New research on medical professionalism and the teaching of humanism

Portrait of young doctorThis post is part of The Arnold P. Gold Foundation’s series of “Research Roundups” — a monthly list of recently published research on humanism in medicine.  If you would like to be notified each time a Research Roundup is published, send an email to bking@gold-foundation.org with the subject line “Subscribe RR”.

Medical professionalism: An experimental look at physicians’ Facebook profiles
Clyde JW, Domenech Rodríguez MM, Geiser C.    Med Educ Online. 2014;19:23149.

Researchers asked 250 students to rate 6 different Facebook profiles of medical professionals. Profiles that contained healthy behavior were rated as most professional followed by profiles with strictly professional content. Female profiles consistently received higher professionalism ratings than male profiles.

Professionalism and maintenance of certification: Using vignettes describing interpersonal dilemmas to stimulate reflection and learning
Bernabeo EC, Reddy SG, Ginsburg S, Holmboe ES.    J Contin Educ Health Prof. 2014 Apr;34(2):112-22.
120 physicians responded to a variety of professionalism dilemmas.  Their responses showed the high level of consideration that is given to making decisions including reflection about patient welfare; types of patients; political, ethical, or legal issues; guiding principles; values; rules; and habits.

Development of a professionalism committee approach to address unprofessional medical staff behavior at an academic medical center
Speck RM, Foster JJ, Mulhern VA, Burke SV, Sullivan PG, Fleisher LA.    Jt Comm J Qual Patient Saf. 2014 Apr;40(4):161-7.
The University of Pennsylvania Health System (UPHS) has established a Professionalism Committee (PC) at each of the three large teaching hospitals. Of 79 resolved cases over 3 years, 30 involved interpersonal issues, and 2 were associated with poor clinical outcomes. One key feature of the UPHS approach is early identification of the role of behavioral health issues in unprofessional behavior (as opposed to physical, cognitive, or systems issues).

Twelve tips on teaching and learning humanism in medical education
Cohen LG, Sherif YA.    Med Teach. 2014 Jun 26:1-5.

The authors’ review of the literature about the teaching of humanistic values resulted in 12 practical tips. Humanistic values can be incorporated into all stages of learning: formal preclinical environments, the transition into clinical settings, medical curricula and clinical clerkships.

Development and initial psychometric properties of the Barriers to Physician Compassion questionnaire
Fernando AT 3rd, Consedine NS.    Postgrad Med J. 2014 Jul;90(1065):388-95.

A 34 item Barriers to Physician Compassion (BPC) questionnaire was administered to 372 physicians. Analysis revealed the presence of four distinct factors: physician burnout/overload, external distractions, difficult patient/family and complex clinical situation. These barriers illuminate potential targets for future self- and practice management, interventions and compassion training among physicians.

An estimate of the cost of burnout on early retirement and reduction in clinical hours of practicing physicians in Canada
Dewa CS, Jacobs P, Thanh NX, Loong D.    BMC Health Serv Res. 2014 Jun 13;14:254.
Using an economic model, the total cost of burnout for all physicians practicing in Canada is estimated to be $213.1 million ($185.2 million due to early retirement and $27.9 million due to reduced clinical hours). Family physicians accounted for 58.8% of the burnout costs, followed by surgeons for 24.6% and other specialists for 16.6%.

Determinants of physician empathy during medical education: Hypothetical conclusions from an exploratory qualitative survey of practicing physicians
Ahrweiler F, Neumann M, Goldblatt H, Hahn EG, Scheffer C.    BMC Med Educ. 2014 Jun 22;14(1):122.
Forty-two physicians took part in a qualitative survey about factors that promoted or inhibited their development of empathy . Six themes emerged:  1. In general, medical education does not promote the development of empathy. 2. Recognizing the psycho-social dimensions of care fosters empathy. 3. Interactions with patients in medical practice promote empathy. 4. Reflective practice helps the development of empathy. 5. Role-modeling of colleagues can both promote and inhibit empathy. 6. Stress, time pressure, and adverse working conditions are detrimental to empathy development.

Research from Gold-Related Researchers

Faculty development to enhance humanistic teaching and role modeling: A collaborative study at eight institutions
Branch WT Jr, Chou CL, Farber NJ, Hatem D, Keenan C, et al.    J Gen Intern Med. 2014 Jun 20.
This article was authored by William Branch, member of the Strategic Planning Task Force for The Arnold P. Gold Foundation Research Institute.  Groups of 7-9 participants at 8 academic medical centers completed an 18-month faculty development program that combined experiential learning of teaching skills with critical reflection. Results showed that this intervention likely enhances humanistic teaching and role modeling.

How to integrate the electronic health record and patient-centered communication into the medical visit: a skills-based approach
Duke P, Frankel RM, Reis S.     Teach Learn Med. 2013;25(4):358-65.

This article was authored by Richard Frankel, member of the Strategic Planning Task Force for The Arnold P. Gold Foundation Research Institute.   Authors conducted a literature search on use of communication skills when interfacing with the EHR. They observed an instructional gap and developed a model that integrates patient-centered interview skills and aims to empower physicians to remain patient centered while effectively using EHRs.

BrandyKingThis post was written by Brandy King, MLIS  – Head of Information Services at The Arnold P. Gold Foundation Research Institute.

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