49%), or 24 years and above (14%). A self-designed questionnaire was used to collect socio-demographical information, with additional questions (social self-esteem, prosocial attitude, subjective quality of life). Empathy was measured with the EQ-40, fatigue with CHFQ-PL, and stress with PSS-10. The results showed a statistically significant regression model for empathy. A high quality of life and having feelings of pleasure when helping other people allows to predict a high level of empathy, especially among females. Higher levels of fatigue and social self-esteem, the latter of which is measured here by the belief that you are more important than others, predicts lower empathy. There were no differences between students from two different kinds of universities when taking into consideration stress levels, subjective quality of life, and prosocial attitude. However, students from the medical university were more exhausted and more convinced that their value was greater than others, as compared to the students studying social sciences. When teaching empathic behavior, it is beneficial to attempt to maintain or restore students' well-being and reduce fatigue and to teach how to achieve such effects in the future. Learning the balance between compassion, willingness to help, and self-compassion also seems to be important.
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Affiliation(s)
- Agata Zdun-Ryżewska
- Department of Quality of Life Research, Faculty of Health Sciences, Medical University of Gdańsk, 80-210 Gdańsk, Poland
| | - Krzysztof Sobczak
- Department of Sociology of Medicine and Social Pathology, Faculty of Health Sciences, Medical University of Gdansk, 80-210 Gdańsk, Poland
| | - Agata Rudnik
- Institute of Psychology, University of Gdansk, 80-309 Gdańsk, Poland
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Han A, Kim TH. A Quasi-experimental Study Measuring the Effectiveness of Two Empathy Enhancement Programs on Caregivers Working with Older Adults Living Alone. Clin Gerontol 2022; 45:1253-1262. [PMID: 32093528 DOI: 10.1080/07317115.2020.1731639] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Objectives: This quasi-experimental study assessed the effectiveness of two empathy enhancement programs on direct care workers of older adults living alone in South Korea.Methods: A total of 104 direct care workers participated in either a simulation-based program or a lecture-based program. Data were collected prior to and 2 weeks after the program implementation using self-reported questionnaires.Results: The lecture-based group had significantly higher levels of empathy compared to the simulation-based group. Pretest-posttest differences were found in the lecture-based group only, including higher levels of empathy and caring efficacy and lower levels of secondary traumatic stress and burnout.Conclusions: More studies are needed to identify helpful components of empathy enhancement programs to direct care workers working with older adults living alone. Also, a further randomized controlled trial study is needed to assess programs' effectiveness on older adults living alone and direct care workers.Clinical implications: A lecture-based empathy enhancement program can increase levels of empathy and caring efficacy of direct care workers working with older adults and decrease care workers' levels of burnout and stress. Training for direct care workers of older adults is needed to improve the empathy of direct care workers while reducing their stress and burnout.
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Affiliation(s)
- Areum Han
- Department of Occupational Therapy, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Tae Hui Kim
- Department of Psychiatry, Yonsei University Wonju College of Medicine, Wonju, South Korea
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32
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Innes SI, Simpson JK. Empathy levels in Australian chiropractic students. THE JOURNAL OF CHIROPRACTIC EDUCATION 2022; 36:110-116. [PMID: 35294012 PMCID: PMC9536223 DOI: 10.7899/jce-21-16] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/23/2021] [Revised: 05/12/2021] [Accepted: 09/13/2021] [Indexed: 06/14/2023]
Abstract
OBJECTIVE Empathy is an important modifiable quality of health care practitioners that relates to the quality of patient care. The educative process may adversely affect the empathy levels of health care students at key phases of training. This topic remains unexplored in chiropractic students to date. METHODS A voluntary and anonymous questionnaire was distributed to all chiropractic students in an Australian university-based program in April 2021. This questionnaire recorded age, sex, year of study, and Toronto Empathy Questionnaire scores. RESULTS Chiropractic student empathy scores approximated those of other Australian health care students. No statistical differences were found when comparing the mean scores of empathy levels across the 5 student cohorts. The empathy levels of female chiropractic students' were significantly higher than those of the male chiropractic students. CONCLUSION This study provides a baseline from which further explorations on empathy may be conducted in chiropractic students. This holds the potential to improve practitioners' quality of life and patient outcomes and for educators to identify subject matter that may negatively affect empathy levels.
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Assing Hvidt E, Ulsø A, Thorngreen CV, Søndergaard J, Andersen CM. Weak inclusion of the medical humanities in medical education: a qualitative study among Danish medical students. BMC MEDICAL EDUCATION 2022; 22:660. [PMID: 36064397 PMCID: PMC9442995 DOI: 10.1186/s12909-022-03723-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/21/2022] [Accepted: 08/30/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND The modern medical education is predominantly grounded in the biomedical sciences. In recent years, medical humanities have been included into the medical curricula in many countries around the world one of the objectives being to promote patient-centred, empathic care by future physicians. Studies have been made of the impact of inclusion of medical humanities components within the medical curriculum. Although some results suggest increased empathy, others remain inconclusive. To gain insight into the depth, context, and impact of inclusion of the medical humanities for future physicians, this study aimed to explore Danish medical students' understanding of and reflections on how the medical humanities relate to the medical education, including the clinic. METHODS We conducted a qualitative research study, involving semi-structured interviews with twenty-three Danish medical students across years of curriculum and medical schools. Interviews were recorded, transcribed verbatim and analyzed using Braun and Clarke's thematic analysis. RESULTS The findings demonstrate the subordinate role of the medical humanities in the medical educational system. Students prioritize biomedical knowledge building in the preclinical curriculum, partly as a reaction to an unbalanced institutional inclusion of the medical humanities. Observing how structural empathy incentives are lacking in the clinical curriculum, the values inherent in the medical humanities are undermined. CONCLUSION Danish medical students become part of an educational environment with lacking institutional conditions and structures to promote the strong inclusion of the medical humanities. A focus is therefore needed on the values, norms and structures of the medical educational systems that undermine a strong inclusion of the medical humanities into medical education.
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Affiliation(s)
- Elisabeth Assing Hvidt
- Research Unit of General Practice, Department of Public Health, University of Southern Denmark, J.B. Winsløwsvej 9 A, 5000, Odense, Denmark.
| | - Anne Ulsø
- Research Unit of General Practice, Department of Public Health, University of Southern Denmark, J.B. Winsløwsvej 9 A, 5000, Odense, Denmark
| | | | - Jens Søndergaard
- Research Unit of General Practice, Department of Public Health, University of Southern Denmark, J.B. Winsløwsvej 9 A, 5000, Odense, Denmark
| | - Christina Maar Andersen
- Department of Psychology, University of Southern Denmark, Odense, Denmark
- Steno Diabetes Center Odense, Odense University Hospital, Odense, Denmark
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Assing Hvidt E, Ulsø A, Thorngreen CV, Søndergaard J, Andersen CM. Empathy as a learning objective in medical education: using phenomenology of learning theory to explore medical students' learning processes. BMC MEDICAL EDUCATION 2022; 22:628. [PMID: 35982451 PMCID: PMC9389818 DOI: 10.1186/s12909-022-03696-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/13/2022] [Accepted: 08/16/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND Clinical empathy has been associated with a range of positive patient- and clinician outcomes. Educating medical students to become empathic physicians has in recent years become a clearly pronounced learning objective in medical education in many countries worldwide. Research knowledge about how medical students experience the learning processes conveyed by empathy-enhancing educational interventions is lacking. Our study aimed to explore Danish medical students' perspectives on which experiences allowed learning processes to take place in relation to empathy and empathic communication with patients. METHODS We conducted a qualitative research study, involving semi-structured interviews with twenty-three Danish medical students across years of curriculum and universities. Braun and Clarke's reflexive thematic analysis (RTA) guided the analytical process, moving on a continuum from inductive to deductive, theoretical approaches. Key concepts in regard to learning processes deriving from Amadeo Giorgi's learning theory were applied to analyse the data. RESULTS Learning processes in relation to clinical empathy occured: 1. when theoretical knowledge about empathy became embodied and contextualied within a clinical context 2. through interpersonal interactions, e.g., with peers, faculty members and clinicians, that conveyed behavior-mobilizing positive and negative affect and 3. when new learning discoveries in 2. and 3. were appropriated as a personalized and adequate behavior that transcends the situational level. CONCLUSION Rather than being an immediate product of knowledge transmission, skill acquisition or training, learning clinical empathy is experienced as a dynamic, temporal process embedded in a daily clinical lifeworld of becoming an increasingly human professional.
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Affiliation(s)
- Elisabeth Assing Hvidt
- Research Unit of General Practice, Department of Public Health, University of Southern Denmark, J.B. Winsløwsvej 9 A, 5000, Odense, Denmark.
| | - Anne Ulsø
- Research Unit of General Practice, Department of Public Health, University of Southern Denmark, J.B. Winsløwsvej 9 A, 5000, Odense, Denmark
| | | | - Jens Søndergaard
- Research Unit of General Practice, Department of Public Health, University of Southern Denmark, J.B. Winsløwsvej 9 A, 5000, Odense, Denmark
| | - Christina Maar Andersen
- Department of Psychology, University of Southern Denmark, Odense, Denmark
- Steno Diabetes Center Odense, Odense University Hospital, Odense, Denmark
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Lobchuk M, Hoplock L, Harder N, Friesen M, Rempel J, Bathi PR. Usability testing of a Web-Based Empathy Training Portal: A Mixed Methods Study (Preprint). JMIR Form Res 2022; 7:e41222. [PMID: 37014693 PMCID: PMC10131903 DOI: 10.2196/41222] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2022] [Revised: 01/26/2023] [Accepted: 02/13/2023] [Indexed: 02/17/2023] Open
Abstract
BACKGROUND The prepandemic period saw a rise in web-based teaching. However, web-based tools for teaching the essential clinical skill of cognitive empathy (also known as perspective taking) remain limited. More of these tools are needed and require testing for ease of use and understanding by students. OBJECTIVE This study aimed to evaluate the usability of the In Your Shoes web-based empathy training portal application for students using quantitative and qualitative methods. METHODS This 3-phase formative usability study used a mixed methods design. In mid-2021, we conducted a remote observation of student participants interacting with our portal application. Their qualitative reflections were captured, followed by data analysis and iterative design refinements of the application. Overall, 8 third- and fourth-year nursing students from an undergraduate baccalaureate program at a Canadian university, in the western province of Manitoba, were included in this study. Participants in phases 1 and 2 were remotely observed by 3 research personnel while engaged in predefined tasks. In phase 3, two student participants were asked to use the application as they liked in their own environments, after which a video-recorded exit interview with a think-aloud process was conducted as participants responded to the System Usability Scale. We calculated descriptive statistics and performed content analysis to analyze the results. RESULTS This small study included 8 students with a range of technology skills. Usability themes were based on participants' comments on the application's appearance, content, navigation, and functionality. The biggest issues that participants experienced were with navigating the application's "tagging" features during video analysis and the length of educational material. We also observed variations in 2 participants' system usability scores in phase 3. This may be because of their different comfort levels with technology; however, additional research is required. We made iterative refinements to our prototype application (eg, added pop-up messages and provided a narrated video on the application's "tagging" function) based on participant feedback. CONCLUSIONS With increasing engagement in web-based teaching, technology has become an essential medium for receiving health care education. We developed a novel prototype application as a supplemental classroom tool to foster students' self-directed learning of empathy. This study provided direction for refinements to optimize the usability of and satisfaction with this innovative application. Qualitative feedback revealed favorable input toward learning perspective taking place on the web and helpful recommendations for improving user experiences with the application. We could not fully assess the application's key functions owing to the COVID-19 protocols. Thus, our next step is to obtain feedback from a larger sample of student users, whose experiences performing "live" video capture, annotation, and analysis will be more authentic and wholesome with the refined application. We discuss our findings in relation to research on nursing education, perspective taking, and adaptive e-learning.
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Affiliation(s)
- Michelle Lobchuk
- College of Nursing, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada
| | | | - Nicole Harder
- College of Nursing, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada
| | - Marcia Friesen
- Price Faculty of Engineering, University of Manitoba, Winnipeg, MB, Canada
| | - Julie Rempel
- College of Nursing, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada
| | - Prachotan Reddy Bathi
- Department of Computer Science and Engineering, Manipal Institute of Technology, Manipal, India
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Baguley SI, Pavlova A, Consedine NS. More than a feeling? What does compassion in healthcare 'look like' to patients? Health Expect 2022; 25:1691-1702. [PMID: 35661516 PMCID: PMC9327826 DOI: 10.1111/hex.13512] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2021] [Revised: 04/08/2022] [Accepted: 04/11/2022] [Indexed: 12/30/2022] Open
Abstract
OBJECTIVE Compassion is important to patients and their families, predicts positive patient and practitioner outcomes, and is a professional requirement of physicians around the globe. Yet, despite the value placed on compassion, the empirical study of compassion remains in its infancy and little is known regarding what compassion 'looks like' to patients. The current study addresses limitations in prior work by asking patients what physicians do that helps them feel cared for. METHODS Topic modelling analysis was employed to identify empirical commonalities in the text responses of 767 patients describing physician behaviours that led to their feeling cared for. RESULTS Descriptively, seven meaningful groupings of physician actions experienced as compassion emerged: listening and paying attention (71% of responses), following-up and running tests (11%), continuity and holistic care (8%), respecting preferences (4%), genuine understanding (2%), body language and empathy (2%) and counselling and advocacy (1%). CONCLUSION These findings supplement prior work by identifying concrete actions that are experienced as caring by patients. These early data may provide clinicians with useful information to enhance their ability to customize care, strengthen patient-physician relationships and, ultimately, practice medicine in a way that is experienced as compassionate by patients. PUBLIC CONTRIBUTION This study involves the analysis of data provided by a diverse sample of patients from the general community population of New Zealand.
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Affiliation(s)
- Sofie I. Baguley
- Department of Psychological Medicine, Faculty of Medical and Health SciencesUniversity of AucklandAucklandNew Zealand
| | - Alina Pavlova
- Department of Psychological Medicine, Faculty of Medical and Health SciencesUniversity of AucklandAucklandNew Zealand
| | - Nathan S. Consedine
- Department of Psychological Medicine, Faculty of Medical and Health SciencesUniversity of AucklandAucklandNew Zealand
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Ekele R, Onodugo V, Okwo H, Ogba S, Onodugo C, Chukwu B. Medical intern job demands and job carry-over strain: The moderating role of psychosocial mentoring and job satisfaction. JOURNAL OF PSYCHOLOGY IN AFRICA 2022. [DOI: 10.1080/14330237.2022.2031625] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
Affiliation(s)
- Rita Ekele
- Department of Management, Faculty of Business Administration, University of Nigeria, Enugu, Nigeria
| | - Vincent Onodugo
- Department of Management, Faculty of Business Administration, University of Nigeria, Enugu, Nigeria
| | - Henry Okwo
- Department of Management, Faculty of Business Administration, University of Nigeria, Enugu, Nigeria
| | - Sinclair Ogba
- Department of Management, Faculty of Business Administration, University of Nigeria, Enugu, Nigeria
| | - Chike Onodugo
- Department of Management, Faculty of Business Administration, University of Nigeria, Enugu, Nigeria
| | - Benjamin Chukwu
- Department of Management, Faculty of Business Administration, University of Nigeria, Enugu, Nigeria
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Assing Hvidt E, Søndergaard J, Wehberg S, Hvidt NC, Andersen CM. A cross-sectional study of student empathy across four medical schools in Denmark-associations between empathy level and age, sex, specialty preferences and motivation. BMC MEDICAL EDUCATION 2022; 22:489. [PMID: 35739548 PMCID: PMC9223265 DOI: 10.1186/s12909-022-03532-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/02/2022] [Accepted: 06/06/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND Professional empathy has been associated with a range of positive patient- and clinician outcomes and is therefore considered important to develop for future physicians. Measuring changes in empathy scores among medical students by using the Jefferson Scale of Empathy (Student version) (JSE-S) has led to mixed results. So far, no investigation of Danish medical students' empathy development has been conducted. The aim of this study was therefore to examine the associations between empathy scores among Danish medical students and medical school, year of curriculum, age, sex, co-habitation, and parental status, specialty preferences and motivations for choosing medicine as a future profession. METHODS This was a cross-sectional questionnaire study. All medical students from four medical schools in Denmark in their first, third and sixth year (N = 4,178) were invited to participate in the study in October 2020. The associations between JSE-S sum score and the above explanatory factors were analysed by uni- and multivariable linear regression models. RESULTS The JSE-S was completed by 672 medical students. The overall mean score was 112.7. There were no statistically significant differences in empathy between medical schools, first, third- and sixth- year medical students, age groups or parental status. Female students and students living with a spouse or partner scored higher on JSE-S than male students or students living alone, and the sex difference remained statistically significant in the multivariable regression. In both the univariable and multivariable setting, preference for future medical specialty was statistically significant, with a decrease in scores for students choosing surgery-specialties. Motivational factors were not statistically significantly associated with empathy, although there was a slight upwards trend for one of the motivational categories, named "personal experiences". CONCLUSIONS Overall, our results showed neither decrease nor increase but instead rather stable empathy scores across years of curriculum of medical students in Denmark, adding to the mixed picture of empathy development among medical students. Our findings are consistent with positive associations found in international studies between empathy scores and higher age, female sex, specialty preferences for psychiatry and general practice and altruistic motivations for choosing to enroll. Although specialty preferences are changing during medical education, they may be used meaningfully as predictors of individual student empathy levels.
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Affiliation(s)
- Elisabeth Assing Hvidt
- Research Unit for General Practice, Department of Public Health, University of Southern Denmark, J.B. Winsløwsvej 9 A, 5000, Odense, Denmark.
| | - Jens Søndergaard
- Research Unit for General Practice, Department of Public Health, University of Southern Denmark, J.B. Winsløwsvej 9 A, 5000, Odense, Denmark
| | - Sonja Wehberg
- Research Unit for General Practice, Department of Public Health, University of Southern Denmark, J.B. Winsløwsvej 9 A, 5000, Odense, Denmark
| | - Niels Christian Hvidt
- Research Unit for General Practice, Department of Public Health, University of Southern Denmark, J.B. Winsløwsvej 9 A, 5000, Odense, Denmark
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Can Distance Communication Skills Training Increase the Empathy Levels in Medical Students? An Application During the Pandemic Period. JOURNAL OF BASIC AND CLINICAL HEALTH SCIENCES 2022. [DOI: 10.30621/jbachs.1082337] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Background and Purpose: The aim is to determine the effect of the communication skills training (CST) using interactive synchronous and asynchronous methods, which was applied for the first time on medical students’ empathy levels.
Methods: This study is a cross-sectional-analytical, self-controlled intervention.
The distance CST program was applied to first-year medical students. The change in students’ empathy levels was measured with the student version of the Jefferson Empathy Scale.
Results: 241 students’ forms were included. Empathy mean score increased significantly, this increase was higher in women.
Conclusion: The distance CST produced a positive effect on empathy levels. While interactive
PowerPoint® presentations, videos, movie clips, cartoons, real-life examples, written/audio question-
answer activities, surveys, feedback and, small group work were used in live lessons; in the
asynchronous process, student-based techniques (self-assessment, homework, WhatsApp® sharing)
were used to support the online learning climate. We believe that all of them support the cognitive and
social existence of students throughout the training. We propose our program as a model that can be
used during situations where face-to-face education is not possible and to support face-to-face
education in medical education.
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Wang Y, Zhang X, Xie Q, Zhou H, Cheng L. Humanistic caring ability of midwifery students in China and its associated factors: A multi-centre cross-sectional study. NURSE EDUCATION TODAY 2022; 111:105276. [PMID: 35131563 DOI: 10.1016/j.nedt.2022.105276] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/14/2021] [Revised: 11/29/2021] [Accepted: 01/19/2022] [Indexed: 06/14/2023]
Abstract
BACKGROUND Research regarding humanistic caring has proliferated to enable person-centred and holistic care. Empirical evidence investigating the humanistic caring ability is largely derived from studies recruiting general nursing students. Midwifery students, however, remain underrepresented. OBJECTIVES To assess the humanistic caring ability of midwifery students in China and investigate its associated factors. DESIGN A multi-centre cross-sectional descriptive study. SETTINGS Five medical colleges spreading across Eastern, Central and Southern China. PARTICIPANTS Secondary vocational, higher vocational and undergraduate midwifery students (N = 303). METHODS The Caring Ability Inventory (CAI), the Jefferson Scale of Physician Empathy for Nursing Students (JSPE-NS), the Connor-Davidson Resilience Scale (CD-RISC) and the Professional Identity Scale for Nursing Students (PISNS) were used to measure humanistic caring ability, empathy, resilience and professional identity, respectively. Stepwise multiple linear regression was used to explore associated factors. RESULTS The midwifery students' total mean CAI score was 184.63 ± 19.88. In the multiple linear regression analysis, empathy (β = 0.394, p < 0.001), resilience (β = 0.233, p < 0.001) and professional identity (β = 0.161, p = 0.002) were positively associated with the humanistic caring ability of midwifery students. The humanistic caring ability was also influenced by educationl level, perceived concern from peers and recognition of caring ability as a prerequisite for midwifery profession. CONCLUSIONS Midwifery students in China have poor humanistic caring ability, which needs to be further improved. Interventions that cultivate the empathy, resilience and professional identity have the potential to advance the humanistic caring ability of midwifery students. Promoting a supportive and caring atmosphere among peers is also important.
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Affiliation(s)
- Yarui Wang
- School of Nursing, Sun Yat-sen University, Guangzhou, China.
| | - Xi Zhang
- School of Nursing, Sun Yat-sen University, Guangzhou, China.
| | - Qinqin Xie
- School of Nursing, Sun Yat-sen University, Guangzhou, China.
| | - Hua Zhou
- School of Nursing, Sun Yat-sen University, Guangzhou, China.
| | - Li Cheng
- School of Nursing, Sun Yat-sen University, Guangzhou, China.
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Klöckner CC, Gerbase MW, Nendaz M, Baroffio A, Junod NP. Relationship between self-reported cognitive and behavioural empathy among medical students. PATIENT EDUCATION AND COUNSELING 2022; 105:895-901. [PMID: 34419328 DOI: 10.1016/j.pec.2021.07.053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/15/2020] [Revised: 07/27/2021] [Accepted: 07/30/2021] [Indexed: 06/13/2023]
Abstract
OBJECTIVE The aim of this study was to explore the relationship between cognitive and behavioural empathy in medical students. METHODS Fourteen 4th year medical students recruited on the basis of their scores on the self-reported Jefferson Scale of Empathy (JSE-S) were divided into two groups: low JSE-S scorers (n = 8) (M = 96.75, SD = 10.3) and high JSE-S scorers (n = 6) (M = 121.3, SD = 2.94). They were discreetly videotaped while taking history with an incognito standardized patient. Students' behavioural empathy was measured using the Verona Coding System (VR-CoDES-P) and rating of non-verbal behaviour. RESULTS Patients expressed the same number of concerns per encounter in both groups but gave more cues to high-scorers (p = 0.029). However, students of both groups demonstrated the same amount of verbal empathy (high: 16% vs low: 15% p = 1.00). High JSE-S scorers' non-verbal communication tended to be rated slightly higher than low JSE-S-scorers with a higher use of facial expression (p = 0.008). CONCLUSION This study did not reveal any differences of students' verbal empathy to patients' cues and concerns between low and high JSE_S scorers. PRACTICE IMPLICATIONS The VR-CoDES_P is a useful tool to assess medical students and physicians empathic behaviour, allowing to disentangle the different components of empathy.
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Affiliation(s)
| | - Margaret W Gerbase
- Unit of Development and Research in Medical Education, Geneva Faculty of Medicine, Geneva, Switzerland
| | - Mathieu Nendaz
- Unit of Development and Research in Medical Education, Geneva Faculty of Medicine, Geneva, Switzerland; Division of General Intermal Medicine, Geneva University Hospitals, Geneva, Switzerland
| | - Anne Baroffio
- Unit of Development and Research in Medical Education, Geneva Faculty of Medicine, Geneva, Switzerland
| | - Noelle Perron Junod
- Unit of Development and Research in Medical Education, Geneva Faculty of Medicine, Geneva, Switzerland; Institute of Primary Care, Geneva University Hospitals, Geneva, Switzerland.
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G C KB, Arjyal A, Douglas AH, Subedi M, Gongal R. A quantitative evaluation of empathy using JSE-S Tool, before and after a Medical Humanities Module, amongst first-year medical students in Nepal. BMC MEDICAL EDUCATION 2022; 22:159. [PMID: 35260157 PMCID: PMC8903097 DOI: 10.1186/s12909-022-03188-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/14/2020] [Accepted: 02/18/2022] [Indexed: 06/14/2023]
Abstract
BACKGROUND Doctors' empathy: the understanding of patients' experiences, concerns and perspectives, is highly valued by patients yet often lacking in patient care. Medical Humanities has been introduced within undergraduate curriculum to address this lack in empathy. There is a paucity of research on the impact of a course on medical humanities on the empathy of medical students, particularly in South Asia. Here we report on the impact of such an intervention in first-year medical students and aim to help outcome-based medical education and the evaluation and promotion of humanities within medical courses. METHODS This study is a quantitative evaluation of student empathy before and after a Medical Humanities Module. The study employs the Jefferson Scale of Empathy-Student version (JSE-S). Participants were first-year medical students at Patan Academy of Health Sciences, Nepal. All cohort students were invited to participate and written consent was obtained. Data were collected both prior-to and on-completion-of, a six-week Medical Humanities Module. Pre- and post-module data were analyzed and the resulting empathy scores compared using the paired t-test or Wilcoxon signed-rank test. Subgroup analysis was undertaken to determine the association of the score with gender and preferred future speciality. RESULTS Sixty-two student responses were analyzed, 32 (52%) of whom were male. In the pre-module scores females had a slightly higher mean score than males:108 and 103 respectively. Participants who preferred people-oriented specialities also scored higher than those preferring procedure and technology-oriented specialities: 107 and 103 respectively. There was a significant increase in mean score for the entire class from pre-module to post-module: 105 to 116, p-value of < 0.001. Mean scores rose from 103 to 116 in males, and from 108 to 116 in females. Participants preferring procedure and technology-oriented specialities showed a significant increase in mean scores:103 to 117, and participants preferring people-oriented specialities demonstrated a smaller increase:107 to 111. CONCLUSIONS This study provides evidence of the impact of a Medical Humanities course for increasing medical student empathy scores at an institution in Nepal. Teaching of Medical Humanities is an important contributor to the development of empathy in medical students and its widespread expansion in the whole of South Asia should be considered.
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Affiliation(s)
- Krishna Bahadur G C
- Department of Community Health Sciences, Patan Academy of Health Sciences, GPO Box 26500 Ward No.5, Bagmati Province, Lalitpur Metropolitan City, Nepal
| | - Amit Arjyal
- Department of Community Health Sciences, Patan Academy of Health Sciences, GPO Box 26500 Ward No.5, Bagmati Province, Lalitpur Metropolitan City, Nepal.
| | - Amanda Helen Douglas
- Department of General Practice and Emergency Medicine, Patan Academy of Health Sciences, Lalitpur, Nepal
| | - Madhusudan Subedi
- Department of Community Health Sciences, Patan Academy of Health Sciences, GPO Box 26500 Ward No.5, Bagmati Province, Lalitpur Metropolitan City, Nepal
| | - Rajesh Gongal
- Department of Surgery, School of Medicine, Patan Academy of Health Sciences, Lalitpur, Nepal
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Samarasekera DD, Lee SS, Yeo SP, Ponnamperuma G. Development of student empathy during medical education: changes and the influence of context and training. KOREAN JOURNAL OF MEDICAL EDUCATION 2022; 34:17-26. [PMID: 35255613 PMCID: PMC8906926 DOI: 10.3946/kjme.2022.216] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/22/2021] [Revised: 02/07/2022] [Accepted: 02/07/2022] [Indexed: 06/14/2023]
Abstract
PURPOSE Empathy levels have been observed to often decrease when medical undergraduates move to the clinical years, particularly in the Western countries. However, empathy either remains similar or increases in many Asian medical schools. This study investigated the longitudinal empathy profile of medical students in Singapore. METHODS Two cohorts of medical students who enrolled in 2013 and 2014 to the National University of Singapore were tracked for 5 years. The Jefferson Scale of Empathy-student version was used. Analyses on the mean of the empathy level and individual factors, year-wise and gender comparison were conducted. RESULTS Average response rates for cohort 1 and 2 were 68.1% (n=181-263) and 55.4% (n=81-265), respectively. For both cohorts, there was no significant change across year of study in the mean empathy score. Average scores for both cohorts were 113.94 and 115.66. Though not significant, we observed mean empathy to be lowest at the end of year 5 (112.74) and highest in year 2 (114.72) for cohort 1 while for cohort 2, the lowest level of empathy was observed in year 5 (114.20) and highest in year 4 (118.42). Analysis of subcomponents of empathy only showed a significant difference for cohort one factor 1 (perspective taking) and factor 3 (standing in patients' shoes) across the study years. CONCLUSION No significant change in empathy score was observed during the transition from pre-clinical to clinical years, unlike many Western and Far-Eastern studies. This might be due to the curriculum and influence of the Asian values.
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Affiliation(s)
- Dujeepa D. Samarasekera
- Centre for Medical Education (CenMED), Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Shuh Shing Lee
- Centre for Medical Education (CenMED), Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Su Ping Yeo
- Centre for Medical Education (CenMED), Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Gominda Ponnamperuma
- Department of Medical Education, Faculty of Medicine, University of Colombo, Colombo, Sri Lanka
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Diop S, Turmes L, Specht C, Seehagen S, Juckel G, Mavrogiorgou P. Capacities for meta-cognition, social cognition, and alexithymia in postpartum depression. Psychiatry Res 2022; 309:114430. [PMID: 35134669 DOI: 10.1016/j.psychres.2022.114430] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2020] [Revised: 01/27/2022] [Accepted: 02/02/2022] [Indexed: 11/24/2022]
Abstract
Postpartum depression (PPD), a female-specific disorder, is the most common medical complication associated with childbirth (10-20%). The pathological relevance of emotion processing, meta-cognition, alexithymia, and social cognition to PPD is unclear. We tested 25 mothers with PPD (mean age: 30.72 ± 5.76 years) and 25 healthy mothers (mean age: 32.03 ± 3.54 years) for alexithymia (Toronto Alexithymia Scale) and evaluated cognitive empathy (Faux Pas Test), affective empathy (Interpersonal Reactivity Index), meta-cognition (Meta-Cognitions Questionnaire), sociodemographic and clinical-psychometric characteristics and personality dimensions. Mothers with PPD showed higher levels of neuroticism and more anxiety-depressive characteristics. Their metacognitive abilities were significantly altered and they more often had alexithymia. Significant correlations between alexithymia and meta-cognition, trait anxiety, and neuroticism were found. Alexithymia, neurotic personality traits, and dysfunctional meta-cognition appear more frequently in PPD women than healthy women. Social cognition abilities were not significantly altered. Alexithymia and metacognitive distortions play important roles in the pathogenesis of PPD. Dysfunctional meta-cognition, neuroticism, and alexithymia may be risk factors that should be detected early in expectant mothers to prevent the development of PPD.
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Affiliation(s)
- Shirin Diop
- Department of Psychiatry, Ruhr University Bochum, LWL-University Hospital Bochum, Alexandrinenstr. 1, Bochum 44791, Germany
| | - Luc Turmes
- Psychotherapy and Psychosomatic Health, LWL Hospital Herten of Psychiatry, Im Schloßpark 20, Herten 45699, Germany
| | - Christina Specht
- Psychotherapy and Psychosomatic Health, LWL Hospital Herten of Psychiatry, Im Schloßpark 20, Herten 45699, Germany
| | - Sabine Seehagen
- Department of Psychology, Ruhr University Bochum, Universitätstr. 150, Bochum 44801, Germany
| | - Georg Juckel
- Department of Psychiatry, Ruhr University Bochum, LWL-University Hospital Bochum, Alexandrinenstr. 1, Bochum 44791, Germany.
| | - Paraskevi Mavrogiorgou
- Department of Psychiatry, Ruhr University Bochum, LWL-University Hospital Bochum, Alexandrinenstr. 1, Bochum 44791, Germany
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Yelland J, Whittlestone KD. A Call for Compassionate Empathy: Analysis of Verbal Empathic Communication between Veterinary Students and Veterinary Clients and their Dogs. JOURNAL OF VETERINARY MEDICAL EDUCATION 2022; 49:51-60. [PMID: 33657338 DOI: 10.3138/jvme-2020-0046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
In human medicine, empathy contributes to enhanced patient satisfaction and trust, decreased litigation, and increased adherence to medical recommendations. Understanding client perspectives is crucial in the empathic process; failure to explore these perspectives has been linked to decreased client satisfaction in veterinary consultations. This article explores how veterinary clients verbally expressed emotional concerns during consultations and how veterinary students addressed them. The "Model of Empathic Communication in the Medical Interview" by Suchman et al., is the starting point for a thematic analysis of consultation transcripts. Clients expressed multiple emotional concerns both directly by using explicit words (coded as empathic opportunities-EO), and indirectly (coded as potential empathic opportunities-PEO), throughout the consultations. Indirect examples prevailed and included stories about previous experiences with pet illnesses and pet care received elsewhere. Clients used explicit words, including "fear" and "panic." Students usually responded with a biomedical focus, including asking medical questions and giving medical explanations. Although students demonstrated various communication skills, they failed to demonstrate a complete verbal compassionate empathic response (a novel code) that includes exploring and verbalizing accurate understanding of the clients' perspectives and offering help based on this understanding. These findings suggest that strategies to teach compassionate empathy and support its use in the clinical setting are not fully effective, and veterinary students risk entering practice unprepared to employ this vital competency. The authors also introduce an operational definition for compassionate empathy.
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Pieris D, Jafine H, Neilson S, Amster E, Zazulak J, Lam C, Grierson L. Understanding moral empathy: A verbatim-theatre supported phenomenological exploration of the empathy imperative. MEDICAL EDUCATION 2022; 56:186-194. [PMID: 34612521 DOI: 10.1111/medu.14676] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/22/2021] [Revised: 09/05/2021] [Accepted: 09/29/2021] [Indexed: 06/13/2023]
Abstract
OBJECTIVES Several studies have measured a decline in empathy during medical training, speculating that factors within the formal, informal and hidden curricula are responsible for this phenomenon. Although the medical education literature describes the moral domain of empathy as most fundamental to the empathic response, most research into the decline has examined the cognitive, affective and behavioural domains. This study distinguishes itself by focusing on how moral empathy is affected through training. METHODS Ten medical residents from core education specialties at McMaster University participated in lightly structured interviews concerning their training experiences. Interview transcripts were analysed by way of a descriptive phenomenological approach. Analyses afforded descriptions of the way medical training influences moral empathy. These descriptions were then used to generate a verbatim theatre play that was performed for an audience of residents, educators, learners, researchers and scholars. Following the play, audience participants completed a survey to member-check the descriptions and to glean other reflective experiences in resident training that impact moral empathy. The survey results informed revisions to the codebook that was subsequently used to re-analyse the interview transcripts. This resulted in a final, refined version of the influence of training on learner moral empathy. RESULTS The findings suggest that a resident's sense of moral empathy relies upon the notion of an innate capacity for empathy, and is influenced by their clinical and classroom education, and specific experiences with patients during training. Importantly, these factors are rarely experienced as having a direct deleterious impact on residents' moral empathy but rather are experienced as challenges to their ability to act on their moral empathy. CONCLUSIONS The study promotes reflection of what it means to experience empathy in the moral domain. The description offers a new perspective from which to view empathic declines that have been previously reported, while also highlighting a moral-behavioural tension that has implications for competency-based assessment and the way empathy is conceptualised in medical education.
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Affiliation(s)
- Dilshan Pieris
- Health Sciences Education Graduate Program, Faculty of Health Sciences, McMaster University, Hamilton, Canada
- MD Program, Temerty Faculty of Medicine, University of Toronto, Toronto, Canada
- McMaster FHS Program for Education Research, Innovation, and Theory (MERIT), Faculty of Health Sciences, McMaster University, Hamilton, Canada
| | - Hartley Jafine
- Bachelor of Health Sciences Program, Faculty of Health Sciences, McMaster University, Hamilton, Canada
| | - Shane Neilson
- Department of English and Cultural Studies, Faculty of Humanities, McMaster University, Hamilton, Canada
| | - Ellen Amster
- Department of Family Medicine, Faculty of Health Sciences, Department of Religious Studies, McMaster University, Hamilton, Canada
| | - Joyce Zazulak
- Department of Family Medicine, Faculty of Health Sciences, Department of Religious Studies, McMaster University, Hamilton, Canada
| | - Connie Lam
- Bachelor of Health Sciences Program, Faculty of Health Sciences, McMaster University, Hamilton, Canada
| | - Lawrence Grierson
- Health Sciences Education Graduate Program, Faculty of Health Sciences, McMaster University, Hamilton, Canada
- McMaster FHS Program for Education Research, Innovation, and Theory (MERIT), Faculty of Health Sciences, McMaster University, Hamilton, Canada
- Department of Family Medicine, Faculty of Health Sciences, Department of Religious Studies, McMaster University, Hamilton, Canada
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The Effects of Physicians' Communication and Empathy Ability on Physician-Patient Relationship from Physicians' and Patients' Perspectives. J Clin Psychol Med Settings 2022; 29:849-860. [PMID: 35089529 PMCID: PMC8795960 DOI: 10.1007/s10880-022-09844-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/04/2022] [Indexed: 12/30/2022]
Abstract
Physician communication (PC) is central to influencing physician–patient relationship (PPR), and physician empathy (PE) is central to PC. A comprehensive and objective assessment of the mechanisms underlying PPR from the two-way perspective of physicians and patients are important for social development. However, the relationship between these three variables under the two-way perspective is not clear. To examine the effectiveness of PC in predicting PPR from a two-way perspective of physicians and patients and the underlying mechanisms that influence PPR. We selected 2665 physicians and 2983 patients in China and examined the effect of physician empathy on PPR and the mediating role of PC between PE and PPR using structural equation modeling. The results of the physician self-assessment showed that the link between PC and PPR was not significant, while the results of the patient other assessment showed that physician communication was not only effective in predicting the doctor–patient relationship but also mediated the relationship between physician empathy and PPR; further analysis of the underlying mechanisms affecting PPR revealed that the results of the physician self-assessment showed that PC mediated the relationship between perspective-taking and PPR; however, the results of the patient other assessment showed that physician However, patient ratings showed that PC mediated the relationship between perspective-taking and PPR, as well as between empathic concern and PPR. However, patient ratings indicate that PC mediates the relationship between perspective-taking and PPR and between empathic concern and the PPR.
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Holmes MB, Starr JA. A Comparison of Doctor of Physical Therapy Students’ Self-Reported Empathy With Standardized Patients Perceptions of Empathy During a Simulated Telehealth Encounter. J Patient Exp 2022; 9:23743735221112226. [PMID: 35836780 PMCID: PMC9274409 DOI: 10.1177/23743735221112226] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Empathy is an important factor in developing a positive patient–provider relationship. It
has been shown to lead to improved patient outcomes, well-being, and satisfaction. This
study examines the relationship between first-year physical therapy students’
self-reported empathy levels and a patient's perceptions of caregiver empathy during a
standardized patient interview via telehealth. Forty-five students completed a
self-reported empathy survey before the standardized patient encounter using telehealth.
Following the experience, standardized patients rated the perceived empathy demonstrated
by the students during that patient–provider encounter using 2 validated measures. The
mean student self-reported empathy using the Jefferson Scale of Empathy-Health Care
Provider Student (JSE-HPS) version was 123.93 (range 95-135 SD 7.328). The standardized
Jefferson Scale of Patient Perception of Provider Empathy (JSPPPE) scores showed a mean of
23.8 (range 11-32 SD 3.951) and a mean of 3.16 (range 1-5 SD.85) on the Global Rating of
Empathy (GRE). There was no significant correlation found between the JSE-HPS and the
JSPPPE, r = −.47, P = .760, or the GRE
r = −.166, P = .276. The artificial nature of a
standardized patient interaction using the telehealth format for this encounter may have
contributed to the students’ inability to communicate empathy to the patient and may
explain this discrepancy.
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Affiliation(s)
- Mary Beth Holmes
- Department of Physical Therapy, Sargent College, Boston University, Boston, MA, USA
| | - Julie Ann Starr
- Department of Physical Therapy, Sargent College, Boston University, Boston, MA, USA
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Challenging the clinically-situated emotion-deficient version of empathy within medicine and medical education research. SOCIAL THEORY & HEALTH 2022; 20:306-324. [PMID: 34840531 PMCID: PMC8607055 DOI: 10.1057/s41285-021-00174-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/28/2021] [Indexed: 12/30/2022]
Abstract
In this paper, we argue that the notion of a clinically-situated empathy (e.g. physician empathy), is potentially problematic as it perpetuates an emotion-deficient version of empathy within medicine and medicine education research. Utilizing classic and contemporary empathy theory from various social science disciplines, we discuss how empathy in the general sense differs conceptually from clinically-situated empathy-paying particular attention to the role of emotional contagion. To highlight this contrast, we draw upon Hojat et al.'s model of physician empathy and how this body of work reflects broader medical-cultural norms that problematize the role and impact of emotions within the clinical encounter. Alternatively, we present a more encompassing model of empathy drawing upon the fields of social-psychology and social-neuroscience in order to bring the notion of "feeling with" and emotional contagion more specifically, into medical education, medical education research, and medicine more generally.
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Guidi C, Traversa C. Empathy in patient care: from 'Clinical Empathy' to 'Empathic Concern'. MEDICINE, HEALTH CARE, AND PHILOSOPHY 2021; 24:573-585. [PMID: 34196934 PMCID: PMC8557158 DOI: 10.1007/s11019-021-10033-4] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 06/20/2021] [Indexed: 06/07/2023]
Abstract
As empathy gains importance within academia, we propose this review as an attempt to bring clarity upon the diverse and widely debated definitions and conceptions of empathy within the medical field. In this paper, we first evaluate the limits of the Western mainstream medical culture and discuss the origins of phenomena such as dehumanization and detached concern as well as their impacts on patient care. We then pass on to a structured overview of the debate surrounding the notion of clinical empathy and its taxonomy in the medical setting. In particular, we present the dichotomous conception of clinical empathy that is articulated in the debate around cognitive empathy and affective empathy. We thus consider the negative impacts that this categorization brings about. Finally, we advocate for a more encompassing, holistic conception of clinical empathy; one that gives value to a genuine interest in welcoming, acknowledging and responding to the emotions of those suffering. Following this line of reasoning, we advance the notion of 'empathic concern', a re-conceptualization of clinical empathy that finds its source in Halpern in Med Health Care Philos (2014) 17:301-311 engaged curiosity. We ultimately advance Narrative Medicine as an approach to introduce, teach and promote such an attitude among medical trainees and practitioners.
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