To determine whether lower levels of empathy among a sample of medical students in the United States are associated with personal and professional distress and to explore whether a high degree of personal well-being is associated with higher levels of empathy. Multi-institutional, cross-sectional survey. All medical schools in Minnesota (a private medical school, a traditional public university, and a public university with a focus in primary care). A total of 1,098 medical students. Validated instruments were used to measure empathy, distress (i.e., burnout and symptoms of depression), and well-being (high quality of life). Medical student empathy scores were higher than normative samples of similarly aged individuals and were similar to other medical student samples. Domains of burnout inversely correlated with empathy (depersonalization with empathy independent of gender, all P < .02, and emotional exhaustion with emotive empathy for men, P = .009). Symptoms of depression inversely correlated with empathy for women (all P ≤ .01). In contrast, students’ sense of personal accomplishment demonstrated a positive correlation with empathy independent of gender (all P < .001). Similarly, achieving a high quality of life in specific domains correlated with higher empathy scores (P < .05). On multivariate analysis evaluating measures of distress and well-being simultaneously, both burnout (negative correlation) and well-being (positive correlation) independently correlated with student empathy scores. Both distress and well-being are related to medical student empathy. Efforts to reduce student distress should be part of broader efforts to promote student well-being, which may enhance aspects of professionalism. Additional studies of student well-being and its potential influence on professionalism are needed.

How Do Distress and Well-being Relate to Medical Student Empathy? A Multicenter Study

BACKGROUND
While resident distress and its potential to negatively effect patient care have been well documented, little is known bout resident well-being or its potential to enhance care.

/pdf/relationship-between-increased-personal-well-being-and-1gks1d0fx5.pdf

Relationship between increased personal well-being and enhanced empathy among internal medicine residents

BACKGROUND: While resident distress and its potential to negatively effect patient care have been well documented, little is known about resident well-being or its potential to enhance care.

Relationship between increased personal well-being and enhanced empathy among

Context Case-based teaching is regarded as a superior instructional method compared with lectures in promoting a learner's critical thinking skills. While much is known about the role a discussion facilitator plays in case-based teaching, the debate on the influence of the format and structure of cases on learning is controversial.

Objectives  We sought to identify strategies for constructing cases based on studies from multiple disciplines, which report the development and use of cases in teaching and learning. The purpose was to offer the medical and other educational communities a conceptual framework that can be examined in future research.

Results  Based on a review of 100 studies, we synthesised 17 strategies around 5 core attributes of cases: relevant (level of learner, goals and objectives, setting of case narrative); realistic (authenticity, distractors, gradual disclosure of content); engaging (rich content, multiple perspectives, branching of content); challenging (difficulty, unusual cases, case structure, multiple cases), and instructional (build upon prior knowledge, assessment, feedback, and teaching aids).

Discussion  Despite the wide use of cases in disparate disciplines, there has been no overarching study that synthesises strategies of case development or tests these strategies in research settings. The framework we developed can serve as a menu of case development options that educators and researchers can pilot and evaluate in their local settings.

A conceptual framework for developing teaching cases: a review and synthesis of the literature across disciplines

PurposeIntegrating basic science and clinical concepts in the undergraduate medical curriculum is an important challenge for medical education. The health professions education literature includes a variety of educational strategies for integrating basic science and clinical concepts at multiple lev

Cognition before curriculum: rethinking the integration of basic science and clinical learning.

This article describes a novel course that was designed to bridge the gap between the basic science years and clinical experiences in medical school by using information science and computer technology as major components of problem-based learning (PBL) sessions. The course, Integrated Case Studies and Medical Decision Making, was first given to second-year students at the University of Pittsburgh School of Medicine in the spring of 1994. It consists of 13 PBL exercises, each of which explores a clinical case. The cases, including images and gated access to information, are housed on a computer. Using one of 16 networked terminals in specially designed small-group rooms, groups of nine students progress through the cases with a faculty facilitator. The responses of students and faculty to the initial year of the course were favorable. In comparison with traditional PBL sessions, enhanced quality of and access to images and accountability for accessing case information in sequential fashion were cited as major strengths of the course. Juxtaposition of basic science and clinical material and utility in reviewing for the United States Medical Licensing Examination were also cited as strengths. The diversity of the basic science material involved in completing the cases drew overwhelming enthusiasm from students and facilitators alike. In conclusion, the course successfully employs computer and information science technology, which will be of increasing importance to future physicians. The course also serves as an effective bridge to the clinical years of medical school and as a study adjunct for the USMLE.

Integrated Case Studies and Medical Decision Making: A Novel, Computer-Assisted Bridge from the Basic Sciences to the Clinics

Problem Based Learning (PBL) and Cooperative Learn-ing are both supported in a rich environment for activegroup learning. Groups of students are given a medicalexploration environment to support learning by discoveryand exploration. The environment implements a currentapproach to problem based learning (PBL) and extendsit to support the joint reasoning and cooperation aspectsin medical teams. An information system approach for acomplete cooperative PBL environment, called ComputerAssisted Learning and Exploration(CALE),is based upontheseconcepts. CALEacts as amulti-mediarepositoryforcase materials and manages the structured group access tothose documents and user generated information. CALEsupports collaborative learning, exploration of facilitatoreditablemedical simulatedpatientcases, and access toref-erence materials. With the case presentation shell beingthe same for all cases, new cases can easily be added.Keywords: Problem Based Learning, CollaborativeLearning, Exploration and Discovery Systems, Case andKnowledge Acquisition,Case Display, User Annotations,Group SupportSystems, Group TutoringSystems, SharedInformation Spaces, CSCL Shells.

A collaborative environment for semi-structured medical problem based learning

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Integrated Case Studies and Medical Decision Making: A Novel, Computer-Assisted Bridge from the Basic Sciences to the Clinics

A collaborative environment for semi-structured medical problem based learning