Underlying construct of empathy, optimism, and burnout in medical students.

OBJECTIVE: This study was designed to explore the underlying construct of measures of empathy, optimism, and burnout in medical students. METHODS: Three instruments for measuring empathy (Jefferson Scale of Empathy, JSE); Optimism (the Life Orientation Test-Revised, LOT-R); and burnout (the Maslach Burnout Inventory, MBI, which includes three scales of Emotional Exhaustion, Depersonalization, and Personal Accomplishment) were administered to 265 third-year students at Sidney Kimmel (formerly Jefferson) Medical College at Thomas Jefferson University. Data were subjected to factor analysis to examine relationships among measures of empathy, optimism, and burnout in a multivariate statistical model. RESULTS: Factor analysis (principal component with oblique rotation) resulted in two underlying constructs, each with an eigenvalue greater than one. The first factor involved positive personality attributes (factor coefficients greater than .58 for measures of empathy, optimism, and personal accomplishment). The second factor involved negative personality attributes (factor coefficients greater than .78 for measures of emotional exhaustion, and depersonalization). CONCLUSIONS: Results confirmed that an association exists between empathy in the context of patient care and personality characteristics that are conducive to relationship building, and considered to be positive personality attributes, as opposed to personality characteristics that are considered as negative personality attributes that are detrimental to interpersonal relationships. Implications for the professional development of physicians-in-training and in-practice are discussed

Medical and Mental Health Implications of Gestational Surrogacy and Trends in State Regulations on Compensated Gestational Surrogacy: A Report Submitted to the New York State Legislature

As the New York State legislature considers legalizing compensated gestational surrogacy this legislative session, this report provides insight into (1) the impact of surrogacy on the medical and mental health of women who become surrogates and the children born through gestational surrogacy, and (2) how other state legislatures have addressed compensated gestational surrogacy in recent years. Medical research demonstrates that there is significant growth in gestational surrogacy in the United States. The number of families working with gestational surrogates has quadrupled in the new millennium. Weill Cornell Medicine physicians and medical students reviewed the published literature on the medical and mental health impacts to women who undergo in vitro fertilization (IVF) to become gestational carriers. Although people outside the medical community have questioned the health and psychological impacts of surrogates to prohibit gestational surrogacy, the scientific literature review demonstrates that there are in fact no significant adverse medical or psychological outcomes for women who are gestational carriers nor the children they give birth to

Psychometrics of the scale of attitudes toward physician-pharmacist collaboration: a study with medical students.

BACKGROUND: Despite the emphasis placed on interdisciplinary education and interprofessional collaboration between physicians and pharmacologists, no psychometrically sound instrument is available to measure attitudes toward collaborative relationships. AIM: This study was designed to examine psychometrics of an instrument for measuring attitudes toward physician-pharmacist collaborative relationships for administration to students in medical and pharmacy schools and to physicians and pharmacists. METHODS: The Scale of Attitudes Toward Physician-Pharmacist Collaboration was completed by 210 students at Jefferson Medical College. Factor analysis and correlational methods were used to examine psychometrics of the instrument. RESULTS: Consistent with the conceptual framework of interprofessional collaboration, three underlying constructs, namely responsibility and accountability; shared authority; and interdisciplinary education emerged from the factor analysis of the instrument providing support for its construct validity. The reliability coefficient alpha for the instrument was 0.90. The instrument\u27s criterion-related validity coefficient with scores of a validated instrument (Jefferson Scale of Attitudes Toward Physician-Nurse Collaboration) was 0.70. CONCLUSIONS: Findings provide support for the validity and reliability of the instrument for medical students. The instrument has the potential to be used for the evaluation of interdisciplinary education in medical and pharmacy schools, and for the evaluation of patient outcomes resulting from collaborative physician-pharmacist relationships

Peer Assessments May Predict Objective Long-Term Academic Performance

Introduction: A common challenge in medical education is to create a curriculum that both teaches the required material but still delivers a personable physician. In this data study, 673 Sidney Kimmel Medical College (SKMC) students were given a required survey to judge their group members on personal attributes ranging from preparedness to affability. These scores were used to aid students and hopefully prevent unfortunate habits from settling. We hypothesize that peer assessments will predict academic performance. Methods: A five-question, Likert scale, peer assessment was given to each first-year medical student at SKMC. The electronic survey was given twice during the dissection portion of the curriculum, when students are assigned to groups with 2-3 other students. As the students finished their time at Jefferson, they were assigned a class ranking based on test and clerkship scores, and took national board exams (Step 1 and 2). These metrics were then compared via multi-variable linear regression to determine any correlation. Results: The study found that the peer assessment of another’s preparation (question 1 of the assessment) showed a strong, positive correlation to class rank, Step 1, and Step 2 scores. Conclusion: This study shows the efficacy of a subjective peer assessment of preparation predicting objective academic performance. Further research will determine other predictive value of peer assessments in empathy and mental health

Immune Sensitization to the 60 kD Heat Shock Protein and Pregnancy Outcome

Heat shock proteins are highly conserved proteins present in organisms ranging from bacteria to man. They are both dominant microbial immunogens and among the first proteins produced during mammalian embryo development. Since bacterial and human heat shock proteins share a high degree of amino acid sequence homology, it has been suggested that sensitization to bacterial heat shock proteins during an infection may result in autoimmunity to human heat shock proteins. Infertile couples seeking in vitro fertilization (IVF) may have been previously sensitized to bacterial heat shock proteins as a consequence of an asymptomatic upper genital tract infection. Due to daily clinical monitoring and precisely timed fertilization these patients are an ideal study group to investigate the effect of prior sensitization to heat shock proteins on preimplantation embryo development and implantation failure. Immune sensitization at the level of the cervix to the 60 kD heat shock protein (hsp60) has been associated with implantation failure in some IVF patients. Similarly, the highest prevalence of circulating hsp60 antibodies among IVF patients was found in the sera of women whose embryos failed to develop in vitro. To more directly assess whether humoral immunity to hsp60 influenced in vitro embryo development, a mouse embryo culture model was established. Monoclonal antibody to mammalian hsp60 markedly impaired mouse embryo development in vitro. These data suggest that immune sensitization to human hsp60, possibly developed as a consequence of infection, may adversely affect pregnancy outcome in some patients

The Implementation of a Required Book Club for Medical Students and Faculty

More medical schools are incorporating wellness activities and the medical humanities into their curriculum. Finding implementable programming that is feasible and enjoyable is challenging. Both student participants and faculty who might facilitate programs are busy with clinical and educational responsibilities. Book club discussions in general are an activity that bring people together and expose groups to literature. In medical education, informal books clubs have been shown to increase camaraderie and expose participants to topics in medicine that they may not have encountered without the structure of the group assignment. At one large private urban medical school, all fourth year medical students were required to participate in a one-time hour-long book discussion with a faculty member one week before Match Day 2021. This paper describes the implementation of that program and discusses survey results from 179 students who broadly indicated that the books were enjoyable, the discussions were enriching, and that the program should continue for future classes of medical students

Patient Safety Symposium: Issues, Analyses, Prevention

Abstract Introduction: While learning the basics of patient safety, students can also learn about the contribution members of the various health professions can make to patient safety, which is why we stress the importance of interprofessional interactions in this Introduction to Patient Safety Symposium. Methods: This 4-hour symposium is designed as an introduction to patient safety presented in a classroom setting, with students seated in groups made up of representatives of each health profession. The course revolves around a case scenario presentation of a hypothetical patient who has had his knee replaced and is the victim of a series of medical errors, with consequent deep vein thrombosis and pulmonary embolism. The course is taught through four modules: (1) Culture of Health Team Communication and Conflict Management, (2) Root Cause Analysis and System Problems, (3) Error Disclosure, and (4) Second Victim Trajectory. Each module begins with a didactic presentation, and then learners apply their knowledge in an interactive learning activity with their interprofessional colleagues. Following the fourth module, students complete a pre-/posttest, satisfaction survey, and reflection paper. Results: The course has been presented to 305 students in the schools of medicine, nursing, occupational therapy, pharmacy, physical therapy (PT), and radiologic sciences at Thomas Jefferson University. While results of the pretest revealed that many students arrived with some knowledge of medical errors and the importance of communication, the posttest showed increased knowledge in how to report an error, root cause analysis, and the term second victim. In response to the satisfaction survey, 80%-100% of radiologic science, nursing, pharmacy, and PT students reported they were satisfied or very satisfied, but only 36% of medical students reported that level of satisfaction. Stated reasons for medical student satisfaction level included redundant material and session length. When asked if at least 40% of the material was new, more than 65% of nursing, PT, and radiologic science students agreed, whereas only 54% of pharmacy students and 25% of medical students did. The themes on the individual reflection papers from all students included the importance of communication, teamwork, a culture that promotes acknowledgment of errors, and knowledge of policies and procedures. Discussion: This symposium effectively increased the students\u27 knowledge of the meaning and process of medical errors/patient safety. Since students came from different disciplines and different programs, their knowledge base regarding patient safety was variable. This created a challenge when deciding at what level to teach. Although this symposium was the first interprofessional patient safety experience for all students, some of those who had been taught patient safety in their own disciplines were less satisfied with the course. Educational Objectives By the end of this session, learners will be able to: Discuss patient safety issues, including barriers and systems solutions. Describe the definition of medical error and types of sentinel events. Apply information to know when and how to report medical errors. Promote interprofessional collaboration and communication to improve patient safety. Analyze sentinel events using the process of root cause analysis. Discuss issues of error disclosure. Describe closure and needs of staff who were involved in the error

Heat shock protein expression during gametogenesis and embryogenesis.

When cells are subjected to various stress factors, they increase the production of a group of proteins called heat shock proteins (hsp). Heat shock proteins are highly conserved proteins present in organisms ranging from bacteria to man. Heat shock proteins enable cells to survive adverse environmental conditions by preventing protein denaturation. Thus the physiological and pathological potential of hsps is enormous and has been studied widely over the past two decades. The presence or absence of hsps influences almost every aspect of reproduction. They are among the first proteins produced during mammalian embryo development. In this report, the production of hsps in gametogenesis and early embryo development is described. It has been suggested that prolonged and asymptomatic infections trigger immunity to microbial hsp epitopes that are also expressed in man. This may be relevant for human reproduction, since many couples with fertility problems have had a previous genital tract infection. Antibodies to bacterial and human hsps are present at high titers in sera of many patients undergoing in vitro fertilization. In a mouse embryo culture model, these antibodies impaired the mouse embryo development at unique developmental stages. The gross morphology of these embryos resembled cells undergoing apoptosis. The TUNEL (terminal deoxynucleotidyl transferase-mediated X-dUTP nick end labeling) staining pattern, which is a common marker of apoptosis, revealed that embryos cultured in the presence of hsp antibodies stained TUNEL-positive more often than unexposed embryos. These data extend preexisting findings showing the detrimental effect of immune sensitization to hsps on embryo development