The Gold Foundation is pleased to introduce Nora Jones, PhD, a Consulting Bioethicist and new editor of the Jeffrey Silver Humanism in Healthcare Research Roundup.
Dr. Jones earned her PhD in anthropology from Temple University in 2002 and moved into the bioethics space first as a Senior Fellow at the Center for Bioethics and the Director of Graduate Studies in the Department of Medical Ethics at the University of Pennsylvania. She then moved back to Temple University to co-found and serve as the Director of the MA in Urban Bioethics program. She has given over 40 talks nationally and has over 30 publications; her scholarship focuses on embodiment theory, urban bioethics, critical social science, and the public understanding of science and medicine. She’s recently left academia and, in addition to her work with the Gold Foundation, has moved to the philanthropic space where she is supporting organizations that foster the capacity for health in the lives of children and their families and communities.
Learn more: 8 Questions with Dr. Nora Jones.
As I write this, medical and nursing students are doing final edits on their submissions to the 2025 Arnold P. Gold Foundation’s Dr. Hope Babette Tang Humanism in Healthcare Essay Contest. They were prompted to reflect on Dr. Gold’s statement that “Of all the tools in my medical bag, the most important of all is not in the bag itself — it’s my ears, to listen to the patient.”
In taking on the stewardship of the Jeffrey Silver Humanism in Healthcare Research Roundup, I am struck by the symmetry of Dr. Gold’s imperative to listen and Jeffrey Silver’s legacy as “someone whose life was devoted to doing good for others,” someone who “often went out of his way to help family and friends.”
Listening and helping are core to the Gold Foundation’s championing of humanism in healthcare, defined as clinically excellent care that is kind, safe, and trustworthy. Educators and clinicians have been teaching and writing about the broad umbrella of “medical humanities” for over 100 years, and scholarship broadly spans compassion, empathy, patient-centered outcomes, bedside manner, generosity, altruism, and benevolence, among many other varied terms. In these first few issues of the Jeffrey Silver Humanism in Healthcare Research Roundup we’ll be honing in on the Gold Foundation’s centering of kind, safe, and trustworthy as necessary features of clinically excellent care; we’ll start with kindness.
Scholarship on kindness is limited, with a rise in the first two decades of the 21st century and a period of accelerated growth sparked by the COVID-19 pandemic. If it is true that we pay more attention to things when we feel they are lacking (psychologists will recognize this as the scarcity principle or attention restoration theory while social scientists will recognize the deficit model), the rise in studies is an indicator in itself of the need for explicitly naming “kindness.”
Dr. William G. Pickering wrote about this need in his 1997 Journal of Medical Ethics article, “Kindness, prescribed and natural, in medicine.” His abstract is too clear and beautifully written to paraphrase:
“To omit the word kindness in medical practice and journals, in favour of fashionable notions such as “care” and “skills”, is not in patients’ interests. Health professionals may come to the view that natural kindness (the same as that found in the world outside medicine), because it is absent by name in medical skills courses’ or other official edicts, is somehow unscientific and unworthy of their attention. As lay-people know, it is an essential adjunct to all medical management, sometimes the only one required, and by no means always a time-taking matter. And so its use by name in journals, and its actual use in practice, is here recommended. It is a supreme medical ally.”
I take Dr. Pickering’s words to heart and in the first Research Roundup am sharing 4 recent articles that specifically name and explore kindness — its role in the healthcare context broadly, how it promotes wellness, and how the presence and absence of kindness in educational spaces influences future clinicians.
The Gold Foundation looks forward to adding this year’s Dr. Hope Babette Tang Humanism in Healthcare essay contest winners’ reflections to the collection, and I look forward to featuring the work of these young humanism leaders in the near future.
This roundup emphasizes the critical importance of kindness as a fundamental component of humanism in healthcare, reminding us that technical skills are most powerful when paired with genuine human connection. Four publications are presented and the reader will come away knowing what each article is about, why the research is important, and what the article may mean for them directly. (1070 words, ~5 minute read)
This first article is a good entry point for the literature on kindness in healthcare:
Kindness: Poor cousin or equal kin to Compassion and Empathy in the Healthcare Literature? A Scoping Review. Macklin, N., Wilkinson-Meyers, L., & Dowell, A. (2024). BMJ leader, 8(4). Free full text
What: This analysis of 42 studies found that the terms empathy, compassion, and kindness, while often conflated, represent distinct concepts along a stimulus-response-action continuum. Kindness is action-based, can be both reactive and proactive, involves recognizing shared humanity, is given without obligation, and is motivated by a desire to help others flourish—not just in response to suffering. The authors argue that kindness deserves equal importance to compassion and empathy, rather than being treated as a “poor cousin” or secondary concept.
So What: Lack of consensus on these definitions has impeded research and implementation of humanistic care. By distinguishing kindness from compassion (responds to suffering) and empathy (internal process), healthcare professionals can better appreciate each concept’s unique contribution to care quality.
Now What: Healthcare leaders, educators, and practitioners should recognize kindness as a primary concept rather than subordinating it to compassion or empathy. This clarification provides a foundation for developing more precise measurements, educational approaches, and implementation strategies that recognize all three concepts’ distinct roles. Organizations can use the proposed stimulus-response-action continuum model to build frameworks that intentionally cultivate kindness alongside compassion and empathy, addressing different emotional contexts, and fostering a more humanistic healthcare environment
With the definition provided by Nicki Macklin and colleagues, the next step is to be able to measure kindness. Dr. Austin Hake and Dr. Stephen Post’s article provides an example of one team working to do just that.
Kindness: Definitions and a pilot study for the development of a kindness scale in healthcare. Hake AB, Post SG (2023). PLoS ONE 18(7): e0288766. https://doi.org/10.1371/journal. Free full text
What: This study defines kindness as recipient-perceived beneficial action and distinguishes between “Everyday Kindness” (routine actions) and “Informed Kindness” (personalized attention). Surveying 45 outpatients, researchers found simple behaviors like smiling, making eye contact, and showing genuine interest strongly correlate with perceived physician kindness.
So What: This matters because despite the complexity of teaching empathy and compassion, kindness emerges as a more accessible and implementable approach to improving patient care, with potential implications for patient trust, satisfaction, and potentially even health outcomes.
Now What: For medical educators and administrators, a takeaway is to consider integrating kindness-focused training that emphasizes practical, low-effort behaviors: encouraging physicians to greet patients warmly, listen attentively, ask personal questions, and demonstrate genuine interest. These small actions can be more readily taught and implemented than concepts like empathy which may contribute to provider burnout. Simpler acts of kindness potentially may lead to improved patient experiences and potentially better health engagement.
If it is true that we pay more attention to things when we feel they are lacking, Dr. Angela Greco and colleagues’ scoping review speaks to the idea that many of us are feeling the need for more kindness.
What’s the role of kindness in the healthcare context? A scoping review. Greco, A., González-Ortiz, L.G., Gabutti, L. et al. BMC Health Serv Res 25, 207 (2025). Free full text
What: This review analyzes 19 studies on healthcare kindness across four categories: organizational culture, burnout reduction, staff education, and patient communication. Defining kindness as action-based behavior demonstrating generosity beyond clinical competence, the authors found kindness initiatives create “prosocial contagion” where individuals pass kindness forward, improving outcomes for both patients and providers.
So What: Despite being fundamental to patient-centered care, kindness remains underdeveloped as a distinct concept in healthcare research compared to compassion and humanized care. Evidence shows kindness-centered practices improve staff well-being, reduce burnout, enhance communication, and improve patient experience, with transformative potential for healthcare quality.
Now What: Healthcare leaders should consider implementing specific kindness-focused initiatives such as empathy training programs, recognition systems for kind acts, psychological safety protocols, and flexible work policies. Organizations should prioritize kindness-centered leadership to create cultures where staff feel valued and understood, which improves retention, reduces burnout, and enhances patient outcomes. Future research should develop indicators to measure kindness-related performance across organizational culture, staff well-being, education, and patient experience to compare healthcare organizations that promote kindness against those that don’t.
And finally, the last article highlighted here is not about kindness per se, but provides important insights into the detrimental effects of unkindness.
Being kind in unkind spaces: a qualitative examination of how medical educators and first year medical students perceive empathy training. Harvey, S. D., & Stacey, C. L. (2024). Frontiers in Sociology, 8, 1272357 Free full text
What: This qualitative study examines disconnects between how medical educators and students perceive empathy training. Interviewing 23 students and 9 educators, researchers found both groups value emotional intelligence but differ in their assessment. Students believe their authentic empathy gets undermined by “robotic” standardized training, while educators favor a “fake it till you make it” approach. Both agree the overwhelming biomedical curriculum creates an “unkind space” challenging empathy development.
So What: Current empathy training creates “empathic dissonance” when students perform inauthentic scripted statements, potentially affecting their professional identity and patient relationships. Medical education sends mixed messages — emphasizing empathy while prioritizing biomedical knowledge — making genuine kindness difficult despite good intentions.
Now What: Medical schools should redesign empathy training to build upon students’ existing emotional intelligence rather than imposing standardized approaches. Addressing “unkind spaces” requires examining curriculum priorities and institutional culture to better support empathy development, including integrating emotional intelligence into biomedical coursework rather than treating it as a separate component.
We’d love to hear from you! Please send comments, questions, or suggestions for future Research Roundups to njones@gold-foundation.org.