Background Empathy and compassion are vital components of health care quality; however, physicians frequently miss opportunities for empathy and compassion in patient care. Despite evidence that empathy and compassion training can be effective, the specific behaviors that should be taught remain unclear. We synthesized the biomedical literature on empathy and compassion training in medical education to find the specific curricula components (skills and behaviors) demonstrated to be effective. Methods We searched CENTRAL, MEDLINE, EMBASE, and CINAHL using a previously published comprehensive search strategy. We screened reference lists of the articles meeting inclusion criteria to identify additional studies for potential inclusion. Study inclusion criteria were: (1) intervention arm in which subjects underwent an educational curriculum aimed at enhancing empathy and/or compassion; (2) clearly defined control arm in which subjects did not receive the curriculum; (3) curriculum was tested on physicians (or physicians-in-training); and (4) outcome measure assessing the effect of the curriculum on physician empathy and/or compassion. We performed a qualitative analysis to collate and tabulate effects of tested curricula according to recommended methodology from the Cochrane Handbook. We used the Cochrane Collaboration’s tool for assessing risk of bias. Results Fifty-two studies (total n = 5,316) met inclusion criteria. Most (75%) studies found that the tested curricula improved physician empathy and/or compassion on at least one outcome measure. We identified the following key behaviors to be effective: (1) sitting (versus standing) during the interview; (2) detecting patients’ non-verbal cues of emotion; (3) recognizing and responding to opportunities for compassion; (4) non-verbal communication of caring (e.g. eye contact); and (5) verbal statements of acknowledgement, validation, and support. These behaviors were found to improve patient perception of physician empathy and/or compassion. Conclusion Evidence suggests that training can enhance physician empathy and compassion. Training curricula should incorporate the specific behaviors identified in this report.

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We have shown that exacerbations of bronchiectasis in South Auckland are more common in patients who are predominantly of Maaori or Pacific descent and are socioeconomically deprived. Admission to hospital for an exacerbation is associated with high readmission and mortality rates.

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ABSTRACT-Just as neurons interconnect in networks that create structured thoughts beyond the ken of any individual neuron, so people spontaneously organize themselves into groups to create emergent organizations that no individual may intend, comprehend, or even perceive. Recent technological advances have provided us with unprecedented opportunities for conducting controlled laboratory experiments on human collective behavior. We describe two experimental paradigms in which we attempt to build predictive bridges between the beliefs, goals, and cognitive capacities of individuals and patterns of behavior at the group level, showing how the members of a group dynamically allocate themselves to resources and how innovations diffuse through a social network. Agent-based computational models have provided useful explanatory and predictive accounts. Together, the models and experiments point to tradeoffs between exploration and exploitation-that is, compromises between individuals using their own innovations and using innovations obtained from their peers-and the emergence of group-level organizations such as population waves, bandwagon effects, and spontaneous specialization.KEYWORDS-collective behavior; imitation; social networks; competition; group behavior; foraging It is natural for psychologists to focus on the behavior of single individuals, because introspection provides people with motivation and perspective at this level. However, in a literal sense, we are all participating in entities greater than ourselves. Selforganized collectives of people create emergent group-level patterns that are rarely understood or intended by any individual. A business has a style and ethos that transcends its employees. A culture has a nature, integrity, and systematicity that transcends its inhabitants while still being grounded by their interactions (Atran, Medin, & Ross, 2005). Social phenomena such as the spread of gossip, the World-Wide Web, the popularity of cultural icons, legal systems, and scientific establishments all take on a life of their own, complete with their own self-organized divisions of labor and specialization, dynamics, feedback loops, growth, and adaptations.A considerable amount of early work on group behavior from social psychology focused on interpersonal relations and the attributes that characterize good leaders or work teams. However, the social patterns that people form are often organized without explicit leaders, chains of command, or fixed communication networks (Ball, 2004). Examples of such spontaneously emerging social patterns include book recommendations on Amazon.com (which evolve based upon similar readers' buying habits), fans at a sport stadium, grassroots political movements, the development of a fully cross-indexed and intricately organized online encyclopedia that any person can edit (www. wikipedia.org), and an online venue for media sharing that is freely accessible to both providers and consumers yet still shows striking trends of rich-get-richer popularity (www.youtube.com). I...