Physician gender and apologies in clinical interactions.

OBJECTIVE: We examine whether patients have a preference for affective (i.e., focused on patient's emotions) or cognitive (i.e., focused on the process that led to the error) apologies that are dependent on the apologizing physician's gender. We hypothesize patients will prefer gender-congruent apologies (i.e., when females offer affective apologies and males offer cognitive apologies). METHODS: We randomly assigned analogue patients (APs: participants instructed to imagine they were a patient) to read a scenario in which a female or male physician makes an error and provides a gender-congruent or incongruent apology. APs reported on their perceptions of the physician and legal intentions. RESULTS: An apology-type and gender congruency effect was found such that APs preferred apologies congruent with the gender of the apologizing physician. An indirect effect of congruency on legal intentions through physician perceptions was confirmed (b=-0.24, p=0.02). CONCLUSION: Our results suggest that physician gender plays a role in patient reactions to different apology types. PRACTICE IMPLICATIONS: Apology trainings should incorporate how physician characteristics can influence how patients assess and respond to apologies.

How women's sexual orientation guides accuracy of interpersonal judgements of other women.

This research examines how women's sexual orientation guides the accuracy of judgements of other women. One hundred ten judges (67 straight and 43 lesbian women) watched videotapes of 9 targets (4 straight and 5 lesbian) and made judgements about the targets' thoughts, emotions, personality, and sexual orientation. Accuracy scores were created for each judge by comparing judgements to criterion data gathered about targets. Straight judges were significantly more accurate at judging thoughts and marginally more accurate at judging emotions compared to lesbian judges. There were no significant differences in judging personality. Straight targets' thoughts and personality were more easily assessed than lesbian targets' while lesbians' emotions were more easily judged than straight targets'. Lesbian judges were more accurate at judging sexual orientation regardless of their tendency to categorize women as lesbian compared to straight judges. Findings support past research on the accurate perception of sexual orientation and contribute to understanding how sexual orientation guides person perception.

Feasibility of an electronic stethoscope system for monitoring neonatal bowel sounds.

OBJECTIVE: Bowel dysfunction remains a major problem in neonates. Traditional auscultation of bowel sounds as a diagnostic aid in neonatal gastrointestinal complications is limited by skill and inability to document and reassess. Consequently, we built a unique prototype to investigate the feasibility of an electronic monitoring system for continuous assessment of bowel sounds. METHOD: We attained approval by the Institutional Review Boards for the investigational study to test our system. The system incorporated a prototype stethoscope head with a built-in microphone connected to a digital recorder. Recordings made over extended periods were evaluated for quality. We also considered the acoustic environment of the hospital, where the stethoscope was used. The stethoscope head was attached to the abdomen with a hydrogel patch designed especially for this purpose. We used the system to obtain recordings from eight healthy, full-term babies. A scoring system was used to determine loudness, clarity, and ease of recognition comparing it to the traditional stethoscope. The recording duration was initially two hours and was increased to a maximum of eight hours. RESULTS: Median duration of attachment was three hours (3.75, 2.68). Based on the scoring, the bowel sound recording was perceived to be as loud and clear in sound reproduction as a traditional stethoscope. We determined that room noise and other noises were significant forms of interference in the recordings, which at times prevented analysis. However, no sound quality drift was noted in the recordings and no patient discomfort was noted. Minimal erythema was observed over the fixation site which subsided within one hour. CONCLUSION: We demonstrated the long-term recording of infant bowel sounds. Our contributions included a prototype stethoscope head, which was affixed using a specially designed hydrogel adhesive patch. Such a recording can be reviewed and reassessed, which is new technology and an improvement over current practice. The use of this system should also, theoretically, reduce risk of infection. Based on our research we concluded that while automatic assessment of bowel sounds is feasible over an extended period, there will be times when analysis is not possible. One limitation is noise interference. Our larger goals include producing a meaningful vital sign to characterize bowel sounds that can be produced in real-time, as well as providing automatic control for patient feeding pumps.