Jeffrey Silver Humanism in Healthcare Research Roundup – December 2016

Closeup portrait woman healthcare professional with stethoscope enjoying reading studying in library room

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

Do medical students’ narrative representations of “The Good Doctor” change over time? Comparing humanism essays from a national contest in 1999 and 2013
Rutberg PC, King B, Gaufberg E, Brett-MacLean P, Dinardo P, Frankel RM    Acad Med. 2016 Dec.
Authors King and Gaufberg are from the Arnold P. Gold Foundation Research Institute
Researchers examined medical student essays about “the good doctor” at two points in time separated by 14 years.  Qualitative analysis suggests that medical students understand the “good doctor” as a relational being, with an enduring emphasis on the doctor-patient relationship. Free full text

Reconciling technology and humanistic care: Lessons from the next generation of physicians
Simpkin AL, Dinardo PB, Pine E, Gaufberg E.    Med Teach. 2016 Dec 25:1-6.
All authors are affiliated with the Arnold P. Gold Foundation Research Institute
Researchers analyzed 138 medical student essays about the impact of technology on humanistic patient care. They found seven themes: Patient Perspective; Life-Giving versus Life-Prolonging; Boundaries between Human and Technology; Distancing versus Presence; Adapting to Change; Tools to Enhance Care; and Definitions of Technology. Authors suggest strategies to ensure the successful integration of technology with humanistic patient-centered care.

Death disclosure and delivery of difficult news in trauma #305
Lamba S, Bryczkowski S, Tyrie L, Weissman DE, Mosenthal AC.    J Palliat Med. 2016 May;19(5):566-7.
This work was supported by a grant from the Arnold P. Gold Foundation
Disclosure of a traumatic injury or death is often performed by a clinician who has little relationship with the patient and who is compressed for time in a chaotic environment. Intense emotional reactions from families may range from shock to anger. Authors describe an ABCDE framework for delivering difficult news in trauma settings: Anticipate; Be aware of self and surroundings; Conversation/Concerns; Debrief, document and dictate; End the encounter. The group also created these two related resources in MedEdPORTAL: Difficult conversations after resuscitation in trauma and A teaching OSCE to assess trauma resident skills on how to hold difficult conversations with family of critically-injured patients.

Patients as partners in learning from unexpected events
Etchegaray JM, Ottosen MJ, Aigbe A, Sedlock E, Sage WM, Bell SK, Gallagher TH, Thomas EJ.
Health Serv Res. 2016 Dec;51 Suppl 3:2600-2614.
Dr. Bell is one of our Gold Professors.
Researchers interviewed 72 patients/family members to understand their perceptions about why adverse events happened to them.  Each participant identified at least one contributing factor (on average they identified 3.67 contributing factors). The most frequently mentioned contributing factors were Staff Qualifications/Knowledge (79%), Safety Policies/Procedures (74%), and Communication (64%). Participants were able to provide recommendations that address those contributing factors.

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. 2016 Nov 29.
Dr. Wright is one of our Gold Professors.
Medical students in Israel, Malaysia and China were surveyed about the learning environment (LE) of their schools and were assessed on quality of life, burnout and empath. Statistical analyses showed that favourable overall LE perceptions were associated with higher odds of good quality of life, and lower odds of emotional exhaustion and depersonalization. There was not a statistically significant association between overall LE and empathy.

A patient feedback reporting tool for OpenNotes: Implications for patient-clinician safety and quality partnerships
Bell SK, Gerard M, Fossa A, Delbanco T, Folcarelli PH, Sands KE, Sarnoff Lee B, Walker J.    BMJ Qual Saf. 2016 Dec 13.
Dr. Bell is one of our Gold Professors.
Researchers invited 6225 patients through a patient portal to provide note feedback in a quality improvement pilot. Patients and care partners reported potential safety concerns in about one-quarter of reports, often resulting in a change to the record or care. Early data from an OpenNotes patient reporting tool may help engage patients as safety partners without apparent negative consequences for clinician workflow or patient-clinician relationships.

Other Publications

Association between learning environment interventions and medical student well-being: A systematic review
Wasson LT, Cusmano A, Meli L, Louh I, Falzon L, Hampsey M, Young G, Shaffer J, Davidson KW.    JAMA. 2016 Dec 6;316(21):2237-2252.
In this systematic review of 28 articles, limited evidence suggests that some specific learning environment interventions were associated with improved emotional well-being among medical students. However, the overall quality of the evidence was low.

Prevalence of depression, depressive symptoms, and suicidal ideation among medical students: A systematic review and meta-analysis
Rotenstein LS, Ramos MA, Torre M, Segal JB, Peluso MJ, Guille C, Sen S, Mata DA.    JAMA. 2016 Dec 6;316(21):2214-2236.
Researchers extracted data on medical students depression or depressive symptom prevalence from 167 cross-sectional studies and 16 longitudinal studies (n = 5728) from 43 countries. The summary estimate of the prevalence of depression or depressive symptoms among medical students was 27.2% and that of suicidal ideation was 11.1%.

If you could read my mind: The role of healthcare providers’ empathic and communicative competencies in clients’ satisfaction with consultations
Schrooten I, de Jong MD.    Health Commun. 2017 Jan;32(1):111-118.

Researchers worked with up to 20 patients each of 90 different healthcare providers to investigate the relationship between healthcare providers’ empathic and communicative competencies and clients’ overall satisfaction with consultations. Results showed that healthcare providers’ empathic dispositions, in addition to their overt communicative behavior, appear to contribute to clients’ overall satisfaction.

Definition of compassion in healthcare: A systematic literature review
Perez-Bret E, Altisent R, Rocafort J.    Int J Palliat Nurs. 2016 Dec;22(12):599-606.
Researchers conducted a systematic search and found 28 articles in which to review the definition of compassion in healthcare. Authors conclude that the term refers to the sensitivity shown in order to understand another person’s suffering, combined with a willingness to help and to promote the wellbeing of that person, in order to find a solution to their situation.