Academic Publications
*Some of the following resources are only available in English.
The case for a Canadian standard for 2SLGBTQIA+ medical education
“Today, negative encounters with physicians lead 2SLGBTQIA+ people to avoid seeking health care, and many physicians report feeling underprepared in treating 2SLGBTQIA+ patients. Although medical educators in Canada and the United States have acknowledged the need to prepare trainees to provide 2SLGBTQIA+ patients with informed, compassionate care, medical education in Canada related to health of 2SLGBTQIA+ patients remains sparse and inconsistent.”
In this paper, the authors consider the promise and challenges of integrating 2SLGBTQIA+ content into medical education across Canadian medical schools. The authors argue for the creation of a national standard for 2SLGBTQIA+ health care education and physician competency objectives in Canada.
A Pragmatic Approach for Organizations to Measure Health Care Professional Well-Being
“There is a high prevalence of burnout, depression, and suicide among health care professionals (HCPs). Compromised well-being among HCPs is associated with medical errors, medical malpractice suits, health care associated infections, patient mortality, lower interpersonal teamwork, lower patient satisfaction, job dissatisfaction, reduction in professional eff ort, and turnover of staff.”
In this paper, the authors provide a list of considerations for individuals charged with measuring HCP well-being at their institutions to guide them in selecting the most appropriate measurement instrument.
Fostering a Health-Promoting Learning Environment in Medical Education: Adapting the Okanagan Charter for Administrators and Medical Educators
“Although a healthy environment may allow learners to be well in the educational setting, a health-promoting learning environment strives to promote and embed wellbeing across all aspects of the learner’s experience. Health-promoting learning environments operate by infusing health principles into all aspects of operations, practices, mandates, and businesses. The Okanagan Charter is a widely adopted international framework with principles for best practices of adoption.”
In this paper, the authors have adapted the 5 strategies from the Okanagan Charter for pragmatic integration into the medical education environment and added a sixth strategy…
If Kindness Were a Drug, the FDA Would Approve It
This article explores the evidence that kindness improves medical care.
Physician Well-being 2.0: Where Are We and Where Are We Going
This article discusses research behind the importance of physician well-being and summarizes the historical phase of this journey (the “era of distress”), the current state (Well-being 1.0), and the early contours of the next phase based on recent research and the experience of vanguard institutions (Well-being 2.0).
What is compassion and how can we measure it? A review of definitions and measures
This paper proposes a definition of compassion and offers a systematic review of self- and observer-rated measures.
Interventions to cultivate physician empathy: a systematic review
Physician empathy is both theoretically and empirically critical to patient health, but research indicates that empathy declines throughout medical school and is lower than ideal among physicians. In this paper, the authors synthesize the published literature regarding interventions that were quantitatively evaluated to detect changes in empathy among medical students, residents, fellows and physicians.
Relationship between increased personal well-being and enhanced empathy among internal medicine residents.
The authors used an anonymous, cross-sectional survey to measure resident well-being and explored its relationship with empathy.
Effect of gender, age, and relevant course work on attitudes toward empathy, patient spirituality, and physician wellness.
“The emphasis in medical education on viewing the patient as a whole person addresses current concerns about the negative impact of standard physician training that may lead to impaired patient-physician relationships.” Using a survey completed anonymously by medical students and practitioners from the medical school, the authors assess self-ratings of empathy, spirituality, wellness, and tolerance in a sample of medical students and practitioners to explore differences by gender, age, and training.
How do distress and well-being relate to medical student empathy? A multicenter study.
The authors explore 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.
Harassment in the Field of Medicine: Cultural Barriers to Psychological Safety
“Psychologically safe organizational cultures are inherently inclusive and promote healthy sharing of power and knowledge….Several cultural barriers to psychological safety permit endemic harassment….Programs and policies that promote equity, diversity, and inclusion are an important start, but they are likely insufficient on their own to achieve psychological safety. Leadership that models difficult reflection and supports inclusive transformation is the key to a safe culture shift.”
Psychological safety, the hidden curriculum, and ambiguity in medicine.
“Psychological safety is a feeling that individuals are comfortable expressing and being themselves, as well as comfortable sharing concerns and mistakes without fear of embarrassment, shame, ridicule, or retribution.” This paper discusses psychological safety in the realm of medical education and explores the hidden curriculum of norms, values, and behaviors exhibited in their learning environment.
Does Psychological Safety Impact the Clinical Learning Environment for Resident Physicians? Results From the VA’s Learners’ Perceptions Survey
“Psychological safety (PS) is the perception that it is safe to take interpersonal risks in the work environment. In teaching hospitals, PS may influence the clinical learning environment for trainees.” In this study, the authors assessed whether resident physicians believe they are psychologically safe, and if PS is associated with how they rate satisfaction with their clinical learning experience.
Exploring the meaning of respect in medical student education: an analysis of student narratives
“..The specific meaning of respect varies widely and is underexplored as a lived experience of physicians-in-training.” The authors reviewed narratives and analyzed the content of the (dis)respect narratives to identify themes. Focusing on the lived experience of (dis)respect on wards broadens the concept of respect beyond any one type of act, behavior or attitude. Respect seems to entail responding to a need, while disrespect involves ignoring the need or bluntly violating it.
Perspective: a culture of respect, part 1: the nature and causes of disrespectful behavior by physicians.
The authors identify a broad range of disrespectful conduct, suggesting six categories for classifying disrespectful behavior in the health care setting. Disrespectful behavior is rooted, in part, in characteristics of the individual, such as insecurity or aggressiveness, but it is also learned, tolerated, and reinforced in the hierarchical hospital culture. A major contributor to disrespectful behavior is the stressful health care environment, particularly the presence of “production pressure,” such as the requirement to see a high volume of patients.
A Road Map for Advancing the Practice of Respect in Health Care: The Results of an Interdisciplinary Modified Delphi Consensus Study
“Most health care organizations’ efforts to reduce harm focus on physical harm, but other forms of harm are both prevalent and important.” In this study, a diverse, interdisciplinary panel of experts was convened to discuss strategies to guide health care systems to embrace an expanded definition of patient harm that includes nonphysical harm. Five rounds of surveys were required to reach predefined metrics of consensus.
