Jeffrey Silver Humanism in Healthcare Research Roundup – January 2018

A portrait of a mixed race college asia student at campus in library and read a bookThe 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

Changes in humanism during medical school: A synthesis of the evidence
Buck E, Holden M, Szauter K.     Med.Sci.Educ. (2017) 27: 887.
This study was supported by a Mapping the Landscape grant.
Authors conducted a systematic review of longitudinal studies of medical students to examine whether components of humanism change over time in medical students. Results from the review of 48 studies showed that studies with longer duration were more likely to report negative change over time.

Integrating patient-centered electronic health record communication training into resident onboarding: Curriculum development and post-implementation survey among housestaff
Alkureishi MA, Lee W, Webb S, Arora V.     JMIR Med Educ 2018;4(1):e1
This study was supported by a Mapping the Landscape grant.
Authors developed and delivered mandatory patient-centered EHR training to all incoming housestaff at the University of Chicago.  Self-perceived pre- versus post-training knowledge of barriers, best practices, and ability to implement patient-centered EHR skills significantly increased (3.1 vs 3.9, P<.001 for all). Most felt training was effective (90.5%), should be required (86.7%), and would change future practice as a result (70.9%).

Experience of touch in health care: A meta-ethnography across the health care professions
Kelly MA, Nixon L, McClurg C, Scherpbier A, King N, Dornan T.    Qual Health Res. 2018 Jan;28(2):200-212.
This study was supported by a Mapping the Landscape grant.
Though different professionals have reported their practices around touch in health care, what is currently lacking is a well-theorized, interprofessional synthesis. Authors systematically identified 41 studies across seven health professions and completed a meta-ethnographic line-of-argument synthesis. They found that health professionals connect physically with patients in ways that form strong relationships while also managing the risk that is inherent in such an intimate form of connection.

A brief instrument to assess both burnout and professional fulfillment in physicians: Reliability and validity, including correlation with self-reported medical errors, in a sample of resident and practicing physicians
Trockel M, Bohman B, Lesure E, Hamidi MS, Welle D, Roberts L, Shanafelt T.    Acad Psychiatry. 2017 Dec 1.
Dr. Shanafelt is a Mapping the Landscape grantee.
Researchers aimed to evaluate the Professional Fulfillment Index (PFI), a 16-item instrument to assess physicians’ professional fulfillment and burnout. Two hundred and fifty physicians completed the PFI, along with a measure of self-reported medical errors, the Maslach Burnout Inventory (MBI), the World Health Organization’s abbreviated quality of life assessment (WHOQOL-BREF), and PROMIS short-form depression, anxiety, and sleep-related impairment scales. Results showed that principal components analysis justified PFI subscales for professional fulfillment, work exhaustion, and interpersonal disengagement.

Other Publications

The complexity of empathy during medical school training: Evidence for positive changes
Smith KE, Norman GJ, Decety J.   Med Educ. 2017 Nov;51(11):1146-1159.
Previous studies suggest that empathy declines during medical training. However, this past research relied on a single self-report measure of empathy. In this study, authors assessed empathy using both the Jefferson Scale of Physician Empathy (JSPE) and the Questionnaire of Cognitive and Affective Empathy (QCAE). Results showed that students’ empathy assessed by the JSPE decreased over training. However, on the QCAE, aspects of students’ empathy, specifically overall cognitive empathy and its subcomponent perspective taking, and the emotion contagion subcomponent of affective empathy improved, whereas the remaining subcomponents remained stable.

Medical school factors associated with changes in implicit and explicit bias against gay and lesbian people among 3492 graduating medical students
Phelan SM, Burke SE, Hardeman RR, White RO, Przedworski J, et al.    J Gen Intern Med. 2017 Nov;32(11):1193-1201.

4,700+ medical students from 49 U.S. medical schools were surveyed in their first and fourth years about their formal curriculum, role modeling, diversity climate, and contact with sexual minorities. Researchers found that lower explicit bias against gay men and lesbian women was associated with more favorable contact with LGBT faculty, residents, students, and patients, and perceived skill and preparedness for providing care to LGBT patients. Greater implicit bias was associated with more faculty role modeling of discriminatory behavior.

National landscape of interventions to improve pediatric resident wellness and reduce burnout (free full text)
Wilson PM, Kemper KJ, Schubert CJ, Batra M, Staples BB, Serwint JR, McClafferty H, Mahan JD; Pediatric Resident Burnout and Resilience Study Consortium (PRBRSC)..
Acad Pediatr. 2017 Nov – Dec;17(8):801-804.
In a cross-sectional electronic survey of 101 pediatric residency program directors in the United States and Canada, researchers found that 98% had interventions in place aimed at reducing burnout and improving wellness, but most were not evidence based.  Less than half of the program directors reported formal assessment of trainee wellness and burnout outcome measures. Most programs directors reported one or more barriers to providing wellness activities, including inadequate time, inadequate faculty expertise/availability and inadequate money as the top three.

Effect of meaningful recognition on critical care nurses’ compassion fatigue
Kelly LA, Lefton C.    Am J Crit Care. 2017 Nov;26(6):438-444. doi: 10.4037/ajcc2017471.
A quantitative, descriptive online survey was completed by 726 intensive care unit nurses in 14 hospitals with an established meaningful recognition program and 410 nurses in 10 hospitals without such a program. Researchers found that meaningful recognition was a significant predictor of decreased burnout and increased compassion satisfaction.

Medical humanities teaching in North American allopathic and osteopathic medical schools
Klugman CM.   J Med Humanit. 2017 Nov 7.
One hundred and thirty-four medical schools completed an 18-question, semi-structured survey about required and elective humanities content, hours of humanities instruction, types of disciplines, participation rates, and humanities administrative structure. Results showed that 70% of schools require humanities work and 80% offer electives in humanities. Schools with a formal humanities structure have a greater humanities presence in the curriculum and humanities courses are taken by more students.

The role of emotion in clinical decision making: An integrative literature review (free full text)
Kozlowski D, Hutchinson M, Hurley J, Rowley J, Sutherland J.    BMC Med Educ. 2017 Dec 15;17(1):255.
Authors conducted a literature review to identify and synthesize the empirical evidence for the role of emotion in clinical decision making. Through a synthesis of 23 papers, authors found that clinicians’ experienced emotions can and do affect clinical decision making, but that this occurs in the absence of a clear theoretical framework.

Brandy King, MLIS

Head of Information Services

Provides research services for staff, maintains resources on humanism and healthcare and works closely with Research Institute grantees.