1
|
Neufeld A, Malin G. Cultivating physician empathy: a person-centered study based in self-determination theory. MEDICAL EDUCATION ONLINE 2024; 29:2335739. [PMID: 38566612 PMCID: PMC10993750 DOI: 10.1080/10872981.2024.2335739] [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: 03/02/2023] [Accepted: 03/22/2024] [Indexed: 04/04/2024]
Abstract
While physician empathy is a vital ingredient in both physician wellness and quality of patient care, consensus on its origins, and how to cultivate it, is still lacking. The present study examines this issue in a new and innovative way, through the lens of self-determination theory. Using survey methodology, we collected data from N = 177 (44%) students at a Canadian medical school. We then used a person-centered approach (cluster analysis) to identify medical student profiles of self-determination (based on trait autonomy and perceived competence in learning) and how the learning environment impacted empathy for those in each profile. When the learning environment was more autonomy-supportive, students experienced higher satisfaction and lower frustration of their basic psychological needs in medical school, as well as greater empathy towards patients. The translation into increased empathy, however, was only evident among the students with higher self-determination at baseline. Results from this study suggest that autonomy-supportive learning environments will generally support medical students' psychological needs for optimal motivation and well-being, but whether or not they lead to empathy towards patients will depend on individual differences in self-determination. Findings and their implications are discussed in terms of developing theory-driven approaches to cultivating empathy in medical education.
Collapse
Affiliation(s)
- Adam Neufeld
- Cumming School of Medicine, Department of Family Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Greg Malin
- College of Medicine, Department of Academic Family Medicine, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| |
Collapse
|
2
|
Noonan M, Brown M, Gibbons M, Tuohy T, Johnson K, Bradshaw C, Tighe SM, Atkinson S, Murphy L, Mohamad M, Imcha M, O'Dwyer N, Grealish A. Evaluation of the effectiveness of a video-based educational intervention on perinatal mental health related stigma reduction strategies for healthcare professionals: A single group pre-test-post-test pilot study. Midwifery 2024; 136:104089. [PMID: 38968682 DOI: 10.1016/j.midw.2024.104089] [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: 10/22/2023] [Revised: 06/24/2024] [Accepted: 06/30/2024] [Indexed: 07/07/2024]
Abstract
BACKGROUND Healthcare professionals have a role to play in reducing perinatal mental health related stigma. AIM To assess the effectiveness of a video-based educational intervention developed to provide guidance to healthcare professionals on perinatal mental health related stigma reduction strategies. DESIGN A single group pre-test-post-test pilot study with no control group. SETTING(S) A university affiliated maternity hospital in Ireland PARTICIPANTS: A convenience sample of registered midwives, nurses and doctors (n = 60) recruited from October 2020-January 2021. INTERVENTION A twenty-minute video-based educational intervention. METHODS Respondents (n = 60) completed a pre-test (time point one) and post-test (time point-two) questionnaire, and a three-month follow-up post-test questionnaire (time point-three) (n = 39). The questionnaire included the Mental Illness Clinicians' Attitudes Scale, Reported and Intended Behaviour Scale, Reynolds Empathy Scale and open-ended questions. Wilcoxon Signed Rank Test was selected to evaluate the pre-test post-test scores. RESULTS The difference in mean Mental Illness: Clinicians' Attitudes-4 scores were statistically significant between time points one and three (z = 3.27, df=36, P = 0.0007) suggesting more positive attitudes towards people with mental health conditions after the intervention. The mean total score for the Reported and Intended Behaviour Scale increased from 18.7 (SD 1.87) at time point one to 19.2 (SD 1.60) at time point two (z= -3.368, df=59, P = 0.0004) suggesting an increase in positive intended behaviours towards those with mental health issues immediately following the intervention. These findings were also corroborated by responses to open-ended survey questions. CONCLUSIONS Further research with a larger sample of healthcare professionals evaluated over a longer period would provide further evidence for the sustainability of the intervention. TWEETABLEABSTRACT A video-based intervention can increase healthcare professionals' knowledge of perinatal #mentalhealth related stigma reduction strategies @Journal. Link to article.
Collapse
Affiliation(s)
- Maria Noonan
- Department of Nursing and Midwifery, University of Limerick, Limerick, Ireland
| | - Melissa Brown
- Department of Nursing and Midwifery, University of Limerick, Limerick, Ireland
| | - Maria Gibbons
- University Maternity Hospital Limerick, Limerick, Ireland
| | - Teresa Tuohy
- Department of Nursing and Midwifery, University of Limerick, Limerick, Ireland
| | - Kevin Johnson
- Department of Nursing and Midwifery, University of Limerick, Limerick, Ireland
| | - Carmel Bradshaw
- Department of Nursing and Midwifery, University of Limerick, Limerick, Ireland
| | - Sylvia Murphy Tighe
- Department of Nursing and Midwifery, University of Limerick, Limerick, Ireland
| | - Sandra Atkinson
- Department of Nursing and Midwifery, University of Limerick, Limerick, Ireland
| | - Louise Murphy
- Department of Nursing and Midwifery, University of Limerick, Limerick, Ireland
| | - Mas Mohamad
- University Maternity Hospital Limerick, Limerick, Ireland
| | | | - Niamh O'Dwyer
- University Maternity Hospital Limerick, Limerick, Ireland
| | - Annmarie Grealish
- Department of Nursing and Midwifery, University of Limerick, Limerick, Ireland; Kings Florence Nightingale Faculty of Nursing, Midwifery & Palliative Care, King's College London, UK.
| |
Collapse
|
3
|
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.
Collapse
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.
| |
Collapse
|
4
|
de Graaff E, Bennett C, Dart J. Empathy in Nutrition and Dietetics: A Scoping Review. J Acad Nutr Diet 2024:S2212-2672(24)00193-X. [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] [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.
Collapse
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
| |
Collapse
|
5
|
Licciardone JC, Tran Y, Ngo K, Toledo D, Peddireddy N, Aryal S. Physician Empathy and Chronic Pain Outcomes. JAMA Netw Open 2024; 7:e246026. [PMID: 38602675 PMCID: PMC11009829 DOI: 10.1001/jamanetworkopen.2024.6026] [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] [Received: 11/22/2023] [Accepted: 02/13/2024] [Indexed: 04/12/2024] Open
Abstract
Importance Empathy is an aspect of the patient-physician relationship that may be particularly important in patients with chronic pain. Objective To measure the association of physician empathy with pain, function, and health-related quality of life (HRQOL) among patients with chronic low back pain. Design, Setting, and Participants This cohort study included adult enrollees from the Pain Registry for Epidemiological, Clinical, and Interventional Studies and Innovation national pain research registry. Study dates were from April 1, 2016, to July 25, 2023, with up to 12 months of follow-up. Exposure Physician empathy was assessed with the Consultation and Relational Empathy measure and dichotomized to yield very empathic physician and slightly empathic physician groups. Main Outcomes and Measures Main outcomes were patient-reported pain, function, and HRQOL measured with a numerical rating scale for low back pain intensity, the Roland-Morris Disability Questionnaire for back-related disability, and the Patient-Reported Outcomes Measurement Information System for HRQOL deficits pertaining to anxiety, depression, fatigue, sleep disturbance, and pain interference. Data were collected at 5 quarterly encounters from registry enrollment through 12 months and analyzed with generalized estimating equations, including multivariable models to measure temporal trends and to adjust for baseline and longitudinal covariates. Results Among the 1470 patients, the mean (SD) age was 53.1 (13.2) years, and 1093 (74.4%) were female. Patients completed 5943 encounters in which multivariable analyses demonstrated that greater physician empathy was inversely associated with pain intensity (β = -0.014; 95% CI, -0.022 to -0.006; P < .001), back-related disability (β = -0.062; 95% CI, -0.085 to -0.040; P < .001), and HRQOL deficits on each measure (eg, pain interference: β = -0.080; 95% CI, -0.111 to -0.049; P < .001). Correspondingly, compared with the slightly empathic physician group, the very empathic physician group reported lower mean pain intensity (6.3; 95% CI, 6.1-6.5 vs 6.7; 95% CI, 6.5-6.9; P < .001), less mean back-related disability (14.9; 95% CI, 14.2-15.6 vs 16.8; 95% CI, 16.0-17.6; P < .001), and fewer HRQOL deficits on each measure (eg, fatigue: 57.3; 95% CI, 56.1-58.5 vs 60.4; 95% CI, 59.0-61.7; P < .001). All physician empathy group differences were clinically relevant, with Cohen d statistics ranging from 0.21 for pain intensity to 0.30 for back-related disability, fatigue, and pain interference. Physician empathy was associated with more favorable outcomes than non-pharmacological treatments, opioid therapy, and lumbar spine surgery. Conclusions and Relevance In this cohort study of adult patients with chronic pain, physician empathy was associated with better outcomes over 12 months. Greater efforts to cultivate and improve physician empathy appear warranted.
Collapse
Affiliation(s)
- John C. Licciardone
- Department of Family Medicine, University of North Texas Health Science Center at Fort Worth, Fort Worth
| | - Yen Tran
- University of North Texas Health Science Center at Fort Worth, Fort Worth
| | - Khang Ngo
- University of North Texas Health Science Center at Fort Worth, Fort Worth
| | - David Toledo
- University of North Texas Health Science Center at Fort Worth, Fort Worth
| | - Navya Peddireddy
- University of North Texas Health Science Center at Fort Worth, Fort Worth
| | - Subhash Aryal
- School of Nursing, Johns Hopkins University, Baltimore, Maryland
| |
Collapse
|
6
|
Savvoulidou K, Papageorgiou A, Kolokotroni O, Kapreli P, Tsokani A, Strimpakos N, Kapreli E. Facilitators and barriers of empathetic behaviour in physiotherapy clinical practice: A qualitative focus group study. Musculoskelet Sci Pract 2024; 70:102923. [PMID: 38417284 DOI: 10.1016/j.msksp.2024.102923] [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: 09/09/2023] [Revised: 01/22/2024] [Accepted: 02/21/2024] [Indexed: 03/01/2024]
Abstract
BACKGROUND Empathy is an essential competence of a person-centered approach, and a recognisable ability for providing physiotherapy quality healthcare. Empathetic communication enhances the improvement of patient outcomes and their experience of treatment. OBJECTIVE The aim of the study was to present further insights considering facilitators and barriers of an empathetic communication between patients and physiotherapists. METHODS A qualitative focus group study was designed according to COREQ guidance for qualitative studies. Two focus groups were conducted. The first group included six patients and two individuals from non-governmental organizations, whereas three physiotherapists, two academic physiotherapist personnel and two undergraduate physiotherapy students participated in the second group. Both groups were audio recorded, and all data was verbatim transcribed for coding thematic analysis. RESULTS 9 themes were revealed regarding empathetic facilitators (qualities of good communication, relationship building, interprofessional collaborative practice, positive environment, love for the healthcare profession and professionalism), while 8 themes were revealed regarding barriers (challenging situations, working conditions, burn out, depreciation of empathetic communication, lack of training, lack of professionalism, lack of personal development and health professionals' own personal problems). CONCLUSION(S) The enhancement of empathy can be accomplished in a trustworthy relationship between patient and clinicians where the development of proficient communication skills are prioritized. However, hindering factors associated with health professionals, patients and the health system should be surmounted. ETHICAL APPROVAL NUMBER 339-ΣΕ8/10-1-2020.
Collapse
Affiliation(s)
- Konstantina Savvoulidou
- Clinical Exercise Physiology and Rehabilitation Research Laboratory, Faculty of Health Sciences, Department of Physiotherapy, University of Thessaly, Lamia, Greece.
| | | | | | - Panagiota Kapreli
- Clinical Exercise Physiology and Rehabilitation Research Laboratory, Faculty of Health Sciences, Department of Physiotherapy, University of Thessaly, Lamia, Greece
| | - Aristi Tsokani
- Health Assessment and Quality of Life Research Laboratory, Physiotherapy Department, Faculty of Health Sciences, University of Thessaly, Lamia, Greece
| | - Nikolaos Strimpakos
- Health Assessment and Quality of Life Research Laboratory, Physiotherapy Department, Faculty of Health Sciences, University of Thessaly, Lamia, Greece; Division of Musculoskeletal & Dermatological Sciences, Honorary Research Associate, University of Manchester, Manchester, UK
| | - Eleni Kapreli
- Clinical Exercise Physiology and Rehabilitation Research Laboratory, Faculty of Health Sciences, Department of Physiotherapy, University of Thessaly, Lamia, Greece
| |
Collapse
|
7
|
Stults CD, Mazor KM, Cheung M, Ruo B, Li M, Walker A, Saphirak C, Vaida F, Singh S, Fisher KA, Rosen R, Yood R, Garber L, Longhurst C, Kallenberg G, Yu E, Chan A, Millen M, Tai-Seale M. Patients' Perspectives on Plans Generated During Primary Care Visits and Self-Reported Adherence at 3 Months: Data From a Randomized Trial. J Particip Med 2024; 16:e50242. [PMID: 38483458 PMCID: PMC10979329 DOI: 10.2196/50242] [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: 08/15/2023] [Revised: 11/02/2023] [Accepted: 11/12/2023] [Indexed: 04/01/2024] Open
Abstract
BACKGROUND Effective primary care necessitates follow-up actions by the patient beyond the visit. Prior research suggests room for improvement in patient adherence. OBJECTIVE This study sought to understand patients' views on their primary care visits, the plans generated therein, and their self-reported adherence after 3 months. METHODS As part of a large multisite cluster randomized pragmatic trial in 3 health care organizations, patients completed 2 surveys-the first within 7 days after the index primary care visit and another 3 months later. For this analysis of secondary outcomes, we combined the results across all study participants to understand patient adherence to care plans. We recorded patient characteristics and survey responses. Cross-tabulation and chi-square statistics were used to examine bivariate associations, adjusting for multiple comparisons when appropriate. We used multivariable logistic regression to assess how patients' intention to follow, agreement, and understanding of their plans impacted their plan adherence, allowing for differences in individual characteristics. Qualitative content analysis was conducted to characterize the patient's self-reported plans and reasons for adhering (or not) to the plan 3 months later. RESULTS Of 2555 patients, most selected the top box option (9=definitely agree) that they felt they had a clear plan (n=2011, 78%), agreed with the plan (n=2049, 80%), and intended to follow the plan (n=2108, 83%) discussed with their provider at the primary care visit. The most common elements of the plans reported included reference to exercise (n=359, 14.1%), testing (laboratory, imaging, etc; n=328, 12.8%), diet (n=296, 11.6%), and initiation or adjustment of medications; (n=284, 11.1%). Patients who strongly agreed that they had a clear plan, agreed with the plan, and intended to follow the plan were all more likely to report plan completion 3 months later (P<.001) than those providing less positive ratings. Patients who reported plans related to following up with the primary care provider (P=.008) to initiate or adjust medications (P≤.001) and to have a specialist visit were more likely to report that they had completely followed the plan (P=.003). Adjusting for demographic variables, patients who indicated intent to follow their plan were more likely to follow-through 3 months later (P<.001). Patients' reasons for completely following the plan were mainly that the plan was clear (n=1114, 69.5%), consistent with what mattered (n=1060, 66.1%), and they were determined to carry through with the plan (n=887, 53.3%). The most common reasons for not following the plan were lack of time (n=217, 22.8%), having decided to try a different approach (n=105, 11%), and the COVID-19 pandemic impacted the plan (n=105, 11%). CONCLUSIONS Patients' initial assessment of their plan as clear, their agreement with the plan, and their initial willingness to follow the plan were all strongly related to their self-reported completion of the plan 3 months later. Patients whose plans involved lifestyle changes were less likely to report that they had "completely" followed their plan. TRIAL REGISTRATION ClinicalTrials.gov NCT03385512; https://clinicaltrials.gov/study/NCT03385512. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) RR2-10.2196/30431.
Collapse
Affiliation(s)
- Cheryl D Stults
- Palo Alto Medical Foundation Research Institute, Center for Health Systems Research, Sutter Health, Palo Alto, CA, United States
| | - Kathleen M Mazor
- Department of Medicine, UMass Chan Medical School, Worcester, MA, United States
| | - Michael Cheung
- Herbert Wertheim School of Public Health and Human Longevity Science, University of California San Diego, La Jolla, CA, United States
| | - Bernice Ruo
- Department of Medicine, University of California San Diego, La Jolla, CA, United States
| | - Martina Li
- Palo Alto Medical Foundation Research Institute, Center for Health Systems Research, Sutter Health, Palo Alto, CA, United States
| | - Amanda Walker
- Department of Family Medicine, University of California San Diego, La Jolla, CA, United States
| | - Cassandra Saphirak
- Department of Medicine, UMass Chan Medical School, Worcester, MA, United States
| | - Florin Vaida
- Herbert Wertheim School of Public Health and Human Longevity Science, University of California San Diego, La Jolla, CA, United States
| | - Sonal Singh
- Department of Medicine, UMass Chan Medical School, Worcester, MA, United States
| | - Kimberly A Fisher
- Department of Medicine, UMass Chan Medical School, Worcester, MA, United States
| | - Rebecca Rosen
- Department of Family Medicine, University of California San Diego, La Jolla, CA, United States
| | - Robert Yood
- Research Department, Reliant Medical Group, Worcester, MA, United States
| | - Lawrence Garber
- Research Department, Reliant Medical Group, Worcester, MA, United States
| | - Christopher Longhurst
- Division of Biomedical Informatics, Department of Medicine, University of California San Diego, La Jolla, CA, United States
| | - Gene Kallenberg
- Department of Family Medicine, University of California San Diego, La Jolla, CA, United States
| | - Edward Yu
- Department of Family Medicine, Palo Alto Medical Foundation, Sutter Health, Mountain View, CA, United States
| | - Albert Chan
- Palo Alto Medical Foundation Research Institute, Center for Health Systems Research, Sutter Health, Palo Alto, CA, United States
- Digital Team, Sutter Health, Sacramento, CA, United States
- Department of Medicine, Division of Biomedical Informatics Research, Stanford University, Stanford, CA, United States
| | - Marlene Millen
- Department of Medicine, University of California San Diego, La Jolla, CA, United States
| | - Ming Tai-Seale
- Department of Family Medicine, University of California San Diego, La Jolla, CA, United States
- Division of Biomedical Informatics, Department of Medicine, University of California San Diego, La Jolla, CA, United States
| |
Collapse
|
8
|
Leguízamo-Isaza JM, Campaña-Perilla LA, Moreno-Sarmiento ÁP. Including the Teaching of Empathy and Emotional Intelligence in Medical Education Curriculum: Imperative yet Challenging. Acad Radiol 2024; 31:1226. [PMID: 37926645 DOI: 10.1016/j.acra.2023.09.028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2023] [Accepted: 09/20/2023] [Indexed: 11/07/2023]
Affiliation(s)
- Juan M Leguízamo-Isaza
- Department of Diagnostic Imaging, Fundación Santa Fe de Bogotá, 116 street #9-02, Bogotá, 110111, Colombia (J.M.L.-I., L.A.C.P., Á.P.M.S.); Universidad El Bosque, Diagnostic Radiology Residency Program, Bogotá D.C., Colombia.
| | - Laura A Campaña-Perilla
- Department of Diagnostic Imaging, Fundación Santa Fe de Bogotá, 116 street #9-02, Bogotá, 110111, Colombia (J.M.L.-I., L.A.C.P., Á.P.M.S.)
| | - Ángela P Moreno-Sarmiento
- Department of Diagnostic Imaging, Fundación Santa Fe de Bogotá, 116 street #9-02, Bogotá, 110111, Colombia (J.M.L.-I., L.A.C.P., Á.P.M.S.)
| |
Collapse
|
9
|
Doyle AJ, Sullivan C, O'Toole M, Tjin A, Simiceva A, Collins N, Murphy P, Anderson MJ, Mulhall C, Condron C, Nestel D, MacAulay R, McNaughton N, Coffey F, Eppich W. Training simulated participants for role portrayal and feedback practices in communication skills training: A BEME scoping review: BEME Guide No. 86. MEDICAL TEACHER 2024; 46:162-178. [PMID: 37552799 DOI: 10.1080/0142159x.2023.2241621] [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: 08/10/2023]
Abstract
BACKGROUND Providing feedback is a key aspect of simulated participants' (SPs) educational work. In teaching contexts, the ability to provide feedback to learners is central to their role. Suboptimal feedback practices may deny learners the valuable feedback they need to learn and improve. This scoping review systematically maps the evidence related to SPs' role as educators and identifies how SPs prepare for their role and feedback practices. METHODS The authors conducted a scoping review and included a group of international stakeholders with experience and expertise in SP methodology. Five online databases were systematically searched and ERIC, MedEdPortal and MedEdPublish were hand searched to identify relevant studies. Inclusion/exclusion criteria were developed. Data screening and subsequently data charting were performed in pairs. The results of data charting were thematically analysed including categories relating to the Association of SP Educators (ASPE) Standards of Best Practice (SOBP). RESULTS From 8179 articles identified for the title and abstract screening, 98 studies were included. Studies reported the benefit of SPs' authentic role portrayal and feedback interactions for learners and on the reported learning outcomes. Data was heterogeneous with a notable lack of consistency in the detail regarding the scenario formats for communication skills training interventions, SP characteristics, and approaches to training for feedback and role portrayal. CONCLUSIONS The published literature has considerable heterogeneity in reporting how SPs are prepared for role portrayal and feedback interactions. Additionally, our work has identified gaps in the implementation of the ASPE SOBP, which promotes effective SP-learner feedback interactions. Further research is required to identify effective applications of SP methodology to prepare SPs for their role as educators.
Collapse
Affiliation(s)
- Andrea J Doyle
- RCSI SIM Centre for Simulation Education and Research, RCSI University of Medicine and Health Sciences, Dublin, Ireland
| | - Clare Sullivan
- RCSI SIM Centre for Simulation Education and Research, RCSI University of Medicine and Health Sciences, Dublin, Ireland
| | - Michelle O'Toole
- RCSI SIM Centre for Simulation Education and Research, RCSI University of Medicine and Health Sciences, Dublin, Ireland
| | - Anna Tjin
- RCSI SIM Centre for Simulation Education and Research, RCSI University of Medicine and Health Sciences, Dublin, Ireland
| | - Anastasija Simiceva
- RCSI SIM Centre for Simulation Education and Research, RCSI University of Medicine and Health Sciences, Dublin, Ireland
| | - Naoise Collins
- Department of Visual & Human Centred Computing, Dundalk Institute of Technology, Co. Louth
| | - Paul Murphy
- RCSI Library, RCSI University of Medicine and Health Sciences, Dublin Ireland
| | - Michael J Anderson
- RCSI SIM Centre for Simulation Education and Research, RCSI University of Medicine and Health Sciences, Dublin, Ireland
| | - Claire Mulhall
- RCSI SIM Centre for Simulation Education and Research, RCSI University of Medicine and Health Sciences, Dublin, Ireland
| | - Claire Condron
- RCSI SIM Centre for Simulation Education and Research, RCSI University of Medicine and Health Sciences, Dublin, Ireland
| | - Debra Nestel
- School of Clinical Sciences, Faculty of Medicine, Nursing & Health Sciences, Monash University, Australia
- Department of Surgery, University of Melbourne, Australia
| | - Robert MacAulay
- School of Medicine, University of California San Diego, United States of America
| | - Nancy McNaughton
- The Wilson Centre for Research in Education, Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
| | - Frank Coffey
- DREEAM (Department of Research and Education in Emergency and Acute medicine, Nottingham University Hospitals' NHS Trust)
- School of Health Sciences, University of Nottingham, UK
| | - Walter Eppich
- RCSI SIM Centre for Simulation Education and Research, RCSI University of Medicine and Health Sciences, Dublin, Ireland
| |
Collapse
|
10
|
Keshtkar L, Madigan CD, Ward A, Ahmed S, Tanna V, Rahman I, Bostock J, Nockels K, Wang W, Gillies CL, Howick J. The Effect of Practitioner Empathy on Patient Satisfaction : A Systematic Review of Randomized Trials. Ann Intern Med 2024; 177:196-209. [PMID: 38285985 DOI: 10.7326/m23-2168] [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] [Indexed: 01/31/2024] Open
Abstract
BACKGROUND Practitioners who deliver enhanced empathy may improve patient satisfaction with care. Patient satisfaction is associated with positive patient outcomes ranging from medication adherence to survival. PURPOSE To evaluate the effect of health care practitioner empathy on patient satisfaction, using a systematic review of randomized trials. DATA SOURCES Ovid MEDLINE, CINAHL, PsycInfo, Cochrane Central Register of Controlled Trials, and Scopus to 23 October 2023. STUDY SELECTION Randomized trials published in any language that evaluated the effect of empathy on improving patient satisfaction as measured on a validated patient satisfaction scale. DATA EXTRACTION Data extraction, risk-of-bias assessments, and strength-of-evidence assessments were done by 2 independent reviewers. Disagreements were resolved through consensus. DATA SYNTHESIS Fourteen eligible randomized trials (80 practitioners; 1986 patients) were included in the analysis. Five studies had high risk of bias, and 9 had some concerns about bias. The trials were heterogeneous in terms of geographic locations (North America, Europe, Asia, and Africa), settings (hospital and primary care), practitioner types (family and hospital physicians, anesthesiologists, nurses, psychologists, and caregivers), and type of randomization (individual patient or clustered by practitioner). Although all trials suggested a positive change in patient satisfaction, inadequate reporting hindered the ability to draw definitive conclusions about the overall effect size. LIMITATIONS Heterogeneity in the way that empathy was delivered and patient satisfaction was measured and incomplete reporting leading to concerns about the certainty of the underpinning evidence. CONCLUSION Various empathy interventions have been studied to improve patient satisfaction. Development, testing, and reporting of high-quality studies within well-defined contexts is needed to optimize empathy interventions that increase patient satisfaction. PRIMARY FUNDING SOURCE Stoneygate Trust. (PROSPERO: CRD42023412981).
Collapse
Affiliation(s)
- Leila Keshtkar
- Stoneygate Centre for Empathic Healthcare, Leicester Medical School, University of Leicester, Leicester, United Kingdom (L.K., A.W., I.R., J.H.)
| | - Claire D Madigan
- Centre for Lifestyle Medicine and Behaviour (CLiMB), The School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, United Kingdom (C.D.M.)
| | - Andy Ward
- Stoneygate Centre for Empathic Healthcare, Leicester Medical School, University of Leicester, Leicester, United Kingdom (L.K., A.W., I.R., J.H.)
| | | | - Vinay Tanna
- Wythenshawe Hospital, Manchester Foundation Trust, Manchester, United Kingdom (V.T.)
| | - Ismail Rahman
- Stoneygate Centre for Empathic Healthcare, Leicester Medical School, University of Leicester, Leicester, United Kingdom (L.K., A.W., I.R., J.H.)
| | | | - Keith Nockels
- Library and Learning Services, University of Leicester, Leicester, United Kingdom (K.N.)
| | - Wen Wang
- School of Business, University of Leicester, Leicester, United Kingdom (W.W.)
| | - Clare L Gillies
- Leicester Real World Evidence Unit, University of Leicester, Leicester, United Kingdom (C.L.G.)
| | - Jeremy Howick
- Stoneygate Centre for Empathic Healthcare, Leicester Medical School, University of Leicester, Leicester, United Kingdom (L.K., A.W., I.R., J.H.)
| |
Collapse
|
11
|
Páez DC, Flórez J, Gómez MT, García D, Arango-Paternina CM, Duperly J. Curricular and pedagogical approaches for physical activity prescription training: a mixed-methods study of the "Exercise is Medicine" workshops in Colombia. BMC MEDICAL EDUCATION 2024; 24:79. [PMID: 38254169 PMCID: PMC10804704 DOI: 10.1186/s12909-023-04999-3] [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: 03/28/2023] [Accepted: 12/20/2023] [Indexed: 01/24/2024]
Abstract
BACKGROUND The physical activity (PA) prescription workshop for physicians, through the global health initiative "Exercise is Medicine" (EIM), has trained more than 4000 health care professionals (HCPs) in Latin America. It has shown to be effective in increasing PA prescription knowledge and awareness among HCPs. The purpose of this paper is to evaluate the curricular and pedagogical approach used by EIM Colombia at the PA prescription workshops implemented between 2014 and 2015. METHODS A mixed methods study, with a sequential explanatory design was implemented among a convenience sample of HCPs attending twenty-six PA prescription workshops. HCPs health status, PA personal habits, and medical practices were collected using a questionnaire at baseline among 795 participants (pre-test measurement), and subsequently quantitatively analyzed. A workshop satisfaction survey was administered after the completion of the workshop among 602 HCPs. The curricular and pedagogical approach of the workshop, the designers' and students' contextual factors, and perceptions about the workshop were measured using qualitative methods (analysis of the procedures manual, two workshop observations, three semi-structured interviews, and one focus group including 8 HCPs). RESULTS The workshop is student-centered and guided by an expert with an academic and clinical background. Learning was achieved with theoretical and practical components using authentic performance and collaborative learning. An active teaching and learning approach was used with strategies such as interactive lectures, hands-on elements, and role-playing (patient-counselor). The workshop emphasized an individual approach when prescribing PA integrating in clinical practice not only health benefits but also patient´s beliefs, motivations, needs, and barriers. CONCLUSIONS Evidence-based practices and authentic performance were the most salient pedagogical elements used by EIM Colombia at the PA prescription workshop. A knowledge assessment that includes the practical aspect is suggested for future workshops. The curricular and pedagogical approach of the PA prescription workshop implemented in Colombia is well received by the medical community and a useful continuing medical education intervention with a potential contribution to current, and future health promotion needs.
Collapse
Affiliation(s)
- Diana C Páez
- School of Medicine, Universidad de los Andes, Carrera 1, #18a-12, Bogotá, Colombia.
| | - Johanna Flórez
- School of Medicine, Universidad de los Andes, Carrera 1, #18a-12, Bogotá, Colombia
| | - María Teresa Gómez
- School of Medicine, Universidad de los Andes, Carrera 1, #18a-12, Bogotá, Colombia
- Centro de Investigación y Formación en Educación, Universidad de los Andes, Carrera 1, #18a-12, Bogotá, Colombia
| | - Daniel García
- Centro de Investigación y Formación en Educación, Universidad de los Andes, Carrera 1, #18a-12, Bogotá, Colombia
| | - Carlos M Arango-Paternina
- Instituto Universitario de Educación Física y Deporte, Universidad de Antioquia, Calle 74 # 70 - 59, Medellín, Colombia
| | - John Duperly
- School of Medicine, Universidad de los Andes, Carrera 1, #18a-12, Bogotá, Colombia
- Institute of Exercise Medicine and Rehabilitation, Fundación Santa Fe de Bogotá, Cra. 7 #117 -15, Bogotá, Colombia
| |
Collapse
|
12
|
Keikhaee R, Sanaat Z, Mousavi S, Shaghaghi A. Cross-Cultural Adaptation and Psychometric Validation of the Interview Satisfaction Questionnaire (ISQ) to Assess Unmet Health Communication Needs of Iranian Breast Cancer Patients. HEALTH COMMUNICATION 2023:1-11. [PMID: 38053361 DOI: 10.1080/10410236.2023.2288712] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/07/2023]
Abstract
Autonomous and patient-centered health communication (PCHC) between a healthcare provider (HCP) and a client (HCC) is a critical fundament for successful healthcare outcomes. A standard and validated data collection tool for studying the satisfaction of Iranian breast cancer patients (BCPs) with various aspects of their health communication with HCPs does not exist. The current study assessed the application, feasibility, and cultural appropriateness of the Persian-translated version of the interview satisfaction questionnaire (ISQ) in the Iranian context. A standard translation/back-translation procedure was used to prepare a preliminary Persian version of the ISQ (ISQ-P) which was then evaluated for content and face validity by a panel of experts. The study data were collected from 200 breast cancer patients and used to estimate the internal consistency measure of Cronbach's alpha and intra-class correlation coefficient. Confirmatory factor analysis (CFA) was performed to verify the compatibility of the instrument's identified dimensions with the original ISQ's factor structure. The calculated content validity index (CVI = 0.89), content validity ratio (CVR = 0.49), and Cronbach's alpha coefficient (0.79) indicated the appropriateness of the ISQ-P for its intended purpose. The CFA's outputs (root mean square error of approximation (RMSEA) = 0.09, comparative fit index (CFI) = 0.954, Tucker-Lewis index (TLI) = 0.931, standardized root mean square residual (SRMR) = 0.04) affirmed the fitness of the study data to the original 4-factor conceptual model. The study findings supported the suitability of ISQ-P for assessing health communication episodes by Persian-speaking BCPs. However, due to cultural variation, cross-border diversity of health systems, and organizational circumstances, further validity and reliability appraisal of the ISQ-P in distinct sub-samples is recommended.
Collapse
Affiliation(s)
- Razieh Keikhaee
- Department of Health Education and Promotion, Faculty of Health, Tabriz University of Medical Sciences
| | - Zohreh Sanaat
- Hematology and Oncology Research Center, Tabriz University of Medical Sciences
| | - Saeid Mousavi
- Department of Bio-Statistics and Epidemiology, Faculty of Health, Tabriz University of Medical Sciences
| | - Abdolreza Shaghaghi
- Department of Health Education and Promotion, Faculty of Health, Tabriz University of Medical Sciences
| |
Collapse
|
13
|
Herber-Valdez CR, Blow JA, Salazar TT, Horn KV, Herrera DG, Lacy NL, Beinhoff L, de la Rosa JM. The integrated curriculum and student empathy: a longitudinal multi-cohort analysis. ADVANCES IN HEALTH SCIENCES EDUCATION : THEORY AND PRACTICE 2023:10.1007/s10459-023-10292-1. [PMID: 37946064 DOI: 10.1007/s10459-023-10292-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/30/2021] [Accepted: 09/25/2023] [Indexed: 11/12/2023]
Abstract
Research has demonstrated erosion of empathy in students during medical education. Particularly, U.S. studies have demonstrated empathy declines during clinical training in the third and fourth year of traditional medical programs. Yet, studies conducted outside the U.S. have not confirmed this trend. Timing and extent of patient interactions have been identified as empathy-protective factors. The need to examine empathy within different learning contexts has been noted, as has the need for longitudinal and time-series research designs to analyze trajectories. Between fall 2010 and spring 2019, we assessed empathy longitudinally among six student cohorts (N = 493) at a U.S. medical school, where patient interaction occurs early and throughout an integrated curriculum. Empathy levels of students in each cohort were assessed at five time points utilizing the Jefferson Scale of Physician Empathy-Student version. We hypothesized empathy levels will not degrade by program end, and trajectories will not show patterns of decline in Years Three and Four. Analysis of Variance (ANOVA) and Linear Mixed Model (LMM) analyses were used to analyze differences at baseline and changes in empathy trajectories. ANOVA analyses revealed statistically significant differences at baseline by class cohort (F(5, 487) = [23.28], p < 0.001). LMM analyses indicated empathy was either significantly higher or not different at the end of the program (F(19, 1676) = [13.97], p < 0.001). Empathy trajectories varied among cohorts; yet, none resulted in an overall empathy decline by the end of the program. Findings demonstrate empathy in U.S. medical students can be unchanged or higher by the end of medical education. Outcomes are consistent with reports of non-declining medical student empathy outside the U.S. and support the notion of context-specificity. Results further support recent research, suggesting decreases in empathy during training can stabilize or increase by program end. These findings have important implications for future empathy research context and design considerations, as well as program planning.
Collapse
Affiliation(s)
- Christiane R Herber-Valdez
- Office of Academic Affairs, Texas Tech University Health Sciences Center at El Paso, 5001 El Paso Drive, El Paso, TX, 79905, USA.
- Department of Medical Education, Paul L. Foster School of Medicine, Texas Tech University Health Sciences Center at El Paso, El Paso, TX, USA.
| | - Julie A Blow
- Office of Institutional Research and Effectiveness, Texas Tech University Health Sciences Center at El Paso, El Paso, TX, USA
| | - Tammy T Salazar
- Department of Family Medicine, Paul L. Foster School of Medicine, Office of Academic Support, Texas Tech University Health Sciences Center at El Paso, El Paso, TX, USA
- The University of Texas at El Paso, El Paso, TX, USA
| | - Kathryn V Horn
- Paul L. Foster School of Medicine, Office of Student Services, Texas Tech University Health Sciences Center at El Paso, El Paso, TX, USA
- University of Houston College of Medicine, Houston, TX, USA
| | - Dyanne G Herrera
- Office of Institutional Research and Effectiveness, Texas Tech University Health Sciences Center at El Paso, El Paso, TX, USA
- Texas Department of Health, Austin, TX, USA
| | - Naomi L Lacy
- Department of Medical Education, Paul L. Foster School of Medicine, Texas Tech University Health Sciences Center at El Paso, El Paso, TX, USA
| | - Lisa Beinhoff
- Libraries of the Health Sciences, Texas Tech University Health Sciences Center at El Paso, El Paso, USA
| | - J Manuel de la Rosa
- Department of Pediatrics Paul L. Foster School of Medicine, Office of Outreach and Community Engagement, Texas Tech University Health Sciences Center at El Paso, El Paso, TX, USA
| |
Collapse
|
14
|
Yaden ME, Sawaya RT, Reddy J, Jong KA, White J, Moniz T, Chisolm MS. A systematic review of the arts and humanities in psychiatry education. Int Rev Psychiatry 2023; 35:540-550. [PMID: 38461397 DOI: 10.1080/09540261.2023.2278718] [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: 07/31/2023] [Accepted: 10/30/2023] [Indexed: 03/11/2024]
Abstract
This systematic review characterizes the published literature on arts and humanities curricula for psychiatry learners that include any form of program evaluation. Authors searched three databases (Medline ALL, Embase.com, and PsycINFO) to identify articles on arts and humanities in psychiatry education. Criteria for the review included articles reporting outcome measures for arts and humanities learning activities in psychiatry learners. For those articles meeting inclusion criteria, a descriptive analysis was performed as well as an assessment of the level of program evaluation using the Kirkpatrick framework. Of 1,287 articles identified, 35 met inclusion criteria. About half of the programs included medical students (n = 17, 49%). Film and television was the most frequent arts and humanities subject (n = 16, 46%). Most studies incorporated a non-randomized, non-controlled design (n = 30, 86%). Twenty-two (63%) achieved a Kirkpatrick Level 1 designation, 12 achieved Level 2 (34%), and one study achieved Level 3 (3%). Arts and humanities programs have a promising role in psychiatry education. At present, significant heterogeneity in the extant literature makes it difficult to draw general conclusions that could guide future program development. This review underscores the need for rigorous evaluative methods of arts and humanities programs for psychiatry learners.
Collapse
Affiliation(s)
- Mary E Yaden
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Rayah T Sawaya
- Department of Psychiatry, Boston University School of Medicine, Boston, Massachusetts, USA
| | - Jessica Reddy
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Katherine A Jong
- Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Seattle, Washington, USA
| | - Jacob White
- Welch Medical Library, Johns Hopkins University, Baltimore, Maryland, USA
| | - Tracy Moniz
- Department of Communication Studies, Mount Saint Vincent University, Halifax, Nova Scotia, Canada
| | - Margaret S Chisolm
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| |
Collapse
|
15
|
Massa E, Lai E, Donisi C, Scartozzi M, Orgiano L, Mulas O, Pretta A, Caocci G, Carta MG. Understanding the User's Point of View: When the Doctor Gets Sick with Cancer and Seeks Help. Clin Pract Epidemiol Ment Health 2023; 19:e17450179241325. [PMID: 38164454 PMCID: PMC10758133 DOI: 10.2174/0117450179241325231011070735] [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: 01/31/2023] [Revised: 07/21/2023] [Accepted: 08/01/2023] [Indexed: 01/03/2024]
Abstract
Background When physicians confront a serious personal illness, they may discover that the transition to the "sick" role is challenging and not easy. We conducted a qualitative study in which a group of doctors with cancer (DP) was compared with a group of patients with cancer, not doctors (NDP) but with a degree of education, qualifications, and a professional role comparable to that of a doctor. Objectives The main objective was to evaluate the effect of the diagnosis and the treatment of cancer on both the patient's personal and professional life. It was also designed to understand the effect that the experience of cancer may have on the subsequent clinical practice of DP. Methods The eligibility criteria included diagnosis of tumors of different sites and at any stage of disease treated with local (surgery, radiotherapy) or systemic (chemotherapy, hormonal, target) therapies or a combination of both; patients actively working. A semi-structured interview was used to collect information about the patient's cancer experiences. In both groups, six main themes and ten subthemes were identified. Results From July to November 2021, 59 patients were enrolled in the study. Among them, 29 were DP and 30 were NDP. The median age and gender were 55.9 years ± 9.3 SD (range 38-82 y), M/F ratio 12/17 for DP, and 56.3 years ± 8.9 SD (range 40-83 y), M/F ratio 11/19 for NDP, respectively. The main themes were: theme 1, practical aspects related to diagnosis: most of the DP did not encounter difficulties in performing the tests necessary to confirm the diagnosis of cancer, unlike what was observed in NDP. Theme 2, cancer diagnosis experience: Many DP and NDP felt prepared for their own cancer experience. Two-thirds of DP already knew their cancer prognosis from their previous background knowledge and one-third of NDP did not want to discuss the prognosis in depth with their referring oncologists for the fear of learning that their cancer had a poor prognosis. Theme 3, treatment experience: for many DP, having a professional background contributed to more active participation in care and also in the management of side effects of treatments. Most NDP were satisfied with the treatment received in the hospital and the relationship with the health professionals. Theme 4, changes in work: None of the patients from both the groups stopped working permanently or lost their job because of the disease. A higher number of DP and NDP reported a loss of interest in their job. Theme 5, changes in personal/family life and friendships: more than half of the patients in both groups developed a new perspective on their private lives. Theme 6, comfort from faith: most of the patients in both groups who followed a faith, found comfort in that faith. For DP only, we explored the theme of the change in the doctor/patient relationship. Important findings from our study included positive changes in the doctor's clinical practice including having a more empathic relationship with patients, greater consideration of the psychological impact of cancer, and greater attention to certain symptoms of cancer reported by patients. Conclusion This study suggests the need to know the special needs of professional patients, in particular, related to the emotional difficulties, maintenance of privacy, and the need for support on their return to work. These results can help to foster improvements in current cancer care practices.
Collapse
Affiliation(s)
- Elena Massa
- Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - Eleonora Lai
- Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - Clelia Donisi
- Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - Mario Scartozzi
- Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - Laura Orgiano
- Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - Olga Mulas
- Ematology Hematology and e CTMOHSCT Center, Businco Hospital, ARNAS “G. Brotzu”, Cagliari, Italy
| | - Andrea Pretta
- Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - Giovanni Caocci
- Ematology Hematology and e CTMOHSCT Center, Businco Hospital, ARNAS “G. Brotzu”, Cagliari, Italy
| | - Mauro Giovanni Carta
- Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| |
Collapse
|
16
|
Taff H, Gilkerson L, Osta A, Seo-Lee A, Schwartz A, Chunara Z, McGinn L, Pillai N, Barnes MM. Strengthening Parent - Physician Communication: A Mixed Methods Study on Attuned Communication Training for Pediatric Residents. TEACHING AND LEARNING IN MEDICINE 2023; 35:577-588. [PMID: 35946430 DOI: 10.1080/10401334.2022.2107528] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/25/2021] [Accepted: 07/11/2022] [Indexed: 06/15/2023]
Abstract
Problem: High-quality communication improves patient satisfaction and clinical outcomes, yet formal communication training in residency is often minimal. Many studies on empathic communication show mixed results and are often hindered and skewed by brief study lengths, insufficiently and ambiguously defined concepts, and limited methods for objective measurements. Intervention: The FAN Curriculum is a unique communication curriculum, based on the conceptual frameworks of patient-centered communication, reflective practice, mindfulness, and attunement using the Facilitating Attuned Interactions (FAN) model. The first part of the FAN Curriculum was delivered as a 3-hour interactive workshop involving didactics, group discussion, and role play with pediatric residents. Residents then completed weekly self-reflections, a follow-up one-hour training to reinforce concepts, and five monthly mentor sessions, all emphasizing reflective practice. Context: This longitudinal, mixed-methods study examined the effects of the FAN Curriculum on residents' empathy levels and ability to communicate with parents in the clinical setting. The study was conducted at two urban, academic, medium-sized pediatric residency programs in Chicago between October 2016 and November 2017. First- and second-year pediatric residents whose continuity clinic site was located at their home institution participated. Residents received training in the use of the FAN Communication Tool using a delayed-start crossover study design. Impact: At five time points, residents and parents completed instruments validated for measuring physician empathy and mindfulness. Post-study interviews were conducted for one institution's residents and mentors and were evaluated using open and focused coding. Participants (n = 23) demonstrated a high degree of use of the FAN Communication Tool six months post-training and a significant rise in self-reported comfort with four of five FAN core processes. One parent-completed survey (Consultation and Relational Empathy, CARE) showed a statistically significant rise of 3.26% in resident relational empathy and collaboration after training (p = 0.02). In qualitative analysis of interviews, residents and mentors found the FAN Communication Tool beneficial, making clinic visits more efficient and collaborative. Both groups noted improvement in the residents' relationship-building skills; residents were able to use enhanced communication skills to better approach challenging encounters and work through parent concerns. Lessons Learned: Family-centered communication training can improve physician-perceived empathy and mindfulness. Effective communication for pediatric residents incorporates an empathic approach, and introduction to this formal curriculum supported their growth in connecting and engaging with children and parents. The FAN Curriculum may provide a useful method for improving resident communication skills with a positive impact on pediatricians' collaboration with patients and families.
Collapse
Affiliation(s)
- Heather Taff
- Department of Pediatrics, University of Illinois College of Medicine at Chicago, Chicago, Illinois, USA
- VNA Health Care, Aurora, Illinois, USA
| | | | - Amanda Osta
- Department of Pediatrics, University of Illinois College of Medicine at Chicago, Chicago, Illinois, USA
| | - Alisa Seo-Lee
- Department of Pediatrics, Cook County Health, Chicago, Illinois, USA
| | - Alan Schwartz
- Department of Pediatrics, University of Illinois College of Medicine at Chicago, Chicago, Illinois, USA
- Department of Medical Education, University of Illinois College of Medicine at Chicago, Chicago, Illinois, USA
| | - Zobia Chunara
- Department of Medical Education, University of Illinois College of Medicine at Chicago, Chicago, Illinois, USA
| | - Lander McGinn
- Department of Medical Education, University of Illinois College of Medicine at Chicago, Chicago, Illinois, USA
| | - Nikita Pillai
- Department of Medical Education, University of Illinois College of Medicine at Chicago, Chicago, Illinois, USA
| | - Michelle M Barnes
- Department of Pediatrics, University of Illinois College of Medicine at Chicago, Chicago, Illinois, USA
| |
Collapse
|
17
|
Liu A, Ben-Zion S, Schwartz A, Mahan JD, Reed S. Well-being factors associated with confidence in providing calm, compassionate care in pediatric residents. PATIENT EDUCATION AND COUNSELING 2023; 115:107906. [PMID: 37478547 DOI: 10.1016/j.pec.2023.107906] [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: 05/05/2023] [Revised: 07/06/2023] [Accepted: 07/16/2023] [Indexed: 07/23/2023]
Abstract
OBJECTIVE Engagement in calm, compassionate care (CCC) is important in fostering patient-centered care. We aimed to study factors which predict confidence in providing CCC in pediatric residents. METHODS We performed a retrospective, multi-center, cohort study utilizing data from the Pediatric Resident Burnout and Resilience Study (PRB-RSC) from 2016 to 2018. The Calm Compassionate Care Scale (CCCS) was used to assess confidence in delivering CCC. We examined cross-sectional associations between CCC, demographic measures, programmatic features, and psychological scales. RESULTS The following showed significant positive associations with confidence in providing CCC: Cognitive and Affective Mindfulness Scale, Neff's Self Compassion, Patient Reported Outcomes Measures-mental health, and Interpersonal Reactivity Index-empathetic concern. For the Maslach Burnout Index subscales, decreased personal accomplishment, increased emotional exhaustion, and increased depersonalization showed significant negative associations. CONCLUSIONS We found that several well-being measures and an increased sense of personal accomplishment are associated with increased confidence in providing CCC. These findings underscore the interrelatedness of these measures and highlight the importance of personal accomplishment as a positive factor in trainee development. PRACTICE IMPLICATIONS Program level interventions that decrease trainee burnout and enhance resiliency as well as support trainees' development of empathy and compassion may help trainees develop skills that promote patient-centered, compassionate care.
Collapse
Affiliation(s)
- Alex Liu
- The Ohio State University College of Medicine, Columbus, OH, USA
| | - Sabrina Ben-Zion
- Department of Pediatrics, Akron Children's Hospital, Akron, OH, USA
| | - Alan Schwartz
- Department of Pediatrics, University of Illinois College of Medicine - Chicago, Chicago, IL, USA
| | - John D Mahan
- Department of Pediatrics Nationwide Children's Hospital/The Ohio State University College of Medicine, Columbus, OH, USA
| | - Suzanne Reed
- Department of Pediatrics Nationwide Children's Hospital/The Ohio State University College of Medicine, Columbus, OH, USA.
| |
Collapse
|
18
|
Jack K, Illingworth S. Rehearsing empathy: exploring the role of poetry in supporting learning. Arts Health 2023:1-14. [PMID: 37747288 DOI: 10.1080/17533015.2023.2256361] [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: 07/25/2023] [Accepted: 09/03/2023] [Indexed: 09/26/2023]
Abstract
Empathy is an important aspect of therapeutic relationships in health and social care settings. Health educators can foster empathy development in learners through creative writing activities. Drawing on the humanities, specifically poetry, this paper offers strategies for educators to support empathy development in learners, with a focus on service user poetry and associated creative writing activities. We discuss how poetry can enable alternative perspectives about care to emerge thereby challenging previously held assumptions about mental and physical states. Using poetry can enable a rehearsal of empathy by bringing experiences to the learner in a safe and facilitated environment. Through creative writing activities, we believe that students can learn to better understand and empathise with others, as well as explore their own feelings and experiences related to caregiving, to support self-care.
Collapse
Affiliation(s)
- Kirsten Jack
- Independent Education Consultant/Writing for Wellbeing Facilitator
| | - Sam Illingworth
- Department of Learning and Teaching Enhancement, Edinburgh Napier University, Edinburgh, UK
| |
Collapse
|
19
|
Dellasega C, George DR, Lokon E. The transformative power of participating in Opening Minds Through Art (OMA), an expressive arts program for medical students. GERONTOLOGY & GERIATRICS EDUCATION 2023:1-13. [PMID: 37722717 DOI: 10.1080/02701960.2023.2255537] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/20/2023]
Abstract
Opening Minds Through Art (OMA) is a standardized expressive arts-based program that improves student attitudes toward persons living with dementia. Understanding how this change occurs is important for both educators and clinicians. In this study, narrative analysis was used to explore the impact of OMA on participating medical students. 111 students at six medical schools accepted an invitation to be part of OMA during the 2018-2020 academic years. After completing the program, participants were asked to write briefly about the impact of their OMA experience on their work as future physicians. These narratives were analyzed to identify themes relevant to the impact of the program. Students described appreciating both pragmatic and novel creative experiences in OMA, which differed from their traditional studies. Themes from the evaluation included: Inter and Intrapersonal Connection and Growth; Mastery of Anticipated Challenges; Acquisition of Knowledge and Skills; and Appreciation of Health Care Team Members. Teaching students to embrace clinical work with challenging and perceived "difficult" patients is often unaddressed in the medical school curriculum. This study suggests that the combination of medical knowledge and artistic expression can be used to benefit both students and persons living with dementia.
Collapse
Affiliation(s)
- Cheryl Dellasega
- Department of Humanities, Penn State College of Medicine, Hershey, Pennsylvania, USA
| | - Daniel R George
- Department of Humanities, Penn State College of Medicine, Hershey, Pennsylvania, USA
| | - Elizabeth Lokon
- Scripps Gerontology Center, Miami University, Oxford, Ohio, USA
| |
Collapse
|
20
|
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.
Collapse
Affiliation(s)
- Paola Guariglia
- Faculty of Human and Social Sciences, UKE—Kore University of Enna, 94100 Enna, Italy
| | | | - Anna Maria Giannini
- Department of Psychology, Sapienza University of Rome, 00158 Rome, Italy; (A.M.G.); (L.P.)
| | - Laura Piccardi
- Department of Psychology, Sapienza University of Rome, 00158 Rome, Italy; (A.M.G.); (L.P.)
- San Raffaele Cassino Hospital, 03043 Cassino, Italy
| |
Collapse
|
21
|
Hu JX, Chang R, Du JQ, He M. Effect of Training on the Ability of Nurses to Provide Humanistic Care: Systematic Review and Meta-analysis. J Contin Educ Nurs 2023; 54:430-436. [PMID: 37642441 DOI: 10.3928/00220124-20230816-12] [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: 08/31/2023]
Abstract
BACKGROUND This article describes a systematic review evaluating the effectiveness of training on the humanistic care abilities of nurses. METHOD The literature search was conducted in electronic databases to identify studies that evaluated the effect of training on the humanistic care abilities of nurses. Study selection was based on precise eligibility criteria. After the systematic review, a meta-analysis of standardized mean differences (SMDs) between posttraining and pretraining humanistic care scale scores was performed to evaluate the effect of training. RESULTS A total of 11 studies were included (624 nurse participants; 97% women; weighted average age = 38.4 years; 95% confidence interval (CI) [31.5, 45.4]). Training schedules varied and ranged from a full-day workshop to brief weekly sessions for up to 2 months. The training framework involved compassion and empathy communication in most of the included studies. Training improved the humanistic care scale scores of the participants (SMD = 1.171; 95% CI [0.626, 1.716]; p < .0001), whereas no significant change was seen in the scores of control subjects (SMD = 0.588; 95% CI [-0.536, 1.713]; p = .305). The effect of training was observable for up to 1 year, although few studies carried out follow-up evaluations. CONCLUSION Training has the potential to improve the humanistic care abilities of nurses. [J Contin Educ Nurs. 2023;54(9):430-436.].
Collapse
|
22
|
Shields GS, Fisher M, Vega MO. Teaching power skills to improve physician self-efficacy, reduce burnout, and improve patient outcomes. Future Healthc J 2023; 10:119-123. [PMID: 37786631 PMCID: PMC10540802 DOI: 10.7861/fhj.2023-0050] [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: 10/04/2023]
Abstract
If doctors had a way to improve their patients' healthcare experience, improve service feedback, reduce complaints, increase treatment adherence and reduce non-attendance, while at the same time combatting burnout and compassion fatigue in clinicians and enhancing collaborative working between staff and care teams, and all for zero direct cost, could anyone argue against such an intervention? In this paper, we present the views of the educators and clinicians at Maudsley Learning that training in communication and psychological 'power skills' is not only feasible, but crucially important for physicians at all stages of training to improve both patient care and the wellbeing of clinicians themselves. We explore some of the key relevant skills and present examples of high-fidelity simulation training that demonstrate the efficacy of this modality in improving individual skills and confidence as well as inter-team and interdisciplinary working.
Collapse
Affiliation(s)
- Gregory S Shields
- Maudsley Learning, South London & Maudsley NHS Foundation Trust, London, UK
| | - Megan Fisher
- Maudsley Learning, South London & Maudsley NHS Foundation Trust, London, UK
| | - Marta Ortega Vega
- Maudsley Learning, South London & Maudsley NHS Foundation Trust, London, UK
| |
Collapse
|
23
|
Rojas B, Catalan E, Diez G, Roca P. A compassion-based program to reduce psychological distress in medical students: A pilot randomized clinical trial. PLoS One 2023; 18:e0287388. [PMID: 37352295 PMCID: PMC10289411 DOI: 10.1371/journal.pone.0287388] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2023] [Accepted: 06/01/2023] [Indexed: 06/25/2023] Open
Abstract
OBJECTIVES Physicians and medical students are subject to higher levels of psychological distress than the general population. These challenges have a negative impact in medical practice, leading to uncompassionate care. This pilot study aims to examine the feasibility of Compassion Cultivation Training (CCT) to reduce psychological distress and improve the well-being of medical students. We hypothesize that the CCT program, as compared to a waitlist control group, will reduce psychological distress (i.e., stress, anxiety, and depression) and burnout symptoms, while improving compassion, empathy, mindfulness, resilience, psychological well-being, and emotion-regulation strategies after the intervention. Furthermore, we hypothesize that these improvements will be maintained at a two-month follow-up. METHODS Medical students were randomly assigned to an 8-week CCT or a Waitlist control group (WL). They completed self-report assessments at pre-intervention, post-intervention, and a 2-month follow-up. The outcomes measured were compassion, empathy, mindfulness, well-being, resilience, emotional regulation, psychological distress, burnout, and COVID-19 concern. Mixed-effects models and Reliable Change Index were computed. RESULTS Compared with WL, CCT showed significant improvements in self-compassion, mindfulness, and emotion regulation, as well as a significant decrease in stress, anxiety, and emotional exhaustion component of burnout. Furthermore, some of these effects persisted at follow-up. No adverse effects of meditation practices were found. CONCLUSIONS CCT enhanced compassion skills while reducing psychological distress in medical students, this being critical to preserving the mental health of physicians while promoting compassionate care for patients. The need for institutions to include this type of training is also discussed.
Collapse
Affiliation(s)
- Blanca Rojas
- Medical School, Complutense University of Madrid, Madrid, Spain
| | - Elena Catalan
- Medical School, Complutense University of Madrid, Madrid, Spain
- Virgen de la Victoria Hospital, Málaga, Spain
| | - Gustavo Diez
- Nirakara Lab, Complutense University of Madrid, Madrid, Spain
| | - Pablo Roca
- Faculty of Health Sciences, Universidad Villanueva, Madrid, Spain
- Valencian International University, Valencia, Spain
| |
Collapse
|
24
|
Watts E, Patel H, Kostov A, Kim J, Elkbuli A. The Role of Compassionate Care in Medicine: Toward Improving Patients' Quality of Care and Satisfaction. J Surg Res 2023; 289:1-7. [PMID: 37068438 DOI: 10.1016/j.jss.2023.03.024] [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: 01/09/2023] [Revised: 03/12/2023] [Accepted: 03/19/2023] [Indexed: 04/19/2023]
Abstract
INTRODUCTION Despite its description as a cornerstone of a healthcare provider's professional identity, the impact of compassionate care on various aspects of medicine has been poorly defined. In this review, we aimed to elucidate the role of compassionate care in various aspects of medicine and healthcare delivery. METHODS Four databases were searched using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses protocol for a literature review regarding compassionate care and its intersection with medical education, patient-provider communication, patient care, and clinical outcomes, patient and provider characteristics, telemedicine and artificial intelligence, caregiver compassion fatigue, and cost of care. RESULTS Twenty-two articles met the inclusion criteria. Analysis revealed that clinical outcomes are correlated with the degree of patients' perception of empathy and compassion from their providers. Along with enhanced patient outcomes, compassionate care was shown to reduce the costs of care, compassion fatigue and burnout, and the number of malpractice claims. However, compassion can be perceived differently among patients of various cultural and ethnic backgrounds. Compassion training sessions can be implemented among residents in surgical and nonsurgical medical specialties to improve perceived compassion. Furthermore, the use of telehealth modalities may positively or negatively impact compassionate care, requiring further exploration. CONCLUSIONS Compassionate care plays a crucial role in improving patient care and clinical outcomes while reducing caregiver burnout and the risk of malpractice litigation. However, a lack of compassion training and caregiver compassion fatigue may detract from the delivery of effective compassionate care.
Collapse
Affiliation(s)
- Emelia Watts
- NOVA Southeastern University, Dr. Kiran C. Patel College of Allopathic Medicine, Fort Lauderdale, Florida
| | - Heli Patel
- NOVA Southeastern University, Dr. Kiran C. Patel College of Allopathic Medicine, Fort Lauderdale, Florida
| | - Anthony Kostov
- NOVA Southeastern University, Dr. Kiran C. Patel College of Allopathic Medicine, Fort Lauderdale, Florida
| | - Jason Kim
- NOVA Southeastern University, Dr. Kiran C. Patel College of Allopathic Medicine, Fort Lauderdale, Florida
| | - Adel Elkbuli
- Division of Trauma and Surgical Critical Care, Department of Surgery, Orlando Regional Medical Center, Orlando, Florida; Department of Surgical Education, Orlando Regional Medical Center, Orlando, Florida.
| |
Collapse
|
25
|
McNulty JP, Politis Y. Empathy, emotional intelligence and interprofessional skills in healthcare education. J Med Imaging Radiat Sci 2023; 54:238-246. [PMID: 37032263 DOI: 10.1016/j.jmir.2023.02.014] [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: 07/28/2022] [Revised: 02/24/2023] [Accepted: 02/24/2023] [Indexed: 04/11/2023]
Abstract
According to the World Health Organization (WHO), health professionals maintain the health of citizens through evidence-based medicine and caring. Students enroled in health professional programmes are required to have successfully attained all core learning outcomes by reaching key milestones throughout the course of their studies, demonstrating they have developed the required graduate skills and attributes upon completion of the programme. While some of the knowledge, skills and competencies that make up these learning outcomes are very discipline specific, there are more general professional skills across all disciplines which are difficult to define, such as empathy, emotional intelligence and interprofessional skills. These are at the heart of all health professional programmes that once defined, can be mapped through curricula and further evaluated. Literature will be presented on these three professional skills: empathy, emotional intelligence, and interprofessional skills, based on studies that focussed primarily in health professional programmes and highlight some of the key findings and issues at undergraduate and postgraduate levels. The paper will present the need for these skills to be defined and then mapped through curricula so that students are better supported in their professional development. Empathy, emotional intelligence and interprofessional skills transcend the discipline specific skills and as such it is important that all educators consider how best these may be fostered. Efforts should also be made to further the integration of these professional skills within curricula to produce health professionals with an enhanced focus on person-centred care.
Collapse
Affiliation(s)
- Jonathan P McNulty
- Radiography and Diagnostic Imaging, School of Medicine, University College, Ireland.
| | - Yurgos Politis
- Center for Teaching and Learning, Central European University, Vienna, Austria
| |
Collapse
|
26
|
Nguyen M, Beltramo G, Audia S, Devilliers H, Laurent A, Blot M. [Correlation between Objective structured clinical examinations (OSCE) and knowledge examination scores and analysis of factors associated with better OSCE success in fourth and fifth year medicine students at Dijon university hospital]. Rev Med Interne 2023:S0248-8663(23)00114-5. [PMID: 37024357 DOI: 10.1016/j.revmed.2023.03.009] [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: 11/12/2022] [Revised: 03/08/2023] [Accepted: 03/17/2023] [Indexed: 04/08/2023]
Abstract
RATIONALE Objective structured clinical examinations (OSCEs) were introduced to evaluate students not only on their knowledge, but also on their clinical skills and attitudes. The objectives were to study the correlation between OSCE scores and scores obtained to traditional knowledge examinations and to analyse factors associated with better OSCE performance in DFASM1 and 2 students at Dijon university hospital. METHODS This was a prospective observational study conducted among all fourth and fifth year medical students in Dijon. The scores on the OSCE elective tests (2022) and the average score on the knowledge tests (2021-2022) were collected and their correlation measured. A questionnaire asked students about their demographic characteristics, their investment in formative and practicum OSCEs, their level of empathy (Jefferson questionnaire) and their personality traits (NEO-Pi-R). RESULTS Of 549 students, 513 completed all tests. Scores on OSCE and faculty knowledge tests were correlated (r=0.39, P<0.001). Of these, 111 (20%) students responded to the questionnaire, and 97 were analized. We did not observe any significant difference between students who performed better on OSCEs than on knowledge tests and those who did not, regarding their age, their investment in formative tests, their personality traits or their level of empathy. CONCLUSION Our results underline the need to optimize the evaluation of empathy and clinical skills in OSCE tests, using new tools, in order to better discriminate between students on these skills.
Collapse
Affiliation(s)
- M Nguyen
- Service d'anesthésie et réanimation, centre hospitalo-universitaire de Dijon-Bourgogne, Dijon, France; UFR des sciences de santé, université de Bourgogne, 21000, Dijon, France.
| | - G Beltramo
- UFR des sciences de santé, université de Bourgogne, 21000, Dijon, France; Service de pneumologie et soins intensifs respiratoires, centre-hospitalo universitaire de Dijon-Bourgogne, Dijon, France
| | - S Audia
- UFR des sciences de santé, université de Bourgogne, 21000, Dijon, France; Service de médecine interne et immunologie cinique, centre-hospitalo universitaire de Dijon-Bourgogne, Dijon, France
| | - H Devilliers
- UFR des sciences de santé, université de Bourgogne, 21000, Dijon, France; Service de médecine interne et maladies systémiques, centre-hospitalo universitaire de Dijon-Bourgogne, Dijon, France; Inserm CIC-EC 1432, centre d'investigation clinique, Dijon, France
| | - A Laurent
- Service d'anesthésie et réanimation, centre hospitalo-universitaire de Dijon-Bourgogne, Dijon, France; UFR des sciences de santé, université de Bourgogne, 21000, Dijon, France; EA 7458, laboratoire psy-DREPI, université de Bourgogne Franche-Comté, Dijon, France
| | - M Blot
- UFR des sciences de santé, université de Bourgogne, 21000, Dijon, France; Inserm CIC-EC 1432, centre d'investigation clinique, Dijon, France; Département de maladies infectieuses, centre hospitalo-universitaire de Dijon-Bourgogne, Dijon, France
| |
Collapse
|
27
|
Nembhard IM, David G, Ezzeddine I, Betts D, Radin J. A systematic review of research on empathy in health care. Health Serv Res 2023; 58:250-263. [PMID: 35765156 PMCID: PMC10012244 DOI: 10.1111/1475-6773.14016] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Abstract
OBJECTIVE To summarize the predictors and outcomes of empathy by health care personnel, methods used to study their empathy, and the effectiveness of interventions targeting their empathy, in order to advance understanding of the role of empathy in health care and facilitate additional research aimed at increasing positive patient care experiences and outcomes. DATA SOURCE We searched MEDLINE, MEDLINE In-Process, PsycInfo, and Business Source Complete to identify empirical studies of empathy involving health care personnel in English-language publications up until April 20, 2021, covering the first five decades of research on empathy in health care (1971-2021). STUDY DESIGN We performed a systematic review in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines. DATA COLLECTION/EXTRACTION METHODS Title and abstract screening for study eligibility was followed by full-text screening of relevant citations to extract study information (e.g., study design, sample size, empathy measure used, empathy assessor, intervention type if applicable, other variables evaluated, results, and significance). We classified study predictors and outcomes into categories, calculated descriptive statistics, and produced tables to summarize findings. PRINCIPAL FINDINGS Of the 2270 articles screened, 455 reporting on 470 analyses satisfied the inclusion criteria. We found that most studies have been survey-based, cross-sectional examinations; greater empathy is associated with better clinical outcomes and patient care experiences; and empathy predictors are many and fall into five categories (provider demographics, provider characteristics, provider behavior during interactions, target characteristics, and organizational context). Of the 128 intervention studies, 103 (80%) found a positive and significant effect. With four exceptions, interventions were educational programs focused on individual clinicians or trainees. No organizational-level interventions (e.g., empathy-specific processes or roles) were identified. CONCLUSIONS Empirical research provides evidence of the importance of empathy to health care outcomes and identifies multiple changeable predictors of empathy. Training can improve individuals' empathy; organizational-level interventions for systematic improvement are lacking.
Collapse
Affiliation(s)
- Ingrid M. Nembhard
- Health Care Management DepartmentThe Wharton School, University of PennsylvaniaPhiladelphiaPennsylvaniaUSA
- Leonard Davis Institute of Health EconomicsUniversity of PennsylvaniaPhiladelphiaPennsylvaniaUSA
| | - Guy David
- Health Care Management DepartmentThe Wharton School, University of PennsylvaniaPhiladelphiaPennsylvaniaUSA
- Leonard Davis Institute of Health EconomicsUniversity of PennsylvaniaPhiladelphiaPennsylvaniaUSA
| | - Iman Ezzeddine
- Health Care Management DepartmentThe Wharton School, University of PennsylvaniaPhiladelphiaPennsylvaniaUSA
| | - David Betts
- Life Sciences and Health Care PracticeDeloitte Consulting, LLPNew YorkNew YorkUSA
| | - Jennifer Radin
- Life Sciences and Health Care PracticeDeloitte Consulting, LLPNew YorkNew YorkUSA
| |
Collapse
|
28
|
Luis EO, Martínez M, Akrivou K, Scalzo G, Aoiz M, Orón Semper JV. The role of empathy in shared intentionality: Contributions from Inter-Processual Self theory. Front Psychol 2023; 14:1079950. [PMID: 36968699 PMCID: PMC10036387 DOI: 10.3389/fpsyg.2023.1079950] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2022] [Accepted: 02/22/2023] [Indexed: 03/12/2023] Open
Abstract
Research in psychology related to the conceptualization of empathy has been on the rise in the last decades. However, we argue that there is still space for further research to help capture the important notion of empathy and its theoretical and conceptual depth. Following a critical review of the current state of the research that conceptualizes and measures empathy, we focus on works that highlight the importance of a shared vision and its relevance in psychology and neuroscience. Considering the state of the art of current neuroscientific and psychological approaches to empathy, we argue for the relevance of shared intention and shared vision in empathy-related actions. Upon review of different models that emphasize a shared vision for informing research on empathy, we suggest that a newly developed theory of self, human growth and action–the so-called Inter-Processual Self theory (IPS)–can significantly and novelly inform the theorization on empathy beyond what the literature has stated to date. Then, we show how an understanding of integrity as a relational act that requires empathy is an essential mechanism for current key research on empathy and its related concepts and models. Ultimately, we aim to present IPS as a distinctive proposal to expand upon the conceptualization of empathy.
Collapse
Affiliation(s)
- Elkin O. Luis
- Psychological Processes in Education and Health Group, School of Education and Psychology, University of Navarra, Pamplona, Spain
- Methods and Research in Affective and Cognitive Psychology, School of Education and Psychology, University of Navarra, Pamplona, Spain
| | - Martín Martínez
- Methods and Research in Affective and Cognitive Psychology, School of Education and Psychology, University of Navarra, Pamplona, Spain
| | - Kleio Akrivou
- Henley Business School, University of Reading, Reading, United Kingdom
- *Correspondence: Kleio Akrivou,
| | - Germán Scalzo
- School of Business, Universidad Panamericana, Mexico City, Mexico
| | - Martín Aoiz
- Institute of Modern Languages, School of Education and Psychology, University of Navarra, Pamplona, Spain
| | | |
Collapse
|
29
|
Kobayashi M, Katayama M, Hayashi T, Hashiyama T, Iyanagi T, Une S, Honda M. Effect of multimodal comprehensive communication skills training with video analysis by artificial intelligence for physicians on acute geriatric care: a mixed-methods study. BMJ Open 2023; 13:e065477. [PMID: 36868602 PMCID: PMC9990644 DOI: 10.1136/bmjopen-2022-065477] [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: 03/05/2023] Open
Abstract
OBJECTIVES To quantitatively analyse by artificial intelligence (AI) the communication skills of physicians in an acute care hospital for geriatric care following a multimodal comprehensive care communication skills training programme and to qualitatively explore the educational benefits of this training programme. DESIGN A convergent mixed-methods study, including an intervention trial with a quasi-experimental design, was conducted to quantitatively analyse the communication skills of physicians. Qualitative data were collected via physicians' responses to an open-ended questionnaire administered after the training. SETTING An acute care hospital. PARTICIPANTS A total of 23 physicians. INTERVENTIONS In a 4-week multimodal comprehensive care communication skills training programme, including video lectures and bedside instruction, from May to October 2021, all the participants examined a simulated patient in the same scenario before and after their training. These examinations were video recorded by an eye-tracking camera and two fixed cameras. Then, the videos were analysed for communication skills by AI. MAIN OUTCOME MEASURES The primary outcomes were the physicians' eye contact, verbal expression, physical touch and multimodal communication skills with a simulated patient. The secondary outcomes were the physicians' empathy and burnout scores. RESULTS The proportion of the duration of the participants' single and multimodal types of communication significantly increased (p<0.001). The mean empathy scores and the personal accomplishment burnout scores also significantly increased after training. We developed a learning cycle model based on the six categories that changed after training from the physicians' perspective: multimodal comprehensive care communication skills training; increasing awareness of and sensitivity to changes to geriatric patients' condition; changes in clinical management; professionalism; team building and personal accomplishments. CONCLUSIONS Our study showed that multimodal comprehensive care communication skills training for physicians increased the proportions of time spent performing single and multimodal communication skills by video analysis through AI. TRIAL REGISTRATION NUMBER UMIN Clinical Trials Registry (UMIN000044288; https://center6.umin.ac.jp/cgi-open-bin/ctr_e/ctr_view.cgi?recptno=R000050586).
Collapse
Affiliation(s)
- Masaki Kobayashi
- Department of Geriatric Medicine, National Hospital Organization Tokyo Medical Centre, Meguro-ku, Japan
- Division of Geriatric Medicine, Rochester Regional Health System, Rochester, New York, USA
| | - Mitsuya Katayama
- Department of General Internal Medicine, National Hospital Organization Tokyo Medical Centre, Meguro-ku, Japan
| | - Tomofumi Hayashi
- Department of General Internal Medicine, National Hospital Organization Tokyo Medical Centre, Meguro-ku, Japan
| | - Takuhiro Hashiyama
- Department of General Internal Medicine, National Hospital Organization Tokyo Medical Centre, Meguro-ku, Japan
| | - Toshinori Iyanagi
- Department of General Internal Medicine, National Hospital Organization Tokyo Medical Centre, Meguro-ku, Japan
| | - Saki Une
- Department of Geriatric Medicine, National Hospital Organization Tokyo Medical Centre, Meguro-ku, Japan
| | - Miwako Honda
- Department of Geriatric Medicine, National Hospital Organization Tokyo Medical Centre, Meguro-ku, Japan
- Department of General Internal Medicine, National Hospital Organization Tokyo Medical Centre, Meguro-ku, Japan
| |
Collapse
|
30
|
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.
Collapse
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
| |
Collapse
|
31
|
Melton B, O’Connell-Sussman E, Lord J, Weiss MJ. Empathy and Compassion as the Radical Behaviorist Views it: A Conceptual Analysis. Behav Anal Pract 2023. [DOI: 10.1007/s40617-023-00783-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/25/2023] Open
|
32
|
Lu R, Zhao S, Wang X, Zhou J, Ou W, Jiang Y, Wen J, Hu L. Insights Into the Relationships Between Health Communication and Doctor-patient Relationship: A Scientometric Analysis Based on CiteSpace and Validation of Questionnaires. INQUIRY : A JOURNAL OF MEDICAL CARE ORGANIZATION, PROVISION AND FINANCING 2023; 60:469580231152071. [PMID: 36748743 PMCID: PMC9909062 DOI: 10.1177/00469580231152071] [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] [Indexed: 02/08/2023]
Abstract
In order to understand the research status of the relationship between health communication and doctor-patient relationship, and to explore a new path of the impact of health communication on doctor-patient relationship, this paper adopted qualitative methods to quantize the literature over the past 10 years in the Web of Science database and carried out Co-Authorship Analysis, Co-Citation Analysis and Co-Occurrence Analysis based on CiteSpace. In addition, according to the results of bibliometric research, self-designed questionnaires were used to verify the result. A convenience sampling survey was conducted through the online "Questionnaire Star" platform (https://www.wjx.cn) on May 8, 2022, and a total of 254 questionnaires were collected. Interviewees were asked to use social software to acquire health knowledge. Participants come from 21 provinces, 4 municipalities, and 4 autonomous regions across the country, which is geographically representative. The results show that uncertainty of social media information and the particularity of the epidemic make the research on health communication and doctor-patient relationship in social media become a new hot spot. Social media health information quality (source credibility and content trust perception), information asymmetry perception, doctor-patient communication, doctor-patient consistency, doctor-patient trust, doctor-patient relationship may be the key variables for constructing theoretical models.
Collapse
Affiliation(s)
- Renjie Lu
- Changzhou Third People’s Hospital, Changzhou Medical Center, Nanjing Medical University, Jiangsu, China,Business School, ISCTE University Institute of Lisbon, Portugal,School of Health Management, Southern Medical University, Guangdong, China
| | - Shenyu Zhao
- Department of Neurology, Changzhou Third People’s Hospital, Changzhou Medical Center, Nanjing Medical University, Jiangsu, China
| | - Xiaoyu Wang
- Department of Reproduction, Changzhou Maternity and Child Health Care Hospital, Changzhou Medical Center, Nanjing Medical University, Jiangsu, China
| | - Jing Zhou
- Department of Reproduction, Changzhou Maternity and Child Health Care Hospital, Changzhou Medical Center, Nanjing Medical University, Jiangsu, China
| | - Weiyan Ou
- Business School, ISCTE University Institute of Lisbon, Portugal,School of Health Management, Southern Medical University, Guangdong, China
| | - Yongyi Jiang
- School of Health Management, Southern Medical University, Guangdong, China
| | - Juan Wen
- Nanjing Maternity and Child Health Care Institute, Women’s Hospital of Nanjing Medical University, Nanjing Maternity and Child Health Care Hospital, Jiangsu, China
| | - Lingmin Hu
- Department of Reproduction, Changzhou Maternity and Child Health Care Hospital, Changzhou Medical Center, Nanjing Medical University, Jiangsu, China,Lingmin Hu, Department of Reproduction, Changzhou Maternity and Child Health Care Hospital, Changzhou Medical Center, Nanjing Medical University, N0.16 Dingxiang Road, Zhonglou District, Changzhou, 213000, Jiangsu Province, China.
| |
Collapse
|
33
|
Lee YS, Yun Y, Kim EK, Kim HS. Relationship between self-consciousness and empathy for cancer patients among nursing students: The moderating effects of clinical practice satisfaction. NURSE EDUCATION TODAY 2023; 121:105715. [PMID: 36652745 DOI: 10.1016/j.nedt.2023.105715] [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: 07/25/2022] [Revised: 12/19/2022] [Accepted: 01/07/2023] [Indexed: 06/17/2023]
Abstract
BACKGROUND Patients with cancer experience physical and mental difficulties that can be relieved with the support and empathy of healthcare professionals. Empathy can be affected by self-consciousness. The clinical performance and interpersonal competence of nursing students are related to their satisfaction with clinical practice. OBJECTIVE This study explored the moderating effect of clinical practice satisfaction of nursing students on the relationship between self-consciousness and empathy for patients with cancer. DESIGN Cross-sectional descriptive study. SETTING Three colleges of nursing in South Korea. PARTICIPANTS A total of 136 senior nursing students across three universities. METHODS The participants completed an online questionnaire on demographic and education-related characteristics, self-consciousness, and empathy competency. We used the Korean versions of the Self-Consciousness Scale and Empathy Construct Rating Scale. The overall response rate was 42.5 %. SPSS PROCESS macro was used to test the moderating role of satisfaction with clinical practice. RESULTS Private self-consciousness was significantly associated with clinical practice satisfaction and empathy. The relationship between practice satisfaction and empathy was significantly positive. In addition, the satisfaction of the nursing students with clinical practice moderated the association between private self-consciousness and empathy for patients with cancer. Empathy was more affected by private self-consciousness among senior nursing students who were less satisfied with clinical practice than among those who were more satisfied with clinical practice. CONCLUSION To improve empathy for patients with cancer, educational strategies must be created to improve the private self-consciousness and satisfaction with the clinical practice of nursing students.
Collapse
Affiliation(s)
- Ye Sol Lee
- College of Nursing, Seoul National University, 103 Daehak-ro, Jongno-gu, Seoul 03080, Republic of Korea
| | - Younghee Yun
- Department of Community Health Systems, School of Nursing, University of California, San Francisco, 2 Koret Way, Suite N531H, San Francisco, CA 94143, USA
| | - Eun Kyung Kim
- Department of Nursing, Suwon Women's University, 72 Onjeong-ro, Gwonseon-gu, Suwon-si, Gyeonggi-do, Republic of Korea
| | - Hye Sook Kim
- Fanshawe College, 1001 Fanshawe College Blvd., London, Ontario N5Y 5R6, Canada
| |
Collapse
|
34
|
Schepergerdes B, Standage H, Wetzel C, Kelley KA, Brasel K, Hoops H. How well do we understand our patients' perioperative experience? A qualitative analysis of themes derived from patient-centric resident conferences. Am J Surg 2023; 225:819-823. [PMID: 36737398 DOI: 10.1016/j.amjsurg.2023.01.022] [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: 11/11/2022] [Revised: 12/26/2022] [Accepted: 01/20/2023] [Indexed: 01/22/2023]
Abstract
BACKGROUND Patient-centric resident conferences (PCRCs) provide meaningful time to connect with and learn from patients. This qualitative study explores themes of patients' perioperative experiences from PCRCs through patient and resident perspectives. METHODS General Surgery residents participated in six PCRCs, which include condensed standard didactics to accommodate a patient panel regarding their perioperative experience. Panel transcripts and resident survey responses describing what they learned were coded using grounded theory methodology. Themes were evaluated and compared. RESULTS 76 identified codes were grouped into major categories: "Medical/Surgical Knowledge," "Patient Perspective," "Patient-Physician Relationship," and "Communication." Themes from resident responses predominantly paralleled patient discussion, with common themes including "impact of disease and surgery on patient" and "compassion/empathy." "Medical/surgical knowledge" was only present in resident responses while themes regarding quality of life were more frequent in patient transcripts. CONCLUSIONS PCRCs are a valuable tool in resident education to understand patients' perioperative experiences. Themes from patient panels complement, but do not replace, information covered in didactic lectures.
Collapse
Affiliation(s)
- Benjamin Schepergerdes
- Department of Surgery, Oregon Health and Science University School of Medicine, 3181 SW Sam Jackson Park Road, Mailcode L611, Portland, OR, 97239, USA.
| | - Hayley Standage
- Department of Surgery, Oregon Health and Science University School of Medicine, 3181 SW Sam Jackson Park Road, Mailcode L611, Portland, OR, 97239, USA.
| | - Cate Wetzel
- Department of Surgery, Oregon Health and Science University School of Medicine, 3181 SW Sam Jackson Park Road, Mailcode L611, Portland, OR, 97239, USA.
| | - Katherine A Kelley
- Department of Surgery, Western Michigan University Homer Stryker School of Medicine, 300 Portage Street, Kalamazoo, MI, 49007, USA.
| | - Karen Brasel
- Department of Surgery, Oregon Health and Science University School of Medicine, 3181 SW Sam Jackson Park Road, Mailcode L611, Portland, OR, 97239, USA.
| | - Heather Hoops
- Department of Surgery, Oregon Health and Science University School of Medicine, 3181 SW Sam Jackson Park Road, Mailcode L611, Portland, OR, 97239, USA.
| |
Collapse
|
35
|
Winter R, Ward A, Norman RI, Howick J. A survey of clinical empathy training at UK medical schools. BMC MEDICAL EDUCATION 2023; 23:40. [PMID: 36658502 PMCID: PMC9850684 DOI: 10.1186/s12909-022-03993-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/13/2022] [Accepted: 12/28/2022] [Indexed: 06/17/2023]
Abstract
BACKGROUND The benefits of enhancing practitioner empathy include better patient outcomes and improved job satisfaction for practitioners. Evidence suggests empathy can be taught and empathy is listed as an outcome for graduates in the General Medical Council requirements. Despite this, empathy training is not mandatory on medical school curricula and the extent to which medical students are given empathy-specific training is unknown. AIM To conduct a survey of empathy training currently offered to medical students in UK medical schools. METHODS An invitation to participate in an online survey was sent to all UK medical schools (n = 40). The survey was developed through a consultancy and pilot process to ensure validity and reliability. Questions explored what empathy-focused training is offered, and asked educators whether or not they believed that current provision of empathy training is sufficient. In parallel, medical school websites were searched to identify what information regarding empathy-focused training is described as being part of the degree course. Descriptive statistics were used to describe empathy training delivery from the results of the online materials survey and closed survey questions. Thematic analysis was used to explore free text comments. RESULTS Response rate was 70% (28/40), with 28 medical schools included in the analysis. Twenty-six schools reported that their undergraduate curriculum included some form of empathy-focused training with variation in what, when and how this is delivered. Thematic analysis revealed two overarching themes with associated sub-themes: (i) empathy-focused training and development (considering where, when and how empathy training should be integrated); (ii) challenges presented by including empathy on the curriculum (considering the system, students and faculty). All schools agreed empathy training should be on the undergraduate curriculum. CONCLUSION This is the first nationwide survey of empathy-focused training at UK medical schools. While some form of empathy-focused training appears to be provided on the undergraduate curriculum at most UK medical schools, empathy is rarely specifically assessed. Most medical educators do not feel their school does enough to promote empathy and the majority would like to offer more.
Collapse
Affiliation(s)
- Rachel Winter
- Stoneygate Centre for Empathic Healthcare, Leicester Medical School, George Davies Centre, University of Leicester, University Road, LE1 7RH, Leicester, England.
| | - Andy Ward
- Stoneygate Centre for Empathic Healthcare, Leicester Medical School, George Davies Centre, University of Leicester, University Road, LE1 7RH, Leicester, England
| | - Robert I Norman
- Leicester Medical School, College of Life Sciences University of Leicester, George Davies Centre, LE1 7RH, Leicester, England
| | - Jeremy Howick
- Stoneygate Centre for Empathic Healthcare, Leicester Medical School, George Davies Centre, University of Leicester, University Road, LE1 7RH, Leicester, England
- The Oxford Empathy Programme, Faculty of Philosophy, University of Oxford, OX2 6GG, Oxford, England
| |
Collapse
|
36
|
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.
Collapse
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
| |
Collapse
|
37
|
Posa S, Wasilewski MB, Mercer SW, Simpson S, Robinson LR, Simpson R. Conceptualization, use, and outcomes associated with empathy and compassion in physical medicine and rehabilitation: a scoping review. Int J Rehabil Res 2022; 45:291-301. [PMID: 35837691 DOI: 10.1097/mrr.0000000000000542] [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: 11/26/2022]
Abstract
The purpose of this review is to scope the literature on the conceptualization, use, and outcomes associated with empathy and compassion in physical medicine and rehabilitation. Eligible studies included quantitative, qualitative, or mixed-methods research that presented primary data on the conceptualization, use, and outcomes associated with empathy and compassion in physical medicine and rehabilitation. Relevant studies were identified through CINAHL, Cochrane Library, EMBASE, MEDLINE, and PEDRO. Twenty-four studies were included (participant n = 3715): 13 quantitative, six mixed-methods, and five qualitative. In qualitative analysis, empathy and compassion were conceptualized as both intrinsic and exhibitory. Where self-compassion was examined as an intervention for patients, improvements in anxiety, depression, and quality of life were reported. Survey data suggested that when rehabilitation health care providers were perceived to be more empathic, patients reported greater treatment satisfaction, acceptance, adherence, and goal attainment. Individuals receiving and health care providers who deliver rehabilitative care conceptualize empathy and compassion as valuable in physical medicine and rehabilitation settings, with cognitive and behavioural elements described. Health care provider empathy and compassion-based interventions may influence outcomes positively in this context. More research is needed to understand the mechanisms of action of empathy and compassion and effectiveness in physical medicine and rehabilitation settings.
Collapse
Affiliation(s)
- Stephanie Posa
- St. John's Rehab Research Program, Sunnybrook Research Institute, Toronto, Ontario, Canada
| | - Marina B Wasilewski
- St. John's Rehab Research Program, Sunnybrook Research Institute, Toronto, Ontario, Canada
- Rehabilitation Sciences Institute, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Stewart W Mercer
- Usher Institute, Edinburgh Medical School, University of Edinburgh, Edinburgh, UK
| | - Sharon Simpson
- Institute of Health and Wellbeing, University of Glasgow, Glasgow,UK
| | - Lawrence R Robinson
- St. John's Rehab Research Program, Sunnybrook Research Institute, Toronto, Ontario, Canada
- Division of Physical Medicine & Rehabilitation, Department of Medicine, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
| | - Robert Simpson
- Institute of Health and Wellbeing, University of Glasgow, Glasgow,UK
- Division of Physical Medicine and Rehabilitation, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| |
Collapse
|
38
|
Sprague C. What Matters Most? The Power of Kafka's Metamorphosis to Advance Understandings of HIV Stigma and Inform Empathy in Medical Health Education. THE JOURNAL OF MEDICAL HUMANITIES 2022; 43:561-584. [PMID: 35188615 PMCID: PMC8858723 DOI: 10.1007/s10912-022-09729-2] [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] [Indexed: 06/14/2023]
Abstract
HIV stigma, a social-medical problem, continues to confound researchers and health professionals, while undermining outcomes. Empathy may reduce stigma; its absence may predict stigma. This research investigates: How does Kafka's Metamorphosis advance understandings of HIV stigma in medical health education? Metamorphosis amplifies the sociological-relational mechanisms fostering HIV stigma. It offers a multi-disciplinary, responsive space for ethical, humanistic and clinical inquiry to meet: enabling students to consider how social structures shape health inequities, moral, social experience, and their professional identity within. Metamorphosis may ultimately promote medical health humanities' social mission-allowing literature to unfold such revelations towards greater equity in health.
Collapse
|
39
|
Mroz EL, McDarby M, Arnold RM, Bylund CL, Kutner JS, Pollak KI. Empathic Communication in Specialty Palliative Care Encounters: An Analysis of Opportunities and Responses. J Palliat Med 2022; 25:1622-1628. [PMID: 35426742 PMCID: PMC9836699 DOI: 10.1089/jpm.2021.0664] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/24/2022] [Indexed: 01/22/2023] Open
Abstract
Background: Although empathic responding is considered a core competency in specialty palliative care (PC), patterns of empathic communication in PC encounters are not well understood. Objectives: In this secondary analysis, we delineate types and frequency of empathic communication and examine relationships between patient empathic opportunities and clinician responses. Design: We used the Empathic Communication Coding System to analyze empathic opportunities across three types: emotion (i.e., negative affective state), progress (i.e., stated recent positive life event or development), and challenge (i.e., stated problem or recent, negative life-changing event) and clinician responses. Setting/Subjects: Transcripts from a pilot randomized trial of communication coaching in specialty PC encounters (N = 71) audio-recorded by 22 PC clinicians at two sites in the United States: an academic health system and a community-based hospice and PC organization. Results: Empathic opportunities were frequent across encounters; clinicians often responded empathically to those opportunities (e.g., confirming or acknowledging patients' emotions or experiences). Even though challenge empathic opportunities occurred most frequently, clinicians responded empathically more often to progress opportunities (i.e., 93% of the time) than challenge opportunities (i.e., 75% of the time). One in 12 opportunities was impeded by the patient or a family member changing the topic before the clinician could respond. Conclusions: PC patients frequently express emotions, share progress, or divulge challenges as empathic opportunities. Clinicians often convey empathy in response and can differentiate their empathic responses based on the type of empathic opportunity. PC communication research and training should explore which empathic responses promote desired patient outcomes.
Collapse
Affiliation(s)
- Emily L. Mroz
- Section of Geriatrics, Department of Internal Medicine, Yale University, New Haven, Connecticut, USA
| | - Meghan McDarby
- Department of Psychological and Brain Sciences, Washington University in St. Louis, St. Louis, Missouri, USA
| | - Robert M. Arnold
- Section of Palliative Care and Medical Ethics, Division of General Internal Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Carma L. Bylund
- Health Outcomes and Biomedical Informatics, University of Florida, Gainesville, Florida, USA
| | - Jean S. Kutner
- Division of General Internal Medicine, Department of Medicine, University of Colorado School of Medicine, Aurora, Colorado, USA
| | - Kathryn I. Pollak
- Cancer Prevention and Control, Duke Cancer Institute, Duke University, Durham, North Carolina, USA
- Department of Population Health Sciences, Duke University School of Medicine, Durham, North Carolina, USA
| |
Collapse
|
40
|
Winter R, Leanage N, Roberts N, Norman RI, Howick J. Experiences of empathy training in healthcare: A systematic review of qualitative studies. PATIENT EDUCATION AND COUNSELING 2022; 105:3017-3037. [PMID: 35811257 DOI: 10.1016/j.pec.2022.06.015] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/29/2021] [Revised: 05/27/2022] [Accepted: 06/26/2022] [Indexed: 06/15/2023]
Abstract
OBJECTIVE To synthesise qualitative studies reporting student, practitioner, or patient experiences of empathy-training in healthcare. METHODS We included qualitative studies exploring (i) student or practitioner experiences of empathy training, or (ii) patient experiences of being treated by someone who has undergone empathy training. We used the Critical Appraisal Skills Programme (CASP) tool to assess study quality. Thematic synthesis was used to integrate findings from studies and to generate new insights. RESULTS Our search yielded 2768 citations, of which 23 (1487 participants) met inclusion criteria. Two clusters of themes were identified from included studies. Firstly, themes related to practitioner/trainee professionalism and wellbeing, where the main finding was that participants experienced benefit from therapeutic empathy training. Secondly, themes related to the understanding and treatment of patients, where the main finding was practitioners' deeper recognition of the positive impact of empathic care. CONCLUSIONS This review found that taking part in empathy-focused training can benefit practitioner/student personal growth and professional development, and benefits patient care. This review is limited by the difficulty in defining empathy and heterogeneity amongst included studies. PRACTICE IMPLICATIONS These results support a rationale for empathy training and the development of a framework to ensure training is having the desired effect.
Collapse
Affiliation(s)
- Rachel Winter
- Leicester Medical School, College of Life Sciences, University of Leicester, George Davies Centre, Leicester LE1 7RH, United Kingdom.
| | - Navin Leanage
- Leicester Medical School, College of Life Sciences, University of Leicester, George Davies Centre, Leicester LE1 7RH, United Kingdom
| | - Nia Roberts
- Bodleian Health Care Libraries, University of Oxford, Oxford OX1 3BG, United Kingdom
| | - Robert I Norman
- Leicester Medical School, College of Life Sciences, University of Leicester, George Davies Centre, Leicester LE1 7RH, United Kingdom
| | - Jeremy Howick
- Faculty of Philosophy, University of Oxford, Oxford OX2 6GG, United Kingdom
| |
Collapse
|
41
|
Haribhai-Thompson J, McBride-Henry K, Hales C, Rook H. Understanding of empathetic communication in acute hospital settings: a scoping review. BMJ Open 2022; 12:e063375. [PMID: 36171029 PMCID: PMC9528576 DOI: 10.1136/bmjopen-2022-063375] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVE Empathy and empathy education have been reviewed a number of times through systematic reviews and meta-analyses; however, the topic of 'empathetic communication' remains poorly understood when considering engaging in hospital-based research. Therefore, this scoping review aimed to explore the existing literature concerning empathetic communication in hospital settings and to evaluate the definitions presented. DESIGN Scoping review. DATA SOURCES Systematic searches of the PubMed, CINAHL, Cochrane, PsycINFO, and PsycArticles databases were conducted. STUDY SELECTION All English studies in which empathetic communication in hospital settings were explored. The search terms used included empathy, communication, hospital settings, providers, and consumers. DATA EXTRACTION Data were assessed through the use of a pre-set analysis tool. RESULTS After conducting the searches, 419 articles were identified, of which 26 were included in this review. No single article specifically defined the term 'empathetic communication'; however, 33 unique definitions of 'empathy' were identified, of which 23 considered communication to be a component of empathy. There was a considerable lack of consistency between the empathy definitions, with some classifying communication in empathy as an ability and others classifying it as a dynamic process. CONCLUSION Future and contextually focused research is needed to develop a consistent and clear definition of empathetic communication and empathy within a hospital setting to better build positive healthcare cultures. PRACTICE IMPLICATIONS Inconsistencies between definitions of empathy in empathetic communication research could reduce the efficacy of future research gains and impact the translation of research findings into clinical practice.
Collapse
Affiliation(s)
| | - Karen McBride-Henry
- Faculty of Health, Victoria University of Wellington, Wellington, New Zealand
| | - Caz Hales
- Faculty of Health, Victoria University of Wellington, Wellington, New Zealand
| | - Helen Rook
- Faculty of Health, Victoria University of Wellington, Wellington, New Zealand
| |
Collapse
|
42
|
Anto T, D S. Reflective narratives on unfolding ethics case vignettes: integration into the physiology course of first-year medical students. ADVANCES IN PHYSIOLOGY EDUCATION 2022; 46:389-399. [PMID: 35658612 DOI: 10.1152/advan.00155.2021] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/14/2021] [Revised: 03/28/2022] [Accepted: 06/01/2022] [Indexed: 06/15/2023]
Abstract
Reflective narrative writing on unfolding ethics case vignettes has the potential to promote values like empathy among medical students, which will prove useful in their future. The objective of this study was to explore the scope of guided reflective narratives on unfolding ethics case vignettes integrated into physiology teaching to promote empathy among first-year medical students. First-year medical students (n = 150) were presented with unfolding case vignettes exploring ethical issues, as part of their physiology curriculum, with questions and prompts for a guided reflective narrative. Feedback about the program was obtained through a semistructured questionnaire. The contents of the students' reflective narratives and feedback were analyzed. The narratives revealed that students empathized with the various individuals involved in medical treatment and research, which was also reflected in student feedback (n = 116; 79%) and high Likert scale scores (74%). The program was considered effective by students in broadening their perspective and promoting critical thinking (n = 129; 88%). Through analysis of reflections, a rubric that would enable the evaluation of students' empathy on a scale of increasing ability to look at a situation from another's point of view emerged. This rubric could be used to quantitatively assess the impact of similar programs. Although divided in their individual opinions, the study population was able to relate to all individuals involved in medical practice and research, recognizing the need for fair and ethical practices. The content analysis led to the development of a rubric to grade empathy.NEW & NOTEWORTHY Unfolding case vignettes exploring ethical issues were introduced into the physiology curriculum of first-year medical students. The effectiveness of guided reflections following the case vignettes was explored. The analysis of the reflections and feedback on the program revealed that students became more empathetic. The reflections broadened their perspective and encouraged critical thinking. The analysis led to development of a rubric to grade the level of empathy, which can be used for quantitative assessment of empathy.
Collapse
Affiliation(s)
- Taniya Anto
- Department of Physiology, St John's Medical College, Bangalore, Karnataka, India
| | - Savitha D
- Department of Physiology, St John's Medical College, Bangalore, Karnataka, India
| |
Collapse
|
43
|
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.
Collapse
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
| |
Collapse
|
44
|
Leyva-Moral JM, Aguayo-González M, San Rafael-Gutiérrez S, Gómez-Ibáñez R. Narrative photography with an expert patient as a method to improve empathy: a satisfaction study with health sciences students. Int J Nurs Educ Scholarsh 2022; 19:ijnes-2021-0124. [PMID: 35618500 DOI: 10.1515/ijnes-2021-0124] [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: 09/17/2021] [Accepted: 01/20/2022] [Indexed: 11/15/2022]
Abstract
OBJECTIVES To assess health sciences students' satisfaction with narrative photography with an expert patient as an empathy-fostering teaching method. METHODS Nineteen students from a public medical sciences university in Barcelona (Spain) voluntarily completed six online training sessions using narrative photography and expert patient. Data were collected using an anonymous online satisfaction questionnaire verified by experts, including 29 quantitative and qualitative questions that were analyzed descriptively. RESULTS Eighteen valid questionnaires were obtained (90% response rate). All students evaluated the teaching method as highly satisfactory. The main positive aspects of the teaching method were being able to express one's emotions and reflections. Students felt the activity enhanced their empathy and helped them minimize their prejudices, specifically to patients living with HIV. Students also evaluated the online format as less optimal than if it were delivered in person. CONCLUSION The students found the teaching method to have a personal and professional impact, which facilitated the integration of empathy in their daily practice when caring for people living with HIV.
Collapse
Affiliation(s)
- Juan M Leyva-Moral
- Nursing Department, Faculty of Medicine. Universitat Autonoma de Barcelona (Spain)
| | | | | | - Rebeca Gómez-Ibáñez
- Nursing Department, Faculty of Medicine. Universitat Autonoma de Barcelona (Spain)
| |
Collapse
|
45
|
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.
Collapse
|
46
|
Voultsos P, Chatzinikolaou F, Papana A, Deliligka A. Reliability of Greek version of the Toronto empathy questionnaire in medical students and associations with sociodemographic and lifestyle factors. BMC Psychol 2022; 10:113. [PMID: 35501889 PMCID: PMC9063083 DOI: 10.1186/s40359-022-00824-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Accepted: 04/26/2022] [Indexed: 01/10/2023] Open
Abstract
BACKGROUND Empathy is an important key driver of any therapeutic relationship. It is beneficial for both physicians and patients. Enhancing physician's empathy should be an important goal of medical education. As there was a literature gap regarding the topic of empathy among medical students in Greece, this study aimed to contribute to filling this gap. METHODS A cross-sectional study was conducted. A socio-demographic questionnaire and the 52-item Greek version of the Toronto composite empathy scale (TCES) for measuring the cognitive and emotional aspects of empathy in both personal and professional life was administered to all the medical students in the Aristotle University of Thessaloniki, in Greece. Descriptive statistics were displayed for demographics. The associations of the variables were quantified by Chi-2 independence tests and Pearson's Correlation Coefficient. The reliability and validity of the questionnaire was determined by Cronbach's α, Hotelling's T-Squared Test, and Pearson correlation. Paired and Independent Sample T-Tests and One-way ANOVAs indicated statistically significant mean differences among the variables or subgroups of the variables. RESULTS The 52-item TCES, 26 for the personal (Per) setting and another 26 for professional (Pro) life, equally divided into cognitive (Cog) and emotional (Emo) empathy in each case. The overall reliability of the TCES questionnaire was found to be high (Cronbach's α = 0.895, significant positive correlations between the subscales). The mean total score of empathy showed that students had a moderately high empathy. Further, there was a statistically significant difference in means between the Per-Cog and Per-Emo settings (p < 0.001), the Pro-Cog and Pro-Emo (p < 0.001), the Per-Cog and Pro-Cog (p = 0.004), and the Per-Emo and Pro-Emo (p < 0.001). Females had significantly higher empathy scores (mean score 208.04) than males (192.5) on the Per-Cog, Per-Emo and Pro-Emo subscales. Furthermore, a positive correlation was found between empathy and factors such as love for animals, interest in medical ethics, belief in God, having an ill person in the family, class year or carrier intention. CONCLUSIONS The TCES is applicable to medical students. For the most part our findings were consistent with previous literature. However, we identified some nuances that might draw researchers' attention. The results of this study may contribute to plan interventions in the curriculum to enhance empathy in the medical students.
Collapse
Affiliation(s)
- Polychronis Voultsos
- Laboratory of Forensic Medicine and Toxicology (Medical Law and Ethics), School of Medicine, Faculty of Health Sciences, Aristotle University, University Campus, 541 24, Thessaloniki, Greece.
| | - Fotios Chatzinikolaou
- Laboratory of Forensic Medicine and Toxicology (Medical Law and Ethics), School of Medicine, Faculty of Health Sciences, Aristotle University, University Campus, 541 24, Thessaloniki, Greece
| | - Angeliki Papana
- Department of Economics, School of Economics and Regional Studies, University of Macedonia, Egnatia Str 156, 546 36, Thessaloniki, Greece
| | - Aspasia Deliligka
- AHEPA University Hospital, Kiriakidi Str 1, 546 21, Thessaloniki, Greece
| |
Collapse
|
47
|
Roberts BW, Roberts MB, Mazzarelli A, Trzeciak S. Validation of a 5-Item Tool to Measure Patient Assessment of Clinician Compassion in Hospitals. J Gen Intern Med 2022; 37:1697-1703. [PMID: 33835313 PMCID: PMC8034051 DOI: 10.1007/s11606-021-06733-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/17/2021] [Accepted: 03/16/2021] [Indexed: 12/30/2022]
Abstract
BACKGROUND We previously validated a 5-item compassion measure to assess patient experience of clinician compassion in the outpatient setting. However, currently, there is no validated and feasible method for health care systems to measure patient experience of clinician compassion in the inpatient setting across multiple hospitals. OBJECTIVE To test if the 5-item compassion measure can validly and distinctly measure patient assessment of physician and nurse compassion in the inpatient setting. DESIGN Cross-sectional study between July 1 and July 31, 2020, in a US health care network of 91 community hospitals across 16 states consisting of approximately 15,000 beds. PATIENTS Adult patients who had an inpatient hospital stay and completed the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey. MEASUREMENTS We adapted the original 5-item compassion measure to be specific for physicians, as well as for nurses. We disseminated both measures with the HCAHPS survey and used confirmatory factor analysis for validity testing. We tested reliability using Cronbach's alpha, as well as convergent validity with patient assessment of physician and nursing communication and overall hospital rating questions from HCAHPS. RESULTS We analyzed 4756 patient responses. Confirmatory factor analysis found good fit for two distinct constructs (i.e., physician and nurse compassion). Both measures demonstrated good internal consistency (alpha > 0.90) and good convergent validity but reflected a construct (compassionate care) distinct from what is currently captured in HCAHPS. CONCLUSION We validated two 5-item tools that can distinctly measure patient experience of physician and nurse compassion for use in the inpatient hospital setting in conjunction with HCAHPS.
Collapse
Affiliation(s)
- Brian W Roberts
- Department of Emergency Medicine, Cooper University Health Care, Cooper Medical School of Rowan University, Camden, NJ, USA. .,Center for Humanism, Cooper Medical School of Rowan University, Camden, NJ, USA. .,Cooper University Hospital, Camden, NJ, USA.
| | - Michael B Roberts
- Institutional Research and Outcomes Assessment, Philadelphia College of Osteopathic Medicine, Philadelphia, PA, USA
| | - Anthony Mazzarelli
- Department of Emergency Medicine, Cooper University Health Care, Cooper Medical School of Rowan University, Camden, NJ, USA.,Center for Humanism, Cooper Medical School of Rowan University, Camden, NJ, USA.,Cooper University Hospital, Camden, NJ, USA
| | - Stephen Trzeciak
- Center for Humanism, Cooper Medical School of Rowan University, Camden, NJ, USA.,Cooper University Hospital, Camden, NJ, USA.,Department of Medicine, Cooper University Health Care, Cooper Medical School of Rowan University, Camden, NJ, USA
| |
Collapse
|
48
|
Kumar N, Parsa AD, Rahman E. A Core Curriculum for Postgraduate Program in Non-Surgical Aesthetics: A Cross-sectional Delphi Study. AESTHETIC SURGERY JOURNAL OPEN FORUM 2022; 4:ojac023. [PMID: 35662906 PMCID: PMC9154017 DOI: 10.1093/asjof/ojac023] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Background The desire for portraying a young and beautiful face and body is driving people to seek aesthetic treatment and accelerating the exponential growth of nonsurgical aesthetic (NSA) procedures. Unfortunately, despite impressive advances, NSA is yet to have a formal clinical education program. Objectives This study aimed to identify the content and structure of an evidence-based postgraduate curriculum in NSA. Methods The Delphi questionnaire was developed after a comprehensive literature review and a focus group discussion. The questionnaire was emailed to 40 experts and 20 trainee physicians worldwide through the online survey platform and was asked to assign a rating on a 4-point Likert scale. A “1” represents a strong disagreement about integrating a topic in the NSA curriculum, and a “4” indicates a firm agreement. A pre-fixed percentage agreement of 80% and Cronbach’s α = 0.90 was established to represent a consensus for the current study. Results The response rate for the Delphi study was 90.0%, 88.8%, and 90% in the first, second, and third rounds, respectively. The experts and trainee physicians agreed with all the proposed topics (≥80%) and considered them critical for the proposed NSA curriculum. The mean score for each was ≥ 3, and Cronbach’s α value for the Delphi was 0.94, confirming internal consistency and reliability. Conclusions The consensus demonstrates significant advances toward developing an evidence-based curriculum for a postgraduate program in NSA, which is essential to support the growing demand for trained aesthetic physicians.
Collapse
Affiliation(s)
- Narendra Kumar
- Division of Biosciences, Department of Cell and Developmental Biology, University College London, London, WC1E6BT, United Kingdom
| | - Ali Davod Parsa
- Faculty of Health, Education, Medicine and Social Care, Anglia Ruskin University, East Road, Cambridge, CB1 1PT, United Kingdom
| | - Eqram Rahman
- Department of Plastic and Reconstructive Surgery, Royal Free Hospital, Pond Street, Hampstead, London NW3 2QG, United Kingdom
| |
Collapse
|
49
|
Yu CC, Tan L, LE MK, Tang B, Liaw SY, Tierney T, Ho YY, Lim BEE, Lim D, Ng R, Chia SC, Low JA. The development of empathy in the healthcare setting: a qualitative approach. BMC MEDICAL EDUCATION 2022; 22:245. [PMID: 35379249 PMCID: PMC8981670 DOI: 10.1186/s12909-022-03312-y] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/25/2021] [Accepted: 03/24/2022] [Indexed: 06/01/2023]
Abstract
BACKGROUND Healthcare professionals' empathetic behaviors have been known to lead to higher satisfaction levels and produce better health outcomes for patients. However, empathy could decrease over time especially during training and clinical practice. This study explored factors that contributed to the development of empathy in the healthcare setting. Findings could be used to improve the effectiveness and sustainability of empathy training. METHOD A qualitative approach, informed by aspects of grounded theory, was utilized to identify factors that enabled the development of empathy from the perspectives of doctors, nurses, allied healthcare workers and students. Twelve sessions of focus group discussions were conducted with 60 participants from two hospitals, a medical school, and a nursing school. Data was analyzed independently by three investigators who later corroborated to refine the codes, subthemes, and themes. Factors which influence the development of empathy were identified and categorized. This formed the basis of the creation of a tentative theory of empathy development for the healthcare setting. RESULTS The authors identified various personal (e.g. inherent characteristics, physiological and mental states, professional identity) and external (e.g. work environment, life experience, situational stressors) factors that affected the development of empathy. These could be further categorized into three groups based on the stability of their impact on the individuals' empathy state, contributed by high, medium, or low stability factors. Findings suggest empathy is more trait-like and stable in nature but is also susceptible to fluctuation depending on the circumstances faced by healthcare professionals. Interventions targeting medium and low stability factors could potentially promote the development of empathy in the clinical setting. CONCLUSIONS Understanding factors that impact the development of empathy allows us to develop measures that could be implemented during training or at the workplace leading to improve the quality of care and higher clinical work satisfaction.
Collapse
Affiliation(s)
- Chou Chuen Yu
- Geriatric Education and Research Institute Ltd, Singapore, Singapore
| | - Laurence Tan
- Geriatric Education and Research Institute Ltd, Singapore, Singapore
- Department of Geriatric Medicine, Khoo Teck Puat Hospital, Singapore, Singapore
| | - Mai Khanh LE
- Geriatric Education and Research Institute Ltd, Singapore, Singapore
| | - Bernard Tang
- Geriatric Education and Research Institute Ltd, Singapore, Singapore.
| | - Sok Ying Liaw
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Tanya Tierney
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore
| | - Yun Ying Ho
- Ministry of Health Holdings, Singapore, Singapore
| | - Beng Eng Evelyn Lim
- School of Health & Social Sciences, Nanyang Polytechnic, Singapore, Singapore
| | - Daphne Lim
- School of Health & Social Sciences, Nanyang Polytechnic, Singapore, Singapore
| | - Reuben Ng
- Lee Kuan Yew School of Public Policy, National University of Singapore, Singapore, Singapore
| | | | - James Alvin Low
- Geriatric Education and Research Institute Ltd, Singapore, Singapore
- Department of Geriatric Medicine, Khoo Teck Puat Hospital, Singapore, Singapore
| |
Collapse
|
50
|
Pereira AT, Brito MJ, Cabaços C, Carneiro M, Carvalho F, Manão A, Araújo A, Pereira D, Macedo A. The Protective Role of Self-Compassion in the Relationship between Perfectionism and Burnout in Portuguese Medicine and Dentistry Students. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:2740. [PMID: 35270432 PMCID: PMC8910448 DOI: 10.3390/ijerph19052740] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/06/2022] [Revised: 02/11/2022] [Accepted: 02/18/2022] [Indexed: 02/06/2023]
Abstract
Recent studies have documented the high prevalence of burnout among medicine and dentistry students, with potentially catastrophic consequences for both students and patients. Both environmental and personality factors play a part in burnout; perfectionism, a common trait in medicine students' personalities, has been linked to psychological distress and increasing students' vulnerability to burnout. Self-compassion, i.e., treating oneself kindly through hardship, has recently emerged as a buffer between perfectionism and psychological distress. While using a novel three-factor conceptualization of perfectionism (BIG3), this study aims to analyze if self-compassion has a protective role in the relationship between perfectionism and burnout, in a sample of medicine and dentistry students, through mediation analysis. We found that self-compassion significantly mediated the relationship between all three forms of perfectionism and burnout: as a partial mediator in self-critical and rigid perfectionism, as well as a full mediator in narcissistic perfectionism. Our findings underline self-compassion's relevance in burnout prevention and management, supporting its use as an intervention target in burnout reduction programs and strategies.
Collapse
Affiliation(s)
- Ana Telma Pereira
- Institute of Psychological Medicine, Faculty of Medicine, University of Coimbra, Rua Larga, 3004-504 Coimbra, Portugal; (M.J.B.); (C.C.); (M.C.); (F.C.); (A.M.); (A.A.); (D.P.); (A.M.)
| | | | | | | | | | | | | | | | | |
Collapse
|