A two-item version of the Japanese Consultation and Relational Empathy measure:A pilot study using secondary analysis of a cross-sectional survey in primary care

BACKGROUND: The Consultation and Relational Empathy (CARE) measure is a patient-reported measure of physician empathy which is widely used internationally. The Japanese version of the CARE measure has very high internal reliability, suggesting that a shorter version may have adequate validity and reliability. OBJECTIVE: To investigate a valid shorter version of the Japanese CARE measure. METHODS: We conducted a pilot study using secondary analysis of previous data obtained from 9 general practitioners and 252 patients and used to develop the Japanese CARE measure. All 1,023 possible combinations of the Japanese CARE items (n = 1–10) were candidates for the short measure. The internal consistency (Cronbach’s alpha) and the correlations between candidate short questionnaires and the original questionnaire were calculated. After selecting the most valid short questionnaire, inter-rater reliability was determined using generalizability theory, and construct validity (Spearman’s rho) was determined using patient satisfaction. RESULTS: Two items were selected for a pilot shorter version: item 6 “Showing care and compassion” and item 9 “Helping you to take control.” These showed high internal consistency and correlations with the 10-item measure (Cronbach’s alpha = 0.920, correlation = 0.979). Forty-five questionnaires per doctor allowed us to reliably differentiate between practitioners. The construct validity for the pilot short measure was high (Spearman’s rho 0.706, P < 0.001). CONCLUSION: We generated a pilot 2-item version of the Japanese CARE measure. This pilot 2-item version provides a basis for future validation studies of short CARE measures in other languages

Expressing one’s feelings and listening to others increases emotional intelligence: a pilot study of Asian medical students

&lt;p&gt;Background: There has been considerable interest in Emotional Intelligence (EI) in undergraduate medical education, with respect to student selection and admissions, health and well-being and academic performance. EI is a significant component of the physician-patient relationship. The emotional well-being of the physician is, therefore, a significant component in patient care. The aim is to examine the measurement of TEIQue-SF in Asian medical students and to explore how the practice of listening to the feelings of others and expressing one’s own feelings influences an individual’s EI, set in the context of the emotional well-being of a medical practitioner.&lt;/p&gt; &lt;p&gt;Methods: A group of 183 international undergraduate medical students attended a half-day workshop (WS) about mental-health and well-being. They completed a self-reported measure of EI on three occasions, pre- and post-workshop, and a 1-year follow-up.&lt;/p&gt; &lt;p&gt;Result: The reliability of TEIQue-SF was high and the reliabilities of its four factors were acceptable. There were strong correlations between the TEIQue-SF and personality traits. A paired t-test indicated significant positive changes after the WS for all students (n=181, p= .014), male students (n=78, p= .015) and non-Japanese students (n=112, p= .007), but a repeated measures analysis showed that one year post-workshop there were significant positive changes for all students (n=55, p= .034), female students (n=31, p= .007), especially Japanese female students (n=13, p= .023). Moreover, 80% of the students reported that they were more attentive listeners, and 60% agreed that they were more confident in dealing with emotional issues, both within themselves and in others, as a result of the workshop.&lt;/p&gt; &lt;p&gt;Conclusion: This study found the measurement of TEIQue-SF is appropriate and reliable to use for Asian medical students. The mental health workshop was helpful to develop medical students’ EI but showed different results for gender and nationality. The immediate impact on the emotional awareness of individuals was particularly significant for male students and the non-Japanese group. The impact over the long term was notable for the significant increase in EI for females and Japanese. Japanese female students were more conscious about emotionality. Emotion-driven communication exercises might strongly influence the development of students’ EI over a year.&lt;/p&gt

Listen to the outpatient: qualitative explanatory study on medical students’ recognition of outpatients’ narratives in combined ambulatory clerkship and peer role-play

Abstract Background Understanding patients’ narratives has been associated with methods of improving care that go beyond what may be regarded as a “narrow” view of scientific medicine. Medical interview training in which medical students develop understanding of the importance of patients’ narratives is receiving increased attention. However, students generally receive education on patients’ narratives that does not distinguish inpatients and outpatients. No studies exploring the characteristics of outpatients’ narratives have been reported. We developed an educational program combining ambulatory clerkship and peer role-play using actual narratives from outpatients that students had encountered during their clerkship. These narratives were used as peer role-play scenarios in which the students acted as outpatients. This study explored what and how medical students learned about the characteristics of outpatients’ narratives through this original educational program. Methods Participants were 70 fifth-year medical students from Nagoya University, Japan. We conducted 13 focus groups, based on a convenience sample of 11 groups in 2012, one group in 2013, and one group in 2017 (from 17 clinical groups in each year). Focus group transcripts were analyzed using the “Steps for Coding and Theorization” qualitative data analysis method. We assessed medical anthropological findings regarding narratives in a conceptual framework. Results Patients’ narratives as perceived by medical students were divided into four quadrants by two axes: medical versus lived content, and objective versus subjective structure. Students recognized that outpatients’ narratives mainly used a subjective structure, but were mixed and crossed each quadrant. This was described as “irreproducibility.” Students also recognized that narratives of simulated patients and inpatients were mainly limited to a medical-lived content with an objective structure. These differences in narrative characteristics were recognized through students’ previous interactions with simulated patients and inpatients. Conclusions Despite some limitations, medical students learn about patients’ narratives in our original educational program in a way that would be difficult to achieve through training using simulated patients or inpatients