Jeffrey Silver Humanism in Healthcare Research Roundup – May 2017

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

How do patients experience caring? Scoping review
Gillespie H, Kelly M, Duggan S, Dornan T.   Patient Educ Couns. 2017 Mar 31.
Drs. Kelly and Dornan are Mapping the Landscape, Journeying Together grantees 
Authors reviewed 43 articles from nursing, medicine and physiotherapy that reported patients’ lived experiences of caring and contrasted uncaring experiences. Patients experienced caring when competent professionals displayed positive attitudes, communicated effectively, formed relationships, helped them navigate clinical services, and engaged emotionally. This research describes patients’ experiences that can prepare all health professionals to be caring in collaborative, interprofessional practice.

Impact of a video-based interactive workshop on unprofessional behaviors among internal medicine residents
Didwania A, Farnan JM, Icayan L, O’Leary KJ, Saathoff M, Bellam S, Humphrey HJ, Wayne DB, Arora VM.    J Grad Med Educ. 2017 Apr;9(2):241-244.
Dr. Arora is a Mapping the Landscape, Journeying Together grantee 
Authors conducted a pre-post survey study of 181 residents at 3 internal medicine residency programs. The residents received a workshop related to identifying unprofessional behaviors related to on-call etiquette: “blocking” an admission, disparaging a colleague, and misrepresenting a test as urgent. The results of the study showed that this workshop changed some perceptions and lowered some participation in some unprofessional behaviors.

Speaking up about traditional and professionalism-related patient safety threats: A national survey of interns and residents
Martinez W, Lehmann LS, Thomas EJ, Etchegaray JM, Shelburne JT, Hickson GB, Brady DW, Schleyer AM, Best JA, May NB, Bell SK.    BMJ Qual Saf. 2017 Apr 25.
Dr. Bell is one of our Gold Professors.
Researchers examined 1800 interns’ and residents’ experiences, attitudes and factors associated with speaking up about traditional versus professionalism-related safety threats. Interns and residents commonly observed unprofessional behaviour yet were less likely to speak up about it compared with traditional safety threats even when they perceived high potential patient harm.

REMAP: A framework for goals of care conversations
Childers JW, Back AL, Tulsky JA, Arnold RM.   J Oncol Pract. 2017 Apr 26:JOP2016018796.
Dr. Back is a Mapping the Landscape, Journeying Together grantee 
The authors developed a framework with a mnemonic, REMAP: Reframe, Expect emotion, Map out patient goals, Align with goals, and Propose a plan. The processes underlying REMAP encourage clinicians to seek to understand and remain flexible, adapting their recommendations to what they hear from the patient, with ongoing revision based on the shared decision-making process.

The healing power of paint
Toll E, Melfi BS.  JAMA. 2017 Mar 21;317(11):1100-1102.
Dr. Toll is a recipient of an APGF mentoring grant
An urban residency clinic was moving to a new space and staff were asked to oversee the art to decorate it. They allowed patients to decorate tiles with pictures of their face or other meaningful symbols, thereby depicting their varied ages and backgrounds. 500 tiles were made in all and families stated how much they enjoyed working together to create their projects.

Other Publications

Electronic health record logs indicate that physicians split time evenly between seeing patients and desktop medicine
Tai-Seale M, Olson CW, Li J, Chan AS, Morikawa C, Durbin M, Wang W, Luft HS.    Health Aff (Millwood). 2017 Apr 1;36(4):655-662.

Authors used data captured by the access time stamp functionality of 31 million electronic health record (EHR) transactions over the course of 2011-2014 to examine physician work effort. Results showed that each day physicians logged an average of 3.08 hours on office visits and 3.17 hours on desktop medicine (communicating with patients through a secure patient portal; responding to patients’ online requests for prescription refills or medical advice; ordering tests etc). Over time, log records from physicians showed a decline in the time allocated to face-to-face visits, accompanied by an increase in time allocated to desktop medicine.

The power of empathy in the classroom
Franzese, PA.    Seton Hall Law Review. 2017; 47(693).
When instructors teach empathy, they unleash empathy in their students’ learning pathways, allowing both cognitive and emotional aptitudes to align. Empathy cultivates proximity to the “other,” thereby reminding students that the burdens of their own struggles do not relieve them of the responsibility to see others in theirs and find common ground.

Can self-compassion promote healthcare provider well-being and compassionate care to others? Results of a systematic review
Sinclair S, Kondejewski J, Raffin-Bouchal S, King-Shier KM, Singh P.   Appl Psychol Health Well Being. 2017 Apr 10.
Researchers conducted a meta-narrative review of 69 studies about self-compassion in healthcare providers. They found that the construct of self-compassion in healthcare has significant limitations. Empirical studies use the Self-Compassion Scale, which is criticised for its psychometric and theoretical validity. Therapeutic interventions purported to cultivate self-compassion may have a broader effect on general affective states. An alleged outcome of self-compassion is compassionate care; however, we found no studies that included patient reports on this primary outcome.

Student-derived solutions to address barriers hindering reports of unprofessional behaviour
Kohn JR, Armstrong JM, Taylor RA, Whitney DL, Gill AC.    Med Educ. 2017 Apr 18.
Authors surveyed 272 students in their clinical years about barriers to reporting unprofessional behavior. They found that students are unlikely to report a violation unless it is a serious breach of professionalism. Student-derived solutions included simplified reporting, control over report release date, improved feedback to reporters, training for real-time resolution of concerns and a neutral resource to help students triage concerns.

The art of medicine: Arts-based training in observation and mindfulness for fostering the empathic response in medical residents
Zazulak J, Sanaee M, Frolic A, Knibb N, Tesluk E, Hughes E, Grierson LEM.    Med Humanit. 2017 Apr 27.
Authors conducted a prospective cohort study exploring the impact of a course in arts-based visual literacy and mindfulness practice (Art of Seeing) on the empathic response of residents. Results indicated that participants improved in self-confidence and communication relative to a group of control participants  but the majority of the psychometric measures did not reveal differences between groups over the duration of the programme. Thematic qualitative analysis of interview data revealed that the programme had a positive impact on the participants’ perceived empathy towards colleagues and patients and on the perception of personal and professional well-being.