Personality assessments and outcomes in medical education and the practice of medicine: AMEE Guide No. 79

Extravert Surgical Resident Applicants Get Higher 360-Degree Evaluations From Coworkers

INTRODUCTION

360-degree evaluations are used as an assessment in order to identify strengths and weaknesses of, or as a continuous evaluation for, residents. The aim of this study was to investigate the relationship between personality and ratings on 360-degree evaluations among surgical residency applicants. A secondary aim was to describe the personality profile of applicants for a surgical residency position.

METHODS

Doctors interviewed for a residency or locum position in general, urology, or pediatric surgery were included. Participants rated their personality on the Neutralized Big Five Inventory. A 360-degree assessment was conducted. Scores from two laparoscopic simulators were used as a measure of technical ability. Univariate analyses were used to assess the results. Student's t-test was used to compare personality and Pearson correlations between 360-degree assessment and personality.

RESULTS

Fifty doctors participated: data were complete for 38. Personality profiles showed higher emotional stability, agreeableness, conscientiousness and openness ratings than the norm. Correlations revealed a significant relationship between extraversion and higher scores on the 360-degree assessments. Significant univariate correlations were found between extraversion and the 360-degree assessments, and two of the correlations held up after adjustment for multiple tests. No correlations with performance when using laparoscopic simulators were found.

CONCLUSIONS

Applicants for surgical residency rated significantly higher than the norm in four personality domains. Extraversion correlated with overall higher scores in 360-degree assessments by coworkers. Higher scores were not related to objective measures of technical skill, highlighting the importance of using objective measures for assessment.

Reframing selection as a learning experience: Insights from a residency selection assessment

PURPOSE

Selection for postgraduate medical training is high-stakes and complex. The learning value of assessments for selection has, thus far, been underexplored, limiting their uptake as potentially meaningful learning experiences. The aim of this study was to explore the learning value residency applicants derive from an intelligence, personality, motivation and competency selection assessment and what factors influence the experienced learning value.

METHODS

In Autumn 2020 and Spring 2021, we conducted individual semi-structured interviews with sixteen applicants for pediatric residency training. Selection outcomes were unknown at the time of the interview. Interviews were transcribed verbatim and thematically analyzed.

RESULTS

Participants reported that the assessment was valuable in fostering self-reflection and self-awareness, embracing self-acceptance, pursuing development goals, assessing professional fit, and harnessing motivational drivers in work. The experienced learning value was influenced by applicants' ability to interpret its results, their focus on the high-stakes selection process and concerns regarding the acceptability and credibility of the selection tool.

CONCLUSIONS

While the selection assessment showed learning potential, its learning value was impeded by a preoccupation with the high-stakes nature of the selection procedure. Intentional integration of the selection assessment in the learning curriculum may play a pivotal role in realizing its learning potential.

A scoping review on the relationship between mental wellbeing and medical professionalism

BACKGROUND

Mental wellbeing issues among medical students are common, and their relationship to medical professionalism is debated. Few studies have attempted to link such issues with undergraduate medical education. This review aimed to advance the knowledge on this matter by exploring the relationship between mental wellbeing and medical professionalism in undergraduate medical education.

METHODS

We collected the literature about mental wellbeing and medical professionalism (published from 1 January 1986 to 31 March 2021) from the Web of Science, PubMed, Scopus and ScienceDirect databases using the search terms 'mental wellbeing' and 'medical professionalism'.We included all peer-reviewed articles in which mental wellbeing and medical professionalism in the undergraduate medical education context were the central topics regardless of the age range, nationality, race and gender of the participants.

RESULTS

From the 13,076 Iinitially found articles, 16 were included. These 16 articles were from nine countries in four different continents, which all together helped us find answer to our research question using extracted points relating to the main study themes (mental wellbeing and medical professionalism). Under theme 1 (mental wellbeing), six subthemes emerged: burnout, stress, depression, disappointment, depersonalisation and conscientiousness. Theme 2 (medical professionalism), on the other hand, had five subthemes: empathy, academic performance, compassion, unprofessional behaviour and professionalism. A significant inverse association was found between empathy and burnout. Academic performance was also related to burnout. At the same time, empathy was found to have a varied association with stress. Moreover, compassion was found to alleviate burnout and nurture professional gratification.

CONCLUSION

The medical professionalism attributes were found to deteriorate as the mental wellbeing issues grow. This can harm medical students' overall health, current learning abilities and future attitudes towards their patients. Explicit primary research is thus required to examine and intervene in the cause-effect relationship between medical professionalism and mental wellbeing.

Do students' personality traits change during medical training? A longitudinal cohort study

Many medical schools incorporate assessments of personal characteristics, including personality traits, in their selection process. However, little is known about whether changes in personality traits during medical training affect the predictive validity of personality assessments. The present study addressed this issue by examining the stability of personality traits and their predictive validity over a 6-year medical training course. Participants were two cohorts of Swiss medical students (N = 272, 72% of students admitted to Year 2) from whom we collected demographic data, Swiss medical studies aptitude test (EMS) scores, Big Five personality traits scores measured at three times and scores on the multiple-choice and objective structured clinical examination parts of the final medical examination. Our findings indicated that personality traits had medium-to-high rank-order stability (r > .60 over 3 years and r > .50 over 6 years). Mean-level changes were moderate for agreeableness (d = + 0.72) and small for neuroticism and conscientiousness (d = -0.29, d = -0.25, respectively). Individual reliable change indices ranged from 4.5% for openness to 23.8% for neuroticism. The predictive validity was similar to that of the first three years of follow-up. To the best of our knowledge, this is the first study to investigate changes in personality across undergraduate curriculum. Medical students' personality traits were mostly stable across medical school and retain their predictive validity. Consequently, this study supports the use of tools measuring constructs underlying personality traits in selection. In addition, this study confirms that examination formats could favor students with certain personality traits.

Does doctors' personality differ from those of patients, the highly educated and other caring professions? An observational study using two nationally representative Australian surveys

OBJECTIVES

Personality differences between doctors and patients can affect treatment outcomes. We examine these trait disparities, as well as differences across medical specialities.

DESIGN

Retrospective, observational statistical analysis of secondary data.

SETTING

Data from two data sets that are nationally representative of doctors and the general population in Australia.

PARTICIPANTS

We include 23 358 individuals from a representative survey of the general Australian population (with subgroups of 18 705 patients, 1261 highly educated individuals and 5814 working in caring professions) as well as 19 351 doctors from a representative survey of doctors in Australia (with subgroups of 5844 general practitioners, 1776 person-oriented specialists and 3245 technique-oriented specialists).

MAIN OUTCOME MEASURES

Big Five personality traits and locus of control. Measures are standardised by gender, age and being born overseas and weighted to be representative of their population.

RESULTS

Doctors are significantly more agreeable (a: standardised score -0.12, 95% CIs -0.18 to -0.06), conscientious (c: -0.27 to -0.33 to -0.20), extroverted (e: 0.11, 0.04 to 0.17) and neurotic (n: 0.14, CI 0.08 to 0.20) than the general population (a: -0.38 to -0.42 to -0.34, c: -0.96 to -1.00 to -0.91, e: -0.22 to -0.26 to -0.19, n: -1.01 to -1.03 to -0.98) or patients (a: -0.77 to -0.85 to -0.69, c: -1.27 to -1.36 to -1.19, e: -0.24 to -0.31 to -0.18, n: -0.71 to -0.76 to -0.66). Patients (-0.03 to -0.10 to 0.05) are more open than doctors (-0.30 to -0.36 to -0.23). Doctors have a significantly more external locus of control (0.06, 0.00 to 0.13) than the general population (-0.10 to -0.13 to -0.06) but do not differ from patients (-0.04 to -0.11 to 0.03). There are minor differences in personality traits among doctors with different specialities.

CONCLUSIONS

Several personality traits differ between doctors, the population and patients. Awareness about differences can improve doctor-patient communication and allow patients to understand and comply with treatment recommendations.

Do personal and behavioural characteristics of physiotherapy students predict performance during training and course completion?

BACKGROUND

Specific personal and behavioural characteristics are required for competent health care practice. Research investigating relationships between these characteristics and course performance of health professions students is expanding, yet little research is conducted within the undergraduate physiotherapy student population. This study aimed to explore the relationships between personality, approaches to learning, and coping strategies of undergraduate physiotherapy students and their performance in academic, clinical and in-course assessment tasks and course progression.

METHODS

Participants from six cohorts of undergraduate physiotherapy students (commencing years 2012-2017, 66% response rate) completed questionnaires measuring personality (NEO-FFI-3), approaches to learning (RASI) and coping strategies (Brief COPE). Correlation and multiple regression analysis were conducted to investigate relationships between scores on written examinations, in-course assessment tasks and assessments of clinical performance. Mann-Whitney U test was used to compare subgroups on these measures in those who completed or did not complete the course.

RESULTS

Conscientiousness and a strategic approach to learning predicted higher scores in written examinations, and for most clinical and in-course assessments with conscientiousness being a stronger predictor. A lack of purpose (surface) learning approach was predictive of lower clinical placement scores. Non-course completers had higher scores for lack of purpose (surface) approach to learning and lower scores for the coping strategies of support seeking and humour.

CONCLUSIONS

This study confirms the importance of conscientiousness and a strategic learning approach on the academic and clinical performance of undergraduate physiotherapy students. Identifying learners with a surface learning approach and low support seeking coping strategies could assist in providing support to students at risk of poor performance and minimising attrition.

If You Build It, Will They Come? Exploring the Impact of Medical Student Engagement on Clerkship Curriculum Outcomes

Introduction

Inconsistent or superficial access to workplace learning experiences can impede medical students' development. Well-designed clerkship curricula provide comprehensive education by offering developmental opportunities in and out of the workplace, explicitly linked to competency objectives. Questions remain about how students engage with clerkship curriculum offerings and how this affects their achievement. This study investigated student engagement as the source of an apparent clerkship curriculum malfunction: increasing rate of substandard summative clinical competency exam (SCCX) performance over 3 years following curriculum reform.

Materials and Methods

We sampled from three cohorts of US medical students (classes of 2018-2020) based on their post-clerkship SCCX performance: substandard (N = 33) vs. exemplary (N = 31). Using a conceptually based, locally developed rubric, a five-person team rated students' engagement in a curriculum offering designed to provide standardized deliberate practice on the clerkship's competency objectives. We examined the association between engagement and SCCX performance, taking prior academic performance into account.

Results

Rate of substandard SCCX performance could not be explained by cohort differences in prior academic performance. Student engagement differed across cohorts and was significantly associated with SCCX performance. However, engagement did not meaningfully predict individual students' SCCX performance, particularly in light of prior academic performance.

Discussion

Engagement with a particular learning opportunity may not affect clerkship outcomes, but may reflect students' priorities when navigating curricular offerings, personal learning goals, and curriculum policy. Proposing four patterns of engagement in clerkship learning, this study prompts reflection on the complex interaction among factors that affect engagement and outcomes.

Exploring variation in surgical practice: does surgeon personality influence anastomotic decision-making?

BACKGROUND

Decision-making under uncertainty may be influenced by an individual's personality. The primary aim was to explore associations between surgeon personality traits and colorectal anastomotic decision-making.

METHODS

Colorectal surgeons worldwide participated in a two-part online survey. Part 1 evaluated surgeon characteristics using the Big Five Inventory to measure personality (five domains: agreeableness; conscientiousness; extraversion; emotional stability; openness) in response to scenarios presented in Part 2 involving anastomotic decisions (i.e. rejoining the bowel with/without temporary stomas, or permanent diversion with end colostomy). Anastomotic decisions were compared using repeated-measure ANOVA. Mean scores of traits domains were compared with normative data using two-tailed t tests.

RESULTS

In total, 186 surgeons participated, with 127 surgeons completing both parts of the survey (68.3 per cent). One hundred and thirty-one surgeons were male (70.4 per cent) and 144 were based in Europe (77.4 per cent). Forty-one per cent (77 surgeons) had begun independent practice within the last 5 years. Surgeon personality differed from the general population, with statistically significantly higher levels of emotional stability (3.25 versus 2.97 respectively), lower levels of agreeableness (3.03 versus 3.74), extraversion (2.81 versus 3.38) and openness (3.19 versus 3.67), and similar levels of conscientiousness (3.42 versus 3.40 (all P <0.001)). Female surgeons had significantly lower levels of openness (P <0.001) than males (3.06 versus 3.25). Personality was associated with anastomotic decision-making in specific scenarios.

CONCLUSION

Colorectal surgeons have different personality traits from the general population. Certain traits seem to be associated with anastomotic decision-making but only in specific scenarios. Further exploration of the association of personality, risk-taking, and decision-making in surgery is necessary.

Machiavellian Medical Students Report More Academic Misconduct: A Cocktail Fuelled by Psychological and Contextual Factors

Purpose

Maladaptive personality traits and some psychological functioning indicators have been linked to academic misbehaviour; yet their role is still poorly explored in medical students. This study aims to assess associations of academic misconduct with dark personality traits and psychological well-being.

Methods

Five hundred and ninety-one medical students attending the first, third and fifth-year at one Portuguese medical school replied to the Dark Triad Dirty Dozen, Ryff’s Psychological Well-Being Scales and an original Academic Misconduct Questionnaire, using a cross-sectional design. Multiple linear regression was performed to assess associations.

Results

Fifth-year medical students who scored higher in Machiavellianism and psychological well-being and perceived greater peer fraud and lower penalty for cheating reported more academic misconduct. The explanatory power of the model was 16.6%. Machiavellianism showed the strongest associations with cheating, while sex and age were not significant predictors.

Conclusion

This study offers relevant insights into how maladaptive personalities influence academic misconduct in medical students, and how this relationship is moulded by psychological and contextual factors. These findings can help guide institutional actions to foster academic integrity in future physicians.

Academic and non-academic predictors of academic performance in medical school: an exploratory cohort study

BACKGROUND

Medical schools should also evaluate applicants' non-academic characteristics in the search for successful students and future physicians, but ideal non-academic criteria have not yet been found. We followed two successive generations of medical students at the University of Split School of Medicine (USSM) to assess both academic and non-academic constructs as predictors of academic performance, defined as medical school grade point average (GPA). We also interviewed some of the participants to gain additional insight for future studies.

METHODS

We measured study GPA in first and last year, as well as attitudes towards science, motivation, emotional intelligence, self-esteem, and perceived personal incompetence in first year. We also obtained their scores on existing medical school enrollment criteria, the State Graduation Exam (SGE) and high-school GPA. Regression models were constructed for predictors of GPA in the last year of medical school. Four structured pilot interviews were conducted to explore participants' perceptions of necessary traits for medical school and later practice.

RESULTS

Regression analysis showed that only SGE predicted final academic performance in medical school (β=0.35, 95% confidence interval (CI)=0.06-0.64), while none of the non-academic constructs we assessed predicted this outcome of education. The two generations did not significantly differ in any variable except that intrinsic motivation was higher in the generation that enrolled in 2011 (OR=1.47, 95%CI=1.12-1.93, P=0.005).

DISCUSSION

None of the non-academic constructs predicted academic performance in medical school. Their use as selection criteria may not be warranted as they could impact the academic quality of enrolling medical students.

Assessing the Psychometric Properties of the Chinese Version of Ten-Item Personality Inventory (TIPI) Among Medical College Students

Objective

The Ten-Item Personality Inventory (TIPI) was designed as a brief instrument of the Big Five personality traits. This study aimed to explore the internal consistency and structural validity of the Chinese version of TIPI (TIPI-C) in medical college students.

Methods

A cross-sectional study was conducted in 11 provinces of China. Spearman–Brown coefficient, standardized Cronbach’s α coefficient, and Cronbach’s α coefficient were applied to estimate the internal consistency. Spearman–Brown coefficient was applied to estimate split-half reliability. Principal components analysis (PCA) and confirmatory factor analysis (CFA) were used to identify the structural validity.

Results

A total of 2223 medical college students recruited from different regions of China were included. The Spearman–Brown coefficients of TIPI-C ranged from 0.129 to 0.786 and the Cronbach’s α coefficients ranged from 0.119 to 0.785. The split-half reliability of the Spearman–Brown coefficient was 0.508. The latent structure of Extraversion, Emotional Stability, and Conscientiousness complied with the intended structure, and the internal consistency coefficients of these three traits were supported. However, the internal consistency coefficients of Agreeableness and Openness were low and the structural validity was not supported.

Conclusion

TIPI-C primarily stands out as a feasible instrument for brief measurements of the Extraversion, Emotional Stability, and Conscientiousness domains. Further research is required to evaluate the concurrent validity and the test–retest reliability of TIPI-C in different populations and potentially modify the instrument to be more suitable for the Chinese population.

Role of Empathy and Lifelong Learning Abilities in Physicians and Nurses Who Work in Direct Contact with Patients in Adverse Working Conditions

Empathy and lifelong learning are two professional competencies that depend on the four principles of professionalism: humanism, altruism, excellence, and accountability. In occupational health, there is evidence that empathy prevents work distress. However, in the case of lifelong learning, the evidence is still scarce. In addition, recent studies suggest that the development of lifelong learning varies in physicians and nurses and that it is sensitive to the influence of cultural stereotypes associated with professional roles. This study was performed with the purpose of determining the specific role that empathy and lifelong learning play in the reduction in occupational stress. This study included a sample composed by 40 physicians and 40 nurses with high dedication to clinical work in ambulatory consultations from a public healthcare institution in Paraguay. Somatization, exhaustion, and work alienation, described as indicators of occupational stress, were used as dependent variables, whereas empathy, lifelong learning, gender, discipline, professional experience, civil status, and family burden were used as potential predictors. Three multiple regression models explained 32% of the variability of somatization based on a linear relationship with empathy, lifelong learning, and civil status; 73% of the variability of exhaustion based on a linear relationship with empathy, somatization, work alienation, and discipline; and 62% of the variability of work alienation based on a linear relationship with lifelong learning, exhaustion, and discipline. These findings indicate that empathy and lifelong learning play important roles in the prevention of work distress in physicians and nurses. However, this role varies by discipline.

Inferring signs from purposeful samples: The role of context in competency assessment

CONTEXT

Medical students' clinical competencies are customarily assessed using convenience samples of performance from real practice. The question is how these convenience samples can be turned into purposeful samples to extrapolate students' overall competency profile at the end of medical school, particularly given the context specificity of clinical performance. In this paper, we will address this issue of inferring signs from samples using insights from the discipline of psychology.

THEORETICAL PERSPECTIVE

We adapted Smith's theory of predictor validity of universals, occupationals and relationals to the context of clinical competency assessment. Universals are characteristics required by all working individuals and therefore not context dependent. Occupationals refer to characteristics required by certain jobs but not others and therefore are dependent on task-related features of an occupation. Relationals are required in a specific organisational context with habitual ways of working together.

APPLICATION

Through seven propositions, we assert that generalising from samples of assessed clinical competencies during clerkships to generic competencies (i.e., signs) is dependent on whether characteristics are universals, occupationals and relationals, with universals most and relationals least generalisable.

CONCLUSION

When determining what types of ratings to use to evaluate medical student competence, medical education has shown too little nuance in considering the degree to which particular characteristics are likely to be generalisable, approaching the issue in an all-or-none manner. Smith's distinction between universals, occupationals and relationals offers a promising way forward that has implications for assessment, student selection and career choice.

Perceived effectiveness of learning methods among preclinical medical students - role of personality and changes over time

Background and Objectives:

Active learning methods are vital in inculcating skills of critical thinking, lifelong learning and effective communication. Personality may influence learning method preferences and academic performance. The aim of this cross sectional study was to examine the relationship between students’ personality and their predilection for learning methods and academic performance.

Methods:

Perceived effectiveness of learning methods was assessed over time. Second- and third-year medical students (n=112) completed a questionnaire consisting of Big Five Inventory to measure the personality dimensions, and evaluated lecture, problem-based learning (PBL) and team-based learning (TBL) for their helpfulness in learning. Grade point average (GPA), PBL and TBL grades were obtained. Correlation coefficients were calculated between personality traits and learning method effectiveness scores, and grades. Learning methods effectiveness was compared between second- and third-year students.

Results:

Positive correlations were identified between conscientiousness and lecture (r = 0.30), agreeableness and lecture (r = 0.20), and agreeableness and TBL (r = 0.23). Likewise, positive correlations were seen between extraversion and PBL grade (r=0.20), and conscientiousness and GPA (r = 0.23). In third year, significant decline in perceived effectiveness of lecture was seen (81% vs 57%; p = 0.006), while increased perceived effectiveness for PBL (38% vs. 50%) was not statistically significant (p = 0.22).

Conclusions:

The findings provide an evidence for modest correlations between personality and perceived effectiveness of learning methods. Remarkably, perceived effectiveness decreased for the lecture and increased for the PBL over time. The findings may help educators in better implementing active learning modalities. Besides, an earlier introduction may help students becoming acquainted with and getting the most out of PBL.

Non-cognitive testing in medical student selection: the development and evaluation of a novel MMI station

BACKGROUND

Multiple mini-interviews (MMIs) are a well-established method of assessing non-cognitive skills in medical student selection in the United Kingdom; however, there are concerns that as MMIs become more predictable, candidates can be coached through the process. An innovative station was introduced at a new medical school to assess less commonly evaluated non-cognitive skills in the context of a skills task.

OBJECTIVE

Our study aimed to evaluate candidate scores on the novel station and explore how they compared with scores on a traditional questions-based station and to the overall interview score.

METHODS

Using a laparoscopic skills trainer, candidates were asked to pass a string through as many hoops as possible, only viewing the image on a screen. All candidates were assessed on decision making, managing stressful situations and creativity using several psychological parameters. Scores were then compared with scores on a traditional values-based question and the overall interview score.

RESULTS

Two hundred eighty-seven candidates completed the station. The average score on the novel station was significantly higher than the average scores on the other stations (paired Student's t-test, p < 0.05). There was no correlation between scores on the novel station and the traditional values-based question, suggesting different skills were being assessed in each station.

DISCUSSION

This station showed it is possible to test less commonly tested non-cognitive skills, in a realistic way. Unlike traditional stations, there is no reliance on candidate recall to award marks, therefore making it more difficult to coach. However, further work is required to refine and improve the testing environment.

One size doesn’t fit all: framework and resources for individualized interventions for struggling medical students

When helping struggling medical students, a “one size fits all” approach is often ineffective, as many different factors affect academic success. In our experience, these factors may overlap or be distinct for each student, and thus require individualized interventions based on student needs. We recommend an individualized model of academic support includes an intake interview, assessment, individualized interventions, and follow up to assess progress. This paper provides a recommended framework of resources for medical school faculty and staff who work with struggling students. Different issues that lead students to struggle are categorized in the main domains of Bloom’s taxonomy: cognitive, affective, and psychomotor. A discussion of the impact of the factors in each domain includes detailed tables with corresponding manifestations, assessments, and support strategies literature for each issue. An application of a proposed framework is presented on a case example. Individualized approaches to improving medical student success are presented to address the complex and interrelated areas of academic success, wellbeing, quality of life, career potential, and satisfaction with medical school.

The Use of Personality Assessment in Mentoring and to Aid in Self-reflection in Orthopaedic Surgery Residency Programs

Personality plays an important role in performance in medical education and mentorship. Personality assessment can aid in the ability to identify strengths and areas for development by understanding how one's personality influences their learning and interpersonal relationships. We sought to evaluate personality assessment as an effective tool in mentoring during orthopaedic residency in this prospective, cross-sectional study from two orthopaedic surgery residency programs using the Hogan Personality Inventory (HPI). Participants completed a survey regarding their experience with the assessment. Descriptive statistics were calculated, and two-sample t-tests were used to examine differences between groups. In total, thirty-four individuals completed the survey. Our results showed 82.4% reported that the HPI very accurately represented them and 58.8% reported better understanding potentially perceived strengths and weaknesses. In total, 75.7% and 72.7% were satisfied with their mentorship about development as a clinician and researcher, respectively. Significant differences were seen between participants who did and did not re-review their results, and participants who did and did-not believe their results profile was accurate. We conclude that personality assessments can be valuable in promoting introspection and strengthening relationships within orthopaedic surgery, particularly when they are valued and emphasized by the user. Our results suggest that use of the HPI provided participants with a better understanding of their perceived strengths and weaknesses as they progress through their orthopaedic residency training.

A comparison of personality traits, learning style, and perceived stress among surgical and nonsurgical residents in a tertiary care hospital in India

INTRODUCTION

It is often perceived that the presence of a distinct surgical personality plays an important role in predicting success in their surgical career. This study compares the personality profiles, perceived stress, and learning styles of surgical and nonsurgical residents.

AIM

The aim of this study is to examine the differences in personality traits, learning style preferences, and perceived stress among surgical and nonsurgical residents.

SETTING AND DESIGN

A cross-sectional study was conducted comparing surgical and non-surgical residents in a tertiary care teaching hospital.

MATERIALS AND METHODS

The 50-item International Personality Item Pool Big- Five Factor Marker questionnaire was used to score 5 personality domains. The 24-item Learning Style Inventory Questionnaire was used to determine the preferential learning styles (visual, auditory, or tactile). The Perceived Stress Scale was administered to assess the perception of stress in the residents.

STATISTICAL ANALYSIS

t-test and chi-square test were done for statistical analysis.

RESULTS

A statistically significant difference was found in learning style preferences with visual (14.78 ± 3.73 vs. 7.4 ± 2.25) and kinesthetic styles being (13.84 ± 4.37 vs. 6.96 ± 1.47) preferred by surgical residents whereas auditory style was preferred by nonsurgical residents (P < 0.05). Surgical residents scored higher in extraversion (P = 0.00), conscientiousness (P = 0.00), and openness to experience (P = 0.00) which was statistically significant. Nonsurgical residents were found to have a higher perception of stress which was statistically significant (13.40 ± 7.10 vs. 21.12 ± 7.52) (P = 0.01).

CONCLUSION

The significant trait variance supports the concept of surgical personality.

Medical students' preclinical service-learning experience and its effects on empathy in clinical training

BACKGROUND

Service learning (SL) is an educational methodology presumed to help medical students be more empathetic and compassionate. We longitudinally investigated the level of empathy in medical students and how preclinical SL experience was related to their level of empathy in their clinical clerkships.

METHODS

Our cohort comprised fifth-year medical students engaged in clerkships as part of a 7-year medical programme at one medical school in Taiwan. Surveys were conducted at the beginning of the clerkship in September 2015 (T1) to collect data on the medical students' preclinical SL experience in curriculum-based service teams (CBSTs) and extracurricular service teams (ECSTs) and their SL self-efficacy, demographic characteristics, and empathy level. Subsequently, three follow-up surveys were conducted once every 3 months to determine the empathy level of the students during their clinical clerkships (T2-T4). Seventy students who returned the written informed consent and completed the baseline (T1) and two or more follow-up surveys (T2-T4) were included in our analysis with the response rate of 34%. In total, 247 responses across the 1-year clerkship were analysed. Descriptive statistics, paired t tests, and generalised estimating equations were employed.

RESULTS

Our study revealed that changes in empathy level in the dimensions of perspective taking, compassionate care, and standing in patients' shoes in their clinical clerkships. Relative to that at T1, their empathy decreased in perspective taking and compassionate care at T2-T4 but increased in standing in patients' shoes at T3. Additionally, our study verified the positive effect of medical students' preclinical SL experience in CBSTs and ECSTs on empathy in terms of compassionate care and perspective taking, respectively, but not on that of standing in patients' shoes.

CONCLUSIONS

Separate investigations into subconstructs of empathy, such as perspective taking, compassionate care, and standing in patients' shoes, in medical students may be necessary for exploring the various driving forces or barriers to developing empathy in medical students. Moreover, SL experience through both CBSTs and ECSTs at medical academies may have positive effects on medical students' empathy in their clinical clerkships and should be promoted at medical schools.

Medical Student Personality Traits and Clinical Grades in the Internal Medicine Clerkship

BACKGROUND

Third year clerkship grades include subjective evaluations. The purpose of this study is to identify if personality traits and self-esteem predispose students to better clerkship performance.

METHODS

Third-year medical students completed the OCEAN Five Factor Model Personality Test and Rosenberg Self-Esteem Scale. Clerkship grades were matched to survey results. Chi-squared and linear regression analyses assessed the correlation between students' clerkship grades, personality traits, and self-esteem.

RESULTS

There was no association between OCEAN personality domains and any component of clerkship grade. In secondary post hoc analysis, students who are "deep thinking" (OR 2.97, 95% CI 1.26-7.01, p = 0.01), "sophisticated" (OR 2.70, 95% CI 1.12-6.50, p = 0.03), and "outgoing" (OR 2.45, 95% CI 1.02-5.89, p = 0.04) were significantly more likely to get an overall clerkship grade of Honors. "Deep thinking" (OR 3.44, 95% CI 1.47-8.04, p = 0.004) and "efficient" (OR 2.87, 95% CI 1.12-7.36, p = 0.03) students scored better on shelf exams, while "shy" students scored worse (OR 0.30, 95% CI 0.13-0.69, p = 0.004); "aloof" students received worse clinical scores (OR 0.57, 95% CI 0.37-0.89, p = 0.03), and "rude" (OR 5.08, 95% CI 1.03-24.94, p = 0.03) and "sophisticated" (OR 2.47, 95% CI 1.02-6.00, p = 0.04) students received higher preceptor scores. There was no correlation between self-esteem and clerkship grades.

CONCLUSION

Students with certain personality traits may be predisposed to success during clerkships. Medical educators should be cognizant of biases favoring certain personalities and help students maximize success by recognizing their strengths and identifying gaps.

What impact does postgraduate clinical training have on empathy among Japanese trainee dentists?

BACKGROUND

Enhancing empathy in healthcare education is a critical component in the development of a relationship between healthcare professionals and patients that would ensure better patient care; improved patient satisfaction, adherence to treatment, patients' medication self-efficacy, improved treatment outcomes, and reduced patient anxiety. Unfortunately, however, the decline of empathy among students has been frequently reported. It is especially common when the curriculum transitions to a clinical setting. However, some studies have questioned the significance and frequency of this decline. Thus, the purpose of this study was to determine the impact of postgraduate clinical training on dental trainees' empathy from cognitive, behavioral, and patients' perspective.

METHODS

This study included 64 trainee dentists at Okayama University Hospital and 13 simulated patients (SPs). The trainee dentists carried out initial medical interviews with SPs twice, at the beginning and the end of their clinical training. The trainees completed the Japanese version of the Jefferson Scale of Empathy for health professionals just before each medical interview. The SPs evaluated the trainees' communication using an assessment questionnaire immediately after the medical interviews. The videotaped dialogue from the medical interviews was analyzed using the Roter Interaction Analysis System.

RESULTS

No significant difference was found in the self-reported empathy score of trainees at the beginning and the end of the clinical training (107.73 [range, 85-134] vs. 108.34 [range, 69-138]; p = 0.643). Considering the results according to gender, male scored 104.06 (range, 88-118) vs. 101.06 (range, 71-122; p = 0.283) and female 109.17 (range, 85-134) vs. 111.20 (range, 69-138; p = 0.170). Similarly, there was no difference in the SPs' evaluation of trainees' communication (10.73 vs. 10.38, p = 0.434). Communication behavior in the emotional responsiveness category for trainees in the beginning was significantly higher than that at the end (2.47 vs. 1.14, p = 0.000).

CONCLUSIONS

Overall, a one-year postgraduate dental training program neither reduced nor increased trainee dentists' empathy levels. Providing regular education support in this area may help trainees foster their empathy.

A scoping review of admission criteria and selection methods in nursing education

BACKGROUND

Nursing education institutions are required to select and train applicants who have appropriate characteristics for delivering effective healthcare. Unlike other healthcare professions and despite the need to attract and select a competent workforce, there has been no comprehensive analysis of the selection criteria and methods used to recruit nursing students. As there is relatively limited prior research available, we conducted a scoping review to explore and synthesise the existing evidence regarding admission criteria and selection methods of nursing students and for the purpose of identifying an agenda for future research in this field.

METHODS

Our scoping review follows the Arksey and O'Malley five-step proposition including identifying the research question and relevant studies, study selection, tabulation of data, and summarizing and reporting the results. Seven databases (PubMed, CINAHL, Scopus, ERIC, SID, Irandoc and PsycINFO) were searched systematically using relevant keywords. Articles on admission of undergraduate nursing students published in both English and/or Persian from 2006 to 2019 were retrieved.

RESULTS

Existing research evidence suggests that nursing students are largely selected on the basis of two criteria - "cognitive-academic abilities" and "non-cognitive abilities." Cognitive-academic abilities were assessed in four main dimensions of mathematics, language, natural sciences and reasoning skills mainly through standardized tests and academic records. Our review shows a wide range of non-cognitive characteristics are evaluated in nursing applicants including: morality, interpersonal communication skills and psychological strength. The selection method most commonly used to assess characteristics was through interviews (panel interviews or multiple mini interviews). Other methods included references, personal statements and personality assessment tools.

CONCLUSIONS

This is the first scoping review of literature regarding nursing education selection and recruitment. Results can be used to inform nursing education policymakers and institutions in the design of their selection practices. Future research should concentrate on the evaluation and improvement methods of student selection including content and predictive validity analysis of multiple mini interview and standardized tests, development of cost-effective selection methods and job analysis studies to identify specific non-cognitive characteristics for nursing.

Empathy for patient care in medical students: new evidence on the importance of self-transcendence

Empathy is essential in clinical care to achieve patient satisfaction, treatment adherence and health outcomes. Understanding how personality traits might influence the development of medical students' empathy for patient care is important in medical education. Previous studies have shown associations between medical students' personality and empathy. This study aims to explore the associations between temperament and character and empathy for patient care in a sample of young medical students. Participants were 299 second-year Italian medical students. They completed the Italian versions of the Jefferson Scale of Empathy for medical students (JSE-S) and the Temperament and Character Inventory (TCI-140). Correlation and regression analyses were performed. Significant positive low correlations were found between empathy and Reward Dependence, Cooperativeness and Self-transcendence. The regression model of the sex and personality dimensions explained 14% of the variance in empathy with two significant predictors: sex (B = 4.034) and Self-transcendence (B = 0.361). This study confirms that female medical students are more empathetic than males. It also suggests that the greater students' Self-transcendence is, the more empathetic towards patient care they are. Attention to medical students' personality should be present within medical curricula, as it may help to generate methods of enhancing and sustaining the empathy of students.

Does gender impact personality traits in female versus male otolaryngology residents and faculty?

OBJECTIVE

Gender differences in personality have long been a subject of interest. This study assessed personality traits within female and male residents and faculty and evaluated for meaningful differences between the groups.

METHODS

A series of web-based, commercially available, self-administered five factor-based personality assessments were given to otolaryngology residents and faculty at nine academic training programs. The psychometrically validated assessments evaluate innate personality 1) strengths, 2) challenges, and 3) motivators/values. Differences between groups were evaluated using the Mann-Whitney U test. A standardized measure of effect size, Cohen's d, was calculated to indicate the magnitude of gender differences. Subset analysis was done to examine differences between female and male residents and female and male faculty.

RESULTS

Seventy-eight faculty (42.6%) and 104 residents (70.3%), responded, which included 63 female (34.6%) participants. Significant differences between females and males overall were found across four traits (mischievous, imaginative, altruistic, and commercial) out of twenty-eight (4/28; 14.3%). Subset analysis of residents revealed two statistically significant differences related to motivators/values (increased altruism in females and increased commercial in males). Faculty exhibited a statistically significant difference in one stress tendency (increased imaginative in males). When examining the seven total traits that exhibited a statistically significant difference between any of the groups (7/84; 8.3%), four were considered a small difference and three a moderate difference.

CONCLUSION

When personality trait differences were identified in both otolaryngology resident and faculty populations based on gender, they were relatively small. Overall, females and males in otolaryngology exhibit significant overlap in the distribution of their personality traits. Therefore, personality-based initiatives should focus on the individual, rather than perceived gender "norms."

The impact of psychological factors on the management of intraoperative haemodynamic events in children

INTRODUCTION

Paediatric anaesthesia requires specific theoretical knowledge and practical training. Non-technical skills and psychological factors might influence learning and practice. The aim of this study was to assess personality type and decision-making styles of paediatric anaesthesiology residents during the management of simulated intraoperative life-threatening cases.

METHOD

Residents in anaesthesiology (between 4 and 5 years of training) participated in a simulated hypoxic cardiac arrest in the operating theatre. Their performance was evaluated using a score derived from international recommended management algorithm. They were asked to answer self-assessment questionnaires regarding both their personality (the five personality factors) and their decision-making style. Correlations between performance and personality were investigated.

RESULTS

Thirty-eight residents participated in the simulation session and 36 accepted to answer the questionnaires. Good management scoring was positively correlated with agreeableness and conscientiousness personality traits but was negatively correlated with avoidance and spontaneous decision-making styles.

DISCUSSION

The current study identified personality traits and decision-making styles that might influence the management of critical situations during paediatric anaesthesia. The proper identification of these factors might allow targeted personalised training to improve knowledge mobilisation and translation in the clinical context.

The Association Between Personality Traits and Specialty Preference Among Medical Students in Jordan

Aim

To assess the association between personality traits by the five-factor model and specialty choice preference among medical students and immediate medical graduates in Jordan and to identify if there were any significant differences in personality profiles between those planning to pursue different career pathways.

Methods

This is a cross-sectional study including fifth- and sixth-year medical students and post-graduate internship doctors at five universities in Jordan. An online survey was used to collect data from participants, which included their general characteristics, their personality profile using the Big Five Inventory–2, and questions about their most preferred specialty choice.

Results

One thousand and twelve participants were enrolled in this study. Only 4.9% were interested in pursuing a specialty in basic medical sciences, and about 12% wanted to be non-practicing medical doctors. Almost half of all participants wanted to pursue a career in surgery-oriented specialties. Those were more extraverted, more conscientious, and had less negative emotions than students who chose medicine-oriented specialties. Students who decided to pursue clinical specialties and students who wanted to be practicing doctors were more extraverted and more conscientious.

Conclusion

Medical students and fresh medical graduates from Jordan who exhibited higher extraversion and conscientiousness and lower negative emotions preferred to be practicing clinicians. They were more inclined to pursue a career in surgery-oriented specialties. These findings might be helpful in understanding the preferences of young doctors and in counseling them about their career paths. Medical educators may wish to incorporate personality trait evaluation in planning post-graduate programs.

Psychological predictors of medical residents' perspectives on shared decision-making with patients: a cross-sectional study

BACKGROUND

Shared Decision Making (SDM) is as ideal model for resident-patient relationship which may improve medical outcomes. Nevertheless, predictive psychological factors influencing residents' perspective regarding SDM are unclear. The current study investigated the relationship between two psychological factors, mental health and personality traits, and residents' views toward SDM.

METHOD

In a cross-sectional study, 168 medical residents of the Babol University of Medical Sciences studying in 13 field specialties were recruited. The residents completed three questionnaires including Shared Decision-Making Questionnaire (SDM-Q-Doc, physician version), General Health Questionnaire (GHQ-12), and Big Five Personality (NEO-FFI).

RESULTS

Residents had an overall agreement of about 88% regarding SDM with patients. There was no significant difference between male and female residents in terms of the degree of agreement for SDM. Concerning SDM, there was no significant relationship either between residents' views and neuroticism, extraversion, agreeableness, and conscientiousness. In multivariate regression, mental health did not predict the SDM, but openness to experience negatively predicted residents' views concerning SDM (β = - 0.388, p < 0.001).

CONCLUSION

The residents' personality trait of openness to experience was a significant negative predictor of SDM with patients. A better understanding of how psychological factors relate to residents' perspectives may help clinicians properly discuss the treatment options with the patient thereby encouraging them for SDM or to consider their own preferences.

Use of Personality Frameworks in Health Science Education

Objectives. To review the use of personality frameworks by educators as a tool to increase self-awareness in health professions students. Findings. After screening titles, abstracts, and/or the full text of the 415 articles identified in an initial search, 71 articles involving personality frameworks were included in the study. Several different personality frameworks, including the Five-Factor Model, Myers-Briggs Type Indicator, the Rational Experiential Inventory, and the CliftonStrengths assessment, were used in various health science education disciplines, including medicine, nursing, and pharmacy. Most publications were descriptive in nature and only reported on the personality attributes of the given research cohort. Some studies correlated personality framework results with either learning or non-cognitive outcomes. Very few studies described using personality frameworks as a tool for self-awareness and growth. Summary. While some personality frameworks have been used in health science education for multiple purposes, there is currently a lack of published evidence documenting the use of these frameworks for self-awareness in students.

Student Personality Style and First-Year Academic Performance in a Doctor of Pharmacy Program

Objective. To evaluate whether the personality styles of Doctor of Pharmacy (PharmD) students as determined by the DiSC assessment are associated with students' cumulative grade point average (GPA) or with academic penalties imposed in the first year of a PharmD program. Methods. All incoming PharmD students that provided informed consent and completed the DiSC personality assessment were included in the study. Participants provided demographic data and forwarded their electronic DiSC assessment results to study investigators upon completion. Relevant academic data were collected at the end of each semester. Results. The overall response rate for the classes of 2019-2022 was 95.6%. No significant associations were found when comparing personality styles as defined by the DiSC assessment and cumulative GPA at the end of the first year. Additionally, no associations were noted when comparing students' personality style and semester GPA or academic penalties received. Conclusion. Understanding factors that contribute to students' academic success can aid in early identification of students who are likely to succeed and of students who may benefit from early academic intervention. While no significant associations were found in the first-year of the curriculum, continued evaluation will be conducted to determine the impact of personality style on students' overall academic performance beyond the first year of the PharmD curriculum.

The Sorting Hat of Medicine: Why Hufflepuffs Wear Stethoscopes and Slytherins Carry Scalpels

INTRODUCTION

Choosing a medical specialty is a complex decision comprised of a combination of intrinsic and extrinsic factors that can include economic status, personal interest, input from mentors, and personality traits. The fictional world of Harry Potter, a generational literary phenomenon, describes 4 distinct houses in the wizarding Hogwarts school; each valuing particular traits of mortality that correspond with personality types. As such, we hypothesized that with each medical specialty often attracting particular personalities, the percentage of residents who self-sorted into the different Hogwarts' houses would vary depending on their chosen specialty.

METHODS

A web survey was sent out nationwide to surgical coordinators and residents, collecting demographic information and responses regarding specialty type and Hogwarts' house self-sorting.

RESULTS

The survey was completed by 251 residents (49.4% from surgical specialties) with a 12.6% response rate of surgical coordinator dissemination and a 43.1% resident response rate at Carolinas Medical Center. Surgical specialties were found to have significantly fewer self-sorted Hufflepuffs (p = 0.002) and more Slytherins (p = 0.0061) than nonsurgical specialties. General surgery had significantly more Gryffindors (p = 0.04) and fewer Hufflepuffs (p = 0.0017) whereas orthopedic surgery had significantly more Slytherins (p = 0.0282). Pediatrics had significantly fewer Gryffindors (p = 0.0096) and more Hufflepuffs (p = 0.0006). Obstetrics and gynecology had significantly fewer Gryffindors (p = 0.0082) and the highest percentage of Ravenclaws when compared to all other specialties (35.3% vs 19.9%; p = 0.1344). Family medicine had no self-proclaimed Slytherins.

CONCLUSIONS

The discrepancies between specialties in the ratios of residents per Hogwarts house highlights that certain attributes may be more essential, advantageous, or complementary to a specific specialty. This information may guide medical students in choosing a satisfying and successful career path.

Empathy in Medicine National Norms for the Jefferson Scale of Empathy: A Nationwide Project in Osteopathic Medical Education and Empathy (POMEE)

Context

National norms are necessary to assess individual scores from validated instruments. Before undertaking this study, no national norms were available on empathy scores. The Project in Osteopathic Medical Education and Empathy (POMEE) provided a unique opportunity to develop the first national norms for medical students.

Objective

To develop national norms for the assessments of osteopathic medical students' empathy scores on the broadly used and well-validated Jefferson Scale of Empathy (JSE) at all levels of osteopathic medical school education.

Methods

Participants were students from 41 of 48 participating campuses of osteopathic medical schools. Students were invited to complete a web-based survey, which included the JSE, in the 2017-2018 academic year.

Results

A total of 16,149 completed surveys were used to create national norm tables. Three national norm tables were developed for first-year matriculants and for students in preclinical (years 1 and 2) and clinical (years 3 and 4) phases of medical school. The norm tables allow any raw score on the JSE for male and female osteopathic medical students from matriculation to graduation to be converted to a percentile rank to assess an individual's score against national data.

Conclusions

National norms developed in this project, for men and women and at different levels of medical school education, can not only be used for the assessment of student's individual scores on the JSE, but can also serve as a supplementary measure for admissions to medical school and postgraduate medical education programs.

Personality Assessment and Emotional Intelligence in Orthopaedic Surgery Residency Selection and Training

Orthopaedic surgery has increasingly emerged as one of the most popular and competitive of all medical specialties. The selection of the best applicants has become a more difficult process because the number of qualified medical students has concomitantly grown. Although there are standardized guidelines in residency selection, there are several intangible factors that determine an applicant's fit into a program. Personality assessments, such as the Neuroticism-Extraversion-Openness Personality Inventory and the Myers-Briggs Type Indicator, are proficiencies that have garnered significant interest to help fill this void. Understanding and measuring empirically supported measures of personality traits and styles of medical students and residents may be valuable to medical educators and program directors in a variety of applications such as residency selection, mentoring, and education. Similar to personality identification, emotional intelligence assessments, such as the Mayer-Salovey-Caruso Emotional Intelligence Test, can prove to be pivotal tools in residency education and training. Emotional intelligence has shown to align with current Accreditation Council for Graduate Medical Education residency standardized core competencies that emphasize aptitude in noncognitive characteristics.

Neurologists, neurosurgeons, and psychiatrists' personality traits: a comparison

BACKGROUND

Clinicians in neuroscientific disciplines may present distinct personality profiles. Despite of potential relevance to clinical practice, this has not yet been studied. We therefore aimed to compare personality profiles of physicians working in the three main disciplines of clinical neuroscience, i.e., neurologists, neurosurgeons, and psychiatrists, between each other, across levels of training and to other specialties.

METHODS

An online survey using the Ten-Item Personality Inventory (TIPI), an internationally validated measure of the five-factor model of personality dimensions, was distributed to board-certified physicians, residents, and medical students in several European countries and Canada. Differences in personality profiles were analyzed using multivariate analysis of variance and canonical linear discriminant analysis on age- and sex-standardized z-scores of personality traits. Single personality traits were analyzed using robust t tests.

RESULTS

Of the 5148 respondents who completed the survey, 723 indicated the specialties neurology, neurosurgery, or psychiatry. Compared to all other specialties, personality profiles of training and trained physicians in these three main clinical neuroscience disciplines ("NN&P") significantly differed, with significantly higher scores in openness to experience. Within NN&P, there were significant differences in personality profiles, driven by lower neuroticism in neurosurgeons, higher conscientiousness in neurosurgeons and neurologists, and higher agreeableness in psychiatrists. Across levels of training, NN&P personality profiles did not differ significantly.

CONCLUSION

The distinct clinical neuroscience personality profile is characterized by higher levels of openness to experience compared to non-neuroscience specialties. Despite high variability within each discipline, moderate, but solid differences in the personality profiles of neurologists, neurosurgeons and psychiatrists exist.

The relationship between grit and selected personality measures in medical students

OBJECTIVES

To test the hypothesis that scores on a Grit scale are positively associated with personality measures that are conducive to relationship building (Empathy, Self-Esteem, Activity, and Sociability), but inversely associated with personality measures that are detrimental to interpersonal relationships (Neuroticism-Anxiety, Aggression-Hostility, Impulsive Sensation Seeking, and Loneliness).

METHODS

Convenient sampling was used that included 241 medical students at Sidney Kimmel Medical College at Thomas Jefferson University who participated in this ex post facto research. Validated instruments were used to measure Grit, Empathy, Self-Esteem, Activity, Sociability, Neuroticism-Anxiety, Aggression-Hostility, Impulsive Sensation Seeking, and Loneliness. Bivariate correlations and multivariate regression were used to examine relationships between scores on the Grit scale and personality measures.

RESULTS

Results of bivariate correlational analyses showed that scores on the Grit scale were positively and significantly (p<0.01) correlated with measures of Self-Esteem (r=0.35), Empathy (r=0.26), and Activity (r=0.17); but negatively and significantly (p<0.01) correlated with measures of Loneliness (r=-0.28), Aggression-Hostility (r=-0.23), Neuroticism-Anxiety (r=-0.22), and Impulsive Sensation Seeking (r=-0.18). Regression analysis indicated that in a multivariate model, higher scores on Self-Esteem and Empathy and lower scores on Aggression-Hostility were uniquely and significantly associated with Grit scores (R=0.43, p<0.01).

CONCLUSIONS

Research hypothesis was partially confirmed, suggesting that medical students with higher Grit scores were likely to have higher empathic orientation in patient care and greater Self-Esteem. Conversely, those with higher degrees of Grit displayed lower levels of Aggression-Hostility and Impulsive Sensation Seeking. The Implications of these findings for medical education are discussed.

What makes a great clinical team? Stakeholder perspectives on the attributes of effective veterinary health care teams in Australia

Extensive research in the business and organisational literature links teamwork to enhanced productivity and employee job satisfaction. Good teamwork capability is also a highly regarded graduate attribute linked to employability. This study explored desirable teamwork attributes for veterinary technology graduates in Australia, by surveying veterinarians, veterinary technology graduates, veterinary nurses, clients and academics. Respondents highlighted the importance of seven attributes sourced from the cross-disciplinary teamwork literature-'flexibility' (in approach to work), 'agreeableness', being 'cooperative', 'socially sensitive and perceptive', 'conscientiousness', being 'accepting of others' and 'sharing professional values'. The majority in each stakeholder group viewed all attributes important for teamwork concurring with findings in other fields. Few differences were found between and within groups with veterinarians and academics rating 'conscientiousness' higher than others and female clients placing more importance on relational attributes compared to male clients. Thematic analysis of an open-ended item asking the veterinary health care groups, and veterinary academics, to define teamwork generated nine themes centred on: collaboration, goals and outcomes, sharing values, relationships, diversity, communication, task-orientation, personal attributes, and workplace culture. This study illuminates an interprofessional perspective on veterinary teamwork. Results will be useful for veterinary technology, veterinary nursing and veterinary educators when developing a curriculum for interprofessional teamwork to enhance team performance, employability and, ultimately, the quality of veterinary services.

The personalities of most medical students are suited to rural practice: Implications for rural education program recruitment

Introduction: The success of rural longitudinal integrated clerkship (LIC) programs has contributed to our understanding of selecting and training students for rural practice. Studies have explored the personality traits of students who participate in rural LICs although few have compared them with classmates who have not. The purpose is to compare personalities of four successive cohorts of students in the LIC Rural Physician Associate Program (RPAP) with their non-RPAP classmates. Methods: In a longitudinal cross-sectional design, medical students RPAP and non-RPAP, from 2013 to 2017 completed identical questionnaires comprising measures of personality, perfectionism, ambiguity tolerance, and resilience. T-tests, ANOVA, and post-hoc tests compared groups. K-means cluster analysis identified profiles of traits. Results: Total sample 286; RPAP = 128; non-RPAP = 158. Gender and age proportions were not different between groups. RPAP students were significantly lower in levels of perfectionism and higher in cooperativeness compared to non-RPAP classmates. Similar proportions of both groups were distributed across three personality profiles detected. Conclusions: Lower perfectionism implies advantages for rural practice. Nevertheless, similarities between groups suggest that most students would be successful in rural practice. More encouragement to all students may improve uptake of rural LICs. Greater attention to issues that affect decisions to explore rural medical education, particularly for our next generation of students, is required.

Relationship between Psychological Correlates and Empathy in Medical Students: A Cross-Sectional Study

OBJECTIVE

Empathy is important in the education of medical students. Many psychosocial variables are related to empathy. The aim of the study was to investigate the relationship between empathy and psychosocial factors such as burnout, personality, self-esteem, and resilience.

METHODS

The participants completed a set of self-reporting questionnaires, including questions related to socio-demographic characteristics, the Korean edition of the Jefferson Scale of Empathy, student version (JSE-S-K), Maslach Burnout Inventory General Survey (MBIGS), NEO Five-Factor Inventory (NEO-FFI), Rosenberg Self-esteem Scale (R-SES), and Connor-Davidson Resilience Scale (CD-RISC). Partial correlation and regression analyses were performed.

RESULTS

In male students, there were positive correlations between JSE-S-K and R-SES (r=0.229, p=0.002); conscientiousness of the NEO-FFI (r=0.153, p=0.037) and negative correlations, specifically between JSE-S-K and depersonalization of MBI (r=-0.206, p=0.005). In female students, there was positive correlations between JSE-S-K and personal accomplishment of MBI (r=0.384, p=0.004). In the multiple regression model, the JSE-S-K was affected by conscientiousness of the NEO-FFI (adjusted R2 =0.245, β=0.201, p=0.001); depersonalization, personal accomplishment of the MBI-GS (β=-0.188, p=0.001, β=0.143, p=0.017); R-SES (β=0.176, p=0.004); sex (β=0.117, p=0.029).

CONCLUSION

The present findings suggested that conscientiousness, depersonalization, personal accomplishment, self-esteem and sex have an influence on empathy. Therefore, these must be considered in medical education and can be helpful to nurture more empathetic doctors.

A Five-Minute Situational Judgment Test to Assess Empathy in First-Year Student Pharmacists

Objective. To design, implement, and evaluate the utility of a situational judgment test (SJT) to assess empathy in first-year student pharmacists as part of an end-of-year capstone experience. Methods. First-year students completed a five-minute SJT in lieu of a multiple mini interview (MMI) during the end-of-year capstone. For each SJT item, students selected the two most appropriate response options from a list of five. Various strategies to score the SJT were compared to evaluate the psychometric properties of the test. Student performance on the SJT was examined in relationship to performance on other measures, (eg, MMI stations, personality assessments, and admissions data). Results. A total of 135 first-year pharmacy students completed an average of 9.5 items. Scoring keys based on subject matter experts' and student responses demonstrated high reliability. There was a positive, weak relationship between student performance on the SJT and performance on the adaptability station used in the capstone, and an inverse, weak relationship with students' agreeableness scores. Conclusion. This study suggests that the SJT may be a feasible and efficient assessment strategy in pharmacy education. Additional research is needed to inform SJT design, implementation, and interpretation.

Temperament and character profiles of medical students associated with tolerance of ambiguity and perfectionism

Background

Certain personal attributes, such as perfectionism and tolerance of ambiguity, have been identified as influential in high achieving students. Medical students have been identified as high achievers and perfectionistic, and as such may be challenged by ambiguity. Medical students undertake a long and challenging degree. Personality has been shown to influence the well-being and coping and may equip some students to better cope with challenges. This paper examines the association between temperament and character personality profiles with measures of tolerance of ambiguity and with both adaptive and maladaptive constructs of perfectionism.

Methods

A self-report questionnaire collected data on a sample of 808 Australian medical students in 2014 and 2015. Personality was measured using the Temperament and Character Inventory (TCIR-140) and classified traits as profiles using a latent class analysis. Two profiles were found. Profile 1 was characterized by low-average levels of Harm Avoidance, and high to very high levels of Persistence, Self-Directedness and Cooperativeness. Moderately-high levels of Harm Avoidance and high levels of Persistence, Self-Directedness and Cooperativeness characterized Profile 2. Moderation regression analyses were conducted to examine the association between the personality profiles with levels of Tolerance of Ambiguity (MSAT-II), Perfectionism-Concern over Mistakes and Perfectionism-High Standards (FMPS), considering demographic characteristics.

Results

Students with Profile 1 were higher in levels of Tolerance of Ambiguity, and Perfectionism-High Standards, and lower levels of Perfectionism-Concern over Mistakes compared to Profile 2. These findings remained statistically significant after adjusting for age and gender. A significant personality by age interaction on Tolerance of Ambiguity was found. While higher levels of Tolerance of Ambiguity were associated with older age overall, it remained low across age for students with a personality Profile 2.

Conclusions

A particular combination of personality traits was identified to be associated with low Tolerance of Ambiguity and high levels of maladaptive Perfectionism. An intolerance of ambiguity and over concern about mistakes may be maladaptive and underlie vulnerability to stress and poor coping. The psychobiological model of personality provides insight into traits that are stable and those that can be self-regulated through education and training. The interaction between biological mechanisms and socio-cultural learning is relevant to a sample of medical students because it accounts for interaction of the biological or innate aspects of their personal development within an intense and competitive learning environment of medical school.

Adding Long-term Value to the Residency Selection and Assessment Process

The residency selection process is challenging for both applicants and programs. This is particularly true in competitive specialties such as otolaryngology. The importance of noncognitive competencies in successful residents has been well demonstrated in both medicine and surgery. Unfortunately, there is no streamlined or uniform process for incorporating this information into the selection and training of residents. This review provides a summary of innovative approaches in the selection of residents in otolaryngology and the important role these methods and associated data can play in resident selection and training. The goal of these processes is to create a holistic view of potential residents so programs can enhance the development of current residents and boost long-term success in our specialty. Laryngoscope, 130:65-68, 2020.

Evaluation of critical thinking course for premedical students using literature and film

PURPOSE

Premedical education is one stage in which various educational approaches are used to promote critical thinking. Given that critical thinking ability could be regarded as one of the intended outcomes of social science and humanities education, this study explored the effectiveness of a course to promote critical thinking in a premedical curriculum using both literature and film.

METHODS

Fifty-one 2nd year premedical students enrolled in a 'Critical Thinking for Premeds' course. Students were required to read or watch a selected material, submit group discussion agendas, attend five group discussion sessions, and write critical essays. Five tutors facilitated the group discussions, observed and assessed the students' performance and critical essay. Students' critical thinking disposition and opinion on assigned reading materials were examined before and after the course. A program evaluation survey was conducted to investigate the students' reaction after the course.

RESULTS

On average, students appreciated 78.6% of the total assigned materials. The students indicated that group discussions and the narrative comments of facilitators contributed the most to develop critical thinking. After the course, the students' tendency preferring cheaper price books, as well as medicine-related books decreased significantly. Students who had critical essay scores greater than or equal to the median demonstrated a significant improvement in critical thinking disposition scores.

CONCLUSION

The course was well-accepted by premedical students and had several positive outcomes. A more effective use of the course could be anticipated with a clearer explanation of the purpose, the consideration of previous reading experience, and use of complementary learning activities.

Can communication skills training improve empathy? A six-year longitudinal study of medical students in Japan

BACKGROUND

Empathy is an important component of overall clinical competence; thus, enhancing empathy in medical education is essential for quality patient care.

AIM

This longitudinal study was designed to address the following questions: 1. Can a targeted educational program in communication skills training enhance empathy in medical students? and 2. Can such a program have a sustained effect?

METHODS

Study participants included 116 students who entered Okayama University Medical School in 2011. Students participated in a communication skills training program aimed to enhance their empathy, and completed the Jefferson Scale of Empathy (JSE) five times: at the beginning of medical school, prior to participation in the program, immediately after the program, and in last years of medical school. A total of 69 students, representing 59% of the cohort, completed the JSE in all five test administrations.

RESULTS

Students' total scores on the JSE and its two factors (Perspective Taking and Compassionate Care) increased significantly (p < 0.001) after participation in the communication skills training program. However, the program did not have a sustained effect.

CONCLUSIONS

Targeted educational programs to enhance empathy in medical students can have a significant effect; however, additional reinforcements may be needed for a sustained effect.

Physician experiences when discussing the need for additional oral medication with type 2 diabetes patients: Insights from the cross-national IntroDia® study

AIMS

Physician-patient communication when discussing the need for additional oral medication for type 2 diabetes (add-on) may affect the self-care of people with this condition. We aimed to investigate physicians' recalled experiences of the add-on consultation.

METHODS

We conducted a cross-sectional survey of physicians treating people with type 2 diabetes in 26 countries, as part of a large cross-national study of physician-patient communication during early treatment of type 2 diabetes (IntroDia®). The survey battery included novel questions about physician experiences at add-on and the Jefferson Scale of Physician Empathy.

RESULTS

Of 9247 eligible physicians, 6753 responded (73.0% response rate). Most (82%) agreed that physician-patient discussions at add-on strongly influence patients' disease acceptance and treatment adherence. Half the physicians reported ≥1 challenge in most or all add-on conversations, with a significant inverse relationship between frequency of challenges and Jefferson Scale of Physician Empathy score (standardised β coefficient: -0.313; p < 0.001). Physicians estimated that only around half their patients with type 2 diabetes follow their self-care advice. Exploratory factor analysis of physician beliefs about why their patients did not follow recommendations yielded two distinct dimensions: psychosocial barriers (e.g. depressed mood) and personal failings of the patient (e.g. not enough willpower) (r = 0.37, p < 0.001).

CONCLUSIONS

Physicians' empathy and beliefs about their patients may play a significant role in their success with the add-on conversation and, consequently, promotion of patient engagement and self-care. Although the study was limited by its retrospective, cross-sectional nature, the findings from IntroDia® may inform efforts to improve diabetes care.