Tallying up points for resident professionalism

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 bking@gold-foundation.org with the subject line “Subscribe RR”.

Chalk tallyAccounting for professionalism: An innovative point system to assess resident professionalism
Malakoff GL, Payne CL, Staton LJ, Kolade VO, Panda M.    J Community Hosp Intern Med Perspect. 2014 Apr 14;4.

The University of Tennessee established a point system to assist residents in becoming aware of what constitutes unprofessional behavior and to provide opportunities for remediation.  Over the past three years, there has been a trend of fewer negative points and more positive points assigned.

Interventions to reduce the consequences of stress in physicians: A review and meta-analysis
Regehr C, Glancy D, Pitts A, Leblanc VR.    J Nerv Ment Dis. 2014 May;202(5):353-9.
This meta-analysis of 12 studies involving over 1,000 participants showed that cognitive, behavioral, and mindfulness interventions were associated with decreased symptoms of anxiety in physicians and medical students. Interventions incorporating psychoeducation, interpersonal communication, and mindfulness meditation were associated with decreased burnout in physicians.

Elements of team-based care in a patient-centered medical home are associated with lower burnout among VA primary care employees
Helfrich CD, Dolan ED, Simonetti J, Reid RJ, et al.    J Gen Intern Med. 2014 Apr 9.
Many protective factors from burnout are characteristics of the patient-centered medical home (PCMH) models being implemented at VA hospitals. In a survey of over 4,500 VA primary care employees, researchers found that lower burnout levels may be achieved by medical home models that are appropriately staffed, emphasize participatory decision making, and increase the proportion of time team members spend working to the top of their competency level.

Finding the right interactional temperature: Do colder patients need more warmth in physician communication style?
Cousin G, Schmid Mast M, Jaunin-Stalder N.    Soc Sci Med. 2013 Dec;98:18-23.
Researchers filmed 36 general practitioners in Switzerland while interacting with 69 patients.  After their appointments, patients were surveyed about their satisfaction satisfaction with the physician, their trust in the physician, their determination to adhere to the treatment, and their trait of agreeableness. Results suggest that physicians should be especially attentive to stay warm and friendly with people low in agreeableness because those patients’ satisfaction and trust might be more easily lowered by a cold or distant physician communication style.

A tool to strengthen the older patient-companion partnership in primary care: results from a pilot study
Wolff JL, Roter DL, Barron J, Boyd CM, et al.    J Am Geriatr Soc. 2014 Feb;62(2):312-9.
Researchers designed a checklist for patients who were 65 or older who brought unpaid companions to their medical visits. The goal of the checklist was to elicit and align patient and companion perspectives about health concerns and to stimulate discussion about the companion’s role in the visit. This study showed in visits where the checklist had been used, communication was significantly more patient-centered and patients were much more likely to indicate that they “better understood their doctor’s advice and explanations” because their companion was present (82% vs 47%).

Gold Foundation Publications

The influence of the patient-clinician relationship on healthcare outcomes: A systematic review and meta-analysis of randomized controlled trials
Kelley JM, Kraft-Todd G, Schapira L, Kossowsky J, Riess H.    PLoS One. 2014 Apr 9;9(4):e94207.
This research was supported by the Gold Foundation with a three-year grant to Helen Riess, MD. This systematic review and meta-analysis included randomized controlled trials in adult patients in which the patient-clinic,ian relationship was systematically manipulated and healthcare outcomes were either objective (e.g., blood pressure) or validated subjective measures (e.g., pain scores).  Results suggest that the patient-clinician relationship has a small, but statistically significant effect on healthcare outcomes.  Read a blog post from the author

Into the future: patient-centredness endures in longitudinal integrated clerkship graduates
Gaufberg E, Hirsh D, Krupat E, Ogur B, Pelletier S, Reiff D, Bor D.    Med Educ. 2014 Apr 9.
This research was conducted by Elizabeth Gaufberg, MD — the Jean and Harvey Picker Director of the Arnold P. Gold Foundation Research Institute. Immediately post-clerkship and 4-6 years later, researchers surveyed graduates of a longitudinal integrated clerkship (LIC) and a traditional clerkship.  Results showed that the LIC graduates emerged from their clerkship year with a higher degree of patient-centredness and that these benefits were sustained over time and across multiple domains.  Read more about this longitudinal integrated clerkship.

The virtues of irrelevance
Wolpaw DR, Shapiro D.    N Engl J Med. 2014 Apr 3;370(14):1283-5.
This article was written by Gold Professor Daniel Shapiro, PhD. Wolpaw and Shapiro examine the types of comments physicians make to patients when they first greet them. They stress the importance of this small talk within the context of medical education and the doctor-patient relationship.   Read a blog post from the authors.  

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




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