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Ortiz-Paredes D, Adam Henet P, Desseilles M, Rodríguez C. Empathy in family medicine postgraduate education: A mixed studies systematic review. MEDICAL TEACHER 2024:1-17. [PMID: 38555732 DOI: 10.1080/0142159x.2024.2328324] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/28/2023] [Accepted: 03/05/2024] [Indexed: 04/02/2024]
Abstract
PURPOSE Empathy is an important construct in patient-physician relationships, particularly critical in family physicians' daily practice. We aimed to understand how empathy has been conceived and integrated into family medicine postgraduate training. MATERIALS AND METHODS Medline, PsyINFO, and Embase were searched in this systematic mixed studies systematic review. Two independent reviewers screened abstracts and full texts. Disagreements were solved through research team consensus-based discussion. Included studies were synthesized thematically. RESULTS A total of 18 studies were included. Four themes were identified. (1) Empathy definition. Included studies stressed the cognitive component of empathy, paired either with a behavioural or an affective response. (2) Empathy modifiers. Starting residency right after medical school, having a role model, having high empathy levels before residency, having children, being married, and being exposed to patient involvement in education were found to have a positive impact on empathy. (3) Empathy-burnout relationship. Whereas greater burnout was related to lower empathy levels, excess empathy seems to favour burnout through 'compassion fatigue.' (4) Educational programs for empathy development. Five programs were identified: a communication workshop, a patient-led program, a mindfulness program, a family-oriented intervention, and an arts-based program. CONCLUSIONS Studies mostly measured the cognitive component of empathy. The moral component of empathy was underrepresented in the conceptualization of empathy and the development of educational interventions. Conflicting evidence exists regarding the decline of empathy levels during the family medicine residency. Longitudinal designs should be privileged when exploring the evolution of empathy levels across the continuum of medical education.
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Affiliation(s)
- David Ortiz-Paredes
- Department of Family Medicine, School of Medicine, Faculty of Medicine and Health Sciences, McGill University, Montreal, Canada
| | - Peterson Adam Henet
- Institute of Neuroscience (IoNS), Faculty of Medicine, Université Catholique de Louvain, Brussels, Belgium
- Pôle Enseignement et recherche, Le Beau Vallon-Soins spécialisés en santé mentale, Namur, Belgium
| | - Martin Desseilles
- Department of Psychology, Faculty of Medicine and Transition Institute, Université de Namur, Namur, Belgium
| | - Charo Rodríguez
- Department of Family Medicine, School of Medicine, Faculty of Medicine and Health Sciences, McGill University, Montreal, Canada
- Institute of Health Sciences Education, Faculty of Medicine and Health Sciences, McGill University, Montreal, Canada
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Bishop FL, Cross N, Dewar-Haggart R, Teasdale E, Herbert A, Robinson ME, Ridd MJ, Mallen C, Clarson L, Bostock J, Becque T, Stuart B, Garfield K, Morrison L, Pollet S, Vennik J, Atherton H, Howick J, Leydon GM, Nuttall J, Islam N, Lee PH, Little P, Everitt HA. Talking in primary care (TIP): protocol for a cluster-randomised controlled trial in UK primary care to assess clinical and cost-effectiveness of communication skills e-learning for practitioners on patients' musculoskeletal pain and enablement. BMJ Open 2024; 14:e081932. [PMID: 38508652 PMCID: PMC10953007 DOI: 10.1136/bmjopen-2023-081932] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/09/2023] [Accepted: 03/01/2024] [Indexed: 03/22/2024] Open
Abstract
INTRODUCTION Effective communication can help optimise healthcare interactions and patient outcomes. However, few interventions have been tested clinically, subjected to cost-effectiveness analysis or are sufficiently brief and well-described for implementation in primary care. This paper presents the protocol for determining the effectiveness and cost-effectiveness of a rigorously developed brief eLearning tool, EMPathicO, among patients with and without musculoskeletal pain. METHODS AND ANALYSIS A cluster randomised controlled trial in general practitioner (GP) surgeries in England and Wales serving patients from diverse geographic, socioeconomic and ethnic backgrounds. GP surgeries are randomised (1:1) to receive EMPathicO e-learning immediately, or at trial end. Eligible practitioners (eg, GPs, physiotherapists and nurse practitioners) are involved in managing primary care patients with musculoskeletal pain. Patient recruitment is managed by practice staff and researchers. Target recruitment is 840 adults with and 840 without musculoskeletal pain consulting face-to-face, by telephone or video. Patients complete web-based questionnaires at preconsultation baseline, 1 week and 1, 3 and 6 months later. There are two patient-reported primary outcomes: pain intensity and patient enablement. Cost-effectiveness is considered from the National Health Service and societal perspectives. Secondary and process measures include practitioner patterns of use of EMPathicO, practitioner-reported self-efficacy and intentions, patient-reported symptom severity, quality of life, satisfaction, perceptions of practitioner empathy and optimism, treatment expectancies, anxiety, depression and continuity of care. Purposive subsamples of patients, practitioners and practice staff take part in up to two qualitative, semistructured interviews. ETHICS APPROVAL AND DISSEMINATION Approved by the South Central Hampshire B Research Ethics Committee on 1 July 2022 and the Health Research Authority and Health and Care Research Wales on 6 July 2022 (REC reference 22/SC/0145; IRAS project ID 312208). Results will be disseminated via peer-reviewed academic publications, conference presentations and patient and practitioner outlets. If successful, EMPathicO could quickly be made available at a low cost to primary care practices across the country. TRIAL REGISTRATION NUMBER ISRCTN18010240.
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Affiliation(s)
| | - Nadia Cross
- Primary Care Research Centre, School of Primary Care, Population Science, and Medical Education, University of Southampton, Southampton, UK
| | - Rachel Dewar-Haggart
- School of Psychology, University of Southampton, Southampton, UK
- Primary Care Research Centre, School of Primary Care, Population Science, and Medical Education, University of Southampton, Southampton, UK
| | - Emma Teasdale
- School of Psychology, University of Southampton, Southampton, UK
- Primary Care Research Centre, School of Primary Care, Population Science, and Medical Education, University of Southampton, Southampton, UK
| | - Amy Herbert
- Centre of Academic Primary Care, Bristol Medical School, University of Bristol, Bristol, UK
| | | | - Matthew J Ridd
- Population Health Sciences, University of Bristol Faculty of Health Sciences, Bristol, UK
| | - Christian Mallen
- Keele School of Medicine, Keele University, Newcastle-under-Lyme, UK
| | - Lorna Clarson
- Keele School of Medicine, Keele University, Newcastle-under-Lyme, UK
| | - Jennifer Bostock
- Primary Care Research Centre, School of Primary Care, Population Science, and Medical Education, University of Southampton, Southampton, UK
| | - Taeko Becque
- Primary Care Research Centre, School of Primary Care, Population Science, and Medical Education, University of Southampton, Southampton, UK
| | - Beth Stuart
- Wolfson Institute of Population Health, Queen Mary University of London, London, London, UK
| | - Kirsty Garfield
- Health Economics Bristol, Population Health Sciences, University of Bristol, Bristol, Bristol, UK
| | - Leanne Morrison
- School of Psychology, University of Southampton, Southampton, UK
- Primary Care Research Centre, School of Primary Care, Population Science, and Medical Education, University of Southampton, Southampton, UK
| | - Sebastien Pollet
- School of Psychology, University of Southampton, Southampton, UK
- Primary Care Research Centre, School of Primary Care, Population Science, and Medical Education, University of Southampton, Southampton, UK
| | - Jane Vennik
- Primary Care Research Centre, School of Primary Care, Population Science, and Medical Education, University of Southampton, Southampton, UK
| | - Helen Atherton
- Primary Care Research Centre, School of Primary Care, Population Science, and Medical Education, University of Southampton, Southampton, UK
- Unit of Academic Primary Care, University of Warwick, Coventry, UK
| | - Jeremy Howick
- Leicester Medical School, University of Leicester, Leicester, UK
- Faculty of Philosophy, University of Oxford, Oxford, UK
| | - Geraldine M Leydon
- Primary Care Research Centre, School of Primary Care, Population Science, and Medical Education, University of Southampton, Southampton, UK
| | - Jacqui Nuttall
- Southampton Clinical Trials Unit, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - Nazrul Islam
- Primary Care Research Centre, School of Primary Care, Population Science, and Medical Education, University of Southampton, Southampton, UK
| | - Paul H Lee
- Southampton Clinical Trials Unit, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - Paul Little
- Primary Care Research Centre, School of Primary Care, Population Science, and Medical Education, University of Southampton, Southampton, UK
| | - Hazel A Everitt
- Primary Care Research Centre, School of Primary Care, Population Science, and Medical Education, University of Southampton, Southampton, UK
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Byrne M, Campos C, Daly S, Lok B, Miles A. The current state of empathy, compassion and person-centred communication training in healthcare: An umbrella review. PATIENT EDUCATION AND COUNSELING 2024; 119:108063. [PMID: 38008647 DOI: 10.1016/j.pec.2023.108063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/26/2023] [Revised: 10/18/2023] [Accepted: 11/08/2023] [Indexed: 11/28/2023]
Abstract
OBJECTIVES This umbrella review consolidates evidence available on empathy training, its effectiveness and design mechanisms that contribute to effectiveness. METHODS We conducted an umbrella review (review of reviews) of empathy, compassion and person-centred communication training in healthcare published between 2018 and 2022. One reviewer screened titles, abstracts and full-text articles, with a second reviewer at full-text stage. Quality appraisal was done in duplicate. Data extraction was piloted by two reviewers and conducted by one reviewer with a quality check of all extracted data. All reviewers provided input into synthesis of results and analysis. RESULTS Twenty-five reviews were included. We provide an overview of the definitions of empathy, compassion and person-centred communication, outcome measures used, a synthesis of findings on the mechanisms and effectiveness of training and a summary of review recommendations. CONCLUSIONS For policy and practice, we advise the inclusion of empathic communication into the curriculum; longitudinal and sequenced learning; debriefing, targeted feedback, enabling self-reflection, deliberate practice, experiential learning; improving motivation by teaching the benefits of empathy and teaching sustainable empathy. Future research should involve patients in training and research and study the effect of targeting interventions at healthcare practitioners and patients.
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Affiliation(s)
- Monika Byrne
- School of Psychology, University of Auckland, New Zealand.
| | - Carlos Campos
- Centre for Medical and Health Sciences Education, School of Medicine, University of Auckland, New Zealand
| | - Svetlana Daly
- School of Psychology, University of Auckland, New Zealand
| | - Benjamin Lok
- Virtual Experiences Research Group, University of Florida, USA
| | - Anna Miles
- School of Psychology, University of Auckland, New Zealand
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Cole JD, Ruble MJ, Jacoby JL, Smith AB, Duka S, Kincaid H, Quinn JF. Longitudinal Assessment of Empathy and Burnout Across a Single Pharmacy Class Cohort. AMERICAN JOURNAL OF PHARMACEUTICAL EDUCATION 2024; 88:100604. [PMID: 37832651 DOI: 10.1016/j.ajpe.2023.100604] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/28/2023] [Revised: 09/23/2023] [Accepted: 10/07/2023] [Indexed: 10/15/2023]
Abstract
OBJECTIVE This is a final analysis of longitudinal evaluation of burnout and empathy among a cohort of Doctor of Pharmacy students throughout their 4-year enrollment. METHODS The class of 2021 received sequential Qualtrics (Qualtrics, Provo, UT) surveys containing 2 validated survey instruments, the Jefferson Scale of Empathy and the Maslach Burnout Inventory. Surveys were disseminated at the start of the program (PY1start) and the end of each academic year (PY1end, PY2, PY3, PY4). Linear mixed models accounting for repeated measures, Generalized Estimating Equation, and Cochran's Q statistic were used to evaluate longitudinal change in the Jefferson Scale of Empathy and Maslach Burnout Inventory survey scores, categorized subscales, and burnout. RESULTS Matched survey responses were included for 91 students (85.8% response rate). Across all years, a decrease in empathy and professional efficacy and an increase in exhaustion and cynicism was seen. High categorical levels of exhaustion and cynicism indicated evidence of burnout throughout the program. Year-to-year analysis indicated statistically significant increases in exhaustion and cynicism between PY1start and all subsequent assessments, a decrease in professional efficacy from PY1start to PY1end and PY2, and a decrease in empathy for PY1start to PY1end. CONCLUSION Students reported trends of decreasing empathy and professional efficacy, with a simultaneous increase in exhaustion and cynicism. Further evaluation of the impact of COVID-19 on these results, as well as additional methods to support overall student wellness, is needed.
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Affiliation(s)
- Jaclyn D Cole
- University of South Florida, Taneja College of Pharmacy, Tampa, FL, USA
| | - Melissa J Ruble
- University of South Florida, Taneja College of Pharmacy, Tampa, FL, USA.
| | - Jeanne L Jacoby
- Lehigh Valley Hospital and Health Network/University of South Florida Morsani College of Medicine (USF-MCOM), Lehigh Valley Campus, Allentown, PA, USA
| | - Amy B Smith
- Lehigh Valley Hospital and Health Network/University of South Florida Morsani College of Medicine (USF-MCOM), Lehigh Valley Campus, Allentown, PA, USA
| | - Shae Duka
- Lehigh Valley Hospital and Health Network/University of South Florida Morsani College of Medicine (USF-MCOM), Lehigh Valley Campus, Allentown, PA, USA
| | - Hope Kincaid
- Lehigh Valley Hospital and Health Network/University of South Florida Morsani College of Medicine (USF-MCOM), Lehigh Valley Campus, Allentown, PA, USA
| | - Joann Farrell Quinn
- University of South Florida Morsani College of Medicine (USF-MCOM), Tampa Campus, Tampa, FL, USA
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Ferguson KA, Reitschuler-Cross EB, Stahl ST. A Multimethod Examination of Medical Students' Experiences With Bereavement and Complicated Grief. OMEGA-JOURNAL OF DEATH AND DYING 2023; 88:668-689. [PMID: 34590884 DOI: 10.1177/00302228211049678] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Few studies have examined grief in medical students. This study used a multimethod approach to describe how bereavement and CG may impact medical students' educational experience and their perspectives on grief support and training. One hundred three medical students completed an online survey with quantitative and qualitative methods. Seventy-three (71%) students reported experiencing bereavement, of which 12 (18%) screened positive for CG. Medical students who screened positive for CG reported significantly more emotional and behavioral challenges (M = 3.58 [SD = 2.64]) compared to medical students without CG (M = 0.93 [SD = 1.58], p < .001). Qualitative analyses revealed that bereaved and nonbereaved students wanted more grief education and bereavement support from medical institutions. Therefore, it is crucial for medical institutions, to acknowledge that grief and bereavement may impact students' performance due to multifactorial causes.
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Affiliation(s)
- Kortni A Ferguson
- Department of Medicine, University of Pittsburgh, University of Pittsburgh, Pittsburgh, Pennsylvania, United States
| | - Eva B Reitschuler-Cross
- Department of Medicine, University of Pittsburgh, University of Pittsburgh, Pittsburgh, Pennsylvania, United States
| | - Sarah T Stahl
- Department of Psychiatry, University of Pittsburgh, University of Pittsburgh, Pittsburgh, Pennsylvania, United States
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Onofrei L, Serban CL, Chirita-Emandi A, Jeleriu RM, Puiu M. The impact of theory of mind, stress and professional experience on empathy in Romanian community nurses-a cross-sectional study. BMC Nurs 2023; 22:400. [PMID: 37875900 PMCID: PMC10598942 DOI: 10.1186/s12912-023-01569-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2023] [Accepted: 10/19/2023] [Indexed: 10/26/2023] Open
Abstract
BACKGROUND High empathy levels in health professionals represent an important factor in patient satisfaction and compliance, reducing patient anxiety and pain, enhancing diagnostic and clinical results and strengthening patient empowerment. Our purpose was to determine empathy level and to identify which of the socioeconomic status (SES) and psychological factors were able to predict highest empathy levels in a Romanian sample of community nurses. METHODS Community nurses were invited in January-February 2023 to provide an answer to an online survey, using an advertisement in a professional network. 1580 participants voluntarily agreed to take part in this study, with a response rate of 85.8%. The survey included the Toronto Empathy Questionnaire, the Reading the Mind in the Eyes Test and socio-economic status items. A multivariate model for the prediction of belonging to the highest quartile of empathy as opposed to lowest quartile was constructed using SES and psychological variables as factors. RESULTS The mean (SD) empathy level was 49.1 (6.7), with 74.7% of participants over the threshold of high empathy level. In the multivariate analysis, predictors of belonging to the highest quartile of TEQ, as opposed to the lowest quartile were: low self-perceived stress level (OR = 2.098, 95%CI 1.362-3.231), higher experience as a community nurse (OR = 1.561, 95%CI 1.120-2.175) and higher levels of the theory of mind (OR = 1.158, 95%CI 1.118-1.199), when controlling for gender, age, relationship status, presence of children in families, education, and income. CONCLUSIONS Training programs targeting to increase emotional competences, reduce levels of stress and encourage personnel retention have the potential to increase the quality of community nursing in Romania.
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Affiliation(s)
- Lidia Onofrei
- Department of Microscopic Morphology Genetics Discipline, Center of Genomic Medicine, Regional Center of Medical Genetics Timis, "Victor Babes" University of Medicine and Pharmacy Timisoara, 2 Eftimie Murgu Sqr, 300041, Timisoara, Romania
| | - Costela Lacrimioara Serban
- Regional Center of Medical Genetics Timis, Clinical Emergency Hospital for Children "Louis Turcanu" Timisoara, Timis, Romania.
- Department of Functional Sciences, Discipline of Public Health, "Victor Babeș" University of Medicine and Pharmacy Timisoara, 2 Eftimie Murgu Sqr, 300041, Timișoara, Romania.
| | - Adela Chirita-Emandi
- Department of Microscopic Morphology Genetics Discipline, Center of Genomic Medicine, Regional Center of Medical Genetics Timis, "Victor Babes" University of Medicine and Pharmacy Timisoara, 2 Eftimie Murgu Sqr, 300041, Timisoara, Romania
- Regional Center of Medical Genetics Timis, Clinical Emergency Hospital for Children "Louis Turcanu" Timisoara, Timis, Romania
| | - Roxana Maria Jeleriu
- Department of Microscopic Morphology Genetics Discipline, Center of Genomic Medicine, Regional Center of Medical Genetics Timis, "Victor Babes" University of Medicine and Pharmacy Timisoara, 2 Eftimie Murgu Sqr, 300041, Timisoara, Romania
| | - Maria Puiu
- Department of Microscopic Morphology Genetics Discipline, Center of Genomic Medicine, Regional Center of Medical Genetics Timis, "Victor Babes" University of Medicine and Pharmacy Timisoara, 2 Eftimie Murgu Sqr, 300041, Timisoara, Romania
- Regional Center of Medical Genetics Timis, Clinical Emergency Hospital for Children "Louis Turcanu" Timisoara, Timis, Romania
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Grilo AM, Vinagre G, dos Santos MC, Martinho JF, Gomes AI. Attitudes toward Patient-Centred Care, Empathy, and Assertiveness among Students in Rehabilitation Areas: A Longitudinal Study. Healthcare (Basel) 2023; 11:2803. [PMID: 37893877 PMCID: PMC10606137 DOI: 10.3390/healthcare11202803] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2023] [Revised: 10/15/2023] [Accepted: 10/17/2023] [Indexed: 10/29/2023] Open
Abstract
This study assessed attitudes toward patient-centred care, empathy, assertiveness, and subjective perception of communication skills and technical knowledge among Portuguese undergraduate students in healthcare. These students may develop rehabilitation activities with patients in their person-oriented or technique-oriented professions. Portuguese nursing and allied health students from two public higher education schools completed questionnaires in the first and third academic years: Patient-Practitioner Orientation Scale, Jefferson Scale of Physician Empathy, Scale for Interpersonal Behaviour, and a subjective perception of technical knowledge and communication skills. A total of 183 students completed the surveys. In the first year, students showed moderate to high scores on patient-centredness attitudes, empathy, and assertiveness and perceived themselves as having good communication skills. Students from person-oriented programmes significantly improved their Total and shared patient-centred attitudes in the third year compared with students attending technique-oriented professions. Significant differences in empathy were found between groups in the third year. Distress associated with assertive behaviours increased significantly across time in students from technique-oriented programmes compared with their peers in person-oriented programmes. The results suggest that the health profession's orientation and the programmes' specific curriculum might have a role in how some dimensions evolved in the two groups of students. The increasing assertiveness-related discomfort highlighted the importance of assessing and monitoring students' emotional wellbeing during their initial interactions with patients.
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Affiliation(s)
- Ana Monteiro Grilo
- H&TRC—Health & Technology Research Center, Escola Superior de Tecnologia da Saúde, Av. D. João II, Lote 4.69.01, 1990-096 Lisboa, Portugal
- CICPSI, Faculdade de Psicologia, Universidade de Lisboa, Alameda da Universidade, 1649-013 Lisboa, Portugal;
| | - Graça Vinagre
- Escola Superior de Enfermagem de Lisboa, Av. Prof. Egas Moniz, 1990-096 Lisboa, Portugal;
| | - Margarida Custódio dos Santos
- CICPSI, Faculdade de Psicologia, Universidade de Lisboa, Alameda da Universidade, 1649-013 Lisboa, Portugal;
- Escola Superior de Tecnologia da Saúde, Av. D. João II, Lote 4.69.01, 1990-096 Lisboa, Portugal
| | - Joana Ferreira Martinho
- Câmara Municipal de Oliveira do Bairro, Ed. Paços do Concelho, Praça do Município, 3770-851 Oliveira do Bairro, Portugal;
| | - Ana Isabel Gomes
- Faculdade de Psicologia, Universidade de Lisboa, Alameda da Universidade, 1649-013 Lisboa, Portugal;
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Harz D, Begin AS, Alansari R, Esparza R, Zimmermann C, Evans BD, Eisenberg S, Katz JT. The art of empathy: Teaching empathy through art. CLINICAL TEACHER 2023; 20:e13643. [PMID: 37654209 DOI: 10.1111/tct.13643] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2023] [Accepted: 08/01/2023] [Indexed: 09/02/2023]
Abstract
BACKGROUND The instruction of empathy is challenging. Although several studies have addressed how art-based education can foster empathy, there is a need for more evidence showing its impact and students' perceptions, especially in graduate education. APPROACH We designed and implemented a virtual art-based curriculum focused on fostering empathy-The Art of Empathy. This novel curriculum used diverse art-based education methodologies to promote meticulous and collaborative observation and reflection, building on constructivism. Thirty-six interns at the Brigham and Women's Hospital were invited to participate in the curriculum, while 34 served as control. EVALUATION We used mixed methods to explore interns' perceptions of the curriculum and assess its impact on their empathy. We used two quantitative instruments with known psychometric characteristics: the Toronto Empathy Questionnaire (TEQ) and the Jefferson Scale of Physicians Empathy (JSPE), which were distributed in a survey and completed by 31/99 (31.3%). We collected qualitative data from four interns using semi-structured interviews. Thematic analysis showed how The Art of Empathy promoted interns' reflections and actions toward empathy. This was partially supported by the quantitative data that showed significantly higher scores on the 'Compassionate Care' subscale of the JSPE (p = 0.039) when compared with interns in the control group. The thematic analysis showed that interns appreciated the curriculum and valued its benefits while highlighting the limitations of the virtual delivery approach. IMPLICATIONS Our curriculum was well received by interns and showed the potential of art-based methodology to promote empathic capacities in graduate students.
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Affiliation(s)
- Dominique Harz
- Dental School, Pontificia Universidad Católica de Chile, Santiago, Chile
- Harvard Medical School, Boston, Massachusetts, USA
| | - Arabella Simpkin Begin
- Harvard Medical School, Boston, Massachusetts, USA
- Lincoln College, University of Oxford, Oxford, UK
| | - Reem Alansari
- Harvard Medical School, Boston, Massachusetts, USA
- Arabian Gulf University, Manama, Bahrain
- Massachusetts General Hospital Institute of Health Professions, Boston, Massachusetts, USA
| | - Ramiro Esparza
- Harvard Medical School, Boston, Massachusetts, USA
- University of Guadalajara, Guadalajara, Mexico
| | | | | | | | - Joel T Katz
- Harvard Medical School, Boston, Massachusetts, USA
- Brigham and Women's Hospital, Boston, Massachusetts, USA
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Brami C, Sultan S, Robieux L, Piot MA, Gartili H, Zenasni F. Understanding students' motivations for participating in a mindfulness course: a qualitative analysis of medical students' views. BMC Complement Med Ther 2023; 23:163. [PMID: 37210498 DOI: 10.1186/s12906-023-03949-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2022] [Accepted: 04/06/2023] [Indexed: 05/22/2023] Open
Abstract
OBJECTIVES Improving medical students' wellbeing and empowerment through curricular activities is a topic of interest worldwide. Mindfulness-based interventions (MBIs) are increasingly implemented in medical education often as part of elective courses. To better understand training outcomes and adjust curriculum to students' needs, we will explore why will medical students participate in meditation-based education? METHODS We analyzed 29 transcripts from the first session of an 8-week MBSR program offered to medical students in French. Transcripts were coded and analyzed using a qualitative content thematic analysis and the constant comparison method. RESULTS Analyses resulted in three themes describing students' motivation: (1) Medical education and the physician's role, i.e. improving interpersonal skills, acquiring skills oriented toward a more integrative medicine, being more productive in a highly competitive context. (2) Caring for my health i.e. aiming at stress reduction, emotion regulation, and improving self-compassion. (3) A quest for meaning, i.e. optimizing meaning of care, and meaning of life. CONCLUSION The results highlight the congruence between the perceived motivations and the evidence on the effect of mindfulness on self-care, the development of humanistic medical skills, and the meaning of care. Some findings raise the issue of the limits of using mindfulness to enhance one's productivity. Notably, participants articulated the need for self-care as in mindfulness training, with the ability to care for others.
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Affiliation(s)
- Cloé Brami
- LaPEA - Université Paris Cité and Univ Gustave Eiffel, LaPEA, Boulogne- Billancourt, F-92100, France.
- GIS Théorie et Pratiques du Care, Université Paul Valéry, Montpellier, France.
| | - Serge Sultan
- Centre Hospitalier Universitaire Sainte-Justine, Québec, Montréal, Canada
- Department of Psychology, Université de Montréal, Montreal, QC, Canada
| | - Léonore Robieux
- Laboratory of Psychopathology and processes of change, Université Paris 8, LPPC, Saint Denis, F- 93000, France
| | - Marie-Aude Piot
- Necker Enfants malades hospital, Child and adolescent psychiatry unit, Université de Paris-Cité, AP-HP, CESP, USQV Paris-Saclay, Paris, Inserm, 1018, France
| | - Honorine Gartili
- LaPEA - Université Paris Cité and Univ Gustave Eiffel, LaPEA, Boulogne- Billancourt, F-92100, France
| | - Franck Zenasni
- LaPEA - Université Paris Cité and Univ Gustave Eiffel, LaPEA, Boulogne- Billancourt, F-92100, France
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Laird-Gion JN, Garabedian LF, Conrad R, Shaffer AC, Witkowski ML, Mateo CM, Jones DS, Hundert E, Kasper J. Snuff burnout and reignite passion in medical students. MEDICAL EDUCATION 2023; 57:465-466. [PMID: 36859822 DOI: 10.1111/medu.15037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/18/2023]
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Garcia JT, DuBose L, Arunachalam P, Hairrell AS, Milman RM, Carpenter RO. The Effects of Humor in Clinical Settings on Medical Trainees and the Implications for Medical Educators: A Scoping Review. MEDICAL SCIENCE EDUCATOR 2023; 33:611-622. [PMID: 37261025 PMCID: PMC10226925 DOI: 10.1007/s40670-023-01769-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 03/10/2023] [Indexed: 06/02/2023]
Abstract
Background Clinical settings represent the site of patient care and clinical training for medical students and residents. Both processes involve social interaction, and humor is a fundamental component of social interaction that remains underexplored in medical education. This study investigated the impact of humor on medical trainees in the context of the clinical learning environment and examined the implications for medical educators. Methods Following scoping review methodology, the authors systematically searched six databases and Google Scholar in February 2021 and March 2022. Articles were screened and selected according to inclusion/exclusion criteria, and findings from included articles were synthesized using procedures of metasynthesis. Results Fifteen articles met inclusion criteria. Six themes emerged relating to the functions and effects of humor in clinical training settings: (1) managing emotions; (2) demarcating insider vs outsider status; (3) facilitating camaraderie; (4) ensuring conformity; (5) negotiating power differentials; and (6) fostering discrimination. Conclusions The use of humor by medical educators plays an integral role in trainees' everyday experiences. Positive humor helps with coping and communication, while negative humor serves as an indirect medium for communicating ridicule and prejudice. Further research drawing on social psychology theories may identify ways to reduce effects of negative humor and promote well-being and diversity in medical education. Supplementary Information The online version contains supplementary material available at 10.1007/s40670-023-01769-0.
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Affiliation(s)
- Jordan T. Garcia
- College of Medicine, Texas A&M University Health Science Center, 8447 Riverside Pkwy, Bryan, TX 77807 USA
- Department of Surgery, Vanderbilt University Medical Center, 1161 21st Avenue South, Medical Center North, Nashville, TN 37232 USA
| | - Logan DuBose
- College of Medicine, Texas A&M University Health Science Center, 8447 Riverside Pkwy, Bryan, TX 77807 USA
- Department of Medicine, George Washington University Hospital, Ross Hall, 2300 Eye Street, NW, Washington, D.C. 20037 USA
| | - Priya Arunachalam
- College of Medicine, Texas A&M University Health Science Center, 8447 Riverside Pkwy, Bryan, TX 77807 USA
| | - Angela S. Hairrell
- College of Medicine, Texas A&M University Health Science Center, 8447 Riverside Pkwy, Bryan, TX 77807 USA
| | - Robert M. Milman
- College of Medicine, Texas A&M University Health Science Center, 8447 Riverside Pkwy, Bryan, TX 77807 USA
| | - Robert O. Carpenter
- College of Medicine, Texas A&M University Health Science Center, 8447 Riverside Pkwy, Bryan, TX 77807 USA
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12
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von Knorring J, Lehti A, Fahlström M, Semb O. Empathy as a silent art-A doctor´s daily balancing act: A qualitative study of senior doctors' experiences of empathy. PLoS One 2022; 17:e0277474. [PMID: 36520784 PMCID: PMC9754163 DOI: 10.1371/journal.pone.0277474] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2021] [Accepted: 10/27/2022] [Indexed: 12/23/2022] Open
Abstract
Empathy in the doctor-patient relationship is of great importance and has long been considered a true professional virtue for doctors. Despite the general agreement concerning the importance of empathy, there is no consensus regarding the definition of empathy in medical research. While several quantitative studies, measuring empathy as an individual trait, show a decline in empathy among medical students, other studies have shown that empathy is influenced by contextual factors as well as the availability of role models. Therefore, further studies about the transition from medical school to clinical work also including the perspective of senior doctors are needed. The study presented in this article aims to better understand the clinical conditions for empathy through interviews with senior doctors about their lived experience of empathy. Twelve senior doctors, from different specialities were interviewed using a semi-structured approach. The data was analysed using content analysis. The analysis resulted in the main theme: Empathy as a silent art-a doctor`s daily balancing act. This main theme comprised three categories: "A tacit, yet language-dependent process", "A daily balancing act" and "An unsupported path towards mastery". Doctors face many challenges in their daily balancing act between individual and structural conditions that may affect empathy. In order to maintain and further develop empathy, doctors need working conditions allowing for collegial reflection and conversations that promote empathy.
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Affiliation(s)
- Johanna von Knorring
- Unit of Professional Development, Department of Clinical Sciences, Umeå University, Umeå, Sweden
- * E-mail:
| | - Arja Lehti
- Unit of Professional Development, Department of Clinical Sciences, Umeå University, Umeå, Sweden
| | - Martin Fahlström
- Unit of Professional Development, Department of Clinical Sciences, Umeå University, Umeå, Sweden
| | - Olof Semb
- Unit of Professional Development, Department of Clinical Sciences, Umeå University, Umeå, Sweden
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Zhou H, Wang Y, Cheng L. The mediating effect of self-directed learning in the relationship between caring and resilience among Chinese nursing students: A multi-center cross-sectional study. NURSE EDUCATION TODAY 2022; 119:105598. [PMID: 36272323 DOI: 10.1016/j.nedt.2022.105598] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/11/2022] [Revised: 08/30/2022] [Accepted: 10/06/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND Despite the proliferation of literature focusing on resilience, a paucity of research has attempted a thorough and accurate examination of factors that contribute to resilience among nursing students. OBJECTIVES To examine the mediating effect of self-directed learning in the relationship between caring and resilience in Chinese nursing students. DESIGN A cross-sectional design. SETTINGS Five universities in China. PARTICIPANTS Undergraduate nursing students (N = 511). METHODS The Caring Ability Inventory, Self-Rating Scale of Self-Directed Learning, and Connor-Davidson Resilience Scale (CD-RISC) were administered. Socio-demographic and academic data were collected from nursing students after obtaining their informed consent. A multiple linear regression analysis was performed to assess factors associated with resilience. A structural equation model with bootstrapping estimation was conducted to further explore the potential mediating role of self-directed learning in the relationship between caring and resilience. RESULTS The average score of CD-RISC for nursing students was 92.96 ± 14.85. Multiple linear regression analyses indicated that caring and self-directed learning were significantly positively associated with resilience. Self-directed learning (β = 0.327, 95% Confidence Interval [CI]: 0.049-6.667, p < 0.001) had a significant mediating effect on the relationship between caring and resilience in nursing students, explaining 67.1% of the total effect of caring on resilience. CONCLUSIONS Interventions that enhance students' self-directed learning have the potential to enhance resilience level. Innovative pedagogical approaches, strategic reinforcement, and nursing curriculum transformation are recommended to promote self-directed learning awareness and internalize self-directed learning skills.
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Affiliation(s)
- Hua Zhou
- School of Nursing, Sun Yat-sen University, Nonglin Street, Yuexiu District, Guangzhou, China.
| | - Yarui Wang
- School of Nursing, Sun Yat-sen University, Nonglin Street, Yuexiu District, Guangzhou, China.
| | - Li Cheng
- School of Nursing, Sun Yat-sen University, Nonglin Street, Yuexiu District, Guangzhou, China.
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Kurtses Gürsoy B. The effect of stress coping styles on empathy level in students of medicine: A cross-sectional study. Medicine (Baltimore) 2022; 101:e32066. [PMID: 36451464 PMCID: PMC9704976 DOI: 10.1097/md.0000000000032066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
We aimed to investigate the change in the ability of clinical empathy, which has a special importance in physician-patient relationship, during medical school years, and its relationship between stress coping styles. After the preliminary interview with 292 volunteer medical school students, the students were asked to answer the Hospital Anxiety Depression Scale, the Stress Coping Scale, and the student version of the Jefferson Doctor Empathy Scale. This study shows that the lowest median of the empathy level among medical school students was in the sixth year, and the decrease in empathy in the sixth year was mostly in the perspective taking component. When the relationship between empathy and coping styles with stress was examined, it was seen that self-confident approach was positively correlated with perspective taking (R = 0.182, P = .002) and standing in the patient's shoes (R = 0.172, P = .003). It was observed that the helpless approach, which is one of the negative coping styles, was inversely correlated with standing in the patient's shoes. As a result of the study, it was determined that the styles of coping with stress were related to the components of empathy, except for compassionate care. The self-confidence approach has an impact on the ability of standing in the patient's shoes and perspective-taking. During medical education, focusing on the approaches that increase the student's self-confidence against the stress will encounter throughout their professional life will undoubtedly increase the level of empathy.
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Affiliation(s)
- Betül Kurtses Gürsoy
- Afyonkarahisar Health Sciences University, Faculty of Medicine, Department of Psychiatry, Turkey
- * Correspondence: Afyonkarahisar Health Sciences University, Faculty of Medicine, Department of Psychiatry, Turkey (e-mail: )
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15
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Hu Z, Wen Y, Wang Y, Lin Y, Shi J, Yu Z, Lin Y, Wang Y. Effectiveness of mindfulness-based interventions on empathy: A meta-analysis. Front Psychol 2022; 13:992575. [PMID: 36337535 PMCID: PMC9632989 DOI: 10.3389/fpsyg.2022.992575] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Accepted: 09/29/2022] [Indexed: 10/13/2023] Open
Abstract
Empathy is essential for human survival and social interaction. Although mindfulness-based interventions (MBIs) have been used to improve empathy in healthy populations, its therapeutic efficacy remains unknown. This study aims to investigate the therapeutic effects of MBIs on empathy in a healthy population and the potential factors affecting the efficacy of MBIs. The literature search focused on PubMed, Embase, Web of Science, Cochrane Library, and CNKI from inception to September 2022. Randomized controlled trials and quasi-experimental studies reporting the effects of using MBIs on empathy in healthy populations were included. A total of 13 studies were included in this review. Results of the meta-analysis showed that MBIs improved empathy (SMD, 0.372, 95% CI, 0.164-0.579, p = 0.001) in the healthy population compared with that in the control group. Moreover, results of the subgroup analysis showed that intervention dose (over 24 h vs. under 24 h), format (online vs. offline), and types (different types) were important factors affecting treatment outcomes. This comprehensive review suggests that MBIs are effective treatment for empathy in healthy population. Future research should markedly focus on large-sample, rigorously designed experiments to explore the long-term effects of MBIs on empathy and to elucidate the underlying mechanisms of MBIs. This study provides a reference for the daily application of MBIs.
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Affiliation(s)
- Zhengyu Hu
- Department of Sport Rehabilitation, Shenyang Sport University, Shenyang, China
- Rehabilitation Medicine Center, The Sixth Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Yurong Wen
- Rehabilitation Medicine Center, The Sixth Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
- Department of Sport Rehabilitation, Shanghai University of Sport, Shanghai, China
| | - Yafei Wang
- Rehabilitation Medicine Center, The Sixth Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Yangyang Lin
- Rehabilitation Medicine Center, The Sixth Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Jian Shi
- Department of Sport Rehabilitation, Shenyang Sport University, Shenyang, China
- Rehabilitation Medicine Center, The Sixth Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Zihan Yu
- Department of Sport Rehabilitation, Shenyang Sport University, Shenyang, China
| | - Youtian Lin
- Rehabilitation Medicine Center, The Sixth Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
- Postgraduate Research Institute, Guangzhou Sport University, Guangzhou, China
| | - Yuling Wang
- Rehabilitation Medicine Center, The Sixth Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
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Assing Hvidt E, Ulsø A, Thorngreen CV, Søndergaard J, Andersen CM. Weak inclusion of the medical humanities in medical education: a qualitative study among Danish medical students. BMC MEDICAL EDUCATION 2022; 22:660. [PMID: 36064397 PMCID: PMC9442995 DOI: 10.1186/s12909-022-03723-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/21/2022] [Accepted: 08/30/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND The modern medical education is predominantly grounded in the biomedical sciences. In recent years, medical humanities have been included into the medical curricula in many countries around the world one of the objectives being to promote patient-centred, empathic care by future physicians. Studies have been made of the impact of inclusion of medical humanities components within the medical curriculum. Although some results suggest increased empathy, others remain inconclusive. To gain insight into the depth, context, and impact of inclusion of the medical humanities for future physicians, this study aimed to explore Danish medical students' understanding of and reflections on how the medical humanities relate to the medical education, including the clinic. METHODS We conducted a qualitative research study, involving semi-structured interviews with twenty-three Danish medical students across years of curriculum and medical schools. Interviews were recorded, transcribed verbatim and analyzed using Braun and Clarke's thematic analysis. RESULTS The findings demonstrate the subordinate role of the medical humanities in the medical educational system. Students prioritize biomedical knowledge building in the preclinical curriculum, partly as a reaction to an unbalanced institutional inclusion of the medical humanities. Observing how structural empathy incentives are lacking in the clinical curriculum, the values inherent in the medical humanities are undermined. CONCLUSION Danish medical students become part of an educational environment with lacking institutional conditions and structures to promote the strong inclusion of the medical humanities. A focus is therefore needed on the values, norms and structures of the medical educational systems that undermine a strong inclusion of the medical humanities into medical education.
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Affiliation(s)
- Elisabeth Assing Hvidt
- Research Unit of General Practice, Department of Public Health, University of Southern Denmark, J.B. Winsløwsvej 9 A, 5000, Odense, Denmark.
| | - Anne Ulsø
- Research Unit of General Practice, Department of Public Health, University of Southern Denmark, J.B. Winsløwsvej 9 A, 5000, Odense, Denmark
| | | | - Jens Søndergaard
- Research Unit of General Practice, Department of Public Health, University of Southern Denmark, J.B. Winsløwsvej 9 A, 5000, Odense, Denmark
| | - Christina Maar Andersen
- Department of Psychology, University of Southern Denmark, Odense, Denmark
- Steno Diabetes Center Odense, Odense University Hospital, Odense, Denmark
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17
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Assing Hvidt E, Ulsø A, Thorngreen CV, Søndergaard J, Andersen CM. Empathy as a learning objective in medical education: using phenomenology of learning theory to explore medical students' learning processes. BMC MEDICAL EDUCATION 2022; 22:628. [PMID: 35982451 PMCID: PMC9389818 DOI: 10.1186/s12909-022-03696-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/13/2022] [Accepted: 08/16/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND Clinical empathy has been associated with a range of positive patient- and clinician outcomes. Educating medical students to become empathic physicians has in recent years become a clearly pronounced learning objective in medical education in many countries worldwide. Research knowledge about how medical students experience the learning processes conveyed by empathy-enhancing educational interventions is lacking. Our study aimed to explore Danish medical students' perspectives on which experiences allowed learning processes to take place in relation to empathy and empathic communication with patients. METHODS We conducted a qualitative research study, involving semi-structured interviews with twenty-three Danish medical students across years of curriculum and universities. Braun and Clarke's reflexive thematic analysis (RTA) guided the analytical process, moving on a continuum from inductive to deductive, theoretical approaches. Key concepts in regard to learning processes deriving from Amadeo Giorgi's learning theory were applied to analyse the data. RESULTS Learning processes in relation to clinical empathy occured: 1. when theoretical knowledge about empathy became embodied and contextualied within a clinical context 2. through interpersonal interactions, e.g., with peers, faculty members and clinicians, that conveyed behavior-mobilizing positive and negative affect and 3. when new learning discoveries in 2. and 3. were appropriated as a personalized and adequate behavior that transcends the situational level. CONCLUSION Rather than being an immediate product of knowledge transmission, skill acquisition or training, learning clinical empathy is experienced as a dynamic, temporal process embedded in a daily clinical lifeworld of becoming an increasingly human professional.
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Affiliation(s)
- Elisabeth Assing Hvidt
- Research Unit of General Practice, Department of Public Health, University of Southern Denmark, J.B. Winsløwsvej 9 A, 5000, Odense, Denmark.
| | - Anne Ulsø
- Research Unit of General Practice, Department of Public Health, University of Southern Denmark, J.B. Winsløwsvej 9 A, 5000, Odense, Denmark
| | | | - Jens Søndergaard
- Research Unit of General Practice, Department of Public Health, University of Southern Denmark, J.B. Winsløwsvej 9 A, 5000, Odense, Denmark
| | - Christina Maar Andersen
- Department of Psychology, University of Southern Denmark, Odense, Denmark
- Steno Diabetes Center Odense, Odense University Hospital, Odense, Denmark
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18
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Voultsos P, Chatzinikolaou F, Papana A, Deliligka A. Reliability of Greek version of the Toronto empathy questionnaire in medical students and associations with sociodemographic and lifestyle factors. BMC Psychol 2022; 10:113. [PMID: 35501889 PMCID: PMC9063083 DOI: 10.1186/s40359-022-00824-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Accepted: 04/26/2022] [Indexed: 01/10/2023] Open
Abstract
BACKGROUND Empathy is an important key driver of any therapeutic relationship. It is beneficial for both physicians and patients. Enhancing physician's empathy should be an important goal of medical education. As there was a literature gap regarding the topic of empathy among medical students in Greece, this study aimed to contribute to filling this gap. METHODS A cross-sectional study was conducted. A socio-demographic questionnaire and the 52-item Greek version of the Toronto composite empathy scale (TCES) for measuring the cognitive and emotional aspects of empathy in both personal and professional life was administered to all the medical students in the Aristotle University of Thessaloniki, in Greece. Descriptive statistics were displayed for demographics. The associations of the variables were quantified by Chi-2 independence tests and Pearson's Correlation Coefficient. The reliability and validity of the questionnaire was determined by Cronbach's α, Hotelling's T-Squared Test, and Pearson correlation. Paired and Independent Sample T-Tests and One-way ANOVAs indicated statistically significant mean differences among the variables or subgroups of the variables. RESULTS The 52-item TCES, 26 for the personal (Per) setting and another 26 for professional (Pro) life, equally divided into cognitive (Cog) and emotional (Emo) empathy in each case. The overall reliability of the TCES questionnaire was found to be high (Cronbach's α = 0.895, significant positive correlations between the subscales). The mean total score of empathy showed that students had a moderately high empathy. Further, there was a statistically significant difference in means between the Per-Cog and Per-Emo settings (p < 0.001), the Pro-Cog and Pro-Emo (p < 0.001), the Per-Cog and Pro-Cog (p = 0.004), and the Per-Emo and Pro-Emo (p < 0.001). Females had significantly higher empathy scores (mean score 208.04) than males (192.5) on the Per-Cog, Per-Emo and Pro-Emo subscales. Furthermore, a positive correlation was found between empathy and factors such as love for animals, interest in medical ethics, belief in God, having an ill person in the family, class year or carrier intention. CONCLUSIONS The TCES is applicable to medical students. For the most part our findings were consistent with previous literature. However, we identified some nuances that might draw researchers' attention. The results of this study may contribute to plan interventions in the curriculum to enhance empathy in the medical students.
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Affiliation(s)
- Polychronis Voultsos
- Laboratory of Forensic Medicine and Toxicology (Medical Law and Ethics), School of Medicine, Faculty of Health Sciences, Aristotle University, University Campus, 541 24, Thessaloniki, Greece.
| | - Fotios Chatzinikolaou
- Laboratory of Forensic Medicine and Toxicology (Medical Law and Ethics), School of Medicine, Faculty of Health Sciences, Aristotle University, University Campus, 541 24, Thessaloniki, Greece
| | - Angeliki Papana
- Department of Economics, School of Economics and Regional Studies, University of Macedonia, Egnatia Str 156, 546 36, Thessaloniki, Greece
| | - Aspasia Deliligka
- AHEPA University Hospital, Kiriakidi Str 1, 546 21, Thessaloniki, Greece
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Sibeoni J, Massoutier L, Valette M, Manolios E, Verneuil L, Speranza M, Revah-Levy A. The sensory experiences of autistic people: A metasynthesis. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2022; 26:1032-1045. [PMID: 35362340 DOI: 10.1177/13623613221081188] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
LAY ABSTRACT Sensory atypicalities are very common among autistic people and are integrated in several theories and explanatory models of autism. Qualitative studies have explored these singular sensory experiences from the perspectives of autistic people themselves. This article gathers all these qualitative studies and provides original findings regarding the everyday sensory experience of autistic people, that is, around four dimensions - physical, emotional, relational and social - experienced holistically, as inseparable, and not hierarchically or in terms of cause and effect. Adopting this holistic view could improve the adaptation of the sensory environment in health care facilities and the training of professionals around this specific issue.
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Affiliation(s)
- Jordan Sibeoni
- Argenteuil Hospital Centre, France.,Université de Paris, France
| | - Laura Massoutier
- Université de Paris, France.,Centre Hospitalier de Gonesse, France
| | | | - Emilie Manolios
- Université de Paris, France.,Hôpital Européen Georges Pompidou, France
| | - Laurence Verneuil
- Université de Paris, France.,GHU Paris Psychiatrie & Neurosciences, France
| | - Mario Speranza
- Centre Hospitalier de Versailles, France.,Université Paris-Saclay, France
| | - Anne Revah-Levy
- Argenteuil Hospital Centre, France.,Université de Paris, France
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Lermen C, Wetzel W, Britz V, Sterz J, Bechstein WO, Schreckenbach T. Empathy, personality traits, and emotional management in 2nd and 4th-year dentistry students: a single-center study. BMC MEDICAL EDUCATION 2022; 22:2. [PMID: 34980112 PMCID: PMC8722276 DOI: 10.1186/s12909-021-03080-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/21/2021] [Accepted: 12/14/2021] [Indexed: 06/14/2023]
Abstract
BACKGROUND Patients fearing dental interventions are at risk of delaying or skipping much-needed treatments. Empathic communication could lead to a higher rate of compliance from patients within this group. Empathy, the big five personality traits, and emotion management abilities are all known to influence the quality of communication between dentists and patients. This study was conducted to analyze whether there is a correlation between these factors in dentistry students. METHODS Dentistry students in their 2nd and 4th year of study were asked to complete questionnaires assessing empathy, emotion management, and personality traits. Out of a total of 148 eligible participants, 53 students (34%) volunteered to participate. For empathy, the Jefferson Scale of Physician Empathy (students' version; JSPE-S) and the Interpersonal Reactivity Index (IRI) were used. Personality traits were assessed using the Short Big Five Inventory (BFI-s), and the Situational Test of Emotional Management (STEM) to measure emotional management ability. RESULTS Higher scores for emotion management were significantly correlated with the female gender (p ≤ 0.005) and with higher scores in openness (p ≤ 0.05). Students with higher scores in openness also achieved higher scores on the IRI subscales: Perspective taking (p ≤ 0.05), Fantasy (p ≤ 0.01), Empathic concern (p ≤ 0.05), and Personal distress (p ≤ 0.05). For JSPE-S, no correlation with emotion management and personality traits was found. CONCLUSION Empathy and emotion management might not be significantly related in dentistry students. Regarding personality traits, students who scored higher on openness also indicated higher abilities in emotion management. These findings should be taken into consideration when planning communication courses for dentistry students, as it might be possible to independently train empathy and emotion management as part of emotional intelligence.
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Affiliation(s)
- Christian Lermen
- Goethe-University Frankfurt/Main, Department of General, Visceral, Transplantation and Thoracic Surgery, Goethe-University Frankfurt am Main, Frankfurt University Hospital and Clinics, Theodor-Stern-Kai 7, 60596, Frankfurt/Main, Germany
| | - Willi Wetzel
- Department of Oral Surgery and Implantology, Goethe-University Frankfurt am Main, Carolinum, Theodor-Stern-Kai 7, 60596, Frankfurt/Main, Germany
| | - Vanessa Britz
- Goethe-University Frankfurt am Main, Frankfurt interdisciplinary simulation center FIneST, Medical Faculty, Goethe University, Frankfurt, Germany
| | - Jasmina Sterz
- Goethe-University Frankfurt am Main, Department of Trauma, Hand and Reconstructive Surgery, University Hospital Frankfurt, Goethe-University Frankfurt am Main, Frankfurt/Main, Germany
| | - Wolf O Bechstein
- Goethe-University Frankfurt/Main, Department of General, Visceral, Transplantation and Thoracic Surgery, Goethe-University Frankfurt am Main, Frankfurt University Hospital and Clinics, Theodor-Stern-Kai 7, 60596, Frankfurt/Main, Germany
| | - Teresa Schreckenbach
- Goethe-University Frankfurt/Main, Department of General, Visceral, Transplantation and Thoracic Surgery, Goethe-University Frankfurt am Main, Frankfurt University Hospital and Clinics, Theodor-Stern-Kai 7, 60596, Frankfurt/Main, Germany.
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Challenging the clinically-situated emotion-deficient version of empathy within medicine and medical education research. SOCIAL THEORY & HEALTH 2022; 20:306-324. [PMID: 34840531 PMCID: PMC8607055 DOI: 10.1057/s41285-021-00174-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/28/2021] [Indexed: 12/30/2022]
Abstract
In this paper, we argue that the notion of a clinically-situated empathy (e.g. physician empathy), is potentially problematic as it perpetuates an emotion-deficient version of empathy within medicine and medicine education research. Utilizing classic and contemporary empathy theory from various social science disciplines, we discuss how empathy in the general sense differs conceptually from clinically-situated empathy-paying particular attention to the role of emotional contagion. To highlight this contrast, we draw upon Hojat et al.'s model of physician empathy and how this body of work reflects broader medical-cultural norms that problematize the role and impact of emotions within the clinical encounter. Alternatively, we present a more encompassing model of empathy drawing upon the fields of social-psychology and social-neuroscience in order to bring the notion of "feeling with" and emotional contagion more specifically, into medical education, medical education research, and medicine more generally.
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22
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Elkin B. When Empathy Matters Most. Am J Med 2021; 134:1304-1305. [PMID: 34081898 DOI: 10.1016/j.amjmed.2021.05.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2021] [Revised: 04/29/2021] [Accepted: 05/01/2021] [Indexed: 11/30/2022]
Affiliation(s)
- Baila Elkin
- University of Minnesota Medical School, Minneapolis.
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MacArthur KR, Stacey CL, Harvey S, Markle J. The direct and indirect effects of clinical empathy on well-being among pre-medical students: a structural equation model approach. BMC MEDICAL EDUCATION 2021; 21:412. [PMID: 34340661 PMCID: PMC8327048 DOI: 10.1186/s12909-021-02838-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 04/03/2021] [Accepted: 07/13/2021] [Indexed: 06/13/2023]
Abstract
BACKGROUND Empathy is a well-established facet of clinical competency that research suggests is associated with enhanced medical student well-being. Since little is known about empathy and well-being before students enter medical school-during pre-medical education-the main goal of this study is to test a conceptual model of how clinical empathy is related to two indicators of well-being, depression, and burnout among pre-medical students. The theoretical model hypothesizes that three dimensions of clinical empathy-Perspective-Taking, Compassionate Care, and Standing in Patients' Shoes- will be directly and negatively related to depression, as well as indirectly through its inverse relationship with three facets of burnout, Emotional Exhaustion, Poor Academic Efficacy, and Cynicism. METHODS Using survey data from a sample of 132 pre-medical students at an American Midwestern university, this study employs structural equation modeling (SEM) to test the theoretical model of the relationships between empathy, burnout, and depression among pre-medical students. We identify the direct effects of the three dimensions of the Jefferson Scale of Physician Empathy (JSE-S) on depression (CES-D), as well as the indirect effects of clinical empathy on depression through the three dimensions of the Maslach Burnout Inventory (MBI-S). RESULTS SEM analyses show that while none of the three dimensions of the JSE-S are directly related to depression, clinical empathy does significantly affect depression indirectly through burnout. Specifically, as predicted, we find that Perspective-Taking decreases Emotional Exhaustion, but, contrary to expectations, Compassionate Care increases it. And, the positive relationship between Compassionate Care and Emotional Exhaustion is particularly strong. In turn, Perspective-Taking and Compassionate Care are associated with depression in opposite directions and to different degrees. CONCLUSIONS Findings suggest that clinical empathy as measured by the JSE-S produces both positive and negative effects on personal well-being. We conclude that further conceptual clarity of clinical empathy is needed to better discern how the different dimensions impact different indicators of well-being. Given that pre-medical education is a crucial time for emotional socialization, the challenge for medical education will be fostering the positive, cognitive aspects of clinical empathy while simultaneously mitigating the adverse effects of affective empathy on medical student well-being.
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Affiliation(s)
- Kelly Rhea MacArthur
- Department of Sociology and Anthropology, University of Nebraska Omaha, 6001 Dodge St., Omaha, NE, 68182, USA.
| | - Clare L Stacey
- Department of Sociology, Kent State University, 800 E. Summit St., Kent, OH, 44242, USA
| | - Sarah Harvey
- Department of Sociology, Kent State University, 800 E. Summit St., Kent, OH, 44242, USA
| | - Jonathan Markle
- Northeast Ohio Medical University, College of Medicine, 4209 St, OH-44, Rootstown, OH, 44272, USA
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Zusammenhänge zwischen Empathie, therapeutischer Haltung und Wirkeffizienz. PSYCHOPRAXIS. NEUROPRAXIS 2021. [PMCID: PMC8062112 DOI: 10.1007/s00739-021-00726-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
ZusammenfassungEmpathisch sein heißt, fühlen und verstehen können, was andere fühlen. Vermuten zu können, was das Gegenüber fühlt, denkt und wünscht, beruht auf der Fähigkeit, eigene Gefühle und Gedanken als getrennt von jenen anderer wahrnehmen und regulieren zu können. Definierte Therapieerfolge mit adäquatem Aufwand erreichen zu können, verlangt ein Fokussieren auf Wesentliches und Wichtiges. Die Empathie ist im Bereich der Psychotherapie jener Faktor, für den für sich genommen die höchste Effektstärke nachgewiesen werden konnte. Empathietraining ermöglicht eine bessere soziale Performance. Im Falle von Defiziten in sozialer Kompetenz ist störungsunabhängig ein besonders hoher Leidensdruck nachweisbar.
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La médecine, la guerre et l’empathie à l’âge de la COVID-19, fictions et point de vue. NPG NEUROLOGIE - PSYCHIATRIE - GÉRIATRIE 2021. [PMCID: PMC7904443 DOI: 10.1016/j.npg.2021.02.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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