Jeffrey Silver Humanism in Healthcare Research Roundup – January 2017

shelfThe 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

Epistemic cognition in medical education: A literature review (free full text)
Eastwood JL, Koppelman-White E, Mi M, Wasserman JA, Krug III EF, Joyce B.    International Journal of Medical Education. 2017 Jan 7; 8: 1-12
This study was supported by a Mapping the Landscape, Journeying Together grant.
Authors wanted to learn more about epistemic cognition in medical education; in other words, they wanted to know more about how medical students get to a point where they confidently know something is true, rather thinking/believing that something is true. Researchers conducted database searches then selected and reviewed 27 empirical studies with a central focus on epistemic cognition and participant samples including medical students or physicians. They found that examination of the relationship between the contexts of medical learning and practice and epistemic cognition has potential for improving medical education. There is a need for further investigation into the implications of epistemic cognition for humanistic orientations and ultimately for patient care.

“It’s like heart failure. It’s chronic…and it will kill you”: A qualitative analysis of burnout among hospice and palliative care clinicians
Kavalieratos D, Siconolfi DE, Steinhauser KE, Bull J, Arnold RM, Swetz KM, Kamal AH.    J Pain Symptom Manage. 2017 Jan 4.
Drs. Steinhauser, Arnold and Kamal are recipients of Mapping the Landscape, Journeying Together grants.
Researchers interviewed 20 palliative care clinicians about burnout. Common sources of burnout included increasing workload, tensions between non-specialists and palliative care specialists, and regulatory issues. There were grave concerns about the stability of the palliative care workforce and the ability to provide  high-quality care in light of a distressed, overburdened discipline. Participants proposed anti-burnout solutions including promoting the provision of generalist palliative care, frequent rotations on-and-off service, and organizational support for self-care.

Measuring professional identity formation early in medical school
Kalet A, Buckvar-Keltz L, Harnik V, Monson V, Hubbard S, Crowe R, Song HS, Yingling S.    Med Teach. 2016 Dec 30:1-7.
Drs. Kalet and Yingling are recipients of Mapping the Landscape, Journeying Together grants.
132 entering medical students completed a professional identity essay (PIE) and the defining issues test (DIT2). Students received score reports with individualized narrative feedback. Students reflected on these measures in meaningful ways which suggests the utility of measuring PIF scores in medical education.

Healthy exercise habits are associated with lower risk of burnout and higher quality of life among U.S. medical students
Dyrbye LN, Satele D, Shanafelt TD.    Acad Med. 2016 Dec 27.

Drs. Dyrbye and Shanafelt are recipients of Mapping the Landscape, Journeying Together grants.
Researchers conducted a cross-sectional study of over 4,400 U.S. medical students to explore relationships between burnout, Quality of Life (QOL) and exercise. They found that students whose aerobic exercise and/or strength training habits were consistent with CDC guidelines appeared less likely to experience burnout and to have higher QOL.

Other Publications

Serious illness conversations with doctors: Patients using information obtained from sources other than their doctors
Garden RL, Seiler WJ.    Health Commun. 2017 Jan;32(1):22-31.

Researchers interviewed 22 patients with serious or life-threatening illnesses about how they talk to their doctors about information they have acquired about their illness from the Internet and social or mass media. They found that doctors who have a dominant communication style often discourage patients from bringing outside information to them, and in some cases this results in patients changing doctors. Doctors who are more attentive make patients feel more comfortable about bringing outside information to them, and this leads to more meaningful and beneficial conversations.

Measuring compassion in healthcare: A comprehensive and critical review
Sinclair S, Russell LB, Hack TF, Kondejewski J, Sawatzky R.    Patient. 2016 Nov 19.
This comprehensive and critical narrative synthesis identified and compared existing measures of compassionate care in clinical settings. Researchers found that limited measures available have significant limitations. There is a need for a psychometrically validated instrument that comprehensively measures the construct of compassion in healthcare settings.

Barriers to medical compassion as a function of experience and specialization: Psychiatry, pediatrics, internal medicine, surgery and general practice
Fernando AT 3rd, Consedine NS.  J Pain Symptom Manage. 2017 Jan 3.
Researchers conducted a cross sectional study of 580 doctors using demographic data, specialization, practice parameters, and the Barriers to Physician Compassion Questionnaire. They found that psychiatrists reported lower barriers to medical compassion while general practitioners and internal medicine specialists generally reported greater barriers. Barriers were generally greater among less experienced doctors.

Professionalism, professionalization, expertise and compassion: A qualitative study of medical residents (free full text)
Phillips SP, Dalgarno N.    BMC Med Educ. 2017 Jan 23;17(1):21.
Researchers investigated how 21 junior residents negotiated conflicts between compassion, self-care, duty and medical expertise. They found that in the transition from student to practitioner, trainees’ views and the modeling they receive shift emotion and compassion, whether for self or patients, from assets to liabilities as they aim to be invincible medical experts.

Compassion fatigue: A meta-narrative review of the healthcare literature
Sinclair S, Raffin-Bouchal S, Venturato L, Mijovic-Kondejewski J, Smith-MacDonald L.    Int J Nurs Stud. 2017 Jan 12;69:9-24.
Researchers reviewed 90 studies on compassion fatigue from nursing and healthcare literature. They found that the physical, emotional, social and spiritual health of healthcare providers is impaired by cumulative stress related to their work, which can impact the delivery of healthcare services; however, the precise nature of compassion fatigue—and that it is predicated on the provision of compassionate care—is associated with significant limitations.

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.