The Value & Impact of Interprofessional Training in Empathy & Affect Recognition in Developing Empathic Resilience
Purpose: We propose a workshop to: a.) discuss the role of empathy in provider-patient and provider-provider interactions, b.) highlight the conceptual differences between empathy in the social psychological sense, and “clinical empathy” – and how these differing concepts may relate to the cultivation of empathic resilience among current and future providers c.) discuss aspects of health professions education that can negatively impact empathy development and maintenance, and, d.) showcase an empathy and affect recognition interprofessonal training seminar. Studies have shown that empathic providers enjoy their job more, are less of a financial burden on their practice setting, report lower levels of burnout, and have patients with better medical outcomes and higher satisfaction and compliance regarding their care (Robbins et al. 1993; Beckman and Frankel 1984; Falvo and Tippy 1988; Horowitz et al. 2003; Hojat, 2011; Rake, 2009; Kaptchuck, 2008; Halpern, 2001; 2010, 2012; Reiss, 2012; Shanafelt, 2009, 2005; West 2011). Yet a substantial body of work suggests that aspects of the educational environment negatively impacts health profession students’ ability and willingness to recognize emotional distress in others and, in turn, engage in empathy (Hojat et al., 2009; Nunes et al. 2011; Ward et al., 2012). In fact, structural and institutional mechanisms and processes nested within health professions training, including siloed discipline-specific curriculum and experiences, appear to promote empathic resistance (Michalec, 2010; 2011). In turn, the future provider workforce, including physical therapists, are simply not equipped for the barrage of human-ness, and work-related stressors associated with healthcare delivery, and it is argued that this stems from a lack of opportunities to build empathic resilience, and a conditioned focus on detachment from patients and uni-professional approaches to care. To promote empathic resilience and cultivate understanding of other health professions, we have developed an innovative interprofessional 3 credit seminar to train graduate health profession students in the science of emotions, empathy, and the practice of mindfulness. This seminar is aimed at students interested in various patient-centered healthcare fields (e.g., physical therapy, clinical psychology, speech pathology, nursing, dietetics, disability services, exercise science, etc.) as well as those in more academic health-oriented fields (e.g., health policy, medical sociology, social psychology, etc.). The course will consist of formal training in affect recognition, empathy, and mindfulness (led by experts in each respective field), experiential learning modules, simulation-based learning opportunities, and group and reflection-based exercises.Methods and/or Description of Project: During our presentation we will discuss the various aspects of the course, including the formal training modules (METT, SETT, RE3, Empathetics), simulation exercises, reflections, observation exercises, Art-engagement program, and the mindfulness training (among other exercises). We will elaborate on the value (and necessity) of each aspect, and the reasoning for its inclusion in the program. We will also showcase other related programs at other health education institutions from which we were inspired.Results/Outcomes: The proposed training seminar does not begin until the Spring 2019 semester – however, a similar program was conducted with undergraduate health profession students, and we will share the outcomes/results (quantitative and qualitative) of that program, along with our hypotheses regarding the graduate-level program.Conclusions/Relevance to the conference theme: Our Leadership Landscape: Perspectives from the Ground Level to 30,000 Feet: This program speaks directly to the Conference themes of “Developing Strategies to Build Resilience in Academic and Clinical Environments” as well as “Embedding Leadership Skills Across Didactic and Clinical Education”. Through this presentation we will spotlight the value and impact of explicit training in empathy, affect recognition, and mindfulness to build communication skills (provider-patient and provider-provider) and empathic resilience among the future healthcare workforce, provide others with the blueprint for the program, as well as offer suggestions on how to nest such a program within an already burdened curriculum.References: Beckman, H., & Frankel, R.. (1984) The effect of physician behaviour on the collection of data, Annals of Internal Medicine, 101, pp. 692–696. Falvo, D., & Tippy, P. (1988) Communicating information to patients: patient satisfaction and adherence as associated with resident skill, Journal of Family Practice, 26, pp. 643–647. Halpern, J. 2001. From Detached Concern to Clinical Empathy. New York, NY: Oxford University Press. Hojat, M., Vergare, M., Maxwell, K., et al. 2009. The Devil is in the Third Year: A Longitudinal Study of Erosion of Empathy in Medical School. Academic Medicine. 84(9): 1182-1191. Horowitz, C., Suchman, A., Branch, W., & Frankel, R. 2003. What do Doctors Find Meaningful about Their Work? Annals of Internal Medicine. 138(9): 772-775. Michalec, B. 2010. An Assessment of Medical School Stressors on Preclinical Students’ Levels of Clinical Empathy. Current Psychology. 29(3): 210-221. Michalec, Barret. 2011. “Learning to Cure, but Learning to Care?” Advances in Health Sciences Education. 16: 109-130. Nunes, P., Williams, S., Bidyadhar, S., & Stevenson, K. 2011. A Study of Empathy Decline in Students from Five Health Disciplines During their First Year of Training. International Journal of Medical Education. 2: 12-17. Ward, J., Cody, J., Schaal, M., & Hojat, M. 2012. The Empathy Enigma: An Empirical Study of Decline in Empathy Among Undergraduate Nursing Students. Journal of Professional Nursing. 28(10): 34-40.Course Objectives: Through the presentation participants will be able to: Improve understanding of the role of empathy in healthcare delivery as it relates to patients and team-based care. Recognize the conceptual variations between empathy and “clinical empathy”. Explain certain macro, meso, and micro factors that hinder the cultivation and maintenance of empathy among health profession students Discuss the blueprint for a training program in empathy, affect recognition, and mindfulness – aimed at developing empathic resilience among future healthcare providers.Instructional Methods: lecture, large group discussion, notecard questioning/exercise, question / answerTentative Outline/Schedule: Mins 0-10: quick audience notecard exercise: “What do you think Empathy is?” Audience writes on a note card and posts it on wall – team member does quick analysis of KEY words/terms during next segment Mins 10-40: A.) background on empathy in healthcare delivery and value to team-based care B.) exploration of empathy and clinical empathy, c.) discussion of audiences’ perceptions of empathy Mins 40-50: Quick audience notecard exercise: “How does your institution foster empathy among your students?” “How does your institution hinder empathy among your students?” Audience writes on a note card and posts it on wall – team member does quick analysis of KEY words/terms during next segment Mins 50-60: a.) background on macro, meso, micro impacts on empathy among health profession students, b.) Discussion of audiences’ responses Mins 60-80: Discussion of Empathy & Affect Recognition Training Seminar developed at UD, the notion of empathic resilience, and how the course can foster empathic resilience. Mins 80-90: Q&A