Patient ratings of hospitals are higher when hospitals treat employees with compassion

This post is part of The Arnold P. Gold Foundation’s series of “Research Roundups” — a monthly list of recently published research on humanism in medicine.  If you would like to be notified each time a Research Roundup is published, send an email to with the subject line “Subscribe RR”.

Compassion practices and HCAHPS: Does rewarding and supporting workplace compassion influence patient perceptions?
McClelland LE, Vogus TJ.    Health Serv Res. 2014 May 19.

A cross-sectional study of over 250 nonfederal acute care US hospitals showed that the extent to which a hospital rewards compassionate acts and compassionately supports its employees is significantly and positively associated with hospital ratings and with the likelihood of patients recommending the hospital to others. .

Development and initial psychometric properties of the Barriers to Physician Compassion questionnaire
Fernando AT 3rd, Consedine NS.    Postgrad Med J. 2014 May 28.

A survey of 372 physicians revealed four distinct barriers to compassion: physician burnout/overload; external distractions; difficult patient/family; and complex clinical situations. These areas are potential targets for interventions and compassion training among physicians.

Responding to moderate breaches in professionalism: An intervention for medical students
Gill AC, Nelson EA, Mian AI, Raphael JL, et al.    Med Teach. 2014 May 12:1-4.  

Baylor College of Medicine created a mechanism to assess professionalism competency of medical students as well as policies to address moderate breaches in professional behavior. This article describes the development of an intervention using a guided reflection model, student responses to the intervention, and how the program evolved into a credible resource for deans and other educational leaders.

Competencies and frameworks in interprofessional education: a comparative analysis
Thistlethwaite JE, Forman D, Matthews LR, Rogers GD, et al.    Acad Med. 2014 Jun;89(6):869-75.
Health professionals are increasingly working in collaborative practice teams, which has prompted the creation of several frameworks and list of competencies. This paper distinguishes between competencies that are profession specific, those that are generic, and those designed only for interprofessional education, then compares four IPE frameworks from the US, the UK, Canada and Australia.

Compassionate care? A critical discourse analysis of accreditation standards
Whitehead C, Kuper A, Freeman R, Grundland B, Webster F.    Med Educ. 2014 Jun;48(6):632-43.
The language used in standards for curriculum and accreditation articulate the priorities of professional training.  Researchers analyzed concepts of compassionate care expressed in standards from Canadian family residency programs.  They found very few words, metaphors or statements related to compassionate care, and there was a reduction in these items compared to standards from 2006.

The prevalence of medical student mistreatment and its association with burnout
Cook AF, Arora VM, Rasinski KA, Curlin FA, Yoon JD.    Acad Med. 2014 May;89(5):749-54.
A 2011 nationally representative sample of third-year medical students reported on the frequency of experiencing mistreatment since the beginning of their clinical rotations. A majority reported experiencing at least one incident of mistreatment by faculty (64) and by residents (76%). A minority of students reported experiencing recurrent mistreatment by faculty (10%) and by residents (13%). Recurrent mistreatment was associated with high burnout.

Gold Foundation Publications

Online tool to promote medical student professionalism and moral decision making
Bell SK, Kerfoot BP, Gaufberg E.    Med Educ. 2014 May;48(5):538-9. 

This article was authored by Gold Professor Sigall Bell, MD and Elizabeth Gaufberg, MD, The Jean and Harvey Picker Director of the Gold Foundation Research Institute.  The authors created an online curriculum in Qstream for 3rd year medical students about professionalism-related moral dilemmas. The first time each student saw the case, they created their own statement as to how they would react.  The second time each student saw the case, they were presented with the 10 most common responses from the first round.  92% of students were interested in learning more about communication strategies for navigating the hidden curriculum and 88% felt Qstream was an effective way to learn.

Radiology trainees’ comfort with difficult conversations and attitudes about error disclosure: Effect of a communication skills workshop
Brown SD, Callahan MJ, Browning DM, Lebowitz RL, Bell SK, et al.    J Am Coll Radiol. 2014 Mar 27.
This article was authored by Gold Professor Sigall Bell, MDRadiology trainees from 16 programs attended a full-day communication workshop.  After the workshop trainees reported an increase in comfort communicating with patients about bad news, errors, and radiation risks.  Fewer trainees reported unwillingness to disclose the error despite medicolegal concerns.

A piece of my mind. Let’s show patients their mental health records
Kahn MW, Bell SK, Walker J, Delbanco T.    JAMA. 2014 Apr 2;311(13):1291-2.

This article was authored by Gold Professor Sigall Bell, MD.  Should health professionals encourage patients with mental illness to read their medical record notes? Primary care patients report that reading their doctors’ notes brings many benefits, but inviting patients to read what clinicians write about their feelings, thoughts and behaviors seems different from sharing assessments of their physical health.

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