How to Assess Doctors and Health Professionals
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This fictionalized vignette highlights an important aspect of health care: Providers often have vastly different ways of seeing and treating patients, as differences in profession, specialty, experience, or background lead them to pay attention to particular signals or cues and influence how they approach problems. How these lenses are brought together to inform decision making can have profound implications for patients.
While diverse perspectives and approaches to care are important, if they are not managed appropriately, they can cause misunderstandings, bias decision making, and get in the way of the best care. For instance, had the providers in Mr. Unfortunately, this collaboration tends to be the exception rather than the norm in many health care organizations. Communication failures are a common cause of patient harm.
Even within the same specialty, providers can have varying perspectives and approaches to care, due to their different backgrounds and experiences. Female physicians, for example, are more likely than male physicians to follow evidence-based practice and to engage in more preventive services e. Research has also demonstrated that male cardiologists are more likely to conduct invasive cardiac procedures on the average patient than their female counterparts are which may be warranted for some patients but less so for others.
Similarly, other health care professionals, such as system administrators and managers , also bring varying perspectives to their work that can influence the care patients receive, as highlighted in research by one of us Jemima on the racial backgrounds of opioid treatment program managers. Similarly, individuals must learn to appreciate the limits of their own perspective and seek to adopt other lenses when complex problems demand it. We all adopt a default way of seeing any given issue, which can bias our choices and cause us to overlook other important details. And this tendency has been shown to impact health care providers as well.
For example, in one study inspired by the gorilla experiment , researchers asked radiologists to examine a set of CT scans of lungs for anomalous nodules. In our work to promote more-effective decision making and evidence-based practice, we have come across at least two ways that health professionals can get better at communicating with each other and adopting multiple lenses themselves. Create an environment that supports perspective sharing and effective communication among team members.
The multidisciplinary care team model, championed in modern health care, brings together different providers e. This works best when teams communicate effectively and integrate their diverse perspectives. For instance, many patients come to the ER complaining of dizziness, a symptom that can indicate a variety of possible diagnoses.
They found that including a physical therapist in the emergency department care team helped them more accurately diagnose causes of dizziness among ER patients, resulting in better treatment, better patient satisfaction, and faster discharge.
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This is because the physical therapist had specialized knowledge of a vestibular assessment technique that can help diagnose cause of dizziness. Building this culture requires both top-down and bottom-up efforts, but leaders can set the tone through their actions and the behavior they reward among care team members. One way to create this culture is to have teams practice sharing and adopting different lenses using simulations.
We have begun implementing a case-based teaching exercise among surgeons, anesthesiologists, nurses, and technicians who work together to deliver surgical care to patients at Johns Hopkins. The goal is to help them recognize, surface, and integrate different lenses.
In our simulation they must decide how to deal with a problematic surgeon who is receiving many complaints from coworkers. In doing so, they can hone the effective communication needed to make better decisions during patient care. This is critical for improving care. Not all patient care decisions are made in a team setting, so individuals must also practice applying different lenses to overcome the limitations of their default lens and improve their decision making. Likewise, physicians, nurses, and others who work in one particular specialty might gain new lenses by rotating through a different specialty.
More research is needed to reaffirm the psychometrics of the JSPPPE in different groups of patients inpatient and outpatient with a variety of disease conditions , in different groups of clinicians, in a variety of health professional disciplines, specialties, and settings, and in different cultures and demographic compositions. She provides research support and manages analytic services for the Jefferson Scale of Empathy.
National Center for Biotechnology Information , U.
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Journal List J Patient Exp v. J Patient Exp. Published online Mar Author information Copyright and License information Disclaimer. Corresponding author.
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Email: ude. This article has been cited by other articles in PMC. Keywords: empathy, patient perceptions, Jefferson Scale, patient outcomes, validity, reliability. Introduction Empathy has been described as one of the most frequently mentioned humanistic components of patient care 1 , a royal road to treatment, a symbol of healthcare at its best 2 , and an important component of professionalism in medicine 3.
Definition Despite the consensus among health professions researchers about the importance of empathy in patient care, there is less unanimity about its definition. Face and Content Validity The instrument was developed to be content specific and context relevant to assure its face and content validity. Item-Total Score Correlations To examine the extent to which each item contributes to the total score, we examined corrected item-total score correlations of the JSPPPE ie, correlations between each item score and the total score in which the corresponding item score was excluded.
Criterion-Related Validity Significant correlations between scores of a test and those of conceptually relevant measures are indicators of validity of the test. Acknowledgment The authors would like to thank Dorissa Bolinski for her editorial help. Appendix A. Open in a separate window. References 1. Med Care. Larson EB, Yao X.
Clinical empathy as emotional labor in patient-physician relationship. Veloski J, Hojat M. Measuring specific elements of professionalism: empathy, teamwork, and lifelong learning In: Stern DT, editor. Measuring Medical Professionalism. Hojat M. Acad Med. The relationship between physician empathy and disease complications: an empirical study of primary care physicians and their diabetic patients in Parma , Italy. Sullivan P. Pay more attention to your health, physicians warned. Shamasundar MRC. Reflections: understanding empathy and related phenomena. AM J Psychother.
Mental well-being of good sleepers in a random population sample. Br J Med Psychol. Empathy is a protective factor of burnout in physicians: new neuro-phenomenological hypotheses regarding empathy and sympathy in care relationship. Front Psychol. Empathy in medical students as related to specialty interest, personality, and perceptions of mother and father. Personality and Individual Differences.
Overlap between empathy, teamwork, and integrative approach to patient care. Med Teach. Can empathy, other personality attributes, and level of positive social influence in medical school identify potential leaders in medicine?follow
How to Assess Doctors and Health Professionals | Wiley Online Books
Peer nominations as related to academic attainment, empathy, and specialty interest. The Jefferson Scale of Physician Empathy: development and preliminary psychometric data. Educational and Psychological Measurement. Physician empathy: definition, measurement, and relationship to gender and specialty. Am J Psychiatry. Empathic and sympathetic orientations toward patient care: conceptualization, measurement, and psychometrics. Sympathy, empathy, and physician resource utilization.
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