Influences on students' empathy in medical education: an exploratory interview study with medical students in their third and last year.

BACKGROUND: Empathy is beneficial for patients and physicians. It facilitates treatment and improves physical and psychosocial outcomes. The therapeutic relevance of empathy emphasizes the need to help medical students develop their empathic abilities. Our study aimed to identify factors which promote or hinder the development and expression of empathy in medical students during the course of their studies. METHODS: We interviewed 24 medical students (six male and six female students in their 6th semester as well as six male and six female students in their final clinical year) using semi-structured interviews. The interviews were recorded, transcribed verbatim and analyzed using Braun & Clarke's thematic analysis. RESULTS: We identified four main themes influencing the development and expression of empathy. 1) Course of studies: hands-on-experience, role models, science and theory, and emphasis on the importance of empathy; 2) students: insecurities and lack of routine, increasing professionalism, previous work experiences, professional distance, mood, maturity, and personal level of empathy; 3) patients: "easy" and "difficult" patients including their state of health; and 4) surrounding conditions: time pressure/stress, work environment, and job dissatisfaction. CONCLUSIONS: The development and use of empathy could be promoted by increasing: hands-on-experiences, possibilities to experience the patient's point of view and offering patient contact early in the curriculum. Students need support in reflecting on their actions, behavior and experiences with patients. Instructors need time and opportunities to reflect on their own communication with and treatment of patients, on their teaching behavior, and on their function as role models for treating patients empathically and preventing stress. Practical experiences should be made less stressful for students. The current changes implemented in some medical school curriculums (e.g., in Germany) seem to go in the right direction by integrating patient contact early on in the curriculum and focusing more on teaching adequate communication and interaction behaviors.

[Can Psychometric Tests Predict Success in the Selection Interview for Medical School? A Cross-Sectional Study at One German Medical School]. / Können psychometrische Tests den Erfolg im Auswahlgespräch zum Medizinstudium vorhersagen? Eine Querschnittsstudie an einer deutschen Hochschule.

Background The final exam grade is the main selection criterion for medical school application in Germany. For academic success, it seems to be a reliable predictor. Its use as the only selection criterion is, however, criticised. At some universities, personal interviews are part of the selection process. However, these are very time consuming and are of doubtful validity. The (additional) use of appropriate psychometric instruments could reduce the cost and increase the validity. This study investigates the extent to which psychometric instruments can predict the outcome of a personal selection interview. Methods This is a cross-sectional study on the correlation of the results of psychometric instruments with those of the personal selection interview as part of the application process. As the outcome, the score of the selection interview was used. The NEO - Five Factor Inventory, the Hospital Anxiety and Depression Scale (HADS) and the questionnaire to identify work-related behaviour and experience patterns (AVEM) were used as psychometric interviews. Results There was a statistically significant correlation with the results of the personal selection interview for the sum score of the depression scale from the HADS and the sum score for the dimension of life satisfaction of the AVEM. In addition, those participants who did not previously complete an application training achieved a better result in the selection interview. Conclusion The instruments used measure different aspects than the interviews and cannot replace them. It remains to be seen whether the selected parameters are able to predict academic success.

The MARK-AGE extended database: data integration and pre-processing.

MARK-AGE is a recently completed European population study, where bioanalytical and anthropometric data were collected from human subjects at a large scale. To facilitate data analysis and mathematical modelling, an extended database had to be constructed, integrating the data sources that were part of the project. This step involved checking, transformation and documentation of data. The success of downstream analysis mainly depends on the preparation and quality of the integrated data. Here, we present the pre-processing steps applied to the MARK-AGE data to ensure high quality and reliability in the MARK-AGE Extended Database. Various kinds of obstacles that arose during the project are highlighted and solutions are presented.

Perceived medical school stress and the development of behavior and experience patterns in German medical students.

BACKGROUND: Longitudinal data about the development of health risks and resources in relation to the performance of medical students are limited. AIMS: To evaluate the development of study-related experience and the correlation to performance. METHOD: Medical students in the first (2006), second (2008), and fifth years (2011) of their studies were surveyed with standard instruments for quality of life, study-related behavior and experience, perceived medical school stress, anxiety and depression, and grades in their first major exam. RESULTS: The proportion of students with a healthy behavior and experience pattern decreased from 47.3% in the first year to 36.9% in the second year and 17.6% in the fifth year. This corresponded to an increase in the proportion of students at risk for burnout (7.1% first, 20% second, 19% fifth year). Students with a healthy behavior and experience pattern scored higher in self-perceived performance (p < 0.05) and objective grades. Stress and risk for burnout were important predictors for anxiety and depression. CONCLUSIONS: The decrease in health and the increase in risk patterns indicate a need for prevention and health promotion that should not only focus on individual behavior but also address the contextual factor of study organization within medical school.

[Crisis intervention in the framework of an acute psychiatric general ward]. / Krisenintervention im Rahmen einer akut-psychiatrischen Allgemeinstation.

Basing on the description of the concept for treating patients admitted and treated on the lines of crisis intervention for acute psychogenic crises, in an open, unsegregated (i. e. for both sexes) general psychiatric ward for acute cases in a university hospital, the data collected from 90 patients in the course of a year in respect of age, sex, cause of crisis, suicidal tendencies, diagnosis and duration of stay and follow-up treatment were analysed and compared with those collected by other crisis intervention units. It was found that there was major agreement regarding most criteria between our unit and other units; however, neurosis or personality disorder were diagnosed much more frequently than a psychogenic reaction. Over and above this, the inpatient treatment period was longer. We believe that the differences are due to an understanding of the crisis concerned which classifies the patients not so much as healthy persons thrown off balance by a major upset, rather as patients with chronic psychic difficulties that decompensate through various external factors. In the first place, treatment of the basic disease intends to protect the patients against re-exacerbation of unpleasant conflicts that are of a piercing nature. The article also points out the pros and cons of a ward to which crisis patients and psychiatric emergency cases are admitted without previous selection and can be treated adequately without additional stress being placed on the patient by a transfer or a change of physician and therapist.