Jeffrey Silver Humanism in Healthcare Research Roundup – February 2017

Young brunette woman student trainee or employee smiling while choosing the right book or file from the shelf of an office or a learning library portrait

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

Addressing physician burnout: The way forward (free full text)
Shanafelt TD, Dyrbye LN, West CP.    JAMA. 2017 Feb 9. 
All three authors are Mapping the Landscape, Journeying Together grantees.
Burnout is a syndrome of exhaustion, cynicism, and decreased effectiveness at work. Current estimates suggest that the prevalence of burnout among practicing physicians in the United States exceeds 50%. Substantive progress can be made with a coordinated effort to address this issue at the national and state, organization, leader, and individual levels.

Training internal medicine residents in social medicine and research-based health advocacy: A novel, in-depth curriculum
Basu G, Pels RJ, Stark RL, Jain P, Bor DH, McCormick D.    Acad Med. 2017 Jan 31.
Dr. Basu is a Mapping the Landscape, Journeying Together grantee.
The authors describe the structure, content, and goals of a residency-required course on social medicine and research-based health advocacy. In each of the four years since the course was required, all scholarly work from the course has been presented at conferences by 31 resident presenters and/or coauthors. The course seems to enhance the residency program’s capacity to recruit high-caliber residents and faculty members.

Effect of a patient-centered communication intervention on oncologist-patient communication, quality of life, and health care utilization in advanced cancer: The VOICE randomized clinical trial
Epstein RM, Duberstein PR, Fenton JJ, Fiscella K, et al.    JAMA Oncol. 2017 Jan 1;3(1):92-100.
Dr. Epstein is a Mapping the Landscape, Journeying Together grantee.
38 oncologists and 265 adult cancer patients participated in a cluster randomized trial where both groups received individualized communication training focused on engaging patients in consultations, responding to emotions, informing patients about prognosis and treatment choices, and balanced framing of information. The training was effective in improving patient-centered communication but did not affect the patient-physician relationship, quality of life, or whether patients used aggressive treatment or hospice at the end of life.

Other Publications

The impact of administrative burden on academic physicians: Results of a hospital-wide physician survey
Rao SK, Kimball AB, Lehrhoff SR, Hidrue MK, et al.    Acad Med. 2017 Feb;92(2):237-243.
Over 1,700 physicians participated in a survey about their administrative work. On average, 24% of working hours were spent on administrative duties. Data showed that administrative duties required an average of 24% of physicians’ time and affected physicians’ perceptions of being able to deliver high-quality care, career satisfaction, burnout, and likelihood to continue clinical practice.

International study of medical school learning environments and their relationship with student well-being and empathy
Tackett S, Wright S, Lubin R, Li J, Pan H.    Med Educ. 2017 Mar;51(3):280-289.
400 medical students in Israel, Malaysia and China took part in a cross-sectional survey that used the Johns Hopkins Learning Environment Scale, the Jefferson Empathy Scale and measures of well-being. Data showed that students’ perceptions of the learning environment are closely associated with their well-being. Across the three settings, a perception of the learning environment and empathy were not closely related, suggesting that any influence of learning environment on empathy would be modest.

Disparities in patient- and family-centered care during us children’s health care encounters: A closer examination
Bleser WK, Young SI, Miranda PY.   Acad Pediatr. 2017 Jan – Feb;17(1):17-26.
This study examined data from over 22,000 children. Overall, 95%+ of families received patient- and family-centered care. However, lower prevalence of this kind of care was consistently observed among publicly insured children (relative to the privately insured) and children living in families below the poverty line.

Rethinking empathy decline: Results from an OSCE
Teng VC, Nguyen C, Hall KT, Rydel T, et al.    Clin Teach. 2017 Feb 6.
129 medical students in their first or second year of clinical clerkships completed an OSCE that was directly observed by trained faculty staff, who used the Measure of Patient-Centered Communication (MPCC) instrument to measure empathic behaviors. Findings suggest a discrepancy between self-administered empathy scores and observed empathic behaviors.  But observed empathic behaviors were not lower in the second compared with the first year of clerkship training.