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Hilgeman B, Kurtz K, Hoeschen M, Hovis Z, Harrison R, Vallecillo R, Minshew L. Real-Time, Brief Reflections: An Efficient, Contextual and Familiar Variation of Reflective Writing: A Mixed-Methods Analysis. CLINICAL TEACHER 2025; 22:e70118. [PMID: 40514201 DOI: 10.1111/tct.70118] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2024] [Revised: 04/23/2025] [Accepted: 05/20/2025] [Indexed: 06/16/2025]
Abstract
BACKGROUND Reflective writing is an important pedagogic tool for medical student professional identity formation (PIF) and empathy development. Real-time, brief reflections (RTBRs) are 280-character reflections intended to be contextual, familiar and efficient. METHODS Fourth-year medical students completed RTBRs while rotating in a primary care clinic serving complex patients. Qualitative methodologies were used to develop a codebook to describe the RTBRs; an independent auditor verified codebook accuracy. Student feedback was elicited to understand perspectives on the tool. RESULTS Eighteen students completed 131 RTBRs during 64 clinics; an average of 2.05 reflections per clinic and 4.39 min spent on each reflection. Three codes described the content of the RTBRs: descriptive (49%), emotional (40%) and cognitive (64%). Three derived codes described student growth and were present in 48% of RTBRs: new perspective (16%), practice change (10%) and the human component to care (30%). Many codes described elements of metacognition (cognitive, emotional, new perspective and practice change), a key component to PIF. Many also included elements reflective of the core processes of empathy including valuing others, taking perspective and humanising others (emotional, cognitive and the human component to care). Most students agreed or strongly agreed that RTBRs helped them think more deeply about (9/9, 100%) and remember (8/9, 89%) patient interactions and were a good use of their time (7/9, 78%). CONCLUSIONS RTBRs are a well-received reflective writing tool that allows for deep reflection that is contextual, familiar and efficient and facilitates the development of professional identity and empathy.
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Affiliation(s)
- Brian Hilgeman
- Section of Primary Care, Division of General Internal Medicine, Department of Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
| | - Kevin Kurtz
- Medical College of Wisconsin Medical School, Milwaukee, Wisconsin, USA
| | - Mary Hoeschen
- Department of Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
| | - Zachary Hovis
- Medical College of Wisconsin School of Pharmacy, Milwaukee, Wisconsin, USA
| | - Rachele Harrison
- Medical College of Wisconsin School of Pharmacy, Milwaukee, Wisconsin, USA
| | - Renata Vallecillo
- Medical College of Wisconsin Medical School, Milwaukee, Wisconsin, USA
| | - Lana Minshew
- Medical College of Wisconsin School of Pharmacy, Milwaukee, Wisconsin, USA
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Surowiecka A, Górecka Z, Kozicka M, Staśkiewicz M, Panek S, Majewski M, Wilhelm G, Podleśna M, Strużyna J, Torres K. Establishing new education standards in burns - A scoping review. Burns 2025; 51:107493. [PMID: 40233525 DOI: 10.1016/j.burns.2025.107493] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2024] [Revised: 03/13/2025] [Accepted: 04/02/2025] [Indexed: 04/17/2025]
Abstract
INTRODUCTION This scoping review aimed to provide an overview of prospective new burn education requirements. DATA SOURCE Three independent researchers (AS, ZG, MK) screened the articles in medical databases (PubMed, Scopus, Google Scholar). STUDY INCLUSION AND EXCLUSION CRITERIA The inclusion filters were "education + burn" or "simulation + burns" and "Entrustable Professional Activity + burns". Titles, abstracts and full texts in English were filtered to choose original articles and reviews describing novel methods in education in burns. RESULTS The search strategy identified 2214 records. 24 studies were enrolled into the study. CONCLUSIONS Medical simulation in burns and Entrustable Professional Activities are promising tools in burn education. Skill-specific unified Entrustable Professional Activities should be established to improve burn team performance.
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Affiliation(s)
- Agnieszka Surowiecka
- East Center of Burns Treatment and Reconstructive Surgery, Medical University of Lublin Łęczna, Poland; Department of Plastic, Reconstructive and Microsurgery, Medical University of Lublin, Poland.
| | - Zofia Górecka
- Department of Plastic, Reconstructive and Microsurgery, Medical University of Lublin, Poland
| | - Magdalena Kozicka
- Chair and Department of Didactics and Medical Simulation, Medical University of Lublin, Poland
| | | | - Sylwia Panek
- Medical Education Center (CEM), Medical University of Lublin, Lublin, Poland
| | - Marek Majewski
- Department of Plastic, Reconstructive and Microsurgery, Medical University of Lublin, Poland
| | - Grzegorz Wilhelm
- Department of Plastic, Reconstructive and Microsurgery, Medical University of Lublin, Poland
| | - Marcelina Podleśna
- Department of Plastic, Reconstructive and Microsurgery, Medical University of Lublin, Poland
| | - Jerzy Strużyna
- East Center of Burns Treatment and Reconstructive Surgery, Medical University of Lublin Łęczna, Poland; Department of Plastic, Reconstructive and Microsurgery, Medical University of Lublin, Poland
| | - Kamil Torres
- Department of Plastic, Reconstructive and Microsurgery, Medical University of Lublin, Poland
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Meisenberg BR. Empathy Decline During Medical Training: Insights from a Novelist. J Gen Intern Med 2025:10.1007/s11606-025-09567-7. [PMID: 40372628 DOI: 10.1007/s11606-025-09567-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2024] [Accepted: 04/21/2025] [Indexed: 05/16/2025]
Abstract
Modern concerns that medical students and trainees suffer a loss of empathy during medical training have generated handwringing, research, and innovation. But a literary vignette from a well-known American author reveals adverse attitude changes during medical training have been noted for more than a hundred years. Loss of empathy and rise of cynicism among students has been a subject of academic scrutiny for many decades though the focus has shifted from deficiencies of the student to deficiencies of the care delivery system in which they learn. The causes of empathy loss were recognized in the vignette and are little changed: exhaustion due to the stress and burden of working with the acutely ill in high volume, a devaluing of patient suffering due to insecurity about one's own clinical competence, and working within health care systems that do not celebrate empathy or its sister virtue compassion, as useful or desirable skills on the road to clinical competence. But data is available that links empathetic relationships with many types of improved clinical outcomes. Evidence-based tools for relationship building are available for adaptation in the student/trainee situation. Educators should emphasize the link between empathy and improved clinical outcomes in designing empathy-sustaining curricula.
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Hoque F. Empathy in healthcare: Harmonizing curing and caring in healthcare. J Hosp Med 2025; 20:517-520. [PMID: 39436208 DOI: 10.1002/jhm.13540] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/09/2024] [Revised: 10/10/2024] [Accepted: 10/12/2024] [Indexed: 10/23/2024]
Affiliation(s)
- Farzana Hoque
- Department of Medicine, Division of Hospital Medicine, Saint Louis University School of Medicine, St Louis, Missouri, USA
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Abuzaid MM, Elshami W, Hamd ZY, Ibham M. Experiences in burnout and empathy among undergraduate radiography students. Radiography (Lond) 2025; 31:102934. [PMID: 40158359 DOI: 10.1016/j.radi.2025.102934] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2024] [Revised: 03/10/2025] [Accepted: 03/17/2025] [Indexed: 04/02/2025]
Abstract
INTRODUCTION Burnout and empathy are key factors influencing healthcare professionals' performance, particularly among radiography students, who face the dual challenges of mastering technology and ensuring patient care. This study explores the relationship between burnout and empathy among undergraduate radiography students in the Middle East, with a focus on how empathy varies across different years of study and its correlation with burnout. METHODS A cross-sectional survey was conducted among radiography students from four Middle Eastern countries. Data were collected using the Jefferson Scale of Physician Empathy for Students (JSPE-S) and the Copenhagen Burnout Inventory (CBI). Empathy scores and Burnout was assessed across several few components. Kruskal-Wallis and Pearson's correlation tests were used to explore associations between demographic factors, empathy scores, and burnout levels. RESULTS Significant difference in scores for empathy across years of study (p = 0.001), with the lowest empathy recorded among third-year students (mean = 3.81). Burnout was also significantly higher in third-year students. A significant negative correlation was found between empathy and burnout (r = -0.173, p = 0.017), indicating that higher levels of burnout were associated with lower empathy. Burnout was also found to be higher among female students and those from UAE and Saudi Arabia. CONCLUSION This study identifies a critical decline in empathy during the third year of radiography education, coinciding with heightened burnout levels. The negative correlation between empathy and burnout suggests that as stress and burnout increase, students' ability to empathize with patients decreases. IMPLICATIONS FOR PRACTICE Interventions aimed at reducing burnout and promoting empathy, particularly during high-stress years of radiography education, are essential. Educational programs should focus on communication skills and stress management to ensure students maintain empathy.
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Affiliation(s)
- M M Abuzaid
- Medical Diagnostic Imaging Department, College of Health Sciences, University of Sharjah, Sharjah, United Arab Emirates; Research Institute for Medical and Health Sciences, University of Sharjah, Sharjah, United Arab Emirates
| | - W Elshami
- Medical Diagnostic Imaging Department, College of Health Sciences, University of Sharjah, Sharjah, United Arab Emirates; Research Institute for Medical and Health Sciences, University of Sharjah, Sharjah, United Arab Emirates
| | - Z Y Hamd
- Department of Radiological Sciences, College of Health and Rehabilitation Sciences, Princess Nourah Bint Abdulrahman University, Saudi Arabia
| | - M Ibham
- Medical Diagnostic Imaging Department, College of Health Sciences, University of Sharjah, Sharjah, United Arab Emirates; Research Institute for Medical and Health Sciences, University of Sharjah, Sharjah, United Arab Emirates.
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Spányik A, Simon D, Rigó A, Gács B, Faubl N, Füzesi Z, Griffiths MD, Demetrovics Z. Cynicism among medical students: An in-depth analysis of mental health dynamics and protective factors in medical education using structural equation modeling. PLoS One 2025; 20:e0321274. [PMID: 40273043 PMCID: PMC12021178 DOI: 10.1371/journal.pone.0321274] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2024] [Accepted: 03/03/2025] [Indexed: 04/26/2025] Open
Abstract
BACKGROUND Medical students frequently grapple with challenges during their studies, including emotional impacts, career socialization, psychiatric comorbidities, and burnout syndrome. Burnout syndrome profoundly influences mental and physical health, impacting patient care. Within this complex landscape, elevated stress levels specifically manifest in increased cynicism, reduced idealism, and other mental health issues. The simultaneous decline of empathy during medical education adds a layer of complexity. Understanding these dynamics and the potential protective factors is crucial for addressing students' well-being and optimizing curriculum development. METHODS The present study comprised third-year and fifth-year Hungarian medical students from the University of Pécs in a partially cross-sectional, partially longitudinal investigation conducted at two time points (2018/19: 124 third-years; 127 fifth-years; 2020/21: 82 third-years; 37 fifth-years). All medical students were sampled in the given year of the selected semester (third-year students at the first timepoint were asked once again as fifth-year students at the second timepoint). In addition to descriptive statistics, structural equation modelling was used to assess the impact of time, role model, perceived stress, empathy, and burnout on medical students. RESULTS The analysis indicated that there was a significant increase in cynicism during the institutional socialization of medical students. While there was only partial support for the reduction in the perception of patient-centered role models during institutional socialization, the findings indicated that the perception of patient-centered role models and empathy acted as protective factors mitigating cynicism. Unexpectedly, the analysis found an increase in stress and cynicism over time, possibly influenced by factors such as the COVID-19 pandemic. CONCLUSION The study's findings indicate a rise in cynicism among medical students over time that could threaten future doctor-patient relationships. The findings emphasize the protective role of empathy and patient-centered role models, emphasizing the need for humanistic integration in medical education.
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Affiliation(s)
- András Spányik
- Doctoral School of Psychology, ELTE Eötvös Loránd University, Budapest, Hungary
- Institute of Psychology at ELTE Eötvös Loránd University, Budapest, Hungary
| | - Dávid Simon
- Faculty of Social Science, ELTE Eötvös Loránd University, Budapest, Hungary
| | - Adrien Rigó
- Institute of Psychology at ELTE Eötvös Loránd University, Budapest, Hungary
| | - Boróka Gács
- Department of Behavioural Sciences, Medical School, University of Pécs,
| | - Nóra Faubl
- Department of Behavioural Sciences, Medical School, University of Pécs,
| | - Zsuzsanna Füzesi
- Department of Behavioural Sciences, Medical School, University of Pécs,
| | - Mark D. Griffiths
- International Gaming Research Unit, Psychology Department, Nottingham Trent University, Nottingham, United Kingdom
| | - Zsolt Demetrovics
- Institute of Psychology at ELTE Eötvös Loránd University, Budapest, Hungary
- Flinders University Institute for Mental Health and Wellbeing, College of Education, Psychology and Social Work, Flinders University, Adelaide, South Australia, Australia
- Centre of Excellence in Responsible Gaming at the University of Gibraltar, Gibraltar
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Krishna LKR, Ravindran N, Kwok HYF, Tan XY, Soh J, Leong EYM, Wan DWJ, Low TY, Chan AWJ, Lim NCJ, Ng YK, Thenpandiyan AA, Leong JR, Lim AYD, Quah ELY, Tse LN, Pl S, Rajanala SP, Lua JK, Rajalingam V, Fam VJE, Govindasamy R, AbdulHamid NAB, Lim C, Ong EK, Sim SW, Mason S, Ong SYK. The impact of mentoring relationships on professional identity formation in medical education: a systematic review. BMC MEDICAL EDUCATION 2025; 25:576. [PMID: 40253352 PMCID: PMC12008893 DOI: 10.1186/s12909-025-07158-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/20/2024] [Accepted: 04/09/2025] [Indexed: 04/21/2025]
Abstract
BACKGROUND The promise that enduring and personalised mentoring relationships shape how mentees think, feel and act as professionals, or their professional identity formation (PIF), and thus how they interact, care and support patients and families has garnered significant interest. However, efforts to marshall these elements have been limited due to a lack of effective understanding. To address this lacunae, a systematic scoping review was carried out to map current knowledge on mentoring relationships and its impact on PIF. METHODS Guided by PRISMA guidelines and the Systematic Evidence-Based Approach (SEBA) to ensure a consistent and reproducible review, independent searches and appraisals of relevant articles published between 1st January 2000 and 4th December 2024 on PubMed, Embase, ERIC and Scopus databases were performed. Data from included articles were content and thematically analysed. Related themes and categories were combined using the SEBA methodology. RESULTS 248 articles were identified across four databases and snowballing of key articles. A total of 27 articles were included. The domains identified were: (1) the mentoring ecosystem; (2) mentoring dynamics; (3) shifts in belief systems and professional identity; and (4) complex adaptive systems. CONCLUSIONS The mentoring programme can be seen as a mentoring ecosystem, functioning as a community of practice and supporting the socialisation process within its boundaries and along the mentoring trajectory. The culture and structure of the mentoring ecosystem help inculcate the shared belief systems and programme identity. It also nurtures stakeholder investment and commitment, as well as their internal compass which is key to contending with the complex array of influences upon their development. Through the lens of a complex adaptive system, it is also possible to appreciate transitions between roles and responsibilities and the notion of being and becoming. These findings underline the evolving nature of practice and the need for personalised and longitudinal mentoring support.
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Affiliation(s)
- Lalit Kumar Radha Krishna
- Duke-NUS Medical School, National University of Singapore, 8 College Road, Singapore, 169857, Singapore.
- Centre for Biomedical Ethics, National University of Singapore, Block MD11, 10 Medical Drive, #02- 03, Singapore, 117597, Singapore.
- Division of Supportive and Palliative Care, National Cancer Centre Singapore, 30 Hospital Boulevard, Singapore, 168583, Singapore.
- Division of Cancer Education, National Cancer Centre Singapore, 30 Hospital Boulevard, Singapore, 168583, Singapore.
- Yong Loo Lin School of Medicine, National University of Singapore, NUHS Tower Block, Level 11, Block 1E, Kent Ridge Road, Singapore, 119228, Singapore.
- Lee Kong Chian School of Medicine, Nanyang Technological University, 11 Mandalay Road, Singapore, 308207, Singapore.
- Palliative Care Institute Liverpool, Academic Palliative & End of Life Care Centre, Cancer Research Centre, University of Liverpool, 200 London Road, Liverpool, L3 9TA, UK.
- Health Data Science, University of Liverpool, Whelan Building, The Quadrangle, Brownlow Hill, Liverpool, Liverpool, L69 3GB, UK.
- The Palliative Care Centre for Excellence in Research and Education, PalC, Dover Park Hospice, 10 Jalan Tan Tock Seng, Singapore, 308436, Singapore.
- SingHealth Internal Medicine Residency, Singapore General Hospital, Outram Road, Singapore, 169608, Singapore.
| | - Nila Ravindran
- Centre for Biomedical Ethics, National University of Singapore, Block MD11, 10 Medical Drive, #02- 03, Singapore, 117597, Singapore
- Division of Supportive and Palliative Care, National Cancer Centre Singapore, 30 Hospital Boulevard, Singapore, 168583, Singapore
- Division of Cancer Education, National Cancer Centre Singapore, 30 Hospital Boulevard, Singapore, 168583, Singapore
- Yong Loo Lin School of Medicine, National University of Singapore, NUHS Tower Block, Level 11, Block 1E, Kent Ridge Road, Singapore, 119228, Singapore
| | - Hannah Yi Fang Kwok
- Division of Supportive and Palliative Care, National Cancer Centre Singapore, 30 Hospital Boulevard, Singapore, 168583, Singapore
- Division of Cancer Education, National Cancer Centre Singapore, 30 Hospital Boulevard, Singapore, 168583, Singapore
- Lee Kong Chian School of Medicine, Nanyang Technological University, 11 Mandalay Road, Singapore, 308207, Singapore
| | - Xuan Yu Tan
- Centre for Biomedical Ethics, National University of Singapore, Block MD11, 10 Medical Drive, #02- 03, Singapore, 117597, Singapore
- Division of Supportive and Palliative Care, National Cancer Centre Singapore, 30 Hospital Boulevard, Singapore, 168583, Singapore
- Division of Cancer Education, National Cancer Centre Singapore, 30 Hospital Boulevard, Singapore, 168583, Singapore
- Yong Loo Lin School of Medicine, National University of Singapore, NUHS Tower Block, Level 11, Block 1E, Kent Ridge Road, Singapore, 119228, Singapore
| | - Jasper Soh
- Centre for Biomedical Ethics, National University of Singapore, Block MD11, 10 Medical Drive, #02- 03, Singapore, 117597, Singapore
- Division of Supportive and Palliative Care, National Cancer Centre Singapore, 30 Hospital Boulevard, Singapore, 168583, Singapore
- Division of Cancer Education, National Cancer Centre Singapore, 30 Hospital Boulevard, Singapore, 168583, Singapore
- Yong Loo Lin School of Medicine, National University of Singapore, NUHS Tower Block, Level 11, Block 1E, Kent Ridge Road, Singapore, 119228, Singapore
| | - Elizabeth Yong Mei Leong
- Division of Supportive and Palliative Care, National Cancer Centre Singapore, 30 Hospital Boulevard, Singapore, 168583, Singapore
- Division of Cancer Education, National Cancer Centre Singapore, 30 Hospital Boulevard, Singapore, 168583, Singapore
- Lee Kong Chian School of Medicine, Nanyang Technological University, 11 Mandalay Road, Singapore, 308207, Singapore
| | - Darius Wei Jun Wan
- Centre for Biomedical Ethics, National University of Singapore, Block MD11, 10 Medical Drive, #02- 03, Singapore, 117597, Singapore
- Division of Supportive and Palliative Care, National Cancer Centre Singapore, 30 Hospital Boulevard, Singapore, 168583, Singapore
- Division of Cancer Education, National Cancer Centre Singapore, 30 Hospital Boulevard, Singapore, 168583, Singapore
- Yong Loo Lin School of Medicine, National University of Singapore, NUHS Tower Block, Level 11, Block 1E, Kent Ridge Road, Singapore, 119228, Singapore
| | - Tiat Yan Low
- Centre for Biomedical Ethics, National University of Singapore, Block MD11, 10 Medical Drive, #02- 03, Singapore, 117597, Singapore
- Division of Supportive and Palliative Care, National Cancer Centre Singapore, 30 Hospital Boulevard, Singapore, 168583, Singapore
- Division of Cancer Education, National Cancer Centre Singapore, 30 Hospital Boulevard, Singapore, 168583, Singapore
- Yong Loo Lin School of Medicine, National University of Singapore, NUHS Tower Block, Level 11, Block 1E, Kent Ridge Road, Singapore, 119228, Singapore
| | - Aiden Wei-Jun Chan
- Centre for Biomedical Ethics, National University of Singapore, Block MD11, 10 Medical Drive, #02- 03, Singapore, 117597, Singapore
- Division of Supportive and Palliative Care, National Cancer Centre Singapore, 30 Hospital Boulevard, Singapore, 168583, Singapore
- Division of Cancer Education, National Cancer Centre Singapore, 30 Hospital Boulevard, Singapore, 168583, Singapore
- Yong Loo Lin School of Medicine, National University of Singapore, NUHS Tower Block, Level 11, Block 1E, Kent Ridge Road, Singapore, 119228, Singapore
| | - Nicholas Chong Jin Lim
- Centre for Biomedical Ethics, National University of Singapore, Block MD11, 10 Medical Drive, #02- 03, Singapore, 117597, Singapore
- Division of Supportive and Palliative Care, National Cancer Centre Singapore, 30 Hospital Boulevard, Singapore, 168583, Singapore
- Division of Cancer Education, National Cancer Centre Singapore, 30 Hospital Boulevard, Singapore, 168583, Singapore
- Yong Loo Lin School of Medicine, National University of Singapore, NUHS Tower Block, Level 11, Block 1E, Kent Ridge Road, Singapore, 119228, Singapore
| | - Yen Kit Ng
- Centre for Biomedical Ethics, National University of Singapore, Block MD11, 10 Medical Drive, #02- 03, Singapore, 117597, Singapore
- Division of Supportive and Palliative Care, National Cancer Centre Singapore, 30 Hospital Boulevard, Singapore, 168583, Singapore
- Division of Cancer Education, National Cancer Centre Singapore, 30 Hospital Boulevard, Singapore, 168583, Singapore
- Yong Loo Lin School of Medicine, National University of Singapore, NUHS Tower Block, Level 11, Block 1E, Kent Ridge Road, Singapore, 119228, Singapore
| | - Arthena Anushka Thenpandiyan
- Centre for Biomedical Ethics, National University of Singapore, Block MD11, 10 Medical Drive, #02- 03, Singapore, 117597, Singapore
- Division of Supportive and Palliative Care, National Cancer Centre Singapore, 30 Hospital Boulevard, Singapore, 168583, Singapore
- Division of Cancer Education, National Cancer Centre Singapore, 30 Hospital Boulevard, Singapore, 168583, Singapore
- Yong Loo Lin School of Medicine, National University of Singapore, NUHS Tower Block, Level 11, Block 1E, Kent Ridge Road, Singapore, 119228, Singapore
| | - Jun Rey Leong
- Centre for Biomedical Ethics, National University of Singapore, Block MD11, 10 Medical Drive, #02- 03, Singapore, 117597, Singapore
- Division of Supportive and Palliative Care, National Cancer Centre Singapore, 30 Hospital Boulevard, Singapore, 168583, Singapore
- Division of Cancer Education, National Cancer Centre Singapore, 30 Hospital Boulevard, Singapore, 168583, Singapore
- Yong Loo Lin School of Medicine, National University of Singapore, NUHS Tower Block, Level 11, Block 1E, Kent Ridge Road, Singapore, 119228, Singapore
| | - Adele Yi Dawn Lim
- Centre for Biomedical Ethics, National University of Singapore, Block MD11, 10 Medical Drive, #02- 03, Singapore, 117597, Singapore
- Division of Supportive and Palliative Care, National Cancer Centre Singapore, 30 Hospital Boulevard, Singapore, 168583, Singapore
- Division of Cancer Education, National Cancer Centre Singapore, 30 Hospital Boulevard, Singapore, 168583, Singapore
- Yong Loo Lin School of Medicine, National University of Singapore, NUHS Tower Block, Level 11, Block 1E, Kent Ridge Road, Singapore, 119228, Singapore
| | - Elaine Li Ying Quah
- Centre for Biomedical Ethics, National University of Singapore, Block MD11, 10 Medical Drive, #02- 03, Singapore, 117597, Singapore
- Division of Supportive and Palliative Care, National Cancer Centre Singapore, 30 Hospital Boulevard, Singapore, 168583, Singapore
- Division of Cancer Education, National Cancer Centre Singapore, 30 Hospital Boulevard, Singapore, 168583, Singapore
- Yong Loo Lin School of Medicine, National University of Singapore, NUHS Tower Block, Level 11, Block 1E, Kent Ridge Road, Singapore, 119228, Singapore
| | - Leia Ning Tse
- Centre for Biomedical Ethics, National University of Singapore, Block MD11, 10 Medical Drive, #02- 03, Singapore, 117597, Singapore
- Division of Supportive and Palliative Care, National Cancer Centre Singapore, 30 Hospital Boulevard, Singapore, 168583, Singapore
- Division of Cancer Education, National Cancer Centre Singapore, 30 Hospital Boulevard, Singapore, 168583, Singapore
- Yong Loo Lin School of Medicine, National University of Singapore, NUHS Tower Block, Level 11, Block 1E, Kent Ridge Road, Singapore, 119228, Singapore
| | - Sriram Pl
- Centre for Biomedical Ethics, National University of Singapore, Block MD11, 10 Medical Drive, #02- 03, Singapore, 117597, Singapore
- Division of Supportive and Palliative Care, National Cancer Centre Singapore, 30 Hospital Boulevard, Singapore, 168583, Singapore
- Division of Cancer Education, National Cancer Centre Singapore, 30 Hospital Boulevard, Singapore, 168583, Singapore
- Yong Loo Lin School of Medicine, National University of Singapore, NUHS Tower Block, Level 11, Block 1E, Kent Ridge Road, Singapore, 119228, Singapore
| | - Sri Priyanka Rajanala
- Centre for Biomedical Ethics, National University of Singapore, Block MD11, 10 Medical Drive, #02- 03, Singapore, 117597, Singapore
- Division of Supportive and Palliative Care, National Cancer Centre Singapore, 30 Hospital Boulevard, Singapore, 168583, Singapore
- Division of Cancer Education, National Cancer Centre Singapore, 30 Hospital Boulevard, Singapore, 168583, Singapore
- Yong Loo Lin School of Medicine, National University of Singapore, NUHS Tower Block, Level 11, Block 1E, Kent Ridge Road, Singapore, 119228, Singapore
| | - Jun Kiat Lua
- Centre for Biomedical Ethics, National University of Singapore, Block MD11, 10 Medical Drive, #02- 03, Singapore, 117597, Singapore
- Division of Supportive and Palliative Care, National Cancer Centre Singapore, 30 Hospital Boulevard, Singapore, 168583, Singapore
- Division of Cancer Education, National Cancer Centre Singapore, 30 Hospital Boulevard, Singapore, 168583, Singapore
- Yong Loo Lin School of Medicine, National University of Singapore, NUHS Tower Block, Level 11, Block 1E, Kent Ridge Road, Singapore, 119228, Singapore
| | - Varsha Rajalingam
- Centre for Biomedical Ethics, National University of Singapore, Block MD11, 10 Medical Drive, #02- 03, Singapore, 117597, Singapore
- Division of Supportive and Palliative Care, National Cancer Centre Singapore, 30 Hospital Boulevard, Singapore, 168583, Singapore
- Division of Cancer Education, National Cancer Centre Singapore, 30 Hospital Boulevard, Singapore, 168583, Singapore
- Yong Loo Lin School of Medicine, National University of Singapore, NUHS Tower Block, Level 11, Block 1E, Kent Ridge Road, Singapore, 119228, Singapore
| | - Victoria Jia En Fam
- Division of Cancer Education, National Cancer Centre Singapore, 30 Hospital Boulevard, Singapore, 168583, Singapore
- Division of Psychosocial Oncology, National Cancer Centre Singapore, 30 Hospital Boulevard, Singapore, 168583, Singapore
| | - Ranitha Govindasamy
- Duke-NUS Medical School, National University of Singapore, 8 College Road, Singapore, 169857, Singapore
- Centre for Biomedical Ethics, National University of Singapore, Block MD11, 10 Medical Drive, #02- 03, Singapore, 117597, Singapore
- Division of Supportive and Palliative Care, National Cancer Centre Singapore, 30 Hospital Boulevard, Singapore, 168583, Singapore
- Division of Cancer Education, National Cancer Centre Singapore, 30 Hospital Boulevard, Singapore, 168583, Singapore
| | - Nur Amira Binte AbdulHamid
- Division of Cancer Education, National Cancer Centre Singapore, 30 Hospital Boulevard, Singapore, 168583, Singapore
| | - Crystal Lim
- Medical Social Services, Singapore General Hospital, Block 3, Singapore, 169854, Singapore
| | - Eng Koon Ong
- Division of Cancer Education, National Cancer Centre Singapore, 30 Hospital Boulevard, Singapore, 168583, Singapore
- Division of Medical Oncology, National Cancer Centre Singapore, 30 Hospital Boulevard, Singapore, 168583, Singapore
| | - Shin Wei Sim
- Geylang Polyclinic (National Healthcare Group Polyclinics), 21 Geylang East Central, Singapore, 389707, Singapore
| | - Stephen Mason
- Palliative Care Institute Liverpool, Academic Palliative & End of Life Care Centre, Cancer Research Centre, University of Liverpool, 200 London Road, Liverpool, L3 9TA, UK
| | - Simon Yew Kuang Ong
- Duke-NUS Medical School, National University of Singapore, 8 College Road, Singapore, 169857, Singapore
- Division of Cancer Education, National Cancer Centre Singapore, 30 Hospital Boulevard, Singapore, 168583, Singapore
- Division of Medical Oncology, National Cancer Centre Singapore, 30 Hospital Boulevard, Singapore, 168583, Singapore
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Carrard V, Bourquin C, Berney S, Ranjbar S, Schlegel K, Gaume J, Bart PA, Schmid Mast M, Preisig M, Berney A. Trajectories of medical students' empathy nowadays: a longitudinal study using a comprehensive framework of empathy. BMC MEDICAL EDUCATION 2025; 25:534. [PMID: 40234844 PMCID: PMC11998332 DOI: 10.1186/s12909-025-07051-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/14/2024] [Accepted: 03/25/2025] [Indexed: 04/17/2025]
Abstract
BACKGROUND For more than a decade, the literature has been dominated by the notion that medical students may paradoxically lose their empathy during medical school. However, medical curricula have significantly evolved, and the question is whether this is still the case. The present study aimed to describe the trajectories of different dimensions of empathy from the beginning to the end of a six-year medical curriculum and explore the influence of different psychosocial and health-related factors. METHODS In an open cohort design, all medical students at the University of Lausanne (Switzerland) were invited to complete four waves of yearly online questionnaires. Cognitive, affective, and behavioral empathy were measured with three validated instruments, and emotion recognition was assessed with a performance test. For each measure, linear mixed models including an array of psychosocial and health-related potential covariates were modelled. Different temporal variance-covariance structures and nonlinear trajectories were tested. RESULTS The final sample included 3224 questionnaires completed by 1667 medical students. The cognitive and affective dimensions of empathy significantly increased in the first half of medical school, followed by a plateau, whereas behavioral empathy remained stable. For emotion recognition, a significant linear increase was observed. The only covariate with substantial influence was gender: students identifying as male presented similar trajectories of empathy and emotion recognition but with overall lower scores than students identifying as female or nonbinary. CONCLUSIONS This study revealed significant increases in cognitive empathy, affective empathy, and emotion recognition. Developments in today's medical curricula may have contributed to the observed increase in empathy. Future multisite studies are warranted to identify the features of the educational environment that impact the trajectories of empathy during medical school.
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Affiliation(s)
- Valerie Carrard
- Psychiatric Liaison Service, Department of Psychiatry, Lausanne University Hospital (CHUV) and University of Lausanne, Avenue de Beaumont 23, 1011, Lausanne, Switzerland
| | - Céline Bourquin
- Psychiatric Liaison Service, Department of Psychiatry, Lausanne University Hospital (CHUV) and University of Lausanne, Avenue de Beaumont 23, 1011, Lausanne, Switzerland
| | - Sylvie Berney
- Service of General Psychiatry, Department of Psychiatry, Lausanne University Hospital (CHUV) and University of Lausanne, Lausanne, Switzerland
| | - Setareh Ranjbar
- Psychiatric Epidemiology and Psychopathology Research Centre, Department of Psychiatry, Lausanne University Hospital (CHUV) and University of Lausanne, Lausanne, Switzerland
| | - Katja Schlegel
- Institute of Psychology, University of Bern, Bern, Switzerland
| | - Jacques Gaume
- Addiction Medicine, Department of Psychiatry, Lausanne University Hospital (CHUV) and University of Lausanne, Lausanne, Switzerland
| | - Pierre-Alexandre Bart
- Department of Internal Medicine, Lausanne University Hospital (CHUV) and University of Lausanne, Lausanne, Switzerland
| | - Marianne Schmid Mast
- Department of Organizational Behavior, Faculty of Business and Economics (HEC Lausanne), University of Lausanne, Lausanne, Switzerland
| | - Martin Preisig
- Psychiatric Epidemiology and Psychopathology Research Centre, Department of Psychiatry, Lausanne University Hospital (CHUV) and University of Lausanne, Lausanne, Switzerland
| | - Alexandre Berney
- Psychiatric Liaison Service, Department of Psychiatry, Lausanne University Hospital (CHUV) and University of Lausanne, Avenue de Beaumont 23, 1011, Lausanne, Switzerland.
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9
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Fleck L, Amelung D, Fuchs A, Mayer B, Escher M, Listunova L, Schultz JH, Möltner A, Schütte C, Wittenberg T, Schneider I, Herpertz SC. Interactional competencies in medical student admission- what makes a "good medical doctor"? ADVANCES IN HEALTH SCIENCES EDUCATION : THEORY AND PRACTICE 2025; 30:439-458. [PMID: 39008161 PMCID: PMC11965163 DOI: 10.1007/s10459-024-10348-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/12/2023] [Accepted: 06/02/2024] [Indexed: 07/16/2024]
Abstract
Doctors' interactional competencies play a crucial role in patient satisfaction, well-being, and compliance. Accordingly, it is in medical schools' interest to select candidates with strong interactional abilities. While Multiple Mini Interviews (MMIs) provide a useful context to assess such abilities, the evaluation of candidate performance during MMIs is not always based on a solid theoretical framework. The newly developed selection procedure "Interactional Competencies - Medical Doctors (IC-MD)" uses an MMI circuit with five simulation patient scenarios and is rated based on the theoretically and empirically grounded construct of emotional availability. A first validation study with N = 70 first-semester medical students took place in 2021. In terms of convergent validity, IC-MD ratings showed strong correlations with simulation patients' satisfaction with the encounter (r =.57) but no association with emotional intelligence measures. IC-MD ratings were not related to high school performance or a cognitive student aptitude test, indicating divergent validity. Inter-rater reliability (ICC = 0.63) and generalizability (Eρ2 = 0.64) were satisfactory. The IC-MD proved to be fair regarding participants' age and gender. Participants with prior work experience in healthcare outperformed those without such experience. Participant acceptance of the procedure were good. The IC-MD is a promising selection procedure capable of assessing interactional competencies relevant to the medical setting. Measures of interactional competencies can complement the use of cognitive selection criteria in medical student admission. The predictive validity of the IC-MD needs to be addressed in future studies.
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Affiliation(s)
- Leonie Fleck
- Medical Faculty, Heidelberg University, Heidelberg, Germany
- Central Institute of Mental Health, Mannheim, Germany
| | | | - Anna Fuchs
- Department of Child & Adolescent Psychiatry, University of Heidelberg, Heidelberg, Germany
| | - Benjamin Mayer
- Medical Faculty, Heidelberg University, Heidelberg, Germany
| | - Malvin Escher
- Medical Faculty, Heidelberg University, Heidelberg, Germany
| | - Lena Listunova
- Medical Faculty, Heidelberg University, Heidelberg, Germany
| | - Jobst-Hendrik Schultz
- Department of General Internal Medicine and Psychosomatics, University of Heidelberg, Heidelberg, Germany
| | | | - Clara Schütte
- Medical Faculty, Heidelberg University, Heidelberg, Germany
| | - Tim Wittenberg
- Medical Faculty, Heidelberg University, Heidelberg, Germany
| | - Isabella Schneider
- Department of General Psychiatry, Heidelberg University Hospital, Voßstraße 4, 69115, Heidelberg, Germany.
| | - Sabine C Herpertz
- Medical Faculty, Heidelberg University, Heidelberg, Germany
- Department of General Psychiatry, Heidelberg University Hospital, Voßstraße 4, 69115, Heidelberg, Germany
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10
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Mansuri N, Zelenski AB. Flourishing as an Aim of Medical Education: Are We Hitting the Target? MEDICAL SCIENCE EDUCATOR 2025; 35:1081-1087. [PMID: 40353014 PMCID: PMC12058636 DOI: 10.1007/s40670-024-02255-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Accepted: 12/09/2024] [Indexed: 05/14/2025]
Abstract
In this commentary, we use Reiss and White's contention of educational aims as a lens to examine the aims of medical education and determine whether the flourishing of medical students is among them. We identify an absence of flourishing and observe descriptions of medical students as finished products of training with an emphasis on professional virtues such as altruism. This emphasis is a compensatory response to professional and cultural shifts during the twentieth century. Anchored by this historical context, we draw on the work of Fielding and Moss to offer a path forward for redefining the aims of medical education.
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Affiliation(s)
- Noreen Mansuri
- School of Medicine, University of California, Davis, Sacramento, CA USA
| | - Amy B. Zelenski
- School of Medicine and Public Health, University of Wisconsin, Madison, WI USA
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11
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Alves A, Scorsolini-Comin F. Training veterinarians to deal with death and the dying process: a scoping review. N Z Vet J 2025; 73:67-76. [PMID: 39638572 DOI: 10.1080/00480169.2024.2424189] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2023] [Accepted: 10/13/2024] [Indexed: 12/07/2024]
Abstract
The aim of this scoping review was to investigate the range of methods used to guide veterinarians in their approach to the death of their animal patients with the guiding question: how is this topic addressed in the training of veterinarians? We included studies written in Portuguese or English, with a theme aligned with the objective of the review and which answered the guiding question. Studies not fulfilling these criteria were excluded. A total of 22 complete studies were identified by searching the Scopus, Web of Science, PsycINFO and Pubmed databases/libraries, with no restrictions on the date of publication. Studies from 1989 to 2023 were identified, mostly by North American authors. The results were organised into three major themes: topics in the veterinary curriculum about patient death and its impacts on students and future professionals; teaching methods used to cover this topic; and the extracurricular training available to support veterinarians with their direct experience of this topic. Analysis of these papers indicated that the theme of death appeared in three distinct contexts operating at different stages of veterinarians' training: the hidden curriculum, compulsory training initiatives, and extracurricular training. The review included reflections on the challenges inherent in this theme and inferences from the timeline of publications in this area. Our review clearly indicates that there is increasing recognition of the importance of this subject, as well as a feeling within the profession of being unprepared to manage this aspect of veterinary experience and a perception that teaching in this area needs to be improved.
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Affiliation(s)
- Afr Alves
- Ribeirão Preto College of Nursing, University of São Paulo, São Paulo, Brazil
| | - F Scorsolini-Comin
- Ribeirão Preto College of Nursing, University of São Paulo, São Paulo, Brazil
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12
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Serrada-Tejeda S, Martínez-Cuervo F, Pérez-de-Heredia-Torres M, Montes-Montes R, Obeso-Benítez P, Palacios-Ceña D, Martínez-Piédrola YRM. Healthcare's empathy in elderly care: How anxiety, depression, and professional quality of life influence empathic abilities. Geriatr Nurs 2025; 62:188-193. [PMID: 39951923 DOI: 10.1016/j.gerinurse.2025.01.033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2024] [Revised: 11/29/2024] [Accepted: 01/27/2025] [Indexed: 02/17/2025]
Abstract
The objective of this descriptive cross-sectional study was to determine the relationship between empathy, anxiety, depression, compassion satisfaction, and fatigue in healthcare professionals working in elderly care centers. A sample of 104 healthcare professionals from nursing homes in Spain completed questionnaires assessing empathic skills, anxiety, depression, and quality of life. The results showed high levels of empathy and compassion satisfaction among participants and significant relationships between empathic skills, anxiety, depression, and quality of life measures. The regression analysis identified interpersonal reactivity, depression, compassion satisfaction, fatigue, and years of experience as significant predictors of empathy in the clinical context. Empathy is of paramount importance in the field of geriatric care, with enhanced empathic abilities exerting a beneficial influence on professional practice. However, the presence of depressive symptoms may hinder empathic abilities and affect the quality of care. Compassion satisfaction emerged as a significant predictor of empathy, highlighting the importance of emotional support and communication skills training in healthcare settings.
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Affiliation(s)
- Sergio Serrada-Tejeda
- Department of Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine, Rey Juan Carlos University. Research Group of Assessment and Evaluation of Ability, Functionality and Disability, King Juan Carlos University, 28922 Alcorcón, Spain
| | - Fernando Martínez-Cuervo
- Principality of Asturias. Directorate of Care, Quality and Safety, Socio-sanitary Coordination and Knowledge Management of the Autonomous Body Residential Establishments for the Elderly of Asturias. Oviedo, Asturias España.
| | - Marta Pérez-de-Heredia-Torres
- Department of Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine, Rey Juan Carlos University. Research Group of Assessment and Evaluation of Ability, Functionality and Disability, King Juan Carlos University, 28922 Alcorcón, Spain
| | - Rebeca Montes-Montes
- Department of Social and Health Care. Faculty of Social and Health Sciences. University of Murcia (Lorca Campus), Spain
| | - Paula Obeso-Benítez
- Department of Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine, Rey Juan Carlos University. Research Group of Assessment and Evaluation of Ability, Functionality and Disability, King Juan Carlos University, 28922 Alcorcón, Spain
| | - Domingo Palacios-Ceña
- Department of Physical Therapy, Occupational Therapy, Physical Medicine and Rehabilitation, Research Group of Humanities and Qualitative Research in Health Science, King Juan Carlos University, 28922 Alcorcón, Spain
| | - Y Rosa M Martínez-Piédrola
- Department of Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine, Rey Juan Carlos University. Research Group of Assessment and Evaluation of Ability, Functionality and Disability, King Juan Carlos University, 28922 Alcorcón, Spain
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13
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Wooldridge JS, Soriano E, Filip TF, Moore RC, Eyler LT, Herbert MS. Compassion Dynamics in Medical Students: An Ecological Momentary Assessment Study. J Clin Psychol Med Settings 2025; 32:51-59. [PMID: 38402300 DOI: 10.1007/s10880-024-10003-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/03/2024] [Indexed: 02/26/2024]
Abstract
Effective interventions to support compassionate patient- and self-care requires an understanding of how to best assess compassion. Micro-ecological momentary assessment (micro-EMA), a method in which participants provide brief responses in real-time within their own environments, can capture changes in compassion across time and contexts. This study examined a micro-EMA approach for measuring the temporal dynamics of compassion in medical students during the COVID-19 pandemic. Medical students (N = 47) completed demographic information and self-report questionnaires assessing empathy and compassion for self and others. Participants then completed six bursts of micro-EMA smartphone-delivered surveys. Each burst was 14 days, with 28 days between bursts. During each burst, participants received four daily micro-EMA surveys assessing compassion, stress, positive affect, and negative affect. Dynamic structural equation modeling was used to examine micro-EMA responses. The overall micro-EMA response rate was 83.75%. On average, daily compassion did not significantly change across the academic year. However, there was significant within-person variability in medical students' compassion trajectories over the training year (b = 0.027, p < .01). At concurrent timepoints, micro-EMA assessed compassion was associated with greater happiness (b = 0.142, p < .001) and lower stress (b = -0.052, p < .05) but was not associated with sadness. In lagged analyses, higher micro-EMA assessed compassion predicted higher next day happiness (b = 0.116, p < .01) and vice versa (b = 0.185, p < .01). Results suggest it is feasible to use micro-EMA to assess daily levels of compassion among medical students. Additionally, there is wide variability in day-to-day fluctuations in compassion levels among medical students, with some students showing substantial increases in daily compassion across the training year and others showing decreases. Positive affect as opposed to negative affect may have particularly strong associations with compassion. Further examination of antecedents and consequences of fluctuations in daily compassion could inform potent intervention targets.
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Affiliation(s)
- Jennalee S Wooldridge
- VA San Diego Healthcare System, 3350 La Jolla Village Drive, San Diego, CA, 92161, USA
- Department of Psychiatry, University of California, San Diego, La Jolla, CA, USA
- Center of Excellence for Stress and Mental Health (CESAMH), San Diego, CA, USA
| | - Emily Soriano
- Scripps Whittier Diabetes Institute, San Diego, CA, USA
| | - Tess F Filip
- Department of Psychological and Brain Sciences, University of Iowa, Iowa City, IA, USA
| | - Raeanne C Moore
- Department of Psychiatry, University of California, San Diego, La Jolla, CA, USA
| | - Lisa T Eyler
- Department of Psychiatry, University of California, San Diego, La Jolla, CA, USA
- Desert-Pacific Mental Illness Research, Education and Clinical Center, VA San Diego Healthcare System, San Diego, CA, USA
| | - Matthew S Herbert
- VA San Diego Healthcare System, 3350 La Jolla Village Drive, San Diego, CA, 92161, USA.
- Department of Psychiatry, University of California, San Diego, La Jolla, CA, USA.
- Center of Excellence for Stress and Mental Health (CESAMH), San Diego, CA, USA.
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14
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Huang J, Wang N, Fu Y, Yang R, Zhang M, Guo L, Gamble J, Creedy DK. Effects of empathy on the perspectives of respectful and disrespectful maternity care among nursing and midwifery students in China: A cross-sectional study. NURSE EDUCATION TODAY 2025; 146:106559. [PMID: 40059753 DOI: 10.1016/j.nedt.2024.106559] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/30/2024] [Revised: 12/11/2024] [Accepted: 12/21/2024] [Indexed: 05/13/2025]
Abstract
BACKGROUND Empathy is a crucial attribute in healthcare, benefiting both professionals and patients. It also plays an important role in the midwife-woman relationship, contributing to the implementation of respectful maternity care. Witnessing acts of disrespect towards childbearing women in the clinical setting may impair students' perceptions of respectful maternity care, as they may come to view disrespect as normative. However, empathy may moderate this effect among pre-registration nursing and midwifery students. OBJECTIVES To measure empathy levels and associated factors among pre-registration nursing and midwifery students, and the mediating role of empathy on perceptions of disrespectful and respectful maternity care. DESIGN A cross-sectional survey. SETTINGS Eight universities/colleges. PARTICIPANTS A total of 694 pre-registration nursing and midwifery students. METHODS Participants completed an online survey with questions from the Jefferson Scale of Empathy (Health Profession Students), Students' Perceptions of Respectful Maternity Care and a list of items to measure exposure to disrespectful maternity care. RESULTS Students reported a mean empathy score of 103 out of 140. Factors such as female, Han ethnicity, fourth year of the program, midwifery major, and a hybrid mode of clinical practicum (online and in-person) were found to be associated with higher empathy levels. Empathy mediated the impact of witnessing disrespectful care on students' perceptions of respectful maternity care. CONCLUSION Pre-registration education should consider the different needs of students based on their gender, ethnicity, and different stages of clinical training. Enabling clinical learning environments with empathetic role models may cultivate students' empathy during their clinical training.
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Affiliation(s)
- Jing Huang
- School of Nursing, Capital Medical University, No.10 Xitoutiao Road, Fengtai District, Beijing 100069, China; Florence Nightingale Faculty of Nursing, Midwifery and Palliative Care, King's College London, SE18WA London, UK.
| | - Na Wang
- School of Nursing, Capital Medical University, No.10 Xitoutiao Road, Fengtai District, Beijing 100069, China.
| | - Yuhui Fu
- Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing Maternal and Child Health Care Hospital, No.251 Yaojiayuan Road, Chaoyang District, Beijing 100026, China.
| | - Rui Yang
- School of Nursing, Capital Medical University, No.10 Xitoutiao Road, Fengtai District, Beijing 100069, China.
| | - Mingna Zhang
- School of Nursing, Capital Medical University, No.10 Xitoutiao Road, Fengtai District, Beijing 100069, China
| | - Li Guo
- School of Nursing, Capital Medical University, No.10 Xitoutiao Road, Fengtai District, Beijing 100069, China
| | - Jenny Gamble
- School of Nursing and Midwifery, Griffith University Logan Campus, University Drive, Meadowbrook, Queensland 4131, Australia.
| | - Debra K Creedy
- School of Nursing and Midwifery, Griffith University Logan Campus, University Drive, Meadowbrook, Queensland 4131, Australia.
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15
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Holmes SM. Learning Language, Un/Learning Empathy in Medical School. Cult Med Psychiatry 2025; 49:40-64. [PMID: 37725219 PMCID: PMC12053200 DOI: 10.1007/s11013-023-09830-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/07/2023] [Indexed: 09/21/2023]
Abstract
This article considers the ways in which empathy for patients and related solidarity with communities may be trained out of medical students during medical school. The article focuses especially on the pre-clinical years of medical school, those that begin with orientation and initiation events such as the White Coat Ceremony. The ethnographic data for the article come from field notes and recordings from my own medical training as well as hundreds of hours of observant participation and interviews with medical students over the past several years. Exploring the framework of language socialization, I argue that learning the verbal, textual and bodily language of medical practice contributes to the increasing experience of separation between physicians and patients. Further considering the ethnographic data, I argue that we also learn a form of empathy limited to performance that short circuits clinical care and the possibility for solidarity for health equity. The article concludes with implications for medical education and the medical social sciences and humanities.
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Affiliation(s)
- Seth M Holmes
- University of California, Berkeley, 50 University Hall, MC 7360, Berkeley, CA, 94720, USA.
- University of Barcelona, Barcelona, Spain.
- ICREA Catalan Institution for Research and Advanced Study, Barcelona, Spain.
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16
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Yamada R, Futakawa K, Xu K, Kondo S. Using virtual patients to enhance empathy in medical students: a scoping review protocol. Syst Rev 2025; 14:52. [PMID: 40025554 PMCID: PMC11871709 DOI: 10.1186/s13643-025-02793-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/28/2024] [Accepted: 02/07/2025] [Indexed: 03/04/2025] Open
Abstract
INTRODUCTION Empathy is a crucial skill that enhances the quality of patient care, reduces burnout among healthcare professionals, and fosters professionalism in medical students. Clinical practice and standardized patient-based education provide opportunities to enhance empathy, but a lack of consistency and reproducibility as well as significant dependency on resources are impediments. The COVID-19 pandemic has further restricted these opportunities, highlighting the need for alternative approaches. Virtual patients through standardized scenarios ensure consistency and reproducibility while offering safe, flexible, and repetitive learning opportunities unconstrained by time or location. Empathy education using virtual patients could serve as a temporary alternative during the COVID-19 pandemic and address the limitations of traditional face-to-face learning methods. This review aims to comprehensively map existing literature on the use of virtual patients in empathy education and identify research gaps. METHODS This scoping review will follow the Joanna Briggs Institute's guidelines and be reported according to PRISMA-P. The search strategy includes a comprehensive search across databases such as PubMed (MEDLINE), CINAHL, Web of Science, Scopus, ERIC, Google, Google Scholar, and Semantic Scholar, covering both published and gray literature without language restrictions. Both quantitative and qualitative studies will be included. Two independent researchers will screen all titles/abstracts and full texts for eligibility. Data will be extracted to summarize definitions of empathy, characteristics of virtual patient scenarios, and methods for measuring their impact on empathy development. Results will be presented in narrative and tabular formats to highlight key findings and research gaps. DISCUSSION As this review analyzes existing literature, ethical approval is not required. Findings will be actively disseminated through academic conferences and peer-reviewed publications, providing educators and researchers with valuable insights into the potential of virtual patients to enhance empathy in medical education. This study goes beyond the mere synthesis of academic knowledge by contributing to the advancement of medical education and clinical practice by clarifying virtual patient scenario design and evaluation methods in empathy education. The findings provide a critical foundation for our ongoing development of a medical education platform aimed at enhancing empathy through the use of virtual patients.
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Affiliation(s)
- Rie Yamada
- Department of Adult Nursing, Faculty of Medicine, Academic Assembly, University of Toyama, 2630aq , Toyama-Shi, Toyama-Ken, Sugitani, 930-0194, Japan.
| | - Kaori Futakawa
- Department of Maternal Nursing, Faculty of Medicine, Academic Assembly, University of Toyama, 2630aq , Toyama-Shi, Toyama-Ken, Sugitani, 930-0194, Japan
| | - Kuangzhe Xu
- Institute for Promotion of Higher Education, Hirosaki University, 1 Bunkyo-Cho, Hirosaki-Shi, Aomori-Ken, 036-8560, Japan
| | - Satoshi Kondo
- Department of Medical Education, Graduate School of Medicine, University of Toyama,2630aq , Toyama-Shi, Toyama-Ken, Sugitani, 930-0194, Japan
- Center for Medical Education and Career Development, Graduate School of Medicine, University of Toyama,2630aq , Toyama-Shi, Toyama-Ken, Sugitani, 930-0194, Japan
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17
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Zhai H, Xue J, Wu H, Liao S, Lavender C, Lv Y, Xie W, Wang D, Cheng Y. A national perspective: integrating medical humanities to address burnout and stress in Chinese medical education. BMC MEDICAL EDUCATION 2025; 25:304. [PMID: 40001154 PMCID: PMC11863532 DOI: 10.1186/s12909-025-06875-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/19/2024] [Accepted: 02/14/2025] [Indexed: 02/27/2025]
Abstract
BACKGROUND The significance of issues in medical humanities, such as empathy, professionalism, patient-orientation, disclosure of harms, and communication skills, has been widely acknowledged in previous studies. While these studies have showcased the impact of individual facets of medical humanities on clinical practice, there exists a dearth of comprehensive assessments that encompass these constructs and their relationship with burnout and distress among medical students. This study aims to fill these gaps by exploring Chinese medical students' overall perceptions of medical humanities across different educational phases and shedding light on the intricate associations between perceptions of humanities, burnout, and stress. METHODS We conducted a nationwide survey using a web-based questionnaire across 38 Chinese universities. The questionnaire includes Medical Humanities constructs, the Maslach Burnout Inventory constructs and the Perceived Stress constructs. The survey was administered using the snowball sampling method, with the data collection period running from September 8, 2022, to September 22, 2023. Participants included a national sample of 904 students (out of a total of 969) enrolled in medical schools. To investigate the relationships among all the constructs, PLS-SEM analysis was conducted by using the SmartPLS 3.3.9 software in this study. RESULTS The student's perception of medical humanities was significantly influenced by several factors: years of medical school education (β = -.077; P = .045), work burnout (β = -.208; P < .001), and perceived stress (β = -.467; P < .001). Work burnout was impacted by clinical clerkship experience (β = .106; P = .001), whereas perceived stress was influenced by the number of years in medical school (β = 0.102; P = .002). Additionally, work burnout acts as an intermediate variable between clinical clerkship experience and students' perception of medical humanities. CONCLUSION This study illuminated the complex relationship between medical education, burnout, stress, and students' perception of medical humanities issues. It underscores the critical importance of balancing technical proficiency with humanistic values in medical training. Implementing strategies that support students' well-being and foster empathy is essential in nurturing a compassionate and effective healthcare workforce.
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Affiliation(s)
- Huiwen Zhai
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-Sen University Cancer Center, Guangzhou, China
| | - Jiaolong Xue
- Business School, Sichuan University, Chengdu, China
| | - Haotan Wu
- School of Sociology and Anthropology, Sun Yat-Sen University, Guangzhou, China
| | - Shuang Liao
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-Sen University Cancer Center, Guangzhou, China
| | - Christopher Lavender
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-Sen University Cancer Center, Guangzhou, China
| | - Yangludan Lv
- Second Clinical Medical College, Guangzhou University of Traditional Chinese Medicine, Guangzhou, China
- Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, China
| | - Wanfei Xie
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-Sen University Cancer Center, Guangzhou, China
| | - Di Wang
- The Seventh Affiliated Hospital, Sun Yat-Sen University, Guangming District, Shenzhen, China.
| | - Yu Cheng
- The Seventh Affiliated Hospital, Sun Yat-Sen University, Guangming District, Shenzhen, China.
- School of Medicine, Sun Yat-sen University, Shenzhen, China.
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18
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Hart EJ, de Heer-Koster MH, van der Harst M, Browne JL, Scheele F. Key tips to shift student perspectives through transformative learning in medical education. BMC MEDICAL EDUCATION 2025; 25:202. [PMID: 39920665 PMCID: PMC11806662 DOI: 10.1186/s12909-025-06754-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/22/2024] [Accepted: 01/23/2025] [Indexed: 02/09/2025]
Abstract
Healthcare systems are increasingly complex, facing challenges such as rising costs, aging populations, and persistent health inequities. These challenges demand that medical education adapts, to equip health professionals with the competencies required to navigate and transform complex systems. This is where transformative learning theory can play a crucial role. This article offers twelve practical tips to integrate transformative learning in medical education, emphasizing the need for a shift from traditional educational approaches to more transformative methods. These tips focus on educating learners on the principles of transformative learning, encouraging critical reflection, fostering interdisciplinary collaboration, addressing the hidden curriculum, and creating a supportive learning environment. By implementing these tips, medical education can better prepare healthcare professionals to act as change agents, contributing to the long-term sustainability and effectiveness of healthcare systems. The potential impact of these tips on medical education is substantial, as they provide a pathway toward a more responsive, ethical, and sustainable future of healthcare. Clinical trial number: Not applicable.
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Affiliation(s)
- Efraim J Hart
- Department of medical education, OLVG Hospital, Amsterdam, Netherlands.
- Athena Institute, Faculty of Science, VU, Amsterdam, Netherlands.
| | - Merel H de Heer-Koster
- Department of medical education, OLVG Hospital, Amsterdam, Netherlands
- Amsterdam UMC, Location Vrije Universiteit Amsterdam, Research in Education, Amsterdam, Netherlands
| | - Maria van der Harst
- Centre for Global Challenges, Faculty of law, economics, governance & organization, Utrecht University, Utrecht, Netherlands
- Julius center for health science and primary care, UMC Utrecht, Global Public Health & Bioethics, Utrecht, Netherlands
| | - Joyce L Browne
- Centre for Global Challenges, Faculty of law, economics, governance & organization, Utrecht University, Utrecht, Netherlands
- Julius center for health science and primary care, UMC Utrecht, Global Public Health & Bioethics, Utrecht, Netherlands
| | - Fedde Scheele
- Athena Institute, Faculty of Science, VU, Amsterdam, Netherlands
- ACTA, Academic Center for Dentistry University of Amsterdam, Amsterdam, Netherlands
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Jayasinghe S. Valuing virtue in medicine: a closer look at CanMEDS. CANADIAN MEDICAL EDUCATION JOURNAL 2025; 16:106-114. [PMID: 40135128 PMCID: PMC11931172 DOI: 10.36834/cmej.79246] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 03/27/2025]
Abstract
The CanMEDS-2015 Framework outlines seven key roles expected of practicing physicians: communicator, collaborator, manager, health advocate, scholar, and professional. Critics have expressed concern about the omission of a proposed eighth role, 'Physician as Person' relevant to humane qualities and personal resilience of the physician. Upon further analyses, the Framework has included several virtuous attributes in the roles of a physician as professional and communicator. However, it addresses certain virtues like creativity, love, and spirituality inadequately. Drawing on literature from Positive Psychology, the author categorizes and additional set of virtues into six classes: wisdom, courage, humanity, justice, temperance, and transcendence. Based on these, the author lists virtues and concepts relevant to a 'Virtuous Role' for physicians. The CanMEDS Framework should integrate these virtues as a foundational or overarching role and draw from Virtue Ethics in religious and philosophical traditions. This approach is timely, giving ongoing efforts to update and develop CanMEDS2025. By adopting a Virtuous Role within CanMEDS, we aim to train physicians who are technically skilled and deeply humane, meeting society's expectations for compassionate and virtuous healthcare professionals.
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Affiliation(s)
- Saroj Jayasinghe
- Emeritus Professor of Medicine, Department of Clinical Medicine, University of Colombo, Sri Lanka
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20
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Kataoka H, Tokinobu A, Fujii C, Watanabe M, Obika M. Effectiveness of professional-identity-formation and clinical communication-skills programs on medical students' empathy in the COVID-19 context: comparison between pre-pandemic in-person classes and during-pandemic online classes. BMC MEDICAL EDUCATION 2025; 25:39. [PMID: 39789533 PMCID: PMC11715617 DOI: 10.1186/s12909-024-06597-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/26/2023] [Accepted: 12/22/2024] [Indexed: 01/12/2025]
Abstract
BACKGROUND Enhancing students' empathy is critical in medical school education. The COVID-19 pandemic necessitated a shift from in-person to online classes. However, the effectiveness of online classes for enhancing medical students' empathy has not been investigated sufficiently and the evidence is limited. This study compared the effectiveness of enhancing empathy between pre-pandemic in-person classes and during-pandemic online classes among medical students in Japan using pre-pandemic and during-pandemic data. METHODS This is a retrospective observational study. This study measured students' empathy using the Japanese translation of the Jefferson Scale of Empathy-Student Version (JSE-S) before and after the special programs for professional identity formation and clinical communication among first- and second-year students who matriculated from 2015-2021. This study categorized the matriculation year groups as "pre-pandemic" and "during-pandemic" groups for the first- and second-year students. This study estimated the adjusted mean score differences of the JSE-S and 95% confidence intervals (CIs) from the pre- to post-program between the pre-pandemic and during-pandemic groups in the first and second years using linear regression analysis. RESULTS This study's participants included 653 first-year students and 562 second-year students. In the first year, the during-pandemic group had a significantly higher mean score difference from the pre- to post-program compared to the pre-pandemic group. The adjusted regression coefficient (95% CI) was 7.6 (5.7 - 9.5), with the pre-pandemic group as the reference. In the second year, there were no significant differences between the two groups. CONCLUSIONS The results suggest that online classes are not inferior to in-person classes or even slightly better in enhancing medical students' empathy, which should be clarified by further studies. This study's findings have important implications for medical education and implementing hybrid class formats to enhance students' empathy.
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Affiliation(s)
- Hitomi Kataoka
- Center for Medical Education and Internationalization, Graduate School of Medicine, Kyoto University, Yoshida-Konoe-cho, Sakyo-ku, Kyoto-shi, Kyoto, 606-8501, Japan
- Center for Diversity and Inclusion, Okayama University Hospital, 2-5-1, Shikata-cho, Kita-ku, Okayama-shi, Okayama, 700-8558, Japan
| | - Akiko Tokinobu
- Center for Medical Education and Internationalization, Graduate School of Medicine, Kyoto University, Yoshida-Konoe-cho, Sakyo-ku, Kyoto-shi, Kyoto, 606-8501, Japan.
- Center for Diversity and Inclusion, Okayama University Hospital, 2-5-1, Shikata-cho, Kita-ku, Okayama-shi, Okayama, 700-8558, Japan.
| | - Chikako Fujii
- Center for Diversity and Inclusion, Okayama University Hospital, 2-5-1, Shikata-cho, Kita-ku, Okayama-shi, Okayama, 700-8558, Japan
| | - Mayu Watanabe
- Division of Kidney, Diabetes and Endocrine Diseases, Okayama University Hospital, 2-5-1, Shikata-cho, Kita-ku, Okayama-shi, Okayama, 700-8558, Japan
| | - Mikako Obika
- Department of General Medicine, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, 2-5-1, Shikata-cho, Kita-ku, Okayama-shi, Okayama, 700-8558, Japan
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21
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Sattar K, Yusoff MSB. Unveiling the interplay of medical professionalism, mental well-being and coping in medical students: a qualitative phenomenological study. BMC MEDICAL EDUCATION 2025; 25:12. [PMID: 39748416 PMCID: PMC11697919 DOI: 10.1186/s12909-024-06595-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/08/2024] [Accepted: 12/20/2024] [Indexed: 01/04/2025]
Abstract
BACKGROUND Medical students face significant stress and challenges that impact their professional development by affecting their levels of medical professionalism (MP), coping ability, and mental well-being (MWB). Given the high-stakes environment of medical education, understanding the interplay between these factors is crucial. This study aims to explore undergraduate medical students' lived experiences of MP, coping strategies (CSs), and MWB to inform the development of effective support systems. METHODS A qualitative phenomenological study was conducted using Focus Group Discussions (FGDs) to capture the lived experiences of 40 medical students from first, third, and fifth years of study. Participants, selected through purposive sampling, represented diverse backgrounds (with 27 females, 18 fifth-year students, and 30 Malays). Seven FGDs, each with 5-10 participants, were conducted via Zoom©, yielding comprehensive qualitative data. An inductive coding approach was applied through iterative transcript analysis to ensure robust findings. RESULTS Analysis revealed two themes related to MWB: 'mental well-being issues,' highlighting persistent mental health challenges, and 'happiness,' illustrating factors that sustain well-being. CSs were categorized into 'positive coping,' including seeking support, and 'negative coping,' such as denial. For MP, two themes emerged: 'inter-medical professionalism,' focusing on communication with others, and 'intra-medical professionalism,' emphasizing ethical self-conduct. CONCLUSION The interplay between CSs, MP, and MWB is complex and deeply intertwined. The findings highlight the importance of developing targeted interventions to support medical students in managing stress, maintaining professionalism, and enhancing their mental well-being throughout their training. Future research should further explore these themes to inform policy and curriculum development in medical education. CLINICAL TRIAL NUMBER Not applicable.
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Affiliation(s)
- Kamran Sattar
- Department of Medical Education, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Muhamad Saiful Bahri Yusoff
- Department of Medical Education, School of Medical Sciences, Universiti Sains Malaysia, Kota Bharu, Kelantan, Malaysia.
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22
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Qian J, Zhang W, Wang Y, Xu S. The impact of a narrative medicine program on obstetrics and gynecology residents' empathy ability. BMC MEDICAL EDUCATION 2024; 24:1436. [PMID: 39696257 DOI: 10.1186/s12909-024-06502-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/23/2024] [Accepted: 12/10/2024] [Indexed: 12/20/2024]
Abstract
BACKGROUND Empathy is essential in medical practice, particularly in obstetrics and gynecology. Narrative Medicine, which involves storytelling and reflective writing, has been shown to enhance empathy among healthcare providers. Despite its benefits, there is limited research on the impact of narrative medicine on empathy among obstetrics and gynecology residents. METHODS This study is a prospective controlled trail aimed at investigating the impact of a narrative medicine-based curriculum on the empathy levels of obstetrics and gynecology residents. The subjects of this study are obstetrics and gynecology residents undergoing standardized training at Hangzhou First People's Hospital in 2023, which was divided into two groups: one receiving narrative medicine training and the other, traditional training. The Chinese version of the Jefferson Empathy Scale was used to measure empathy levels before and after the intervention. A self-developed questionnaire was distributed to Group A residents at the end of the narrative medicine course to evaluate the curriculum. RESULTS Before the intervention, there was no significant difference in empathy scores between the two groups. However, after the narrative medicine intervention, Group A showed a significant improvement in empathy scores compared to Group B (P < 0.0001). Residents in Group A also rated the narrative medicine curriculum highly, with 92% considering it "great" or "excellent"; 87% finding it effective in improving empathy and doctor-patient communication; and 91% feeling that this course promoted their self-reflection in medical practice. CONCLUSIONS The integration of narrative medicine into the training of obstetrics and gynecology residents significantly enhanced their empathy levels. Most residents perceive narrative medicine as a valued and effective means of enhancing doctor-patient communication and reflection capability.
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Affiliation(s)
- Jing Qian
- Department of Obstetrics and Gynecology, Affiliated Hangzhou First People's Hospital, School of Medicine, Westlake University, No. 261 Huansha Road, Hangzhou, 310000, Zhejiang, China
- The Fourth School of Clinical Medicine, Zhejiang Chinese Medical University, Hangzhou, 310000, Zhejiang, China
| | - Wei Zhang
- Department of Obstetrics and Gynecology, Affiliated Hangzhou First People's Hospital, School of Medicine, Westlake University, No. 261 Huansha Road, Hangzhou, 310000, Zhejiang, China
- The Fourth School of Clinical Medicine, Zhejiang Chinese Medical University, Hangzhou, 310000, Zhejiang, China
| | - Yahui Wang
- Department of Obstetrics and Gynecology, Affiliated Hangzhou First People's Hospital, School of Medicine, Westlake University, No. 261 Huansha Road, Hangzhou, 310000, Zhejiang, China
| | - Song Xu
- Department of Obstetrics and Gynecology, Affiliated Hangzhou First People's Hospital, School of Medicine, Westlake University, No. 261 Huansha Road, Hangzhou, 310000, Zhejiang, China.
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23
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Keshtkar L, Ward A, Winter R, Leung C, Howick J. Does empathy decline in the clinical phase of medical education? A study of students at Leicester medical school. PEC INNOVATION 2024; 5:100316. [PMID: 39776945 PMCID: PMC11705371 DOI: 10.1016/j.pecinn.2024.100316] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/07/2024] [Revised: 06/27/2024] [Accepted: 07/01/2024] [Indexed: 01/11/2025]
Abstract
Objective To examine whether medical student empathy changes throughout the five years of a UK medical school. Methods Students completed an online version of the Jefferson Scale of Empathy (JSE-S) during the 2022-2023 academic year. Comparisons of empathy scores were made using analysis of variance (ANOVA), and independent t-tests. Results Empathy scores varied across different years of medical school (P ≤ 0.001), with a small drop in empathy between the pre-clinical and clinical phases of medical school (Mean difference = 1.82, P = 0.025). Male students scored lower than female students and there was no statistically significant difference between the mean empathy score and speciality interest. Conclusions Students' empathy appeared declined slightly as they progressed through medical school. As a crucial component of good clinical care, interventions in medical education to enhance empathy should be prioritised. Innovation This is the first time following the COVID-19 pandemic that medical student empathy was measured across all five years of a medical school. Unlike many previous related studies, we identified the point at which empathy appears to decline, providing guidance for educators who can target empathy enhancing interventions where they are most needed.
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Affiliation(s)
- Leila Keshtkar
- Stoneygate Centre for Empathic Healthcare, Leicester Medical School, University of Leicester, George Davies Centre, Lancaster Rd, Leicester LE1 7HA, UK
| | - Andy Ward
- Stoneygate Centre for Empathic Healthcare, Leicester Medical School, University of Leicester, George Davies Centre, Lancaster Rd, Leicester LE1 7HA, UK
| | - Rachel Winter
- Stoneygate Centre for Empathic Healthcare, Leicester Medical School, University of Leicester, George Davies Centre, Lancaster Rd, Leicester LE1 7HA, UK
| | - Char Leung
- Leicester Medical School, University of Leicester, George Davies Centre, Department of Population Health Sciences, Lancaster Rd, Leicester LE1 7HA, UK
| | - Jeremy Howick
- Stoneygate Centre for Empathic Healthcare, Leicester Medical School, University of Leicester, George Davies Centre, Lancaster Rd, Leicester LE1 7HA, UK
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24
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Pohontsch NJ, Stark A, Scherer M. Medical students' understanding of clinical empathy - a qualitative exploratory interview study. BMC MEDICAL EDUCATION 2024; 24:1422. [PMID: 39639269 PMCID: PMC11619624 DOI: 10.1186/s12909-024-06428-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/04/2023] [Accepted: 11/28/2024] [Indexed: 12/07/2024]
Abstract
BACKGROUND Empathy plays an important role in the interaction and communication with patients. Physicians' empathy has various positive patients' and physicians' outcomes. Despite the inclusion of empathy in medical curricula and the relevance of empathy in general and physicians' concept of it to medical care, there is no common definition of empathy in the clinical context: definitions tend to be abstract and we do not know enough about medical students' conceptualization of clinical empathy. A clear and consensual definition of empathy is needed to be able to teach and measure empathy adequately. We aimed to explore German medical students' views and understanding of (clinical) empathy. METHODS We interviewed 24 students from the second half of the 3rd year and in their final clinical year (six female and male students in each subgroup) using a semi-structured interview guide. Interviews were digitally recorded and transcribed verbatim. We analysed the transcripts using thematic synthesis (Braun & Clarke). RESULTS We found three overarching themes: (1) empathy means perceiving and understanding patients' needs and acting accordingly, (2) empathy as an interpersonal, intangible construct and (3) taking time for patients. Showing interests, impartiality and openness towards the patients as well as the need to take patients seriously, treating them with respect, having a holistic view on patients and generate some kind of closeness with patients are subthemes of the first overarching theme. CONCLUSIONS Although it is often stated that the various existing definitions of empathy are abstract or far from practice, German medical students seem to have a good idea how to define empathy. Their definition resembles definitions known from the literature and used in education. Further research is needed to compare concepts of empathy of medical students from different countries and cultural backgrounds to inform research and teaching. It would also be interesting to investigate how concepts of empathy change over the course of study and affect perceptions of empathy in third party assessments.
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Affiliation(s)
- Nadine Janis Pohontsch
- Department of General Practice and Primary Care, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Germany.
| | - Anne Stark
- Department of General Practice and Primary Care, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Germany
| | - Martin Scherer
- Department of General Practice and Primary Care, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Germany
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25
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von Knorring J, Salmi J, Lehti A, Semb O. Lost in translation: a qualitative study of medical students' experiences of theoretical and practical teaching of empathy. BMC MEDICAL EDUCATION 2024; 24:1416. [PMID: 39633447 PMCID: PMC11616379 DOI: 10.1186/s12909-024-06385-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/29/2024] [Accepted: 11/21/2024] [Indexed: 12/07/2024]
Abstract
BACKGROUND Empathy has proven to be a fundamental component in the patient-doctor relationship and correlates to several positive outcomes in patient care. Despite this, research suggests that empathy decreases during medical education. To increase the understanding of empathy development during medical education, this study explores medical students' experiences of learning empathy in the transition from theoretical to practical context. METHODS Eleven semi-structured interviews with students at a medical school in Sweden. The interviews were transcribed verbatim and analysed using grounded theory. RESULTS The analysis resulted in three categories and a core category "Lost in translation". Early on, students regard empathy as a valued and necessary skill. While students generally encounter high expectations of being empathic, they also met gendered expectations. There is a mismatch between the theoretical and the practical teaching of empathy. The core category refers both to the students feeling lost in their own professional development and empathy becoming lost in the translation from theory to clinical practice. CONCLUSION The results describe clashes between theory and clinical reality and the efforts of the students to develop and maintain empathy in this context. To encourage students to develop empathy it is necessary for both educators and practitioners to acknowledge, and attempt to bridge, the gap between the theoretical and the practical curriculum regarding empathy.
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Affiliation(s)
- Johanna von Knorring
- Department of Clinical Sciences, Professional Development, Umeå University, Umeå, Sweden.
- Enheten för Professionell utveckling, Umeå universitet, Klinisk vetenskap, Umeå, 901 85, Sweden.
| | - Johanna Salmi
- Department of Clinical Sciences, Professional Development, Umeå University, Umeå, Sweden
| | - Arja Lehti
- Department of Clinical Sciences, Professional Development, Umeå University, Umeå, Sweden
| | - Olof Semb
- Department of Clinical Sciences, Professional Development, Umeå University, Umeå, Sweden
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Pattanaik D, Purvis E, Jeffrey D. Storytelling: A learning tool to enhance medical students' empathy, attentive listening, clinical curiosity and reflection. J R Coll Physicians Edinb 2024; 54:325-329. [PMID: 39539201 DOI: 10.1177/14782715241299839] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2024] Open
Abstract
Listening to stories of sickness lies at the heart of the patient-doctor relationship. Storytelling serves as a powerful learning tool fostering empathy, attentive listening, clinical curiosity and reflection, key elements of narrative competence. The patient's story, their history, forms the fundamental core of diagnosis, and their emotions are central to crafting appropriate treatment plans that address their true concerns. This study reviews the benefits of storytelling as a learning tool, particularly in enhancing empathy, attentive listening, clinical curiosity and reflection within medical education. It also describes a practical workshop that demonstrates how storytelling can be utilised to inspire students to develop narrative competence in a supportive learning environment. Since the stories draw on participants' clinical experience, in both primary and secondary care, the article aims to engage clinicians involved in medical education and the teaching of communication skills.
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Affiliation(s)
| | - Emma Purvis
- Three Counties Medical School, Worcester, UK
| | - David Jeffrey
- Lead for Ethics & Law, Three Counties Medical School, Worcester, UK
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27
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Mohammadi M, Peyrovi H, Fazeli N, Parsa Yekta Z. Empathic Care Culture in Intensive Care Unit Nurses: A Focused Ethnographic Study. QUALITATIVE HEALTH RESEARCH 2024; 34:1486-1504. [PMID: 38876482 DOI: 10.1177/10497323241240902] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/16/2024]
Abstract
Empathy is one of the important components in the patient-nurse relationship. The aim of the study was to explain the culture of empathic care in intensive care unit (ICU) nurses. The present focused ethnographic study was conducted in the cardiac surgery ICU in Tehran. Three methods of observation, interview, and review of existing documents were used to collect data. From data analysis, three cultural models, "Predominance of task-based care over emotion-based care," "Empathy and lack of empathy, two ends of the spectrum of the nurse-patient relationship," and "Empathy, an interactive and reciprocal process," were extracted. The results showed that empathy creates a caring environment where nurses not only understand their patients but also relate to them, and both are affected by it. Policymakers should consider removing barriers as a means of empowering nurses to provide empathic care.
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Affiliation(s)
- Marziyeh Mohammadi
- Department of Nursing, Faculty of Nursing and Midwifery, Tehran Medical Sciences Islamic Azad University, Tehran, Iran
| | - Hamid Peyrovi
- Nursing and Midwifery Care Research Center/School of Nursing and Midwifery, Iran University of Medical Sciences, Tehran, Iran
| | | | - Zohreh Parsa Yekta
- Department of Nursing, Faculty of Nursing and Midwifery, Tehran Medical Sciences Islamic Azad University, Tehran, Iran
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Krishna LKR, Kwok HYF, Ravindran N, Tan XY, Soh J, Wan DWJ, Rajalingam V, Lua JK, Leong EYM, Low TY, Chan AWJ, Lim CJN, Ng YK, Thenpandiyan AA, Lim AYD, Tse LN, Pl S, Rajanala SP, Leong JR, Quah ELY, Fam VJE, Govindasamy R, Abdul Hamid NAB, Lim C, Sim DSW, Ong EK, Mason S, Somasundaram N, Ong SYK. A systematic scoping review of mentoring support on professional identity formation. BMC MEDICAL EDUCATION 2024; 24:1380. [PMID: 39605048 PMCID: PMC11600620 DOI: 10.1186/s12909-024-06357-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/19/2024] [Accepted: 11/14/2024] [Indexed: 11/29/2024]
Abstract
BACKGROUND Mentoring's success in nurturing professional identity formation (PIF) has been attributed to its ability to build personalised and enduring mentoring relationships. However, beyond functioning as communities of practice (CoPs) supporting socialisation processes, how mentoring integrates programme values and instils a shared identity amongst mentees remains unclear. The need for personalised guidance and timely attention to a mentee's unique needs in evolving mentoring relationships point to the critical role of support mechanisms ('mentoring support'). We conducted a systematic scoping review (SSR) studying "What is known about mentoring support's role in nurturing PIF?". METHODS Adopting PRISMA-ScR guidelines, this SSR was guided by the Systematic Evidence-Based Approach (SEBA). Independent searches were carried out on publications featured between 1st January 2000 and 30th June 2023 in PubMed, Embase, ERIC and Scopus databases. The Split Approach saw concurrent, independent thematic and content analyses of the included articles. The Jigsaw Perspective combined complementary themes and categories, creating broader themes/categories. The subsequent Funnelling Process formed key domains that platformed the synthesis of the discussion. RESULTS Two thousand three hundred forty-one abstracts were reviewed, 323 full-text articles were appraised and 151 articles were included and analysed. The key domains identified were (1) definitions and roles; (2) personalisation; (3) shepherding; and (4) PIF. CONCLUSION The success of mentoring in PIF lies in its ability to blend role modelling, supervision, mentoring, coaching and teaching, with self-care, guided reflection, apprenticeship and assessment to meet the individual needs of the mentee and their changing circumstances. Blending the contents of the mentoring umbrella emphasises the critical role of the mentor and host organisation in supporting mentor training, communications, support and assessment mechanisms. Mentee engagement and its active role in support measures complement the CoP-like mentoring programme's use of blending mentoring support to advance the socialisation process. These insights reflect a complex interactive process scaffolding the development of mentoring relationships and PIF. The effect of the mentoring umbrella on clinical practice requires further study.
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Affiliation(s)
- Lalit Kumar Radha Krishna
- Yong Loo Lin School of Medicine, National University of Singapore, NUHS Tower Block, Level 11, Block 1E, Kent Ridge Road, Singapore, 119228, Singapore.
- Division of Supportive and Palliative Care, National Cancer Centre Singapore, 30 Hospital Boulevard, Singapore, 168583, Singapore.
- Division of Cancer Education, National Cancer Centre Singapore, 30 Hospital Boulevard, Singapore, 168583, Singapore.
- Duke-NUS Medical School, National University of Singapore, 8 College Road, Singapore, 169857, Singapore.
- Centre for Biomedical Ethics, National University of Singapore, Block MD11, 10 Medical Drive, #02-03, Singapore, 117597, Singapore.
- Palliative Care Institute Liverpool, Academic Palliative & End of Life Care Centre, Cancer Research Centre, University of Liverpool, 200 London Road, Liverpool, L3 9TA, UK.
- Health Data Science, University of Liverpool, Whelan Building, The Quadrangle, Brownlow Hill, Liverpool, L69 3GB, UK.
- The Palliative Care Centre for Excellence in Research and Education, PalC, Dover Park Hospice, 10 Jalan Tan Tock Seng, Singapore, 308436, Singapore.
| | - Hannah Yi Fang Kwok
- Division of Supportive and Palliative Care, National Cancer Centre Singapore, 30 Hospital Boulevard, Singapore, 168583, Singapore
- Lee Kong Chian School of Medicine, Nanyang Technological University, 11 Mandalay Road, Singapore, 308207, Singapore
| | - Nila Ravindran
- Yong Loo Lin School of Medicine, National University of Singapore, NUHS Tower Block, Level 11, Block 1E, Kent Ridge Road, Singapore, 119228, Singapore
- Division of Supportive and Palliative Care, National Cancer Centre Singapore, 30 Hospital Boulevard, Singapore, 168583, Singapore
| | - Xuan Yu Tan
- Yong Loo Lin School of Medicine, National University of Singapore, NUHS Tower Block, Level 11, Block 1E, Kent Ridge Road, Singapore, 119228, Singapore
- Division of Supportive and Palliative Care, National Cancer Centre Singapore, 30 Hospital Boulevard, Singapore, 168583, Singapore
| | - Jasper Soh
- Yong Loo Lin School of Medicine, National University of Singapore, NUHS Tower Block, Level 11, Block 1E, Kent Ridge Road, Singapore, 119228, Singapore
- Division of Supportive and Palliative Care, National Cancer Centre Singapore, 30 Hospital Boulevard, Singapore, 168583, Singapore
| | - Darius Wei Jun Wan
- Yong Loo Lin School of Medicine, National University of Singapore, NUHS Tower Block, Level 11, Block 1E, Kent Ridge Road, Singapore, 119228, Singapore
- Division of Supportive and Palliative Care, National Cancer Centre Singapore, 30 Hospital Boulevard, Singapore, 168583, Singapore
| | - Varsha Rajalingam
- Yong Loo Lin School of Medicine, National University of Singapore, NUHS Tower Block, Level 11, Block 1E, Kent Ridge Road, Singapore, 119228, Singapore
- Division of Supportive and Palliative Care, National Cancer Centre Singapore, 30 Hospital Boulevard, Singapore, 168583, Singapore
| | - Jun Kiat Lua
- Yong Loo Lin School of Medicine, National University of Singapore, NUHS Tower Block, Level 11, Block 1E, Kent Ridge Road, Singapore, 119228, Singapore
- Division of Supportive and Palliative Care, National Cancer Centre Singapore, 30 Hospital Boulevard, Singapore, 168583, Singapore
| | - Elizabeth Yong Mei Leong
- Division of Supportive and Palliative Care, National Cancer Centre Singapore, 30 Hospital Boulevard, Singapore, 168583, Singapore
- Lee Kong Chian School of Medicine, Nanyang Technological University, 11 Mandalay Road, Singapore, 308207, Singapore
| | - Tiat Yan Low
- Yong Loo Lin School of Medicine, National University of Singapore, NUHS Tower Block, Level 11, Block 1E, Kent Ridge Road, Singapore, 119228, Singapore
- Division of Supportive and Palliative Care, National Cancer Centre Singapore, 30 Hospital Boulevard, Singapore, 168583, Singapore
| | - Aiden Wei-Jun Chan
- Yong Loo Lin School of Medicine, National University of Singapore, NUHS Tower Block, Level 11, Block 1E, Kent Ridge Road, Singapore, 119228, Singapore
- Division of Supportive and Palliative Care, National Cancer Centre Singapore, 30 Hospital Boulevard, Singapore, 168583, Singapore
| | - Chong Jin Nicholas Lim
- Yong Loo Lin School of Medicine, National University of Singapore, NUHS Tower Block, Level 11, Block 1E, Kent Ridge Road, Singapore, 119228, Singapore
- Division of Supportive and Palliative Care, National Cancer Centre Singapore, 30 Hospital Boulevard, Singapore, 168583, Singapore
| | - Yen Kit Ng
- Yong Loo Lin School of Medicine, National University of Singapore, NUHS Tower Block, Level 11, Block 1E, Kent Ridge Road, Singapore, 119228, Singapore
- Division of Supportive and Palliative Care, National Cancer Centre Singapore, 30 Hospital Boulevard, Singapore, 168583, Singapore
| | - Arthena Anushka Thenpandiyan
- Yong Loo Lin School of Medicine, National University of Singapore, NUHS Tower Block, Level 11, Block 1E, Kent Ridge Road, Singapore, 119228, Singapore
- Division of Supportive and Palliative Care, National Cancer Centre Singapore, 30 Hospital Boulevard, Singapore, 168583, Singapore
| | - Adele Yi Dawn Lim
- Yong Loo Lin School of Medicine, National University of Singapore, NUHS Tower Block, Level 11, Block 1E, Kent Ridge Road, Singapore, 119228, Singapore
- Division of Supportive and Palliative Care, National Cancer Centre Singapore, 30 Hospital Boulevard, Singapore, 168583, Singapore
| | - Leia Ning Tse
- Yong Loo Lin School of Medicine, National University of Singapore, NUHS Tower Block, Level 11, Block 1E, Kent Ridge Road, Singapore, 119228, Singapore
- Division of Supportive and Palliative Care, National Cancer Centre Singapore, 30 Hospital Boulevard, Singapore, 168583, Singapore
| | - Sriram Pl
- Yong Loo Lin School of Medicine, National University of Singapore, NUHS Tower Block, Level 11, Block 1E, Kent Ridge Road, Singapore, 119228, Singapore
- Division of Supportive and Palliative Care, National Cancer Centre Singapore, 30 Hospital Boulevard, Singapore, 168583, Singapore
| | - Sri Priyanka Rajanala
- Yong Loo Lin School of Medicine, National University of Singapore, NUHS Tower Block, Level 11, Block 1E, Kent Ridge Road, Singapore, 119228, Singapore
- Division of Supportive and Palliative Care, National Cancer Centre Singapore, 30 Hospital Boulevard, Singapore, 168583, Singapore
| | - Jun Rey Leong
- Yong Loo Lin School of Medicine, National University of Singapore, NUHS Tower Block, Level 11, Block 1E, Kent Ridge Road, Singapore, 119228, Singapore
- Division of Supportive and Palliative Care, National Cancer Centre Singapore, 30 Hospital Boulevard, Singapore, 168583, Singapore
| | - Elaine Li Ying Quah
- Yong Loo Lin School of Medicine, National University of Singapore, NUHS Tower Block, Level 11, Block 1E, Kent Ridge Road, Singapore, 119228, Singapore
- Division of Supportive and Palliative Care, National Cancer Centre Singapore, 30 Hospital Boulevard, Singapore, 168583, Singapore
| | - Victoria Jia En Fam
- Division of Cancer Education, National Cancer Centre Singapore, 30 Hospital Boulevard, Singapore, 168583, Singapore
- Division of Psychosocial Oncology, National Cancer Centre Singapore, 30 Hospital Boulevard, Singapore, 168583, Singapore
| | - Ranitha Govindasamy
- Yong Loo Lin School of Medicine, National University of Singapore, NUHS Tower Block, Level 11, Block 1E, Kent Ridge Road, Singapore, 119228, Singapore
- Division of Cancer Education, National Cancer Centre Singapore, 30 Hospital Boulevard, Singapore, 168583, Singapore
- Centre for Biomedical Ethics, National University of Singapore, Block MD11, 10 Medical Drive, #02-03, Singapore, 117597, Singapore
| | - Nur Amira Binte Abdul Hamid
- Division of Cancer Education, National Cancer Centre Singapore, 30 Hospital Boulevard, Singapore, 168583, Singapore
| | - Crystal Lim
- Medical Social Services, Singapore General Hospital, Outram Road, Singapore, 169608, Singapore
| | - Dorsett Shin Wei Sim
- Geylang Polyclinic, National Healthcare Group Polyclinics, 21 Geylang East Central, Singapore, 389707, Singapore
| | - Eng Koon Ong
- Division of Supportive and Palliative Care, National Cancer Centre Singapore, 30 Hospital Boulevard, Singapore, 168583, Singapore
- Division of Cancer Education, National Cancer Centre Singapore, 30 Hospital Boulevard, Singapore, 168583, Singapore
- Duke-NUS Medical School, National University of Singapore, 8 College Road, Singapore, 169857, Singapore
- Assisi Hospice, 832 Thomson Road, Singapore, 574627, Singapore
| | - Stephen Mason
- Palliative Care Institute Liverpool, Academic Palliative & End of Life Care Centre, Cancer Research Centre, University of Liverpool, 200 London Road, Liverpool, L3 9TA, UK
| | - Nagavalli Somasundaram
- Division of Cancer Education, National Cancer Centre Singapore, 30 Hospital Boulevard, Singapore, 168583, Singapore
- Duke-NUS Medical School, National University of Singapore, 8 College Road, Singapore, 169857, Singapore
- Division of Medical Oncology, National Cancer Centre Singapore, 30 Hospital Boulevard, Singapore, 168583, Singapore
| | - Simon Yew Kuang Ong
- Division of Cancer Education, National Cancer Centre Singapore, 30 Hospital Boulevard, Singapore, 168583, Singapore
- Duke-NUS Medical School, National University of Singapore, 8 College Road, Singapore, 169857, Singapore
- Division of Medical Oncology, National Cancer Centre Singapore, 30 Hospital Boulevard, Singapore, 168583, Singapore
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Ghiga I, Pitchforth E, Popescu GA, Fulop I, Lundborg CS, Machowska A. Self-assessed levels of preparedness, engagement willingness and teaching preferences on antibiotic use of medical and pharmacy students in Romanian universities: a cross-sectional study. BMC MEDICAL EDUCATION 2024; 24:1214. [PMID: 39456062 PMCID: PMC11520128 DOI: 10.1186/s12909-024-06182-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/21/2023] [Accepted: 10/14/2024] [Indexed: 10/28/2024]
Abstract
BACKGROUND To effectively support health professionals in optimizing antibiotic prescribing and dispensing, policymakers need to understand how these professionals are trained, feel prepared and want to be educated. The study aimed to assess the current situation and explore potential improvements in antibiotic use among future health professionals in Romania by: (i) evaluating their self-assessed preparedness on antibiotic-related topics, (ii) understanding their perceptions of their role in antibiotic stewardship, and (iii) gathering their recommendations for optimizing antibiotic use. METHODS A survey of students' self-assessment of technical preparedness, engagement willingness, expectations, teaching preferences, training received and evolution of situation in Romania. Overall, 41 and 38 questions were asked to medical and pharmacy students respectively. Scores were calculated for preparedness, engagement willingness and teaching preferences to enable various comparisons. Exploratory factor analysis was used to explore the questionnaire construct. RESULTS A total of 479 participants completed the survey- 233 medical students from 7 universities and 246 pharmacy students from 4 universities. Median overall preparedness score indicated that most students felt prepared in at least 14 questions (out of 22 for medical students, and 19 for pharmacy students). Engagement scores for medical and pharmacy students were similar (2 and 3 out of 4). Overall, more than half reported that 'yes, very likely' they received adequate training to ensure the appropriate use of antibiotics in their professional areas (n = 254, 53.5%). Medical and pharmacy students with low preparedness scores expressed a need for more education. Most of both medical and pharmacy students considered the antibiotic situation in Romania 'will get worse' (n = 159, 33.5%). CONCLUSIONS The study's findings have important implications for the education and training of future Romanian health professionals and highlight the need for further research on optimal and standardized tools to allow for periodic monitoring and evaluation of progress into preparedness, engagement willingness and teaching preferences on antibiotic use.
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Affiliation(s)
- Ioana Ghiga
- Department of Global Public Health, Karolinska Institutet, Stockholm, 171 77, Sweden.
| | - Emma Pitchforth
- Primary Care Research Group, University of Exeter Medical School, St Luke's Campus, Heavitree Road, Exeter, EX1 2LU, UK
| | - Gabriel Adrian Popescu
- Faculty of Medicine, University of Medicine and Pharmacy "Carol Davila" Bucharest, Bucharest, Romania
| | - Ibolya Fulop
- Faculty of Pharmacy, George Emil Palade University of Medicine, Pharmacy, Science and Technology of Targu Mures, Targu Mures, Romania
| | | | - Anna Machowska
- Department of Global Public Health, Karolinska Institutet, Stockholm, 171 77, Sweden
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Qu Z, Sun J, Li L, Zhao L, Jiang N, Fan J, Zhang J, Liang B. Corrigendum to "The effect of simulated problem learning in nursing ethics on moral sensitivity, empathy and critical thinking of nursing students: A quasi-experimental study" [Nurse Educ. Pract. 80 (2024) 104119]. Nurse Educ Pract 2024; 80:104173. [PMID: 39490315 DOI: 10.1016/j.nepr.2024.104173] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2024]
Affiliation(s)
- Zhifei Qu
- School of Nursing, Jilin University, Changchun, Jilin 130021, China
| | - Jingjing Sun
- Department of Otolaryngology Head and Neck Surgery, The First Hospital of Jilin University, Changchun, Jilin 130021, China
| | - Li Li
- Nursing Department, The Second Hospital of Jilin University, Changchun, Jilin 130021, China
| | - Lijing Zhao
- School of Nursing, Jilin University, Changchun, Jilin 130021, China
| | - Nan Jiang
- Department of Cardiovascular center, Jilin University First Hospital, Changchun, Jilin 130000, China
| | - Jia Fan
- The Second Hospital of Jilin University, Changchun, Jilin 130021, China
| | - Jiaxin Zhang
- Department of Nursing, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing 100045, China
| | - Bing Liang
- School of Nursing, Jilin University, Changchun, Jilin 130021, China.
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Chaudhuri S, Ghose S, Santra A, Paul KK, Pandey R. Training on empathy skills for elderly persons to medical undergraduates: A quasi-experimental study. J Family Med Prim Care 2024; 13:4462-4468. [PMID: 39629439 PMCID: PMC11610830 DOI: 10.4103/jfmpc.jfmpc_283_24] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2024] [Revised: 04/25/2024] [Accepted: 04/29/2024] [Indexed: 12/07/2024] Open
Abstract
Introduction Undergraduate medical students often lack the soft skill of empathy which is considered as an important attribute for doctors. Hence, this study was conducted to improve the empathy skills among undergraduate students of a medical college in Kolkata. Methods A quasi-experimental study was conducted in the Rural Health Training Centre of a medical college in Kolkata among the undergraduate medical students during community medicine posting. Students were assessed for baseline empathy by Jefferson's Scale of Empathy (student's version) (JSE-S). Baseline perception was taken from geriatric persons about the empathy level of medical undergraduates using Jefferson's Scale of Patient's Perception about Physician's Empathy (JSPPE). Training module was prepared, validated and imparted. Post-training score was obtained using the scales for students as well as geriatric persons. Data were entered in MS Excel and analysed using STATA MP16. Results Total of 93 students participated. Overall Mean ± SD of pre-score of JES-S was 102.03 ± 13.02, and post-score was 109.03 ± 14.57; the difference was found to be statistically significant (P < 0.001). With respect to JSPPE, score difference was found to be statistically significant (P < 0.001). Significant difference was present in scores between the students who prefer people-oriented specialities compared to the technology-oriented specialities (P < 0.05). Increase in mean empathy score was significantly higher among female students than their male counterparts (P = 0.01). Conclusions The study shows the effectiveness of training module in increasing empathy score among medical undergraduates which is the need of the hour to establish the proper building block of doctor-patient relationship.
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Affiliation(s)
- Susmita Chaudhuri
- Associate Professor, Department of Community Medicine, ESI-PGIMSR & ESIC Medical College, Joka, Kolkata, West Bengal, India
| | - Sauryadripta Ghose
- Assistant Professor, Department of Community Medicine, ESI-PGIMSR & ESIC Medical College, Joka, Kolkata, West Bengal, India
| | - Archismita Santra
- Assistant Professor, Department of Community Medicine, ESI-PGIMSR & ESIC Medical College, Joka, Kolkata, West Bengal, India
| | - Kalyan Kumar Paul
- Associate Professor, Department of Community Medicine, ESIC Medical College & Hospital, Bihta, Patna, India
| | - Rajneesh Pandey
- Associate Professor, Department of Anatomy, Seth G S Medical College & KEM Hospital, Mumbai, India
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Ozeki-Hayashi R, Wilkinson DJC. Shinmi (): a Distinctive Japanese Medical Virtue? Asian Bioeth Rev 2024; 16:563-573. [PMID: 39398457 PMCID: PMC11465113 DOI: 10.1007/s41649-023-00261-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Revised: 09/11/2023] [Accepted: 09/18/2023] [Indexed: 10/15/2024] Open
Abstract
In Western countries, the ideal professional and ethical attributes of healthcare providers and the ideal patient-doctor relationship have been analysed in detail. Other cultures, however, may have different norms, arising in response to diverse healthcare needs, cultural values and offering alternative perspectives. In this paper, drawing a case study, we introduce the concept of Shinmi, used in Japan to describe a desirable approach to medical care. Shinmi means kind or cordial in Japanese. In the medical context, it refers to doctors treating patients with a degree of emotional closeness as if they were the doctors' own family. We analyse the concept of Shinmi, drawing on virtue ethics. We distinguish two different elements to a Shinmi-na attitude. As illustrated in our example, excessive Shinmi can be problematic for patients and doctors. Furthermore, elements of Shinmi may conflict with existing Western values (for example, norms that encourage emotional detachment and discourage doctors' treatment of family members). However, if pursued appropriately, we argue that a balanced Shinmi-na approach can be conducive to the goals of medicine. The concept of Shinmi may be valuable for medical students, in Japanese and potentially other health care systems, and help them to cultivate a virtuous approach to meeting the emotional needs of patients.
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Affiliation(s)
- Reina Ozeki-Hayashi
- Oxford Uehiro Centre for Practical Ethics, Faculty of Philosophy, University of Oxford, Oxford, UK
- University of Tokyo, Tokyo, Japan
| | - Dominic J. C. Wilkinson
- Oxford Uehiro Centre for Practical Ethics, Faculty of Philosophy, University of Oxford, Oxford, UK
- John Radcliffe Hospital, Oxford, UK
- Murdoch Children’s Research Institute, Melbourne, Australia
- Centre for Biomedical Ethics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
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Bhagat PR, Kinjal YT, Vijay R. The Empathy Quandary in Postgraduate Medical Training. Int J Appl Basic Med Res 2024; 14:233-238. [PMID: 39749171 PMCID: PMC11691101 DOI: 10.4103/ijabmr.ijabmr_288_24] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2024] [Revised: 07/17/2024] [Accepted: 09/02/2024] [Indexed: 01/04/2025] Open
Abstract
Background Empathy stands as a cornerstone of humanistic qualities and is essential in healthcare for understanding and alleviating emotional suffering. Despite its necessity, formal empathy training remains elusive in postgraduate medical education across the globe, contributing to decline of humanistic practice among trainees. This study aims to assess and establish the need for empathy training by evaluating the perspectives of postgraduate trainees and faculty. Materials and Methods The study was conducted in a medical college of western India in 2023. Three online validated questionnaires were used to assess empathy-related perceptions among faculty and postgraduate trainees across various specialties. The questionnaires focused on demographic data, importance of empathy in patient care, empathy training, perceived levels of empathy, reasons for shortfalls in empathetic behavior and recommendations for nurturing empathy. Data were analyzed quantitatively and thematically. Results A total of 150 and 127 responses were gathered and analyzed from faculty and trainees, respectively. Excessive workload, lack of formal training, and technology-dependent fast paced lifestyle were attributed for lack of empathy in clinical care. All the faculty agreed that empathy training is essential and majority (67%) believed that lack of empathetic behavior led to dissatisfaction among patients and caregivers. Conclusion Empathetic communication and behaviors are fundamental competencies for health-care professionals. There is need for a structured training for empathy in postgraduate medical curriculum.
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Affiliation(s)
- Purvi Raj Bhagat
- Department of Ophthalmology, M and J Western Regional Institute of Ophthalmology, B. J. Medical College and Civil Hospital, Ahmedabad, Gujarat, India
| | - Y. Trivedi Kinjal
- Department of Ophthalmology, M and J Western Regional Institute of Ophthalmology, B. J. Medical College and Civil Hospital, Ahmedabad, Gujarat, India
| | - Rajput Vijay
- Department of Medical Education, Nova Southeastern University, Dr. Kiran C. Patel College of Allopathic Medicine, Florida, United States
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Atta IS. Introducing professionalism and medical ethics in undergraduate integrative medical curriculum through a four-dimensional model. JOURNAL OF EDUCATION AND HEALTH PROMOTION 2024; 13:341. [PMID: 39679035 PMCID: PMC11639436 DOI: 10.4103/jehp.jehp_1767_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/30/2023] [Accepted: 01/15/2024] [Indexed: 12/17/2024]
Abstract
BACKGROUND To develop a method for designing the ethics and professionalism compatible with the integrative medical curriculum. So that the insertion of ethics and professionalism should start from the initial stages of the integrative program in an indirect manner through student-centered activities, passing through introducing some ethical topics that are appropriate for each module, developing a condensed module at the beginning of the clinical stage, and ended by developing a practical course in the internship period. In this way, a four-dimensional model to present ethics and professionalism has been introduced. MATERIALS AND METHODS A questionnaire was conducted for students (230 students) and faculty (65 faculty members) to find out the current situation of ethics and professionalism and the extent of their aspiration and passion for developing it. RESULT The result revealed low student and faculty satisfaction with the ethics presentation in the current situation. Educational objectives and outcomes have been developed, and the appropriate teaching model was selected, selecting the main topics, and mapped through a four-dimensional model and assigning the appropriate assessment tools and evaluation mechanisms. CONCLUSION This model ensures that the student learns ethics and professionalism and breathes its rules from the beginning of his academic studies. In this way, the student will be able to practice those rules in an automatic and spontaneous manner without having any difficulty in practicing them. In addition, this model helps in breaking down the barriers between faculty members, the basic and clinical sciences, and medical departments which are one of the most important goals of integrative medical education.
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Affiliation(s)
- Ihab S. Atta
- Pathology Department, Faculty of Medicine, Al-Baha University, Saudi Arabia
- Pathology Department, Faculty of Medicine, Al-Azhar University, Assuit, Egypt
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Hoplock LB, Lobchuk MM, Strachan SM, Halas G, Olfert C, Webber S, Parsons JL. A randomized pragmatic feasibility trial to promote student perspective-taking on client physical activity level: a collaborative project. Pilot Feasibility Stud 2024; 10:123. [PMID: 39342378 PMCID: PMC11437983 DOI: 10.1186/s40814-024-01547-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2023] [Accepted: 09/02/2024] [Indexed: 10/01/2024] Open
Abstract
BACKGROUND Health-care practitioners have opportunities to talk with clients about unhealthy behaviors. How practitioners approach these conversations involves skill to be effective. Thus, teaching health-care students to communicate empathetically with clients should promote effective client-practitioner conversations about health behavior change. The primary objective of this pilot trial was to assess the feasibility, acceptability, and appropriateness of a theoretically informed intervention designed to improve perspective-taking. METHODS For inclusion in this randomized mixed-methods parallel two-arm trial, participants needed to be a student at the investigators' Canadian university and have completed course content on behavior change communication. Using a 1:1 allocation ratio, participants in Respiratory, Physical, and Occupational Therapy; Nurse Practitioner; and Kinesiology programs were randomly assigned to full or partial intervention conditions. Full intervention participants completed a perspective-taking workshop and practiced perspective-taking prior to an in-lab dialogue with a client-actor (masked to condition) about physical activity. Partial intervention participants received the workshop after the dialogue. We assessed feasibility and appropriateness by comparing recruitment rates, protocol, and psychometric outcomes to criteria. We assessed acceptability (secondary outcome) by analyzing exit interviews. RESULTS We screened and randomized 163 participants (82 = full intervention; 81 = partial intervention). We fell slightly short of our recruitment success criteria (10-15 participants per program) when 2/50 Occupational Therapy students participated. We met some but not all of our protocol criteria: Some full intervention participants did not practice perspective-taking before the dialogue, because they did not see anyone during the practice period or did not have a practice opportunity. Psychometric outcomes met the criteria, except for one measure that demonstrated ceiling effects and low reliability (Cronbach's alpha < .70). There were no adverse events related to participation. CONCLUSIONS The intervention should be largely feasible, appropriate, and acceptable to deliver. We suggest changes that are large enough to warrant conducting another pilot study. We outline recommended improvements that are applicable to researchers and educators interested in recruitment, adherence to home practice, and online uptake of the intervention. TRIAL REGISTRATION This trial was registered retrospectively on November 8, 2023, at https://clinicaltrials.gov/study/NCT06123507 .
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Affiliation(s)
- Lisa B Hoplock
- College of Nursing, University of Manitoba, Winnipeg, MB R3T 2N2, Canada
| | - Michelle M Lobchuk
- College of Nursing, University of Manitoba, Winnipeg, MB R3T 2N2, Canada.
| | - Shaelyn M Strachan
- Faculty of Kinesiology and Recreation Management, University of Manitoba, Winnipeg, MB R3T 2N2, Canada.
| | - Gayle Halas
- Faculty of Health Sciences, University of Manitoba, Winnipeg, MB R3E 0W3, Canada
| | - Cheryl Olfert
- College of Nursing, University of Manitoba, Winnipeg, MB R3T 2N2, Canada
| | - Sandra Webber
- College of Rehabilitation Sciences, University of Manitoba, Winnipeg, MB R3E 0T6, Canada
| | - Joanne L Parsons
- College of Rehabilitation Sciences, University of Manitoba, Winnipeg, MB R3E 0T6, Canada
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Amjadi MF, Kociubuk J, Hollnagel F, Tsenkova VK, Zelenski AB. Zoom Improv is accessible and enhances medical student empathy. BMC MEDICAL EDUCATION 2024; 24:1049. [PMID: 39334240 PMCID: PMC11429412 DOI: 10.1186/s12909-024-06017-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/11/2024] [Accepted: 09/12/2024] [Indexed: 09/30/2024]
Abstract
BACKGROUND Empathy declines during medical training, despite its importance. METHODOLOGY In this randomized controlled trial, we assessed the impact of Zoom improv on medical student empathy using a concurrent mixed-methods approach. Quantitative assessment with three survey tools and qualitative assessment by content analysis of Zoom session field notes were conducted. RESULTS Zoom improv participants had higher empathy scores in perspective-taking and fantasy and lower scores in personal distress compared with the control group. Medical students who participated in Zoom improv exercised emotional expression, active listening, and giving "gifts," which apply to healthcare settings in which affirming team members with empathic concern can advance communication, patient rapport, and teamwork. DISCUSSION This pilot study highlights promising findings for the incorporation of Zoom improv in medical education, including enhanced empathy, self-reflection, and understanding how these skills impact work in healthcare. Future studies may expand on the optimal timing to teach improv. Future studies conducted on virtual platforms may also further investigate our finding that the fantasy domain of empathy increases after Zoom improv sessions, whereas this increase in fantasy was absent from previous in-person studies. Given the increase in telehealth and virtual medical visits, exercising empathy skills through a screen during training may be an important addition to medical curricula.
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Affiliation(s)
- Maya F Amjadi
- Department of Medicine, University of Wisconsin (UW)-Madison, Madison, WI, USA
| | | | - Fauzia Hollnagel
- Department of Medicine, University of Wisconsin (UW)-Madison, Madison, WI, USA
| | - Vera K Tsenkova
- School of Medicine and Public Health, UW-Madison, 1685 Highland Ave, Madison, WI, USA
| | - Amy B Zelenski
- Department of Medicine, University of Wisconsin (UW)-Madison, Madison, WI, USA.
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Albrecht F, Lutz G, Atzeni G, Berberat PO, Matcau P, Jedlicska N, Kiessling C. Insights into the meaning of medical students' studies. An online survey at two medical faculties. GMS JOURNAL FOR MEDICAL EDUCATION 2024; 41:Doc45. [PMID: 39415806 PMCID: PMC11474645 DOI: 10.3205/zma001700] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Figures] [Subscribe] [Scholar Register] [Received: 10/02/2023] [Revised: 03/25/2024] [Accepted: 06/11/2024] [Indexed: 10/19/2024]
Abstract
Objective The aim of the study was to investigate how medical students' deal with their own questions of meaning during their studies, how they cope with patients' questions of meaning or crises of meaning, to what extent their experience of meaning changes during their studies, and what role medical studies play in this. Methods In 2022, we conducted an exploratory cross-sectional study in the form of an online survey at two German universities with students in the clinical part of their studies. Quantitative data were analyzed descriptively, and group differences were analyzed using Mann-Whitney U tests. Free-text comments were analyzed using thematic analysis. Results Of the 111 participants (response rate 12%), 92% had addressed questions of meaning. 64% of the students felt that their studies were meaningful, and 45% felt that their clinical internships were meaningful. 59% reported that they had been confronted with questions of meaning in their contact with patients, although many of them felt that they had been inadequately prepared for this (56%). This impression was stronger among respondents at the beginning of the clinical phase compared to respondents at the end (U(56,34)=660, p=0.012). According to the students, strategies for dealing with questions of meaning were active engagement with topics of meaning, tolerance of uncertainties, or avoidance. In addition to the basic requirement of openness to all topics of meaning, students expressed the wish to be better prepared for professional questions of meaning and for follow-up work on stressful events. A wide range of critical experiences with training and the healthcare system had an inhibiting effect on the experience of meaning. Conclusion Since a higher sense of purpose can be associated with improved health and motivation, university programs might have the potential to support students' sense of purpose and, in the long term, improve their capacities to support patients who grapple with questions of meaning.
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Affiliation(s)
- Felix Albrecht
- Witten/Herdecke University, Faculty of Health, Witten, Germany
| | - Gabriele Lutz
- Witten/Herdecke University, Faculty of Health, Psychosomatic Medicine and Psychotherapy, Witten, Germany
- Gemeinschaftskrankenhaus Herdecke, Herdecke, Germany
| | - Gina Atzeni
- LMU Munich, Institute of Sociology, Munich, Germany
| | - Pascal O. Berberat
- Technical University of Munich, TUM School of Medicine and Health, Department of Clinical Medicine, TUM Medical Education Center, Munich, Germany
| | - Paula Matcau
- Technical University of Munich, TUM School of Medicine and Health, Department of Clinical Medicine, TUM Medical Education Center, Munich, Germany
| | - Nana Jedlicska
- Technical University of Munich, TUM School of Medicine and Health, Department of Clinical Medicine, TUM Medical Education Center, Munich, Germany
| | - Claudia Kiessling
- Witten/Herdecke University, Faculty of Health, Education of Personal and Interpersonal Competencies in Health Care, Witten, Germany
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Moledina A, Ruller S, Halman S, Ying Y. Assessing resident experience of a new experiential learning health advocacy curriculum: a mixed methods study. BMC MEDICAL EDUCATION 2024; 24:988. [PMID: 39261820 PMCID: PMC11391829 DOI: 10.1186/s12909-024-05961-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/11/2023] [Accepted: 08/27/2024] [Indexed: 09/13/2024]
Abstract
BACKGROUND Health Advocacy is considered one of the most difficult skills to teach. Many medical learners feel ill-equipped in social competencies and identify it as a significant gap in their medical training. Experiential learning has recently been emerging as a more effective method to teach health advocacy. The Post Graduate Medical Education (PGME) Health Advocacy Day is a new experiential learning curriculum designed to teach important competencies of health advocacy and social accountability to post-graduate medical residents at the University of Ottawa in Ottawa, Canada. The objective of this mixed-methods study was to assess resident experiences. METHODS Second-year trainees from all adult residency programs attended the Advocacy Day as part of a mandatory academic day. All participants completed a mandatory pre-and post-session quiz to assess knowledge of key topics before and after the course. We also distributed a voluntary survey to all participants and invited residents to participate in semi-structured interviews to provide feedback on the course. We used descriptive statistics to analyze quiz scores and survey results and conducted a paired t-test of pre and post-test quiz scores. We also performed a thematic analysis of qualitative feedback, specifically survey comments and semi-structured interviews. RESULTS One hundred and eighty-three residents participated in the Advocacy Day and 112 (61.2%) completed the post-course survey. Ten residents volunteered to be interviewed. Respondents were generally satisfied by the session and felt it was of good quality. Most residents felt the course enhanced their ability to advocate for individual patients or communities (N = 80; 71.5%) and understand patients and families' lived experience with illness (N = 87; 77.5%). Most residents also felt the course improved their knowledge of the impact of social determinants of health (N = 91; 81.2%) and increased their awareness of local resources that can support patients and their families (N = 88; 78.3%). Visiting community sites in-person and meeting persons with lived experiences were highlighted as the most valuable components of the course. CONCLUSION Experiential learning can be integrated within post-graduate medical curricula to teach health advocacy competencies. Future studies should examine the longitudinal impact of the curricula, to determine whether shifts in perspectives persist over time.
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Affiliation(s)
- Aliza Moledina
- Department of Medicine, University of Ottawa, 501 Smyth Road, K1H8L6, Ottawa, ON, Canada.
- Division of General Internal Medicine, The Ottawa Hospital, Ottawa, Canada.
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Canada.
| | - Sydney Ruller
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Canada
| | - Samantha Halman
- Department of Medicine, University of Ottawa, 501 Smyth Road, K1H8L6, Ottawa, ON, Canada
- Division of General Internal Medicine, The Ottawa Hospital, Ottawa, Canada
| | - Yvonne Ying
- Department of Surgery, University of Ottawa, Ottawa, Canada
- Department of Surgery, Children's Hospital of Eastern Ontario, Ottawa, Canada
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Jordan MN, Sarantaki A, Diamanti A, Vivilaki V. The translation and validation of the MES for an Austrian sample. Eur J Midwifery 2024; 8:EJM-8-54. [PMID: 39351399 PMCID: PMC11440047 DOI: 10.18332/ejm/191394] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2023] [Revised: 06/13/2024] [Accepted: 07/18/2024] [Indexed: 10/04/2024] Open
Abstract
INTRODUCTION Empathy plays an important role in midwifery care, not only for the women but also for midwives. The Midwifery Empathy Scale (MES) was developed to assess the empathy levels of midwives and midwifery students. The purpose of this study was the translation and validation of the MES for an Austrian sample. METHODS A total of 277 midwives working in Austria completed the questionnaire of the MES. The psychometric measurements that were performed included explanatory factor analysis using a varimax rotation and principal components analysis. Moreover, the internal consistency of the MES was assessed with reliability coefficients. The Kaiser-Meyer-Olkin (KMO) measure of sampling adequacy and a Bartlett's test of sphericity were carried out. RESULTS Principal components analysis showed seven orthogonal factors. KMO measure of sample adequacy = 0.724 and Bartlett's test of sphericity = 1058.904 (df=231, p<0.0001). The MES showed an acceptable overall internal consistency: Cronbach's alpha was found to be 0.721 and the Guttman split-half coefficient was 0.611. The findings of our study confirm the multidimensionality of MES, demonstrating a seven-factor structure which contained subscales reflecting empathy and emotional connection. The mean total score of Austrian midwives' responses to the MES was 44.80 with scores ranging from 24 to 81. CONCLUSIONS This study shows that the German version of the Midwifery Empathy Scale is a reliable instrument for evaluating the empathy levels of midwives and midwifery students in Austria. The German MES could be used in the selection and education of future midwives as well as in connection with empathy trainings of midwives.
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Affiliation(s)
- Myriam N. Jordan
- Department of Midwifery, University of West Attica, Athens, Greece
| | | | - Athina Diamanti
- Department of Midwifery, University of West Attica, Athens, Greece
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Habib H, Niinuma SA, Alrefaie K, Khalaf HAA, Hani MJ, Al-Rawi ZYM, Hussain Z, Menezes P, Roy SR, Mathew B, Guraya SY, Nicholson A, Guraya SS. Unfolding the empathic insights and tendencies among medical students of two gulf institutions using interpersonal reactivity index. BMC MEDICAL EDUCATION 2024; 24:976. [PMID: 39252067 PMCID: PMC11385142 DOI: 10.1186/s12909-024-05921-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/19/2023] [Accepted: 08/16/2024] [Indexed: 09/11/2024]
Abstract
BACKGROUND Empathy is an essential core competency for future doctors. Unfortunately, the medical curriculum is infamously known to burn out aspiring doctors, which may potentially lead to a decline in empathy among medical students. This research was planned to understand the evolution of empathic approaches among students across the curriculum using the Interpersonal reactivity index (IRI) as a benchmark at the Royal College of Surgeons in Ireland - Medical University of Bahrain (RCSI-MUB) and University of Sharjah (UoS). METHODS We adopted a cross-sectional design and administered an online survey to the medical students of RCSI-MUB and UoS using a modified version of the IRI along with its three subscales of empathic concern (EC), perspective taking (PT), and personal distress (PD). To identify intra- and inter-institutional variations in empathy scores, the Analysis of Variance (ANOVA) was performed separately for each institution and with both institutions combined. A two-way ANOVA was conducted for the comparison between years and institutions. For the subscale analysis of EC, PT, and PD, we used one-way ANOVA for significant differences between years at both institutions. For the gender-effect analysis, t-test was performed to examine the differences in total IRI scores at both institutions combined and at each institution separately. Additionally, an Analysis of Covariance (ANCOVA) was done to identify the influence of gender on empathy scores. RESULTS A total of 140 students from both institutions participated in this study. We found a fluctuating pattern of empathy scores without a clear trend across the years. The sub-scales of EC, PD, and PT across academic years at both institutions showed significant differences within the EC at RCSI-MUB (p = 0.003). No significant differences were identified across other years from both institutions. There were significant differences between empathy scores from RCSI-MUB and UoS for EC (p = 0.011). Additionally, a pronounced interaction effect between year and institution was observed for PT (p = 0.032). The gender-wise analysis showed that female students had higher empathy scores than males (p = 0.004). The ANCOVA for IRI score results revealed a p-value of 0.023, indicating that gender plays a crucial role in empathy levels among medical students. The ANCOVA results revealed a p-value of 0.022 in the EC subscale. CONCLUSION Our study unveiled intricate patterns in empathy development among medical students across years and genders at RCSI-MUB and UoS. These congruences and dissimilarities in empathy scores signal a subjective understanding of empathy by medical students. The disparities in understanding may encourage medical educators to embed empathy in standard medical curricula for better healthcare outcomes.
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Affiliation(s)
- Haniya Habib
- School of Medicine, Royal College of Surgeons in Ireland Bahrain, Busaiteen, 15503, Bahrain
| | - Sara Anjum Niinuma
- School of Medicine, Royal College of Surgeons in Ireland Bahrain, Busaiteen, 15503, Bahrain
| | - Khadeja Alrefaie
- School of Medicine, Royal College of Surgeons in Ireland Bahrain, Busaiteen, 15503, Bahrain
| | - Heba Awad Al Khalaf
- College of Medicine, University of Sharjah, Sharjah, 27272, United Arab Emirates
| | - Mohammad Jasem Hani
- College of Medicine, University of Sharjah, Sharjah, 27272, United Arab Emirates
| | | | - Zarish Hussain
- School of Medicine, Royal College of Surgeons in Ireland Bahrain, Busaiteen, 15503, Bahrain
| | - Prianna Menezes
- School of Medicine, Royal College of Surgeons in Ireland Bahrain, Busaiteen, 15503, Bahrain
| | - Sornali Rani Roy
- University Hospitals of North Midlands NHS Trust, Stoke-on-Trent, ST4 6QG, UK
| | - Bincy Mathew
- School of Medicine, Royal College of Surgeons in Ireland Bahrain, Busaiteen, 15503, Bahrain
| | - Salman Yousuf Guraya
- College of Medicine, University of Sharjah, Sharjah, 27272, United Arab Emirates.
| | - Alfred Nicholson
- School of Medicine, Royal College of Surgeons in Ireland Bahrain, Busaiteen, 15503, Bahrain
| | - Shaista Salman Guraya
- College of Medicine, Mohammed Bin Rashid University of Medical and Health Sciences, Dubai, 505055, United Arab Emirates
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Li P, Weng L, Dong L. Empathy ability and influencing factors among pediatric residents in China: a mixed-methods study. BMC MEDICAL EDUCATION 2024; 24:955. [PMID: 39223586 PMCID: PMC11370118 DOI: 10.1186/s12909-024-05858-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/29/2024] [Accepted: 08/02/2024] [Indexed: 09/04/2024]
Abstract
BACKGROUND Empathy is one of the fundamental factors enhancing the therapeutic effects of physician-patient relationships, but there has been no relevant research in China on the pediatric resident physicians' capacity for empathy or the influencing factors. METHODS A mixed-methods study was undertaken. The student version of the Jefferson Scale of Empathy was used to assess 181 postgraduate residents at Shanghai Children's Medical Center and Shanghai Children's Hospital. Differences in empathy ability among pediatric resident physicians of different genders and specialties were analyzed using independent sample t-tests and Mann-Whitney U tests. A one-way analysis of variance was used to analyze the differences in empathy ability at different educational levels and years of medical residency training. Seven third-year postgraduate pediatric residents from Shanghai Children's Medical Center participated in semi-structured interviews exploring the influencing factors. We analyzed the interview transcripts using thematic analysis. RESULTS The scale was completed by 154 pediatric residents. No statistically significant differences in empathy were found between educational level, postgraduate year, gender, or specialty. The factors influencing empathy in doctor-patient communication included the person who accompanied the child to see the doctor, how the children cooperated with doctors for medical treatment, the volume of pediatric outpatient and emergency visits, and the physician's ability to withstand pressure. All interviewed resident physicians regarded learning empathy as important but rarely spent extra time learning it. CONCLUSIONS The evaluation results of resident physicians on changes in empathy after improving clinical abilities vary according to their understanding of empathy, and the work environment has an important impact on pediatricians' empathy ability. Their empathy score is relatively low, and this requires exploration and intervention.
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Affiliation(s)
- Pingping Li
- Department of Pediatric Clinical Medicine School, Shanghai Children's Medical Center, School of Medicine, Shanghai Jiao Tong University, Shanghai, 200127, China
| | - Ling Weng
- Department of Science and Education, Fujian Maternity and Child Health Hospital, Fujian, 350000, China
| | - Lu Dong
- Department of Pediatric Clinical Medicine School, Shanghai Children's Medical Center, School of Medicine, Shanghai Jiao Tong University, Shanghai, 200127, China.
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Noonan M, Brown M, Gibbons M, Tuohy T, Johnson K, Bradshaw C, Tighe SM, Atkinson S, Murphy L, Mohamad M, Imcha M, O'Dwyer N, Grealish A. Evaluation of the effectiveness of a video-based educational intervention on perinatal mental health related stigma reduction strategies for healthcare professionals: A single group pre-test-post-test pilot study. Midwifery 2024; 136:104089. [PMID: 38968682 DOI: 10.1016/j.midw.2024.104089] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2023] [Revised: 06/24/2024] [Accepted: 06/30/2024] [Indexed: 07/07/2024]
Abstract
BACKGROUND Healthcare professionals have a role to play in reducing perinatal mental health related stigma. AIM To assess the effectiveness of a video-based educational intervention developed to provide guidance to healthcare professionals on perinatal mental health related stigma reduction strategies. DESIGN A single group pre-test-post-test pilot study with no control group. SETTING(S) A university affiliated maternity hospital in Ireland PARTICIPANTS: A convenience sample of registered midwives, nurses and doctors (n = 60) recruited from October 2020-January 2021. INTERVENTION A twenty-minute video-based educational intervention. METHODS Respondents (n = 60) completed a pre-test (time point one) and post-test (time point-two) questionnaire, and a three-month follow-up post-test questionnaire (time point-three) (n = 39). The questionnaire included the Mental Illness Clinicians' Attitudes Scale, Reported and Intended Behaviour Scale, Reynolds Empathy Scale and open-ended questions. Wilcoxon Signed Rank Test was selected to evaluate the pre-test post-test scores. RESULTS The difference in mean Mental Illness: Clinicians' Attitudes-4 scores were statistically significant between time points one and three (z = 3.27, df=36, P = 0.0007) suggesting more positive attitudes towards people with mental health conditions after the intervention. The mean total score for the Reported and Intended Behaviour Scale increased from 18.7 (SD 1.87) at time point one to 19.2 (SD 1.60) at time point two (z= -3.368, df=59, P = 0.0004) suggesting an increase in positive intended behaviours towards those with mental health issues immediately following the intervention. These findings were also corroborated by responses to open-ended survey questions. CONCLUSIONS Further research with a larger sample of healthcare professionals evaluated over a longer period would provide further evidence for the sustainability of the intervention. TWEETABLEABSTRACT A video-based intervention can increase healthcare professionals' knowledge of perinatal #mentalhealth related stigma reduction strategies @Journal. Link to article.
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Affiliation(s)
- Maria Noonan
- Department of Nursing and Midwifery, University of Limerick, Limerick, Ireland
| | - Melissa Brown
- Department of Nursing and Midwifery, University of Limerick, Limerick, Ireland
| | - Maria Gibbons
- University Maternity Hospital Limerick, Limerick, Ireland
| | - Teresa Tuohy
- Department of Nursing and Midwifery, University of Limerick, Limerick, Ireland
| | - Kevin Johnson
- Department of Nursing and Midwifery, University of Limerick, Limerick, Ireland
| | - Carmel Bradshaw
- Department of Nursing and Midwifery, University of Limerick, Limerick, Ireland
| | - Sylvia Murphy Tighe
- Department of Nursing and Midwifery, University of Limerick, Limerick, Ireland
| | - Sandra Atkinson
- Department of Nursing and Midwifery, University of Limerick, Limerick, Ireland
| | - Louise Murphy
- Department of Nursing and Midwifery, University of Limerick, Limerick, Ireland
| | - Mas Mohamad
- University Maternity Hospital Limerick, Limerick, Ireland
| | | | - Niamh O'Dwyer
- University Maternity Hospital Limerick, Limerick, Ireland
| | - Annmarie Grealish
- Department of Nursing and Midwifery, University of Limerick, Limerick, Ireland; Kings Florence Nightingale Faculty of Nursing, Midwifery & Palliative Care, King's College London, UK.
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Arps S, Noviski KM, Tucker L, Tutwiler A. Medical students' motivations for participating in an elective focused on social inequalities and health disparities. ADVANCES IN HEALTH SCIENCES EDUCATION : THEORY AND PRACTICE 2024; 29:1353-1378. [PMID: 38315269 PMCID: PMC11369016 DOI: 10.1007/s10459-024-10313-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/19/2023] [Accepted: 01/21/2024] [Indexed: 02/07/2024]
Abstract
In this study, we examine students' reasons for pursuing elective training focused on medical racism and systemic health inequities at a midwestern medical school. Data collection included semi-structured interviews with students who participated in an optional course focused on these topics. We analyzed their motivations, goals, and interests using reflexive thematic analysis and created three themes based on students' responses. Theme (1) "pre-existing conditions" focuses on students' knowledge, beliefs, worldviews and experience prior to the class. Theme (2) "enacting change" examines their desires to become effective physicians and improve medicine overall. Theme (3) "creating community" considers their preferences for a supportive and connected learning and social environment. We discuss the findings within the context of adult learning theory and Self-Determination Theory. The research provides insight about the overt and underlying factors that drive medical students' participation in training focused on social inequality. We also share recommendations for curriculum development and future research based on the patterns we found in students' discussions of their needs and expectations.
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Affiliation(s)
- Shahna Arps
- Department of Sociology and Anthropology, University of Toledo, Toledo, OH, USA.
| | | | - Lauren Tucker
- College of Medicine and Life Sciences, University of Toledo, Toledo, OH, USA
| | - Ameisha Tutwiler
- College of Medicine and Life Sciences, University of Toledo, Toledo, OH, USA
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Herber-Valdez CR, Blow JA, Salazar TT, Horn KV, Herrera DG, Lacy NL, Beinhoff L, de la Rosa JM. The integrated curriculum and student empathy: a longitudinal multi-cohort analysis. ADVANCES IN HEALTH SCIENCES EDUCATION : THEORY AND PRACTICE 2024; 29:1131-1153. [PMID: 37946064 PMCID: PMC11368989 DOI: 10.1007/s10459-023-10292-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/30/2021] [Accepted: 09/25/2023] [Indexed: 11/12/2023]
Abstract
Research has demonstrated erosion of empathy in students during medical education. Particularly, U.S. studies have demonstrated empathy declines during clinical training in the third and fourth year of traditional medical programs. Yet, studies conducted outside the U.S. have not confirmed this trend. Timing and extent of patient interactions have been identified as empathy-protective factors. The need to examine empathy within different learning contexts has been noted, as has the need for longitudinal and time-series research designs to analyze trajectories. Between fall 2010 and spring 2019, we assessed empathy longitudinally among six student cohorts (N = 493) at a U.S. medical school, where patient interaction occurs early and throughout an integrated curriculum. Empathy levels of students in each cohort were assessed at five time points utilizing the Jefferson Scale of Physician Empathy-Student version. We hypothesized empathy levels will not degrade by program end, and trajectories will not show patterns of decline in Years Three and Four. Analysis of Variance (ANOVA) and Linear Mixed Model (LMM) analyses were used to analyze differences at baseline and changes in empathy trajectories. ANOVA analyses revealed statistically significant differences at baseline by class cohort (F(5, 487) = [23.28], p < 0.001). LMM analyses indicated empathy was either significantly higher or not different at the end of the program (F(19, 1676) = [13.97], p < 0.001). Empathy trajectories varied among cohorts; yet, none resulted in an overall empathy decline by the end of the program. Findings demonstrate empathy in U.S. medical students can be unchanged or higher by the end of medical education. Outcomes are consistent with reports of non-declining medical student empathy outside the U.S. and support the notion of context-specificity. Results further support recent research, suggesting decreases in empathy during training can stabilize or increase by program end. These findings have important implications for future empathy research context and design considerations, as well as program planning.
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Affiliation(s)
- Christiane R Herber-Valdez
- Office of Academic Affairs, Texas Tech University Health Sciences Center at El Paso, 5001 El Paso Drive, El Paso, TX, 79905, USA.
- Department of Medical Education, Paul L. Foster School of Medicine, Texas Tech University Health Sciences Center at El Paso, El Paso, TX, USA.
| | - Julie A Blow
- Office of Institutional Research and Effectiveness, Texas Tech University Health Sciences Center at El Paso, El Paso, TX, USA
| | - Tammy T Salazar
- Department of Family Medicine, Paul L. Foster School of Medicine, Office of Academic Support, Texas Tech University Health Sciences Center at El Paso, El Paso, TX, USA
- The University of Texas at El Paso, El Paso, TX, USA
| | - Kathryn V Horn
- Paul L. Foster School of Medicine, Office of Student Services, Texas Tech University Health Sciences Center at El Paso, El Paso, TX, USA
- University of Houston College of Medicine, Houston, TX, USA
| | - Dyanne G Herrera
- Office of Institutional Research and Effectiveness, Texas Tech University Health Sciences Center at El Paso, El Paso, TX, USA
- Texas Department of Health, Austin, TX, USA
| | - Naomi L Lacy
- Department of Medical Education, Paul L. Foster School of Medicine, Texas Tech University Health Sciences Center at El Paso, El Paso, TX, USA
| | - Lisa Beinhoff
- Libraries of the Health Sciences, Texas Tech University Health Sciences Center at El Paso, El Paso, USA
| | - J Manuel de la Rosa
- Department of Pediatrics Paul L. Foster School of Medicine, Office of Outreach and Community Engagement, Texas Tech University Health Sciences Center at El Paso, El Paso, TX, USA
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Sanga A, Ranjan R, Sanga P, Kumari R, Sandhya K, Kujur B. Comparative study of the relationship between empathy and motivation among undergraduate students of new curriculum and old curriculum. J Family Med Prim Care 2024; 13:3892-3896. [PMID: 39464935 PMCID: PMC11504799 DOI: 10.4103/jfmpc.jfmpc_433_24] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2024] [Revised: 04/16/2024] [Accepted: 04/22/2024] [Indexed: 10/29/2024] Open
Abstract
Background The new competency-based curriculum incorporates the social sciences and humanism to the basic and clinical sciences, thus giving an integrated approach to medical education. Comparing the empathy score with the motivation level across the two curricula was thus planned to assess the current status. Method A cross-sectional qualitative study using an Internet-based electronic survey containing both an academic motivation scale to assess the motivation level and Jefferson's scale of empathy was used to assess empathy score. Result From the above study, we concluded that males have a higher empathy score across both the curricula. >95% of students of both categories belonged to the High Intrinsic High Control motivational category. The empathy scores were slightly higher among the CBME (Competency Based Medical Education) group compared to the non-CBME group, but it was not statistically significant. In subgroup analysis, Phase 3 was found to have a significant association. Conclusion The majority of the students fall in the High Intrinsic High Control category, where they have the next highest level of empathy. Phase 2 was found to have a significant association; it could be because of the positive effects of AETCOM classes on the ready-to-enter clinical exposure batch. The study also revealed that while motivation and empathy are generally linked, outliers existed, particularly among participants with low initial motivation but high empathy. This suggests a potential association between extrinsic motivation and empathy, possibly influenced by external factors.
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Affiliation(s)
- Aradhana Sanga
- Department of Anatomy, Rajendra Institute of Medical Sciences, Ranchi, Jharkhand, India
| | - Rajiv Ranjan
- Department of Anatomy, Rajendra Institute of Medical Sciences, Ranchi, Jharkhand, India
| | - Prerna Sanga
- MODEL Resource Services Private Limited, Kolkata, West Bengal, India
| | - Rita Kumari
- Department of Anatomy, Rajendra Institute of Medical Sciences, Ranchi, Jharkhand, India
| | - Kumari Sandhya
- Department of Anatomy, Rajendra Institute of Medical Sciences, Ranchi, Jharkhand, India
| | - Babita Kujur
- Department of Anatomy, Rajendra Institute of Medical Sciences, Ranchi, Jharkhand, India
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Selič-Zupančič P, Petek D, Jerala N. Exploring Personality Traits, Values, and Attitudes toward Professionalism: Implications for the Promotion of Mental Health and Functioning in Medical Students. Healthcare (Basel) 2024; 12:1732. [PMID: 39273756 PMCID: PMC11394833 DOI: 10.3390/healthcare12171732] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2024] [Revised: 08/24/2024] [Accepted: 08/28/2024] [Indexed: 09/15/2024] Open
Abstract
Healthcare workers face significant mental health challenges, including stress, burnout, and psychological distress, leading to high rates of mental health symptoms and even suicide attempts, as well as an increase in medication errors and unprofessional behavior. Targeted interventions are needed to address these issues. However, promoting healthier traits in medical students or refining selection could also prove beneficial, as research shows that mental health is significantly influenced by personality traits and personal values. This study examines the relationship between personality traits, values, and attitudes toward professionalism among medical students in Slovenia. A total of 996 participants were examined in three data collections from the academic years 2015-2016 to 2019-2020 using the Big Five Questionnaire, the Personal Values Scale, and the Attitude Toward Professionalism Scale. Hierarchical linear regression analysis was conducted to examine the factors associated with professionalism. The results showed that attitudes toward professionalism were stable over the years, with higher scores consistently associated with the female gender, agreeableness, and conscientiousness. Conversely, material value orientation had a negative impact on professionalism. In addition, we examine the associations between mental health and personality traits, personal values, and attitudes toward professionalism to illustrate the importance of selecting and nurturing medical students, based on traits that promote mental health and professional behavior. These findings may lead to improvements in medical education and selection processes to improve the well-being and functioning of future medical professionals.
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Affiliation(s)
- Polona Selič-Zupančič
- Department of Family Medicine, Faculty of Medicine, University of Ljubljana, Poljanski Nasip 58, 1000 Ljubljana, Slovenia
- Department of Psychology, Faculty of Medicine, University of Maribor, Taborska 8, 2000 Maribor, Slovenia
| | - Davorina Petek
- Department of Family Medicine, Faculty of Medicine, University of Ljubljana, Poljanski Nasip 58, 1000 Ljubljana, Slovenia
| | - Nina Jerala
- University Psychiatric Clinic Ljubljana, Studenec 48, 1260 Ljubljana, Slovenia
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Britz V, Sterz J, Koch Y, Schreckenbach T, Stefanescu MC, Zinßer U, Verboket RD, Sommer K, Ruesseler M. Impact of simulated patient-based communication training vs. real patient-based communication training on empathetic behaviour in undergraduate students - a prospective evaluation study. BMC MEDICAL EDUCATION 2024; 24:870. [PMID: 39134984 PMCID: PMC11318334 DOI: 10.1186/s12909-024-05801-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/10/2024] [Accepted: 07/19/2024] [Indexed: 08/16/2024]
Abstract
BACKGROUND Empathy is a key competency and is essential for doctor-patient relationships. Studies have proven a continuous reduction of empathy in medical students during their study period. The use of SPs is positively evaluated for competency acquisition and real patient communication training has positive effects on empathy empowerment. Therefore, the present study focusses on the impact of simulated patient (SP) vs real patient (RP) communication training on empathetic behaviour in undergraduate medical students. METHODS The prospective evaluation took place during a 210-minute skills lab unit on medical communication for 3rd year medical students. Study participants were allocated in advance to one of three groups: one group trained with an SP (SP-group) and was informed about the fact that it was an SP; another group trained with an SP but assumed to encounter an RP (incognito patient group (IP-group)); the last group trained with an RP and was correctly informed about it (real patient group (RP-group). Self-assessed empathy was measured by using Jefferson Scale of Physician Empathy (JSPE) and Interpersonal Reactivity Index (IRI), as these are the most commonly used instruments for assessing empathy. Study participants were evaluated on empathetic behaviour by their group-associated patient using the Consultation and Relational Empathy (CARE) scale. RESULTS 146 students participated. There was no significant difference in self-assessed empathy between groups for JSPE and IRI. External assessment via CARE showed a statistically significant difference between SP-group and IP-group , as well as between SP-group and RP-group. There was no significant difference between IP-group and RP-group. This means that students training with real patients (or who believed them to be real) did receive significantly lower performance ratings on their empathy. CONCLUSION The results demonstrate a significant lower external empathy rating for students who had trained with a real patient or if they were in the belief of having encountered a real patient; this may be due to inhibitions and a lack of routine. Therefore, we recommend implementing SPs in the early study period with the gradual integration of RPs in the student's further course of study.
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Affiliation(s)
- Vanessa Britz
- Goethe University Frankfurt, Medical Faculty, Institute for Medical Education and Clinical Simulation, Frankfurt/Main, Germany.
| | - Jasmina Sterz
- Goethe University Frankfurt, Medical Faculty, Institute for Medical Education and Clinical Simulation, Frankfurt/Main, Germany
- Goethe-University Frankfurt, University Hospital, Department of Trauma Hand and Reconstructive Surgery, Frankfurt/Main, Germany
| | - Yannik Koch
- Goethe University Frankfurt, Medical Faculty, Institute for Medical Education and Clinical Simulation, Frankfurt/Main, Germany
| | - Teresa Schreckenbach
- Goethe University Frankfurt, University Hospital Frankfurt, Department of General, Visceral, Transplantation and Thoracic Surgery, Frankfurt/Main, Germany
| | - Maria-Christina Stefanescu
- Goethe University Frankfurt, Medical Faculty, Institute for Medical Education and Clinical Simulation, Frankfurt/Main, Germany
- Johannes Gutenberg University, Medical Center Mainz, Department of Pediatric Surgery, Mainz, Germany
| | - Uwe Zinßer
- Goethe University Frankfurt, Medical Faculty, Institute for Medical Education and Clinical Simulation, Frankfurt/Main, Germany
| | - Rene Danilo Verboket
- Goethe-University Frankfurt, University Hospital, Department of Trauma Hand and Reconstructive Surgery, Frankfurt/Main, Germany
| | - Katharina Sommer
- Goethe-University Frankfurt, University Hospital, Department of Trauma Hand and Reconstructive Surgery, Frankfurt/Main, Germany
| | - Miriam Ruesseler
- Goethe University Frankfurt, Medical Faculty, Institute for Medical Education and Clinical Simulation, Frankfurt/Main, Germany
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Ardenghi S, Russo S, Rampoldi G, Bani M, Strepparava MG. Does Medical Curriculum Impact on Empathy? A Longitudinal Study in a Sample of Undergraduate Medical Students. MEDICAL SCIENCE EDUCATOR 2024; 34:873-881. [PMID: 39099873 PMCID: PMC11297006 DOI: 10.1007/s40670-024-02053-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 04/15/2024] [Indexed: 08/06/2024]
Abstract
Empathy in medical students is receiving increasing attention as it is fundamental to build and develop a functional patient-physician relationship. When looking at its determinants, demographic and academic factors seem to concur in shaping empathy in this population. Although data show strong gender differences and changes in empathy throughout medical school, it is not clear the direction of these changes and whether gender and curriculum features modulate them. This longitudinal study examined changes in empathy and explored gender differences throughout the medical school. Four consecutive cohorts of Italian medical students (N = 336) completed the Jefferson Scale of Empathy - Student (JSE-S) and the Interpersonal Reactivity Index (IRI) in their second year of study (before any clinical clerkship and communication skills courses) and fifth year of study (after a 2-year clinical clerkship and communication skills courses). Analysis of variance for repeated-measures revealed that, beyond the effect of gender, JSE-S total score and IRI Perspective Taking increased, whereas IRI Personal Distress and IRI Fantasy significantly decreased throughout medical school. No significant change in IRI Empathic Concern emerged over time. Student's t-tests showed that female students displayed significantly higher mean scores than their male counterparts for all empathy measures in both their second and fifth years of medical training. The findings suggest that the medical curriculum affects self-reported empathy dimensions among undergraduate medical students. Further research is needed to deepen the understanding of the educational factors that promote the changes in empathy levels during medical training.
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Affiliation(s)
- Stefano Ardenghi
- School of Medicine and Surgery, University of Milano-Bicocca, Via Cadore 48, 20900 Monza, MB Italy
- Fondazione I.R.C.C.S. San Gerardo dei Tintori, Via Pergolesi 33, 20900 Monza, MB Italy
| | - Selena Russo
- School of Medicine and Surgery, University of Milano-Bicocca, Via Cadore 48, 20900 Monza, MB Italy
| | - Giulia Rampoldi
- School of Medicine and Surgery, University of Milano-Bicocca, Via Cadore 48, 20900 Monza, MB Italy
| | - Marco Bani
- School of Medicine and Surgery, University of Milano-Bicocca, Via Cadore 48, 20900 Monza, MB Italy
| | - Maria Grazia Strepparava
- School of Medicine and Surgery, University of Milano-Bicocca, Via Cadore 48, 20900 Monza, MB Italy
- Fondazione I.R.C.C.S. San Gerardo dei Tintori, Via Pergolesi 33, 20900 Monza, MB Italy
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Teo MYK, Ibrahim H, Lin CKR, Hamid NABA, Govindasamy R, Somasundaram N, Lim C, Goh JL, Zhou Y, Tay KT, Ong RRS, Tan V, Toh Y, Pisupati A, Raveendran V, Chua KZY, Quah ELY, Sivakumar J, Senthilkumar SD, Suresh K, Loo WTW, Wong RSM, Pei Y, Sng JH, Quek SQM, Owyong JLJ, Yeoh TT, Ong EK, Phua GLG, Mason S, Hill R, Chowdhury AR, Ong SYK, Krishna LKR. Mentoring as a complex adaptive system - a systematic scoping review of prevailing mentoring theories in medical education. BMC MEDICAL EDUCATION 2024; 24:726. [PMID: 38970020 PMCID: PMC11225364 DOI: 10.1186/s12909-024-05707-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/22/2024] [Accepted: 06/25/2024] [Indexed: 07/07/2024]
Abstract
BACKGROUND Effective mentorship is an important component of medical education with benefits to all stakeholders. In recent years, conceptualization of mentorship has gone beyond the traditional dyadic experienced mentor-novice mentee relationship to include group and peer mentoring. Existing theories of mentorship do not recognize mentoring's personalized, evolving, goal-driven, and context-specific nature. Evidencing the limitations of traditional cause-and-effect concepts, the purpose of this review was to systematically search the literature to determine if mentoring can be viewed as a complex adaptive system (CAS). METHODS A systematic scoping review using Krishna's Systematic Evidence-Based Approach was employed to study medical student and resident accounts of mentoring and CAS in general internal medicine and related subspecialties in articles published between 1 January 2000 and 31 December 2023 in PubMed, Embase, PsycINFO, ERIC, Google Scholar, and Scopus databases. The included articles underwent thematic and content analysis, with the themes identified and combined to create domains, which framed the discussion. RESULTS Of 5,704 abstracts reviewed, 134 full-text articles were evaluated, and 216 articles were included. The domains described how mentoring relationships and mentoring approaches embody characteristics of CAS and that mentorship often behaves as a community of practice (CoP). Mentoring's CAS-like features are displayed through CoPs, with distinct boundaries, a spiral mentoring trajectory, and longitudinal mentoring support and assessment processes. CONCLUSION Recognizing mentorship as a CAS demands the rethinking of the design, support, assessment, and oversight of mentorship and the role of mentors. Further study is required to better assess the mentoring process and to provide optimal training and support to mentors.
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Affiliation(s)
- Mac Yu Kai Teo
- Yong Loo Lin School of Medicine, National University of Singapore, Level 11 NUHS Tower Block, 1E Kent Ridge Road, Singapore, 119228, Singapore
- Division of Supportive and Palliative Care, National Cancer Centre Singapore, 30 Hospital Boulevard, Singapore, 168583, Singapore
- Division of Cancer Education, National Cancer Centre Singapore, 30 Hospital Boulevard, Singapore, 168583, Singapore
| | - Halah Ibrahim
- Department of Medical Sciences, Khalifa University College of Medicine and Health Sciences, Abu Dhabi, United Arab Emirates
| | - Casper Keegan Ronggui Lin
- Yong Loo Lin School of Medicine, National University of Singapore, Level 11 NUHS Tower Block, 1E Kent Ridge Road, Singapore, 119228, Singapore
- Division of Supportive and Palliative Care, National Cancer Centre Singapore, 30 Hospital Boulevard, Singapore, 168583, Singapore
- Division of Cancer Education, National Cancer Centre Singapore, 30 Hospital Boulevard, Singapore, 168583, Singapore
- Department of Pharmacy, National Cancer Centre Singapore, 30 Hospital Boulevard, Singapore, 168583, Singapore
- Centre for Biomedical Ethics, National University of Singapore, Blk MD11, 10 Medical Drive, Singapore, #02-03, 117597, Singapore
| | - Nur Amira Binte Abdul Hamid
- Division of Cancer Education, National Cancer Centre Singapore, 30 Hospital Boulevard, Singapore, 168583, Singapore
| | - Ranitha Govindasamy
- Yong Loo Lin School of Medicine, National University of Singapore, Level 11 NUHS Tower Block, 1E Kent Ridge Road, Singapore, 119228, Singapore
- Division of Cancer Education, National Cancer Centre Singapore, 30 Hospital Boulevard, Singapore, 168583, Singapore
- Centre for Biomedical Ethics, National University of Singapore, Blk MD11, 10 Medical Drive, Singapore, #02-03, 117597, Singapore
| | - Nagavalli Somasundaram
- Division of Cancer Education, National Cancer Centre Singapore, 30 Hospital Boulevard, Singapore, 168583, Singapore
- Duke-NUS Medical School, National University of Singapore, 8 College Road, Singapore, 169857, Singapore
- Division of Medical Oncology, National Cancer Centre Singapore, 30 Hospital Boulevard, Singapore, 168583, Singapore
| | - Crystal Lim
- Division of Medical Oncology, National Cancer Centre Singapore, 30 Hospital Boulevard, Singapore, 168583, Singapore
- Medical Social Services, Singapore General Hospital, Block 3, Singapore, 169854, Singapore
| | - Jia Ling Goh
- Yong Loo Lin School of Medicine, National University of Singapore, Level 11 NUHS Tower Block, 1E Kent Ridge Road, Singapore, 119228, Singapore
- Division of Supportive and Palliative Care, National Cancer Centre Singapore, 30 Hospital Boulevard, Singapore, 168583, Singapore
- Division of Cancer Education, National Cancer Centre Singapore, 30 Hospital Boulevard, Singapore, 168583, Singapore
| | - Yi Zhou
- Yong Loo Lin School of Medicine, National University of Singapore, Level 11 NUHS Tower Block, 1E Kent Ridge Road, Singapore, 119228, Singapore
- Division of Supportive and Palliative Care, National Cancer Centre Singapore, 30 Hospital Boulevard, Singapore, 168583, Singapore
- Division of Cancer Education, National Cancer Centre Singapore, 30 Hospital Boulevard, Singapore, 168583, Singapore
| | - Kuang Teck Tay
- Yong Loo Lin School of Medicine, National University of Singapore, Level 11 NUHS Tower Block, 1E Kent Ridge Road, Singapore, 119228, Singapore
- Division of Supportive and Palliative Care, National Cancer Centre Singapore, 30 Hospital Boulevard, Singapore, 168583, Singapore
- Division of Cancer Education, National Cancer Centre Singapore, 30 Hospital Boulevard, Singapore, 168583, Singapore
| | - Ryan Rui Song Ong
- Yong Loo Lin School of Medicine, National University of Singapore, Level 11 NUHS Tower Block, 1E Kent Ridge Road, Singapore, 119228, Singapore
- Division of Supportive and Palliative Care, National Cancer Centre Singapore, 30 Hospital Boulevard, Singapore, 168583, Singapore
- Division of Cancer Education, National Cancer Centre Singapore, 30 Hospital Boulevard, Singapore, 168583, Singapore
| | - Vanessa Tan
- Yong Loo Lin School of Medicine, National University of Singapore, Level 11 NUHS Tower Block, 1E Kent Ridge Road, Singapore, 119228, Singapore
- Division of Supportive and Palliative Care, National Cancer Centre Singapore, 30 Hospital Boulevard, Singapore, 168583, Singapore
- Division of Cancer Education, National Cancer Centre Singapore, 30 Hospital Boulevard, Singapore, 168583, Singapore
| | - Youru Toh
- Yong Loo Lin School of Medicine, National University of Singapore, Level 11 NUHS Tower Block, 1E Kent Ridge Road, Singapore, 119228, Singapore
- Division of Supportive and Palliative Care, National Cancer Centre Singapore, 30 Hospital Boulevard, Singapore, 168583, Singapore
- Division of Cancer Education, National Cancer Centre Singapore, 30 Hospital Boulevard, Singapore, 168583, Singapore
| | - Anushka Pisupati
- Yong Loo Lin School of Medicine, National University of Singapore, Level 11 NUHS Tower Block, 1E Kent Ridge Road, Singapore, 119228, Singapore
- Division of Supportive and Palliative Care, National Cancer Centre Singapore, 30 Hospital Boulevard, Singapore, 168583, Singapore
- Division of Cancer Education, National Cancer Centre Singapore, 30 Hospital Boulevard, Singapore, 168583, Singapore
| | - Vijayprasanth Raveendran
- Yong Loo Lin School of Medicine, National University of Singapore, Level 11 NUHS Tower Block, 1E Kent Ridge Road, Singapore, 119228, Singapore
- Division of Supportive and Palliative Care, National Cancer Centre Singapore, 30 Hospital Boulevard, Singapore, 168583, Singapore
- Division of Cancer Education, National Cancer Centre Singapore, 30 Hospital Boulevard, Singapore, 168583, Singapore
| | - Keith Zi Yuan Chua
- Yong Loo Lin School of Medicine, National University of Singapore, Level 11 NUHS Tower Block, 1E Kent Ridge Road, Singapore, 119228, Singapore
- Division of Supportive and Palliative Care, National Cancer Centre Singapore, 30 Hospital Boulevard, Singapore, 168583, Singapore
- Division of Cancer Education, National Cancer Centre Singapore, 30 Hospital Boulevard, Singapore, 168583, Singapore
| | - Elaine Li Ying Quah
- Yong Loo Lin School of Medicine, National University of Singapore, Level 11 NUHS Tower Block, 1E Kent Ridge Road, Singapore, 119228, Singapore
- Division of Supportive and Palliative Care, National Cancer Centre Singapore, 30 Hospital Boulevard, Singapore, 168583, Singapore
- Division of Cancer Education, National Cancer Centre Singapore, 30 Hospital Boulevard, Singapore, 168583, Singapore
| | - Jeevasuba Sivakumar
- Yong Loo Lin School of Medicine, National University of Singapore, Level 11 NUHS Tower Block, 1E Kent Ridge Road, Singapore, 119228, Singapore
- Division of Supportive and Palliative Care, National Cancer Centre Singapore, 30 Hospital Boulevard, Singapore, 168583, Singapore
- Division of Cancer Education, National Cancer Centre Singapore, 30 Hospital Boulevard, Singapore, 168583, Singapore
| | - Samyuktha Dhanalakshmi Senthilkumar
- Yong Loo Lin School of Medicine, National University of Singapore, Level 11 NUHS Tower Block, 1E Kent Ridge Road, Singapore, 119228, Singapore
- Division of Supportive and Palliative Care, National Cancer Centre Singapore, 30 Hospital Boulevard, Singapore, 168583, Singapore
- Division of Cancer Education, National Cancer Centre Singapore, 30 Hospital Boulevard, Singapore, 168583, Singapore
| | - Keerthana Suresh
- Yong Loo Lin School of Medicine, National University of Singapore, Level 11 NUHS Tower Block, 1E Kent Ridge Road, Singapore, 119228, Singapore
- Division of Supportive and Palliative Care, National Cancer Centre Singapore, 30 Hospital Boulevard, Singapore, 168583, Singapore
- Division of Cancer Education, National Cancer Centre Singapore, 30 Hospital Boulevard, Singapore, 168583, Singapore
| | - Wesley Teck Wee Loo
- Yong Loo Lin School of Medicine, National University of Singapore, Level 11 NUHS Tower Block, 1E Kent Ridge Road, Singapore, 119228, Singapore
- Division of Supportive and Palliative Care, National Cancer Centre Singapore, 30 Hospital Boulevard, Singapore, 168583, Singapore
- Division of Cancer Education, National Cancer Centre Singapore, 30 Hospital Boulevard, Singapore, 168583, Singapore
| | - Ruth Si Man Wong
- Yong Loo Lin School of Medicine, National University of Singapore, Level 11 NUHS Tower Block, 1E Kent Ridge Road, Singapore, 119228, Singapore
- Division of Supportive and Palliative Care, National Cancer Centre Singapore, 30 Hospital Boulevard, Singapore, 168583, Singapore
- Division of Cancer Education, National Cancer Centre Singapore, 30 Hospital Boulevard, Singapore, 168583, Singapore
| | - Yiying Pei
- Yong Loo Lin School of Medicine, National University of Singapore, Level 11 NUHS Tower Block, 1E Kent Ridge Road, Singapore, 119228, Singapore
- Division of Supportive and Palliative Care, National Cancer Centre Singapore, 30 Hospital Boulevard, Singapore, 168583, Singapore
- Division of Cancer Education, National Cancer Centre Singapore, 30 Hospital Boulevard, Singapore, 168583, Singapore
| | - Julia Huina Sng
- Yong Loo Lin School of Medicine, National University of Singapore, Level 11 NUHS Tower Block, 1E Kent Ridge Road, Singapore, 119228, Singapore
- Division of Supportive and Palliative Care, National Cancer Centre Singapore, 30 Hospital Boulevard, Singapore, 168583, Singapore
- Division of Cancer Education, National Cancer Centre Singapore, 30 Hospital Boulevard, Singapore, 168583, Singapore
| | - Simone Qian Min Quek
- Yong Loo Lin School of Medicine, National University of Singapore, Level 11 NUHS Tower Block, 1E Kent Ridge Road, Singapore, 119228, Singapore
- Division of Supportive and Palliative Care, National Cancer Centre Singapore, 30 Hospital Boulevard, Singapore, 168583, Singapore
- Division of Cancer Education, National Cancer Centre Singapore, 30 Hospital Boulevard, Singapore, 168583, Singapore
| | - Jasmine Lerk Juan Owyong
- Division of Cancer Education, National Cancer Centre Singapore, 30 Hospital Boulevard, Singapore, 168583, Singapore
| | - Ting Ting Yeoh
- Division of Cancer Education, National Cancer Centre Singapore, 30 Hospital Boulevard, Singapore, 168583, Singapore
- Department of Pharmacy, National Cancer Centre Singapore, 30 Hospital Boulevard, Singapore, 168583, Singapore
| | - Eng Koon Ong
- Division of Supportive and Palliative Care, National Cancer Centre Singapore, 30 Hospital Boulevard, Singapore, 168583, Singapore
- Division of Cancer Education, National Cancer Centre Singapore, 30 Hospital Boulevard, Singapore, 168583, Singapore
- Duke-NUS Medical School, National University of Singapore, 8 College Road, Singapore, 169857, Singapore
- Assisi Hospice, 832 Thomson Road, Singapore, 574627, Singapore
| | - Gillian Li Gek Phua
- Division of Supportive and Palliative Care, National Cancer Centre Singapore, 30 Hospital Boulevard, Singapore, 168583, Singapore
- Lien Centre for Palliative Care, Duke-NUS Medical School, National University of Singapore, 8 College Road, Singapore, 169857, Singapore
| | - Stephen Mason
- Palliative Care Institute Liverpool, Academic Palliative & End of Life Care Centre, Cancer Research Centre, University of Liverpool, 200 London Road, Liverpool, L3 9TA, UK
| | - Ruaraidh Hill
- Health Data Science, University of Liverpool, Whelan Building The Quadrangle, Liverpool, Brownlow Hill, Liverpool, L69 3GB, UK
| | - Anupama Roy Chowdhury
- Duke-NUS Medical School, National University of Singapore, 8 College Road, Singapore, 169857, Singapore
- Department of Geriatric Medicine, Singapore General Hospital, Academia, Level 3, College Road, Singapore, 169608, Singapore
| | - Simon Yew Kuang Ong
- Division of Cancer Education, National Cancer Centre Singapore, 30 Hospital Boulevard, Singapore, 168583, Singapore
- Duke-NUS Medical School, National University of Singapore, 8 College Road, Singapore, 169857, Singapore
- Division of Medical Oncology, National Cancer Centre Singapore, 30 Hospital Boulevard, Singapore, 168583, Singapore
| | - Lalit Kumar Radha Krishna
- Yong Loo Lin School of Medicine, National University of Singapore, Level 11 NUHS Tower Block, 1E Kent Ridge Road, Singapore, 119228, Singapore.
- Division of Supportive and Palliative Care, National Cancer Centre Singapore, 30 Hospital Boulevard, Singapore, 168583, Singapore.
- Division of Cancer Education, National Cancer Centre Singapore, 30 Hospital Boulevard, Singapore, 168583, Singapore.
- Centre for Biomedical Ethics, National University of Singapore, Blk MD11, 10 Medical Drive, Singapore, #02-03, 117597, Singapore.
- Duke-NUS Medical School, National University of Singapore, 8 College Road, Singapore, 169857, Singapore.
- Palliative Care Institute Liverpool, Academic Palliative & End of Life Care Centre, Cancer Research Centre, University of Liverpool, 200 London Road, Liverpool, L3 9TA, UK.
- Health Data Science, University of Liverpool, Whelan Building The Quadrangle, Liverpool, Brownlow Hill, Liverpool, L69 3GB, UK.
- PalC, The Palliative Care Centre for Excellence in Research and Education, PalC c/o Dover Park Hospice, 10 Jalan Tan Tock Seng, Singapore, 308436, Singapore.
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50
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Bansal E, Rice T. Teaching Moral Courage & Rights-Based Leadership in Medicine: A Cross-Disciplinary Exploration. TEACHING AND LEARNING IN MEDICINE 2024:1-11. [PMID: 38956858 DOI: 10.1080/10401334.2024.2369611] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/22/2023] [Accepted: 05/24/2024] [Indexed: 07/04/2024]
Abstract
Clinical medicine's complexities and demands often surpass the scope of formal ethics and leadership training that medical schools and residency programs provide. The discrepancy between medical education and the realities of clinical work may contribute to ethical erosion among learners, namely, medical students and residents. Unlike traditional approaches to teaching professional ethics and leadership in medicine, rights-based (aspirational) pedagogies approach trainees as autonomous moral agents, whose work has moral value to themselves and others, who live with the ethical consequences of their professional choices, and whose work shapes their individual moral character. By incorporating teaching strategies that intentionally build learners' rights-based leadership through the development of moral courage, medical educators may counter important aspects of ethical erosion while promoting learner preparedness, outcomes, and well-being. Military teaching approaches offer a valuable example to medical educators seeking to create structured curricula that foster moral courage to promote rights-based leadership, given the high level of moral and managerial complexity present in both medicine and the military. Through a comparative analysis of professional ethics in the medical and military disciplines, this Observation article explores the validity of applying precedents from military ethics and leadership education to medical training. Through arguments rooted in moral philosophy, military history, and military organizational research, we explore the expansion of rights-based teaching methods within the predominantly traditional and rules-based norms of medical education. In relating these findings to real-life clinical scenarios, we offer six specific, rights-based modifications to medical ethics curricula that have potential to promote morally courageous leadership and counteract the ethical erosion medical students and residents face.
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Affiliation(s)
- Esha Bansal
- Internal Medicine Residency Program, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Timothy Rice
- Departments of Psychiatry and Medical Education, Icahn School of Medicine at Mount Sinai, Gustave L Levy Place, New York, New York, USA
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