Introducing compassion into the education of health care professionals; can Schwartz Rounds help?

Abstract

Whilst health care professionals embark on their careers with high ideals these can be eroded by the pressures and stress of the system. This paper explores the problems, which may lead both students and professionals, working in health care, to feel isolated and stressed. It considers the value of Schwartz Rounds as an initiative that can be used to enhance student well-being and ultimately enable students to treat each other, colleagues and patients with more compassion.Case description: Qualitative and quantitative data from Schwartz Rounds conducted with medical students at University College London Medical School is drawn on to inform the discussion. Discussion: Potential mechanisms at play in the Rounds are explored. Further research is needed to look at the cost benefits of Rounds in relation to possible benefits including reduced student attrition. Logistical challenges of running Rounds within and across different disciplines need further investigation. Conclusion: Early feedback suggests that the Rounds are well received by the students and a number of benefits reported relating to the normalising of emotions and creating channels for more open, transparent modes of communication.Keywords: Education, Medical Student, Teaching, Undergraduate, Curriculum, Schwartz Centre Rounds, Resilience, Compassion, Burnout, Stress, Professionalism OverviewBehavioural ideals and professional standards determined for those entering the health care professions (doctors, nurses and allied health professionals) are set high. The notion of professionalism encompasses a broad range of behaviours including; integrity, compassion, altruism, continuous improvement, excellence and good team working [1]. Yet it seems that it is the more technical aspects of this ideal 'package' of behaviours, which are prioritised in curriculum planning [2]. The teaching of clinical facts may appear more straightforward to pass on and test, than traits such as empathy and compassion. This paper explores how Schwartz Rounds may be incorporated into the standard curriculum of health care students to help students to engage in more compassionate, open patterns of communication and care -both with colleagues and patients. Data from a pilot project [3] at University College London Medical School (UCLMS) where Schwartz Rounds are now being run with years 5 and 6 medical students will be drawn on.

The case for developing an online intervention to support midwives in work-related psychological distress

“…In fear of shame and a punitive response, these midwives may further shy away from open disclosure and help seeking and instead, display help avoidant behaviours. Face-to-face support such as the Schwartz rounds and restorative supervision already support some midwives in work-related psychological distress (Wallbank 2010, Barker, Cornwell et al 2016). Yet for midwives seeking more private, confidential and anonymous support, the development of a targeted online intervention may now be required.…”

The ‘values journey’ of nursing and midwifery students selected using multiple mini interviews: Evaluations from a longitudinal study

“…An evaluation of Schwartz rounds (Maben et al, ) showed that they led to a greater understanding, empathy and tolerance towards both colleagues and patients. Barker, Cornwell, and Gishen () make a case for the use of Schwartz rounds within healthcare education programmes.…”

Clinical supervision, burnout and intent to leave: an Australian mixed methods study of community-based allied health professionals

“…5) Health care workers exhibit high levels of stress and burnout and are located within health care systems which will be under increasing pressures into the future High levels of stress and burnout have been found in health care workers (Barker, Cornwell, & Gishen, 2016;Marine, Ruotsalainen, Serra, & Verbeek, 2009), including amongst the allied health professions (Chiller & Crisp, 2012;Fischer et al, 2013). There is evidence that healthcare workers experience higher levels of stress and burnout in comparison to the general workforce (Michie & Williams, 2003;Wells, 2011).…”

“…Health care workers, including allied health professionals, exhibit high levels of stress and burnout (Barker et al, 2016;Fischer et al, 2013). Burnout carries significant costs for the health care industry (Marine et al, 2009), is negatively associated with patient satisfaction (Fredette-Carragher, 2016), is related to increased absenteeism (Hawes, 2009) and is consistently linked to worker intention to leave (Alkorashy & Baddar, 2016).…”

“…The empirical literature documents the occurrence of high levels of stress and burnout in health care workers (Barker et al, 2016;Lloyd, King, & Chenoweth, 2002;Marine et al, 2009), including allied health professionals (Chiller & Crisp, 2012;Fischer et al, 2013).…”