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
Silent witnesses: Faculty reluctance to report medical students’ professionalism lapses
Ziring D, Frankel RM, Danoff D, Isaacson JH, Lochnan H. Acad Med. 2018 Feb 27.
Drs. Ziring, Frankel, Danoff and Isaacson are Mapping the Landscape grantees
Researchers investigated why physicians were hesitant to report lapses in the professionalism of medical students. Over 180 physicians participated, and the four themes rated highest as perceived barriers were: “uncertainty about the process,” “ambiguity about the facts,” “effects on the learner,” and “time constraints,” demonstrating that faculty face challenges at both the systems level and individual level.
Adaptive reinventing: Implicit bias and the co-construction of social change
Sukhera J, Milne A, Teunissen PW, Lingard L, Watling C. Adv Health Sci Educ Theory Pract. 2018 Feb 17.
Drs. Sukhera, Lingard and Watling are Mapping the Landscape grantees
Researchers sought to explore how individuals and the workplace learning environment interact once students are made aware of implicit biases. They conducted multiple longitudinal interviews with physician and nurse participants over 12 months. Results suggest that implicit bias recognition provokes dissonance among participants, leading to frustration and critical questioning of workplace constraints. Once awareness is triggered, participants began reflecting on their biases and engaging in explicit behavioral changes that influenced the perception of structural changes within the learning environment itself. Collaboration, communication and role modeling within teams appeared to facilitate the process.
Beyond catharsis: The nuanced emotion of patient storytellers in an educational role
Roebotham T, Hawthornthwaite L, Lee L, Lingard LA. Med Educ. 2018 Feb 12.
Dr. Lingard is a Mapping the Landscape grantee
Researchers conducted semi-structured interviews with 25 patients involved in a storytelling curriculum as part of hospital staff continuing education. Participants described the central role of emotions in their storytelling experience, which varied from 1 to 25 tellings over a period of 1 month to 2 years. These emotions were shaped by the passage of time, repetition of storytelling and audience acknowledgement. However, emotion remained unpredictable and had lingering implications for storytellers’ vulnerability.
Developing a pilot curriculum to foster humanism among graduate medical trainees (Free full text)
Dotters-Katz SK, Chuang A, Weil A, Howell JO. J Educ Health Promot. 2018 Jan 10;7:2.
Dr. Weil is a Mapping the Landscape grantee
Researchers conducted a qualitative analysis of residents’ narratives regarding challenges to humanistic behavior and identified themes of compassion, fatigue, communication challenges, and work-life balance. They used these themes to build a humanism curriculum. The ten participants who completed the curriculum showed decreased burnout and improved compassion scores.
Shared decision-making during inpatient rounds: Opportunities for improvement in patient engagement and communication
Blankenburg R, Hilton JF, Yuan P, Rennke S, Monash B, Harman SM, et al. J Hosp Med. 2018 Feb 5.
Dr. Harman is a Gold Professor
Researchers conducted a 12-week study of 35 inpatient teams’ shared-decision making behaviors during rounds followed by semistructured patient interviews. The most frequently observed behaviors across all services included explaining the clinical issue and matching medical language to the patient’s level of understanding. The least frequently observed behaviors included checking understanding of the patient’s point of view, examining barriers to follow-through, and asking if the patient has any questions.
Exploring patient-centeredness: The relationship between self-reported empathy and patient-centered communication in medical trainees
LaNoue MD, Roter DL. Patient Educ Couns. 2018 Jan 29. pii: S0738-3991(18)30038-7.
This study was supported by a grant from the Gold Foundation Research Institute
Researchers wanted to explore the relationships between self-reported empathy and the patient-centered communication patterns of physician trainees. Eighty-four third-year medical students completed the Jefferson Scale of Empathy (JSE – student version) and had recordings of a single Objective Structured Clinical Examination analyzed using the Roter Interactional Analysis System (RIAS). Analyses revealed that the relationship between student expressions of emotional responsiveness and predicted self-reported empathy provides concurrent validation evidence for the JSE.
Empathy variation in general practice: A survey among general practitioners in Denmark (free full text)
Charles JA, Ahnfeldt-Mollerup P, Søndergaard J, Kristensen T. Int J Environ Res Public Health. 2018 Mar 2;15(3). pii: E433.
Four hundred sixty-four Danish general practitioners (GPs) responded to a survey containing the Danish version of the Jefferson Scale of Empathy for Health Professionals (JSE-HP) and questions related to their demographic, professional and job satisfaction characteristics. Odds of having a high empathy score were higher for GPs who stated that the physician-patient relationship and interaction with colleagues has a high contribution to job satisfaction. In contrast, high contribution of economic profit and prestige did not contribute to increased odds of having a high empathy score.
Mindful self-care and secondary traumatic stress mediate a relationship between compassion satisfaction and burnout risk among hospice care professionals
Hotchkiss JT. Am J Hosp Palliat Care. 2018 Jan 1:1049909118756657.
Researchers conducted a cross-sectional self-report survey of 324 hospice care professionals. Analysis showed that hospice care professionals had higher self-care and compassion satisfaction and lower secondary traumatic stress and burnout compared to published norms. Those who engaged in multiple and frequent self-care strategies experienced higher professional quality of life.
The cost of caring: An exploration of compassion fatigue, compassion satisfaction, and job satisfaction in pediatric nurses
Roney LN, Acri MC. J Pediatr Nurs. 2018 Feb 2. pii: S0882-5963(17)30447-5.
Three hundred eighteen members of the Society of Pediatric Nurses took part in a study where they responded to a demographic questionnaire, the Job Satisfaction Survey (JSS) and the Professional Quality of Life (ProQOL) measure. The majority of nurses had high levels of compassion satisfaction and job satisfaction; further, female gender was associated with higher levels of compassion satisfaction. Over 75% of respondents were second-career nurses and overall, this population had higher levels of compassion satisfaction than first-career nurses.
Patient-centeredness as physician behavioral adaptability to patient preferences
Carrard V, Mast MS, Jaunin-Stalder N, Perron NJ, Sommer J. Health Communication. 2018 Mar 3. p593-600.
Two hundred forty-four patients indicated their preferences for physician interaction style before a consultation and filled in a questionnaire after their appointments. Researchers coded the verbal and nonverbal behavior of 61 participating physicians for each appointment and compared them to the patients’ preferences to obtain a measure of physician behavioral adaptability. Results showed that female physicians who adapted their nonverbal (but not their verbal) behavior had patients who reported more positive consultation outcomes.