Jeffrey Silver Humanism in Healthcare Research Roundup – July 2016

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

Measuring moral courage for interns and residents: Scale development and initial psychometrics
Martinez W, Bell SK, Etchegaray JM, Lehmann LS.    Acad Med. 2016 Jul 5.
Dr. Bell is a 2011 Gold Professor
352 internal medicine and surgical interns and residents from two northeastern U.S. academic medical centers completed a survey about moral courage, empathy, and speaking up about patient safety breaches.  Principal components analysis of the moral courage items demonstrated a single, meaningful, nine-item factor labeled the Moral Courage Scale for Physicians (MCSP). The Cronbach alpha for the MCSP was 0.90. MCSP scores were positively associated with respondents’ Jefferson Scale of Physician Empathy perspective-taking score and self-reported speaking up about patient safety breaches.

Dealing with emotions: Medical undergraduates’ preferences in sharing their experiences
de Vries-Erich JM, Dornan T, Boerboom TB, Jaarsma AD, Helmich E.    Med Educ. 2016 Aug;50(8):817-28.
Dr. Dornan is a Mapping the Landscape, Journeying Together grantee 
19 medical students participated in individual, semi-structured interviews about their preferences for sharing emotional experiences. They preferred to share emotional experiences away from people who might expect them to uphold formal behavior. Instead they preferred to talk to fellow students working in the same department, or family and friends outside medical school.

Patient perceptions of electronic medical record use by faculty and resident physicians: A mixed methods study
Lee WW, Alkureishi MA, Ukabiala O, Venable LR, Ngooi SS, Staisiunas DD, Wroblewski KE, Arora VM.    J Gen Intern Med. 2016 Jul 11.
Drs. Lee, Alkureishi and Arora are Mapping the Landscape, Journeying Together grantees 
One year after EMR implementation at the University of Chicago’s primary care clinic, interviews were conducted with 108 patients about their perceptions of EMR use by physicians. 90% of these patients were satisfied with physician EMR use. 59 % (63/107) reported the computer had a positive effect on their relationship and only 7 % (8/108) reported the EMR made it harder to talk with their doctors.

Clinicians’ strategies for managing their emotions during difficult healthcare conversations
Luff D, Martin EB Jr, Mills K, Mazzola NM, Bell SK, Meyer EC.    Patient Educ Couns. 2016 Jun 28.
Dr. Bell is a 2011 Gold Professor
In response to an open-ended prompt, 126 clinicians qualitatively described their own strategies for managing their emotions during difficult healthcare conversations.  Five strategy categories were identified: Self-Care (51%), Preparatory and Relational Skills, (29%), Empathic Presence (28%), Team Approach (26%), and Professional Identity (20%).

The Community Health and Advocacy Milestones Profile: A novel tool linking community pediatrics and advocacy training to assessment of milestones-based competence in pediatric residency training
Hoffman BD, Barnes M, Ferrell C, Gellin C, Lichtenstein C, Donnelly J, Kaczorowski J; CHAMP Study Group.    Acad Pediatr. 2016 May-Jun;16(4):309-13.
Dr. Hoffman is a Gold Humanism Scholar
The Pediatric Residency Review Committee of the Accreditation Council for Graduate Medical Education (ACGME) requires structured, formal training for pediatricians in community health and advocacy. However many program directors lack a way to assess resident performance in these areas. The tool developed by these authors effectively gauges how well a residency program provides experiences that prepare residents for their professional roles as advocates for children.

Professionalism training for surgical residents: Documenting the advantages of a professionalism curriculum
Hochberg MS, Berman RS, Kalet AL, Zabar S, Gillespie C, Pachter HL.    Ann Surg. 2016 Jul 18.
Dr. Kalet is a Gold Professor
Professionalism skills of surgical residents were evaluated with a 6-station Objective Structured Clinical Examination (OSCE). Identical OSCE scenarios were administered to 2 cohorts of surgical residents: in 2007 (before instituting a professionalism curriculum in 2008) and again in 2014. Standardized Patients rated residents according to a behaviorally anchored professionalism criteria checklist. The 2007 residents received a mean score of 38% of professionalism items “well done” and the 2014 residents received a mean 59% “well done.”

Other Publications

Compassion training in healthcare: What are patients’ perspectives on training healthcare providers? (free full text)
Sinclair S, Torres MB, Raffin-Bouchal S, Hack TF, McClement S, Hagen NA, Chochinov HM.    BMC Med Educ. 2016 Jul 11;16(1):169.

53 hospitalized advanced cancer patients were interviewed about their perspectives on training healthcare providers in compassionate care. They spoke of compassion as an innate quality embedded in the character of learners prior to their healthcare training, which could be nurtured through experiential learning and reflective practices. They also recommended that learners develop an interpersonal relationship with patients, see patients as people and develop human connections.

Communication and shared understanding between parents and resident-physicians at night
Khan A, Rogers JE, Forster CS, Furtak SL, Schuster MA, Landrigan CP.    Hosp Pediatr. 2016 Jun;6(6):319-29.
Researchers studied a cohort of 286 patient parents and 34 night-team senior residents. Parents and residents rated communication and described patients’ reason for admission, overall plan, and overnight plan. Parents and residents reported that they shared an understanding with one another about care plans in 86.0% and 73.1% of cases, respectively, but researchers found that 45% lacked shared understanding.

Nonverbal communication as a pain reliever: The impact of physician supportive nonverbal behavior on experimentally induced pain
Ruben MA, Blanch-Hartigan D, Hall JA.    Health Commun. 2016 Jul 27:1-7.
Researchers examined the impact of an actor-physician’s supportive nonverbal behavior on experimentally induced pain for 205 participants. For objectively rated pain, those interacting with the high nonverbal support physicians showed increased pain tolerance and a reduction in the amount of pain expressed compared to those interacting with the low nonverbal support physicians. For subjectively rated pain, a gender difference existed such that for men, high physician nonverbal support decreased pain ratings and memory of pain, but for women, high physician nonverbal support increased pain ratings and memory of pain.

BrandyKingThis post was written by Brandy King, Head of Information Services at The Arnold P. Gold Foundation Research Institute