Jeffrey Silver Humanism in Healthcare Research Roundup – July 2017

The Jeffrey Silver Humanism in Healthcare Research Roundup features summaries of recently published studies on humanism in healthcare. To receive email notification of new studies once per month, enter your information here and select “Jeffrey Silver Research Roundup” from the checkboxes at the bottom. See previous posts in this series.

Publications from Gold Foundation-Affiliated Authors

How physicians draw satisfaction and overcome barriers in their practices: “It sustains me”
Branch WT Jr, Weil AB, Gilligan MC, Litzelman DK, Hafler JP, Plews-Ogan M, Rider EA, Osterberg LG, Dunne D, Derse AR, Pittman JR, Frankel RM.   Patient Educ Couns. 2017 Jun 8.
This project was funded by the Gold Foundation Research Institute
Researchers sought to understand how physicians who completed an intensive faculty development program in medical humanism sustain their humanistic practices. They analyzed reflection statements from 68 physicians from 8 U.S. medical schools. Motivating factors included: 1) identification with humanistic values; 2) providing care that they or their family would want; 3) connecting to patients; 4) passing on values through role modelling; 5) being in the moment. Inhibiting factors included: 1) time, 2) stress, 3) culture, and 4) episodic burnout.

Findings from the Harvard Medical School Cambridge Integrated Clerkship, a year-long longitudinal psychiatry experience
Cheng E, Hirsh D, Gaufberg E, Griswold T, Wesley Boyd J.    Acad Psychiatry. 2017 Jun 23.
Dr. Gaufberg is the Director of the Gold Foundation Research Institute
Researchers sought to better understand the student experience of this clerkship and how it may have impacted students’ perceptions of and interest in psychiatry, as well as performance. They analyzed data from qualitative surveys of 100 students. They found that clerkship students entered psychiatry residencies at four times the rate of students in traditional clerkships.

The educational climate inventory: Measuring students’ perceptions of the preclerkship and clerkship settings
Krupat E, Borges NJ, Brower RD, Haidet PM, Schroth WS, Fleenor TJ Jr, Uijtdehaage S.    Acad Med. 2017 May 30.
Dr. Krupat has served on the strategic planning committee of the Gold Foundation Research Institute. Dr. Haidet is a Mapping the Landscape grantee.
Researchers developed and tested an instrument to assess educational climate. The final instrument contains 20 items focused on the centrality of learning and mutual respect; competitiveness and stress; and passive learning and memorization. Clerkship students’ ratings of their learning climate were more performance-oriented than preclerkship students’ ratings.

Do HCAHPS doctor communication scores reflect the communication skills of the attending on record? A cautionary tale from a tertiary-care medical service
Velez VJ, Kaw R, Hu B, Frankel RM, Windover AK, Bokar D, Rish JM, Rothberg MB.    J Hosp Med. 2017 Jun;12(6):421-427.
Dr. Frankel serves on the Gold Foundation Research Institute Advisory Committee
Researchers used a cross-sectional design to observe 28 hospitalists during inpatient rounds on three separate occasions. They compared these hospitalists’ scores on the Four Habits Coding Scheme to their doctor communication HCAHPS scores and found that the correlation was not significant.  After patients cared for by more than one hospitalist were excluded, demonstrating empathy did correlate with the doctor communication and respect HCAHPS scores.

Peer facilitation and burnout: The READ-SG pilot
Abrams MP, Granieri E.    Clin Teach. 2017 May 10.
Dr. Abrams is a member of the Gold Humanism Honor Society Membership Advisory Committee
First-year postgraduate doctor trainees in Internal Medicine were given protected time to participate in peer-facilitated monthly small group discussions on topics regarding humanism and professional development. The authors prompted participants before each session and followed a novel Reflect, Empathize, Analyze and Discuss in Small Groups (READ-SG) format. Surveys from participants showed that using the READ-SG method seems to have positive effects on participants’ sense of professional development and symptoms of burnout.

Other Publications

Perceived nonbeneficial treatment of patients, burnout, and intention to leave the job among ICU nurses and junior and senior physicians
Schwarzkopf D, Rüddel H, Thomas-Rüddel DO, Felfe J, Poidinger B, Matthäus-Krämer CT, Hartog CS, Bloos F.    Crit Care Med. 2017 Mar;45(3):e265-e273.
Researchers collected 847 questionnaires from Intensive Care Unit (ICU) nurses and physicians from 23 German ICU’s. Nonbeneficial treatment was in median perceived “sometimes.” They found that the perception of nonbeneficial treatment was independently associated with the core burnout dimension emotional exhaustion, which significantly mediated the effect between nonbeneficial treatment and intention to leave.

What is the key to culturally competent care: Reducing bias or cultural tailoring?
Cuevas AG, O’Brien K, Saha S.    Psychol Health. 2017 Apr;32(4):493-507.
Researchers ran 27 focus groups with the aim of better understanding whether ethnic minority patients would prefer to be treated the same or differently as European American patients are treated. Patients of all groups described experiences that reflected the concepts of patient-centered care. Some African-American patients felt it was appropriate to racially/ethnically contextualize their care. Most Latina/Latino patients preferred language/culturally concordant clinicians.

Association between physician burnout and identification with medicine as a calling
Jager AJ, Tutty MA, Kao AC.    Mayo Clin Proc. 2017 Mar;92(3):415-422.
A total of 2,263 U.S. physicians completed surveys. Twenty-eight percent reported experiencing some degree of burnout. Compared with physicians who reported no burnout symptoms, those who were completely burned out had lower odds of finding their work rewarding, seeing their work as one of the most important things in their lives, or thinking their work makes the world a better place.

Impact of providing compassion on job performance and mental health: The moderating effect of interpersonal relationship quality
Chu LC.   J Nurs Scholarsh. 2017 May 31.
A two-stage survey was completed by 235 registered nurses employed by hospitals in Taiwan. Researchers found that when nurses are frequently willing to listen, understand, and help their suffering colleagues, job performance and mental health improves for those providing the compassion.

Warm communication style strengthens expectations and increases perceived improvement
He X, Sun Q, Stetler C.    Health Commun. 2017 May 25:1-7.
Eighty-nine healthy adults were randomly assigned to interact with a trainer with either a warm or a neutral communication style. Participants in the warm condition had significantly higher expectations of treatment effects and reported more improvement in their performance (though no actual improvement was observed). These results shed light on the importance of nonverbal communication in strengthening expectations and increasing subjective improvement.

Brandy King, MLIS

Head of Information Services

Provides research services for staff; creates resources on humanism and medicine; and maintains the Foundation’s website, blog and social media presence.