Humanism in Medicine Research Roundup — March 2015


This 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

The role of the hidden curriculum in “on doctoring” courses
Hafferty FW, Gaufberg EH, O’Donnell JF.     Virtual Mentor. 2015 Feb 1;17(2):130-9
Elizabeth Gaufberg, Director of the Arnold P. Gold Foundation Research Institute, co-authored this paper about courses often titled “On Doctoring” which teach skills such as patient interviewing, physical diagnosis and exam, clinical reasoning, and developing the doctor-patient relationship. Authors examine what happens when a gulf exists between the “ideals” being taught within such courses and the “reality” that students encounter when they circulate to other courses and “actual” clinical settings.

Rutberg PC, Gaufberg, EH. (2015) “Medical Student Narratives and the Hidden Curriculum” in The Hidden Curriculum in Health Professional Education, Hafferty FW, O’Donnell, JF. Dartmouth College Press: Hanover, NH.
Elizabeth Gaufberg, Director of the Arnold P. Gold Foundation Research Institute, contributed to the first full-length book to examine the history, theory, methodology and application of hidden curriculum theory to health professional education. 

Other New Publications

Patients report better satisfaction with part-time primary care physicians, despite less continuity of care and access
Panattoni L, Stone A, Chung S, Tai-Seale M.    J Gen Intern Med. 2015 Mar;30(3):327-33.
In a study of 205 primary care physicians (PCPs), physician FTE was directly associated with better continuity of care and better access to care, but worse patient satisfaction scores. PCP’s who chose to work fewer clinical hours were rated worse on continuity and access, but higher on patient satisfaction.

Overcoming challenges to teamwork in patient-centered medical homes: A qualitative study
O’Malley AS, Gourevitch R, Draper K, Bond A, Tirodkar MA.   J Gen Intern Med. 2015 Feb;30(2):183-92.
Staff from 27 primary care practices designated at patient-centered medical homes were interviewed about how they overcame teamwork challenges. Results showed that successful teams incrementally delegated non-clinical tasks away from physicians; expanded the roles of medical assistants and nurses; and included staff in workflow redesign. Teams that were supported with resources, system support, and data feedback reported improved provider satisfaction and productivity.

Clinically relevant correlates of accurate perception of patients’ thoughts and feelings
Hall JA, Ship AN, Ruben MA, Curtin EM, et al.    Health Commun. 2015 May;30(5):423-9.
Between 2010 and 2012, four groups of participants (nursing students, medical students, internal medicine residents, and undergraduate students) took a test of accuracy in understanding the thoughts and feelings of patients who were videorecorded during their actual medical visits and who afterward reviewed their video to identify their thoughts and feelings as they occurred. Data showed that accuracy in understanding patients’ thoughts and feelings was significantly correlated with nursing students’ clinical course experience, clinicians’ favorable attitudes to psychosocial discussion, standardized patients’ evaluations of medical students’ interpersonal skill, and independent coding of medical students’ patient-centered behavior while taking a social history.

A cluster randomized trial of interventions to improve work conditions and clinician burnout in primary care: Results from the Healthy Work Place (HWP) study
Linzer M, Poplau S, Grossman E, Varkey A, et al.  J Gen Intern Med. 2015 Feb 28.

In this cluster randomized control trial, researchers worked with 135 physicians in the Midwest and New York City to see if improvements in work conditions could improve clinician stress and burnout. Three types of interventions were assessed: improved communication, changes in workflow, and targeted quality improvement (QI) projects. The study showed that burnout, dissatisfaction and retention were more likely to improve when any of these interventions took place.

What factors promote resilience and protect against burnout in first-year pediatric and medicine-pediatric residents?
Olson K, Kemper KJ, Mahan JD.    J Evid Based Complementary Altern Med. 2015 Feb 18.

Researchers administered surveys to a cross-section of 45 first-year pediatric and medicine-pediatric residents. A minority (40%) of residents met one or more criteria for burnout. Physician empathy and emotional intelligence were not significantly correlated with burnout or resilience. Self-compassion and mindfulness were positively associated with resilience and inversely associated with burnout.

Emotional exhaustion and workload predict clinician-rated and objective patient safety
Welp A, Meier LL, Manser T.    Front Psychol. 2014;5:1573.
Researchers used regression analysis to investigate the effect of burnout on 1425 intensive care physicians and nurses. Data showed that patient mortality was predicted by emotional exhaustion of the healthcare staff and length of stay was predicted by workload. Burnout did not predict length of stay.


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