HAPPE—A pilot programme using humanities to teach junior doctors empathy in a palliative medicine posting

Abstract

Introduction: Physician empathy is declining due to an unproportionate focus on technical knowledge and skills. The medical humanities can counter this by allowing connection with our patients. This is a pilot study that aims to investigate the acceptability, efficacy, and feasibility of a humanities educational intervention to develop physician empathy. Methods: Junior doctors at the Division of Supportive and Palliative Care at the National Cancer Centre Singapore between July 2018 and June 2019 attended two small-group sessions facilitated by psychologists to learn about empathy using literature and other arts-based materials. Feasibility was defined as a completion rate of at least 80% while acceptability was assessed by a 5-question Likert-scale questionnaire. Empathy was measured pre- and post-intervention using Jefferson’s Scale of Physician Empathy (JSPE) and the modified-CARE (Consultation and Relational Empathy) measure. Results: Seventeen participants consented, and all completed the programme. Acceptability scores ranged from 18 to 50 out of 50 (mean 38, median 38). There was an increase in JSPE scores (pre-test mean 103.6, SD=11.0 and post-test mean 108.9, SD=9.9; t (17) =2.49, P=.02). The modified-CARE score increased between pre-test mean of 22.9(SD=5.8) and a post-test mean of 28.5(SD=5.9); t (17) = 5.22, P<0.001. Conclusion: Results indicate that the programme was acceptable, effective, and feasible. The results are limited by the lack of longitudinal follow-up. Future studies that investigate the programme’s effect over time and qualitative analysis can better assess its efficacy and elicit the participants' experiences for future implementation and refinement.

Burnout in junior doctors in palliative care - a qualitative study on culture, identity, and systems

“…"…irrespective of how di cult the communication… or how much time it would take, they would invest that effort… a lot of dedication to that craft and being there… It is inspiring to see someone who has been in this eld for very long and still able to do something with so much passion and… a lot of us commonly ask whether we're able to last that long or whether we are able to keep this up and do this for many years on as a career." (P11, PGY3) d. Staff wellness There were formal staff support sessions and informal practices that promoted self-care, including artmaking programs, 30,31 and free drinks and food from consultants respectively. These layers of support signalled that staff wellness was important.…”

Literacia Em Competências Humanísticas No Contexto De Cuidados Paliativos: Revisão Integrativa

“…A pesquisa em educação médica deve continuar examinando a melhor forma de desenvolver e capturar os constituintes dos médicos humanísticos que queremos produzir, aqueles capazes de "estar presentes diante do sofrimento (Tait & Hodges, 2013). O uso das humanidades na educação médica têm o potencial para múltiplas funções na medicina e, talvez mais importante, servem para preencher a lacuna entre as ciências biomédicas e a "arte da medicina (Ong, 2021).…”

The employment of art therapy to develop empathy and foster wellbeing for junior doctors in a palliative medicine rotation - a qualitative exploratory study on acceptability

“…Despite indications of acceptability and effectiveness, the presence of mixed feedback, low participation rates, difficulties in program evaluation, and a dearth of qualitative data from research on the arts and humanities in medical education have highlighted the need for a more in-depth exploration of the integration of medical humanities (MH) in medical education [ 1 , 5 , 6 , 12 ]. The considerations involved in the designing and implementation of a medical humanities program into the curriculum deserve greater attention as they have direct bearings on the selection of faculty for such programs [ 13 – 16 ].…”

“…These elements support the mastery of skills, reflective practice, and transformative growth [ 2 – 11 ]. Since 2018, we have initiated pilot studies aimed at integrating content and methods from the visual arts, literature, and theatre to cultivate self-awareness and empathy among junior doctors specializing in palliative care (PC) [ 2 , 5 – 6 ]. These initiatives have undergone refinement based on frameworks proposed by review papers, advocating for increased collaboration among various stakeholders in the arts and humanities [ 3 , 12 ].…”