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

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

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

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

Reduction in the incidence of type 2 diabetes with lifestyle intervention or metformin.

BACKGROUND: Type 2 diabetes affects approximately 8 percent of adults in the United States. Some risk factors--elevated plasma glucose concentrations in the fasting state and after an oral glucose load, overweight, and a sedentary lifestyle--are potentially reversible. We hypothesized that modifying these factors with a lifestyle-intervention program or the administration of metformin would prevent or delay the development of diabetes. METHODS: We randomly assigned 3234 nondiabetic persons with elevated fasting and post-load plasma glucose concentrations to placebo, metformin (850 mg twice daily), or a lifestyle-modification program with the goals of at least a 7 percent weight loss and at least 150 minutes of physical activity per week. The mean age of the participants was 51 years, and the mean body-mass index (the weight in kilograms divided by the square of the height in meters) was 34.0; 68 percent were women, and 45 percent were members of minority groups. RESULTS: The average follow-up was 2.8 years. The incidence of diabetes was 11.0, 7.8, and 4.8 cases per 100 person-years in the placebo, metformin, and lifestyle groups, respectively. The lifestyle intervention reduced the incidence by 58 percent (95 percent confidence interval, 48 to 66 percent) and metformin by 31 percent (95 percent confidence interval, 17 to 43 percent), as compared with placebo; the lifestyle intervention was significantly more effective than metformin. To prevent one case of diabetes during a period of three years, 6.9 persons would have to participate in the lifestyle-intervention program, and 13.9 would have to receive metformin. CONCLUSIONS: Lifestyle changes and treatment with metformin both reduced the incidence of diabetes in persons at high risk. The lifestyle intervention was more effective than metformin

Effects of Screening and Brief Intervention Training on Resident and Faculty Alcohol Intervention Behaviours: A Pre- Post-Intervention Assessment

Background: Many hazardous and harmful drinkers do not receive clinician advice to reduce their drinking. Previous studies suggest under-detection and clinician reluctance to intervene despite awareness of problem drinking (PD). The Healthy Habits Project previously reported chart review data documenting increased screening and intervention with hazardous and harmful drinkers after training clinicians and implementing routine screening. This report describes the impact of the Healthy Habits training program on clinicians\u27 rates of identification of PD, level of certainty in identifying PD and the proportion of patients given advice to reduce alcohol use, based on self-report data using clinician exit questionnaires. Methods: 28 residents and 10 faculty in a family medicine residency clinic completed four cycles of clinician exit interview questionnaires before and after screening and intervention training. Rates of identifying PD, level of diagnostic certainty, and frequency of advice to reduce drinking were compared across intervention status (pre vs. post). Findings were compared with rates of PD and advice to reduce drinking documented on chart review. Results: 1,052 clinician exit questionnaires were collected. There were no significant differences in rates of PD identified before and after intervention (9.8% vs. 7.4%, p = .308). Faculty demonstrated greater certainty in PD diagnoses than residents (p = .028) and gave more advice to reduce drinking (p = .042) throughout the program. Faculty and residents reported higher levels of diagnostic certainty after training (p = .039 and .030, respectively). After training, residents showed greater increases than faculty in the percentage of patients given advice to reduce drinking (p = .038), and patients felt to be problem drinkers were significantly more likely to receive advice to reduce drinking by all clinicians (50% vs. 75%, p = .047). The number of patients receiving advice to reduce drinking after program implementation exceeded the number of patients felt to be problem drinkers. Recognition rates of PD were four to eight times higher than rates documented on chart review (p = .028). Conclusion: This program resulted in greater clinician certainty in diagnosing PD and increases in the number of patients with PD who received advice to reduce drinking. Future programs should include booster training sessions and emphasize documentation of PD and brief intervention

Professionalism in medicine : A case-based guide for medical students

https://jdc.jefferson.edu/jeffersonfacultybooks/1063/thumbnail.jp

Videos: Professionalism in Medicine

18 videos addressing Professionalism in Medicine. Medical professionalism is a challenging, evolving, and life-long endeavour. Professionalism in Medicine: A Case-Based Guide for Medical Students, published by Cambridge University Press, helps begin this process by engaging students and their teachers in reflection on cases that resonate with the experiences of life in medicine. Through the book\u27s seventy-two cases, commentaries, videos, and literature-based reviews, students explore the many challenging areas of medical professionalism. Readers will appreciate the provocative professionalism dilemmas encountered by students from the pre-clinical years and clinical rotations and by physicians of various specialties. Each case is followed by two commentaries by writers who are involved in health care decisions related to that case, and who represent a wide variety of perspectives. Authors represent forty-six medical schools and other institutions and include physicians, medical students, medical ethicists, lawyers, psychologists, nurses, social workers, pharmacists, health care administrators, and patient advocates. On this website you will find videos from eight of the book\u27s vignettes, all involving medical students. Also please find links to other medical professionalism online resources. In the future, this site will contain professionalism cases and commentaries submitted by students. We look forward to developing this and look forward to any feedback you may have