Humanism in Medicine Research Roundup — May 2015

booksThis post is part of our series of Research Roundups — a list of recently published studies on humanism in medicine. If you would like to be notified each time a Research Roundup is published, send an email to with the subject line “Subscribe RR”.

Publications from Gold Foundation-Affiliated Authors

Transparency when things go wrong: Physician attitudes about reporting medical errors to patients, peers, and institutions
Bell SK, White AA, Yi JC, Yi-Frazier JP, Gallagher TH.    J Patient Saf. 2015 Feb 24.
Sigal Bell, MD is a Gold Professor.
Researchers analyzed over 3,000 physician responses to a survey about medical error communication. Those who were likely to support transparent communication with patients and peers/institution included females, US (vs Canadian) doctors, those in academic (vs private) practice, those who believe that disclosure decreased likelihood of litigation, and those who believe that system changes occur after error reporting. In comparison, doctors who believed that disclosure would decrease patient trust were less likely to agree with error disclosure to patients.

A systematic review and meta-analysis of meditative interventions for informal caregivers and health professionals
Dharmawardene M, Givens J, Wachholtz A, Makowski S, Tjia J.    BMJ Support Palliat Care. 2015 Mar 26.
This paper is part of our Mapping the Landscape project.
Researchers performed a systematic review of 27 randomized clinical trials and pre-post intervention studies with meditative interventions for caregivers. Controlled trials of informal caregivers showed statistically significant improvement in depression, anxiety, stress  and self-efficacy, at an average of 8 weeks following intervention initiation. Controlled trials of health professionals showed improved emotional exhaustion, personal accomplishment, and life satisfaction at an average of 8 weeks following intervention initiation.

Essential steps in developing best practices to assess reflective skill: A comparison of two rubrics
Miller-Kuhlmann R, O’Sullivan PS, Aronson L.    Med Teach. 2015 Apr 29:1-7.
Louise Aronson, MD MFA is a Gold Professor.
Researchers evaluated the two reflection assessment rubrics used in medical education: the holistic, reflection theory-based Reflection-on-Action and the analytic REFLECT developed from both reflection and narrative-medicine literatures. After trained raters used each rubric to score 56 student reflections, they found that Reflection-on-Action is easier to use for measuring overall quality, and that training on REFLECT takes longer but yields detailed data on multiple dimensions of reflection.

Reclaiming a theoretical orientation to reflection in medical education research: A critical narrative review
Ng SL, Kinsella EA, Friesen F, Hodges B.    Med Educ. 2015 May;49(5):461-75.
Stella Ng, PhD is the recipient of an APGF Research Grant.
Researchers argue that some of the common ways in which reflection has been applied are influenced by broader discourses of assessment and evidence, and divorced from original theories of reflection and reflective practice. Using a critical narrative approach they present two theoretical lenses of reflection followed by a summary of relevant literature, then compare the trends to the theoretical lenses.

Tasking the “self” in the self-governance of medicine
Cohen JJ.    JAMA. 2015 May 12;313(18):1839-40.
Jordan J. Cohen, MD is the Chairman of the APGF Board of Trustees.
In the U.S., there are three types of mechanisms governing interactions between doctors and patients: regulation through private sector organizations; governmental regulation; and personal self-regulation. The author argues that “sustaining public trust in the profession is ultimately the responsibility of individual physicians” whose motivation is bolstered by humanism in medicine.

A piece of my mind: Back to the heart of the matter
Toll E.    JAMA. 2015 May 12;313(18):1829-30.    
Elizabeth Toll, MD is a recipient of an APGF mentoring grant.
The author describes why and how she went from treating patients’ physical health only to also treating their emotional health.

The forthcoming June 2015 issue of Academic Medicine is a theme issue on professional identity formation. The issue was co-edited by Hedy Wald, PhD, one of our Gold Humanism Scholars. Several papers are already out online ahead of print including:

Other publications

Interventions to cultivate physician empathy: A systematic review
Kelm Z, Womer J, Walter JK, Feudtner C.    BMC Med Educ. 2014 Oct 14;14:219.
Researchers performed a systematic review of literature regarding interventions that were quantitatively evaluated to detect changes in empathy among medical students, residents, fellows and physicians. After qualitatively synthesizing the findings of 64 studies, they found that 8 of the 10 studies with highly rigorous designs showed that targeted interventions did increase empathy. The remainder of the studies were inadequately designed.

How patient-centered do female physicians need to be? Analogue patients’ satisfaction with male and female physicians’ identical behaviors
Hall JA, Roter DL, Blanch-Hartigan D, Mast MS, Pitegoff CA.    Health Commun. 2015 Sep;30(9):894-900.
Researchers conducted an experiment where two male and two female actors portrayed physicians speaking to a patient using high or low patient-centered scripts while not varying their nonverbal cues. 192 students watched videos of these interactions and rated their satisfaction with the physician. Researchers found that high verbal patient-centered behavior by female physicians is not recognized as a marker of clinical competence, as it is for male physicians, but is rather seen as expected female behavior.

A mapping of people’s positions regarding the breaking of bad news to patients
Igier V, Muñoz Sastre MT, Sorum PC, Mullet E.    Health Commun. 2015 Jul;30(7):694-701.
Researchers surveyed 50 nursing professionals and 140 adults who had in the past received bad medical news or whose elderly relatives had in the past received bad news. These participants indicated the acceptability of physicians’ conduct in 72 vignettes of giving bad news to elderly patients. Researchers found four qualitatively different positions about how much truth should be told to patients.

BrandyKing-150x150This post was written by Brandy King, Head of Information Services at The Arnold P. Gold Foundation Research Institute