Associations of emotional intelligence and gratitude with empathy in medical students

Emotional intelligence among medical students in Sweden - a questionnaire study

BACKGROUND

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

METHODS

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

RESULTS

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

CONCLUSIONS

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

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

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

Gender differences in empathy, emotional intelligence and problem-solving ability among nursing students: A cross-sectional study

BACKGROUND

Empathy, emotional intelligence (EI) and problem-solving ability are three important characteristics that influence effective communication in clinical practice. Previous studies have not adequately explored the specific relationships between these three abilities and their gender differences among nursing students.

OBJECTIVE

We sought to investigate the current state of emotional intelligence, empathy, and problem-solving ability in nursing students and to identify whether gender differences affect these three characteristics and how gender differences can be used to educate nurses on empathy.

DESIGN

We conducted a cross-sectional survey.

PARTICIPANTS

A total of 993 nursing students from two grade A tertiary hospitals in Hunan, China participated in this study.

METHODS

Data were collected using the Empathy of Clinical Nurse Scale (ENCS), Emotional Intelligence Scale of Clinical Junior Nurses (EIS) and Social Problem-Solving Inventory (SPSI). Data were analyzed using an independent samples t-test, Pearson correlation and hierarchical multiple linear regression.

RESULTS

There was no significant difference in the ENCS and SPSI scores between male and female nursing students, but male nursing students had lower EIS scores (P < 0.05). A significant association was found between ENCS, EIS and SPSI on most dimensions among female nursing students, but no significant association was found between ENCS and EIS for total scores among males. We found that problem-solving ability was the most important factor affecting the variation in empathy for both male and female nursing students through hierarchical multiple regression analysis.

CONCLUSIONS

Gender differences are reflected not only in the level of emotional intelligence but also in the relationships between emotional intelligence, empathy, and problem-solving ability. Nursing educators should be aware of how gender differences can affect these three traits; this is particularly important for teaching based on students' aptitudes.

Comparing gratitude and pride: evidence from brain and behavior

Gratitude and pride are both positive emotions. Yet gratitude motivates people to help others and build up relationships, whereas pride motivates people to pursue achievements and build on self-esteem. Although these social outcomes are crucial for humans to be evolutionarily adaptive, no study so far has systematically compared gratitude and pride to understand why and how they can motivate humans differently. In this review, we compared gratitude and pride from their etymologies, cognitive prerequisites, motivational functions, and brain regions involved. By integrating the evidence from brain and behavior, we suggest that gratitude and pride share a common reward basis, yet gratitude is more related to theory of mind, while pride is more related to self-referential processing. Moreover, we proposed a cognitive neuroscientific model to explain the dynamics in gratitude and pride under a reinforcement learning framework.

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

OBJECTIVE

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

METHODS

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

RESULTS

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

CONCLUSION

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

PRACTICE IMPLICATIONS

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

First-year nursing students' initial contact with the clinical learning environment: impacts on their empathy levels and perceptions of professional identity

Background

Research shows that the clinical learning environment can affect medical learners’ levels of empathy and formation of professional identity. However, few studies examined the impacts of early exposure to the clinical learning environment on first-year nursing students’ empathy levels and professional identity perceptions.

Aim

This study aimed to explore effects of initial contact with the clinical learning environment on first-year nursing students’ empathy levels and perceptions of professional identity.

Methods

This is a mixed-methods study conducted in a medical university and its affiliated hospital in Northeast China. For quantitative analysis, 220 first-year nursing students finished Interpersonal Reactivity Index (IRI) twice before and after their five-day clinical placement in the hospital in June, 2021. Paired samples t tests were used to explore the changes in first-year nursing students’ cognitive empathy, affective empathy and total empathy levels as measured by IRI before and after the clinical placement. For qualitative analysis, 15 first-year nursing students’ diary recording their clinical learning experiences were analyzed. An inductive thematic analysis approach was adopted to extract themes from the content on professional identity in nursing students’ diary.

Results

After the five-day clinical placement, first-year nursing students’ cognitive empathy, affective empathy and total empathy levels all increased. Five themes emerged regarding nursing students’ perceptions of professional identity: (1) Love for the nursing profession; (2) Multiple roles nurses play; (3) Personal characteristics a good nurse needs to have; (4) Deeper understanding of the nursing profession; (5) New understanding of the relationships between patients and nurses, between patients and doctors, and between doctors and nurses.

Conclusions

First-year nursing students’ initial contact with the clinical learning environment helped them enhance empathy levels and shape professional identity. Nursing educators may consider providing nursing students with opportunities of early exposure to the clinical learning setting to cultivate their empathy and develop their professional identity.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12912-022-01016-8.

Does a sense of gratitude protect against empathy loss in medical students? An exploratory study

INTRODUCTION

The promotion of physicians' empathy (PE) skills in medical school plays a central role in physician-patient communication. However, a significant decline in empathy among medical students during their training has been repeatedly reported. Gratitude could be a possible protective factor for PE. However, as some students do not seem to be affected by this empathy loss, this study explores the relationship between gratitude and PE.

METHODS

Using validated questionnaires (JSPE-S, IRI and GQ-6), 88 medical students at LMU München evaluated their self-assessed PE and gratitude. In addition, they went through four OSCE stations focusing on general medicine, in which their empathy and communication skills were assessed by simulated patients (SP) and by an assessor using the Berlin Global Rating. Correlations were analysed using Pearson's correlation coefficient and gender differences were analysed using Mann-Whitney U-tests.

RESULTS

In the self-assessment, there was a significant, moderate correlation between students' attitude towards empathy (JSPE-S) and their gratitude (GQ-6) and a weak correlation between the IRI subscale "Empathy" and the GQ-6. In terms of the performance-based assessment, there were also weak correlations between PE or communication skills and gratitude. There were no gender-specific differences in the gratitude of the students.

CONCLUSION

We were able to demonstrate a correlational relationship between gratitude and empathy in medical students. Whether gratitude acts causally as a protective or supportive factor for empathy remains open. A causal relationship of gratitude to empathy should therefore be examined in a prospective study design.

Tiny Habits® for Gratitude-Implications for Healthcare Education Stakeholders

The COVID-19 pandemic has led to diminished sleep and increased stress, anxiety, and burnout for many health professionals and health professions students. One simple approach that may be effective for bolstering personal well-being is consciously cultivating gratitude. Gratitude is positively associated with physical health, psychological health, hope, sleep, and health behavior engagement; and randomized studies indicate that gratitude interventions can improve psychological well-being and sleep. The primary aim of this study was to assess the impact of practicing Tiny Habits^® on self-reported gratitude, as measured by the 6-Item Gratitude Questionnaire (GQ-6). In January 2021, 154 adult participants with GQ-6 <35/42 were randomized to one of 3 groups: Tiny Habits for Gratitude (n = 50), Tiny Habits Control (n = 52), and Inactive Control (n = 52). Both Tiny Habits groups chose 3 Tiny Habits Recipes to practice daily and participated in the free, email-based 5-Day Program with automated daily check-in emails and personalized feedback from a Certified Tiny Habits Coach. The Recipes for the Tiny Habits for Gratitude group focused on cultivating gratitude, while those for the Tiny Habits Control group did not. Post-intervention, the mean change in GQ-6 scores in the Tiny Habits for Gratitude (Δ = ↑6.9 ± 5.6; n = 37/50, 74%; p< 0.001, Cohen's d = 0.85) and Tiny Habits Control (Δ = ↑5.6 ± 4.1; n = 31/52, 60%; p = 0.009, Cohen's d = 0.71) groups were greater than that of the Inactive Control group (Δ = ↑2.5 ± 4.4; N = 42/52, 81%). At 1 month, the mean change in GQ-6 scores in the Tiny Habits for Gratitude group (Δ = ↑7.0 ± 5.3; N = 28/50, 56%) was greater than that of the Inactive Control group (Δ = ↑2.9 ± 5.4; N = 39/52, 72%; p = 0.002, Cohen's d = 0.78). These findings suggest that practicing Tiny Habits Recipes and participating in the 5-Day Program can significantly increase gratitude in the short term and focusing specifically on gratitude during this process can sustain the increase in gratitude for up to 1 month. Implementation is quick, simple, and free. This has significant implications for healthcare education stakeholders.

Empathy scores amongst undergraduate medical students and its correlation to their academic performance

INTRODUCTION

Empathy is one of the soft skills required for building rapport and having meaningful patient-doctor interaction. Its effect on academic performance at the undergraduate level amongst Pakistani medical students is not known. This study was done to assess the relationship between empathy and gender, and the academic performance of undergraduate medical students of Azad Kashmir.

METHODS

This cross-sectional study was done in Poonch Medical College, Azad Kashmir, Pakistan, from May 2018 to May 2019. The sample size for this study consisted of 200 students, determined by Krejcie and Morgan sample size determination chart. Students who agreed to participate in the study were enrolled according to convenience sampling using google forms. The Interpersonal Reactivity Index (IRI) questionnaire was utilized as the data collection tool. Data were analyzed using SPSS version 25. The ethical review board approved the study. Comparisons between males and females at the IRI questions level, IRI domains level, and total IRI were made using the Mann-Whitney U test. The Spearman Rank Correlation test was used to assess the correlation between academic performance, IRI domains, and total IRI scores. A one-way ANOVA test was done to assess the relationship between academic performance and their study years.

RESULTS

A total of one hundred and fifty-one students (males 83, females 68, response rate 75.5%) participated in the study from the third to the final year of medical college. The mean empathy scores of males and females were 90.76 ± 8.39 and 91.72 ± 9.76 (p-value = 0.552). On the empathic concern scale, female students had significantly higher empathy scores (25.44 ± 3.49) than males (23.78 ± 3.88) (p-value=0.008). No significant correlation was found between the empathy scores and academic performance, using Spearman's correlation test (p>0.05).

CONCLUSION

Females showed significantly higher empathy scores than males for two Interpersonal Reactivity Index items and empathic concern scale. Overall, male and female students had similar total empathy scores. The relationship between empathy and academic performance was non-significant.

Emotional intelligence in undergraduate medical students: a scoping review

PURPOSE

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

METHOD

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

RESULTS

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

CONCLUSIONS

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

The Usefulness of a Massive Open Online Course about Postural and Technological Adaptations to Enhance Academic Performance and Empathy in Health Sciences Undergraduates

Massive open online courses (MOOCs) provide accessible and engaging information for Physical Therapy and Occupational Therapy students. The objective of this research was to determine the usefulness in improving academic performance and empathy in health sciences undergraduates, and to test a hypothetical model through structural equation analysis. This research was carried out using a descriptive and quasi-experimental design. It was conducted in a sample of 381 participants: 176 used a MOOC and 205 did not. The results of the Student’s t-test showed statistically significant differences in academic performance between the groups in favor of those students who had realized the MOOC. Participants carried out an evaluation rubric after taking MOOC. Statistically significant differences in empathy were also obtained between the pre (X = 62.06; SD = 4.41) and post (X = 73.77; SD = 9.93) tests. The hypothetical model tested via structural equation modeling was supported by the results. Motivation for the MOOC explained 50% of the variance. The MOOC (participation and realization) explained 58% of academic performance, 35% of cognitive empathy and 48% of affective empathy. The results suggest an association between higher realization and participation in a MOOC and higher levels of academic performance, and cognitive and affective empathy.

Cross-Cultural Comparison of Relationships between Empathy and Implicit Theories of Emotions (in Chinese and Russians)

The current manuscript presents the results of a cross-cultural comparison of the relationships between empathy and implicit theories of emotion in individuals from China and Russia. We hypothesized that the members of the Chinese culture would differ from the more Western Russian participants in terms of relationships between the various components of the emotional domain. Thus, we aimed to identify latent personality profiles while hypothesizing that the Chinese sample would demonstrate more prominent links between empathy and implicit theories regarding the possibility of controlling emotions. We also assumed that immediate social context could affect the results, and therefore, we compare two groups of Chinese participants-those living in China and those living in Russia, predominantly studying in Russian universities. The initial sample included Russians (N = 523), Chinese living in Russia (N = 376), and Chinese living in China (N = 423). However, following matching procedures to enable the sociodemographic comparability of samples, the final comparison was reduced to a final sample of Russians (N = 400), a sample of Chinese living in Russia (N = 363), and a sample of Chinese living in China (N = 421). We used latent class analysis and correlation analyses to test the study hypotheses. The study found that, unlike Russians, the Chinese participants demonstrated a positive correlation between incremental implicit theories of emotions and empathy. We also established significant group and gender differences. Russian women reported higher affective empathy than men, whereas Chinese women demonstrated higher affective empathy and cognitive empathy, as well as incremental implicit theories of emotion.

Big Five Personality Traits and Gratitude: The Role of Emotional Intelligence

Background

Among many possible variables that can be associated with gratitude, researchers list personality traits. Considering that these relationships are not always consistent, the first purpose of the present study was to verify how the Big Five factors connect to dispositional gratitude in a sample of Polish participants. The second purpose was to assess the unique contribution of personality traits on gratitude with multiple regression analyses. Moreover, because much remains to be learned about whether these associations are indirectly influenced by different personal or social variables, the third goal was to explore the role of emotional intelligence as a potential mediational mechanism implicated in the relationship between personality traits and gratitude.

Participants Methods and Data Collection

The sample consisted of 712 Polish respondents who were aged between 17 and 88. Most of them were women (64.3%). They answered questionnaires concerning their personality traits, emotional intelligence, and gratitude. The research was conducted using the paper-and-pencil method through convenience sampling.

Results

The results showed that both gratitude and emotional intelligence correlated positively and significantly with extraversion, openness to experience, agreeableness, and conscientiousness. Gratitude and emotional intelligence correlated negatively and significantly with neuroticism. The personality predictor of gratitude with the highest and positive standardized regression value was agreeableness, followed by openness to experience and extraversion. Neuroticism had a negative impact on gratitude. Conscientiousness was the only statistically insignificant predictor in the tested multiple regression model. Moreover, emotional intelligence mediated the relationship between four dimensions of personality (extraversion, openness to experience, agreeableness, and conscientiousness) and gratitude and acted as a suppressor between neuroticism and gratitude.

Conclusion

The current study broadens our comprehension of the interaction among personality traits, emotional intelligence, and a grateful disposition. Moreover, it imparts a noteworthy foundation not only for the mediatory role of emotional intelligence between four dimensions of personality and gratitude but also for its suppressor effect between neuroticism and being grateful.