Substantial Increases in Healthcare Students' State Empathy Scores Owing to Participation in a Single Improvisation Session.

PURPOSE: To determine whether the 12-item state empathy scale could be modified reliably to measure empathy in healthcare professions students and to detect changes in their empathy owing to a single improvisation (improv) session. METHODS: Three cohorts of students from two healthcare professions programs (total = 165 students) participated in an improv session. During the session, one of the researchers (BS) tasked the students with several improv activities. Participants' self-reported state empathy scores were assessed at three time points (pre-improv, post-improv, and end of semester) using revised, in-class paper versions of the State Empathy Scale. RESULTS: The exploratory factor analysis revealed a single factor solution for the revised scale, justifying the creation of an overall state empathy score from the questionnaire. Cronbach's alpha reliability values averaged 0.87. Students' mean empathy scores were higher directly after the improv session than directly prior to the session (p < 0.0001; effect size = r = 0.67, 0.55, and 0.79 for cohorts 1, 2, and 3, respectively). CONCLUSIONS: These findings show that a single one- or two-hour improv session can foster substantial increases in healthcare professional students' state empathy for one another. Greater healthcare professional empathy and compassion foster better healthcare team cooperation and patient outcomes, so healthcare professionals and their students should engage in such empathy-enhancing activities at regular intervals throughout their training and careers.

Further development of the reflective practice questionnaire.

Background: This article provides an update of the Reflective Practice Questionnaire (RPQ). The original RPQ consisted of 40-items with 10-sub-scales. In this article, the RPQ is streamlined into a 10-item single reflective practice construct, and a 30-item extended version that includes additional sub-scales of confidence, uncertainty/stress, and work satisfaction. Methods: A total of 501 university students filled out an online questionnaire that contained the original Reflective Practice Questionnaire, and two general measures of reflection: The Self-Reflection and Insight Scale, and the Rumination-Reflection Questionnaire. Results: Based on factor analysis, the RPQ was streamlined into a brief 10-item version, and an extended 30-item version. Small positive correlations were found between the RPQ reflective practice measure and the two measures of general reflection, providing discriminant validity evidence for the RPQ. The RPQ was found to be sensitive to differences among industries, whereas the general measures of reflection were not. Average reflective practice scores were higher for health and education industries compared to retail and food/accommodation industries.

Intrinsic motivation in a virtual reality mock crime affects participants' willingness to invest more effort in deceptive interviews.

In studies of investigative interviewing, it is not well understood how participant experience of mock-crime activities might affect participants' desire to perform (well) in subsequent interviews. In this study, we utilized two immersive virtual reality mock-crimes to examine if participants' intrinsic motivation (i.e., competence, autonomy, relatedness) while committing the virtual mock-crime affects their desire to perform well in interviews. We also examined if the self-reported feeling of presence during the virtual reality mock-crime is associated with participants' intrinsic motivation. We found significant positive associations between presence and all intrinsic motivation variables in both truth and lie conditions. We also found that competence and relatedness significantly predicted the self-reported effort to perform well in interviews. We discuss these results in the context of prior literature and provide recommendations for researchers on the design of mock-crime experiences.

Survey of attitudes toward performing and reflecting on required team service-learning (SASL): psychometric data and reliability/validity for healthcare professions students in preclinical courses.

Purpose: Previously we assessed healthcare professional students' feelings about team-based learning, implicit bias, and service to the community using an in-house paper survey. In this study, we determined whether this survey is a reliable and valid measure of prospective medical students' attitudes toward required service-learning in an Immunology course. To our knowledge, no published questionnaire has been shown to be dependable and useful for measuring such attitudes using only eight survey items. Methods: Fifty-eight prospective medical students in Colorado (CO) and 15 in Utah (UT) completed the same Immunology course using remote technology. In addition to the usual course content, students were required to write critical reflections on required team service-learning. On the last day of class, they completed the survey of attitudes toward service-learning (SASL). Results: Data analyses found Cronbach's alpha values of 0.84 and 0.85 for the surveys of UT and CO students, respectively. Factor analysis of CO student data revealed only one Eigenvalue greater than one (3.95) justifying retention of a single factor termed "attitudes toward required service-learning." In addition, CO students' attitudes toward community service were highly positive, while UT students' attitudes were nearer neutral (p < 0.0001). Conclusion: Our factor analysis and good Cronbach's alpha values support the conclusion that the SASL was a reliable measure of prospective medical students' attitudes toward required team service-learning for an Immunology course. Moreover, we used the SASL to distinguish these attitudes in CO versus UT students, and, thus, the SASL appears to be a valid measure of this difference. Calculation of similarly good Cronbach's alpha values - for a predecessor of the SASL among pharmacy, masters, and medical students at another institution - indicates that the SASL may be useful more widely. However, the reliability and validity of the SASL needs to be demonstrated more rigorously for other healthcare students at different universities.

'Teachers are the guinea pigs': teacher perspectives on a sudden reopening of schools during the COVID-19 pandemic.

Primary and secondary education systems experienced substantial disruption during the COVID-19 pandemic. However, little is known about how public health policy has affected Australian teachers during the pandemic. This study examines teacher perspectives on a sudden change of policy, whereby schools were abruptly opened to students at the beginning of the pandemic. At the same time, strict social distancing rules applied to the remainder of the population. Qualitative data from 372 Western Australian schoolteachers were analysed using thematic analysis. Results highlight substantial impacts on teachers' workloads and adverse effects on wellbeing. Perceptions that they were acting as guinea pigs and subjected to different social distancing rules than other citizens were particular stressors. Findings highlight substantial consequences of public health policies on the roles and wellbeing of teachers.

Ability of the Australian general public to identify common emergency medical situations: Results of an online survey of a nationally representative sample.

OBJECTIVE: To investigate the Australian general public's ability to identify common medical emergencies as requiring an emergency response. METHODS: An online survey asked participants to identify likely medical treatment pathways they would take for 17 hypothetical medical scenarios (eight emergency and nine non-emergency). The number and type of emergency scenarios participants correctly suggested warranted an emergency medical response was examined. Participants included Australian residents (aged>18 years; n = 5264) who had never worked as an Australian registered medical doctor, nurse or paramedic. RESULTS: Most emergencies were predominately correctly classified as requiring emergency responses (e.g. Severe chest pain, 95% correct). However, non-emergency medical responses were often chosen for some emergency scenarios, such as a child suffering from a scalp haematoma (67%), potential meningococcal disease (57%), a box jellyfish sting (40%), a paracetamol overdose (37%), and mild chest pain (26%). Participants identifying as Aboriginal or Torres Strait Islander suggested a non-emergency response to emergency scenarios 29% more often compared with non-indigenous participants. CONCLUSIONS: Educational interventions targeting specific medical symptoms may work to alleviate delayed emergency medical intervention. This research highlights a particular need for improving symptom identification and healthcare system confidence amongst Aboriginal and Torres Strait Islander populations.

Body Gaze as a Marker of Sexual Objectification: A New Scale for Pervasive Gaze and Gaze Provocation Behaviors in Heterosexual Women and Men.

Body gaze behavior is assumed to be a key feature of sexual objectification. However, there are few self-report gaze measures available and none capturing behavior which seeks to invite body gaze from others. Across two studies, we used existing self-report instruments and measurement of eye movements to validate a new self-report scale to measure pervasive body gaze behavior and body gaze provocation behavior in heterosexual women and men. In Study 1, participants (N = 1021) completed a survey with newly created items related to pervasive body gaze and body gaze provocation behavior. Participants also completed preexisting measures of body attitudes, sexual assault attitudes, pornography use, and relationship status. Exploratory and confirmatory factor analyses across independent samples suggested a 12-item scale for men and women to separately measure pervasive body gaze (5 items) and body gaze provocation (7 items) toward the opposite sex. The two scales yielded excellent internal consistency estimates (.86-.89) and promising convergent validity via positive correlations with body and sexual attitudes. In Study 2, a subsample (N = 167) of participants from Study 1 completed an eye-tracking task to capture their gaze behavior toward matched images of partially and fully dressed female and male subjects. Men exhibited body-biased gaze behavior toward all the female imagery, whereas women exhibited head-biased gaze behavior toward fully clothed male imagery. Importantly, self-reported body gaze correlated positively with some aspects of objectively measured body gaze behavior. Both scales showed good test-retest reliability and were positively correlated with sexual assault attitudes.

Change in mental health, physical health, and social relationships during highly restrictive lockdown in the COVID-19 pandemic: evidence from Australia.

BACKGROUND: A novel coronavirus first reported in Wuhan City in China in 2019 (COVID-19) developed into a global pandemic throughout 2020. Many countries around the world implemented strict social distancing policies to curb the spread of the virus. In this study we aimed to examine potential change in mental/physical health and social relationships during a highly restrictive COVID-19 lockdown period in Australia during April 2020. METHODS: Our survey (n = 1, 599) included questions about concerns, social behaviour, perceived change in relationship quality, social media use, frequency of exercise, physical health, and mental health during COVID-19 lockdown (April, 2020). RESULTS: When estimating their mental health for the previous year 13% of participants reported more negative than positive emotion, whereas this increased to 41% when participants reflected on their time during COVID-19 lockdown. A substantial proportion (39-54%) of participants reported deterioration in mental health, physical health, financial situation, and work productivity. However, most of these participants reported 'somewhat' rather than 'a lot' of deterioration, and many others reported 'no change' (40-50%) or even 'improvement' (6-17%). Even less impact was apparent for social relationships (68% reported 'no change') as participants compensated for decreased face-to-face interaction via increased technology-mediated interaction. CONCLUSIONS: The psychological toll of COVID-19 on Australians may not have been as large as other parts of the world with greater infection rates. Our findings highlight how technology-mediated communication can allow people to adequately maintain social relationships during an extreme lockdown event.

Influence of the COVID-19 Pandemic on Mood and Training in Australian Community Tennis Players.

The COVID-19 outbreak has led to the implementation of strict restrictions in Australia, which have severely impacted sporting activities. Tennis is played by 6.2% of the population within the Oceania region, and is a valuable sport for maintaining social, mental, and physical health. Current literature indicates the COVID-19 pandemic has negatively affected the mental health of Australian residents. The aim of this study was to investigate changes in training and match play due to the outbreak, and its effects on emotional well-being of Australian senior tennis players. Additionally, explore any differences between middle aged (41-60 years) and senior (61 years and over) Australian tennis players. An online survey was used to assess training and match play habits, as well as ascertain the emotional well-being of tennis players. The survey was active from 24th April 2020 until 6th June 2020. Participants were adult (41+ years) tennis players from Australia. Wilcoxon signed rank tests were performed to check for differences in training hours and tennis matches played. Mann-Whitney U tests were used to assess the difference in Brief Emotional Experience Scale (BEES) scores, employment status as well as the training hours and tennis matches played between the two age groups. A Kendall's Tau B correlation test was performed to assess the associations of training, match play and demographic characteristics with BEES scores. Kruskal-Wallis tests assessed differences in BEES scores between participants of differing match play formats, tennis experience and cessation of tennis training time periods. There were 245 respondents who met our inclusion criteria. Tennis training hours along with the tennis matches played significantly decreased during COVID-19 compared to pre-COVID-19, 85.09 and 88.48%, respectively. No significant (p > 0.05) differences were observed between age groups for any of the training modality hours, nor was there any significant difference in number of tennis matches played. The participants average BEES score was 0.99 ± 1.27, indicating that respondents had a positive emotional well-being during the COVID-19 pandemic. The emotional well-being of the senior group was significantly (P = 0.002) higher than the middle aged group. Together, our results show that training and tennis match play decreased during the COVID-19 pandemic, however the emotional well-being of senior tennis players in Australia appeared to not be negatively affected.

A Survey to Evaluate the Association of COVID-19 Restrictions on Perceived Mood and Coping in Australian Community Level Athletes.

Highlights: No differences in coping or well-being in Australian community athletes based on the level of support received during COVID-19 restrictions.Community level athletes had better coping when a training program was provided.No difference between individual or team community athletes for well-being or coping scores. Australian community level athletes faced unprecedented changes to their training and competition options as the global COVID-19 pandemic took a stronghold. This disruption was predicted to have a negative impact on emotional well-being as communities braced through periods of social isolation and physical distancing requirements. This study provides an Australian perspective on the emotional well-being of community level athletes and the extent to which they coped during the COVID-19 pandemic. Emotional well-being and coping were measured using the Brief Emotional Experience Scale and the 28-item Brief Cope Scale. Both instruments were administered along with other questions pertaining to participant demographics and training status via an online survey between April and June 2020. The survey was disseminated to community athletes through word-of-mouth and social media platforms. No significant differences in emotional well-being were observed between athlete groups as a result of COVID-19 and its associated restrictions. Coping scores also appeared to be preserved in Australian community athletes, which contrasts the impact expected as a result of the COVID-19 pandemic. While tentative, the observed preservation in coping may have buffered potential declines in emotional well-being, which has been documented in professional and semi-professional athletes and the general population. These unexpected findings and tentative suppositions warrant further investigation and highlight the importance of conducting a country- or region-specific approach to examining the impact of COVID-19 on community athletes, as responses to COVID-19 are undoubtedly not consistent throughout the world.

The role of place, people and perception in law student well-being.

There is a growing body of international research examining psychological distress in law students. Generally, the studies have tended to be either very narrow, focussing on a single law school, or very broad, targeting all law students regardless of their institutional affiliation. This study adds to the existing literature by examining the levels of psychological distress of law students at two quite different law schools in Australia. An online survey was used to assess self-reported emotional well-being, university appraisal, university belongingness, perceptions of competitiveness and supportiveness, perceived sources of pressure, and motivations for studying law in 225 law students. Consistent with prior research, the data reflect lower levels of well-being in law student participants compared to the general public. However, the factors that appear to affect the students' well-being differed slightly between the two participant cohorts. For the law school that caters more to mature age and online students, the students' perception of their overall law school experience, belongingness, and support are important factors. Whereas for the law school that caters more to high achieving younger students, the competitiveness and perceived lack of support within the law school environment appear to have a greater influence on the students' self-reported well-being. In addition, across both participant cohorts, self-imposed pressure was notably high. Overall, the results of the study reported in this article provide valuable insights into the external and internal factors underpinning the well-established heightened levels of psychological distress in Australian law students.

A Novel Approach to Measure Executive Functions in Students: An Evaluation of Two Child-Friendly Apps.

Interest in measurement of children's executive functions has shown a major increase over the past two decades. The present study evaluates two new apps (EYT and eFun) for measuring executive functions in children. The results of this study show that children (aged 5-8) enjoy executive function assessment in the form of games on an iPad. However, only one executive function, EYT working memory, showed significant positive correlations with several types of grades (e.g., English and maths) in primary school students. New, self-assessed, child-friendly executive function measurement tools have the potential to provide future possibilities for teachers to integrate information on cognitive ability into student learning plans.

Applications of the reflective practice questionnaire in medical education.

BACKGROUND: We sought to determine whether the Reflective Practice Questionnaire (RPQ) is a reliable measure of reflective capacity and related characteristics in medical students. We also planned to learn how the RPQ could be used in medical education. METHODS: The RPQ is a 40 item self-report questionnaire that includes a multi-faceted approach to measuring reflective capacity. It also includes sub-scales on several other theoretically relevant constructs such as desire for improvement, confidence, stress, and job satisfaction. The reliabilities of reflective capacity and other sub-scales were determined by calculating their Cronbach alpha reliability values. In the present study, the RPQ was answered by 98 graduating fourth-year medical students from an American University, and these RPQ scores were compared with general public and mental health practitioner samples from a prior study using ANOVA and Bonferroni adjusted comparisons. RESULTS: Medical students reported a higher reflective capacity than the general public sample, but students were statistically indistinguishable from the mental health practitioner sample. For medical students, reflective capacity was associated with features of confidence, stress, and desire for improvement. Job satisfaction was positively associated with confidence in communication with patients, and negatively associated with stress when interacting with patients. A cluster analysis revealed that around 19% of the medical students exhibited a relatively high level of anxiety interacting with patients, 23% were less engaged, 5% were dissatisfied, and 7% expressed a level of over-confidence in their knowledge and skills that was concerning. CONCLUSIONS: The RPQ is a reliable measure of reflective capacity (Chronbach's alpha value = 0.84) and related characteristics (Cronbach's alpha values from 0.75 to 0.83) in medical students. The RPQ can be used as part of pre-post evaluations of medical education initiatives, to complement student self-reflection activities in the curriculum, and to identify students who might benefit from targeted intervention.

Contact Is in the Eye of the Beholder: The Eye Contact Illusion.

In a simple experiment, we demonstrate that you don't need to mindfully look at the eyes of your audience to be perceived as making eye contact during face-to-face conversation. Simply gazing somewhere around the face/head area will suffice. Or to borrow a term from Mareschal and colleagues, direct gaze will suffice. For those readers who experience anxiety when gazing specifically at another person's eyes, or when being gazed at, we expect this is welcome news.

Rethinking the Lawyer-Client Interview: Taking a Relational Approach.

The client interview is an integral part of a lawyer's work. Despite this, there is little research focused on the client interview and how it might influence the economy of the legal strategies and processes that follow. This study examined students' perceptions of perspective-taking, trust, self-disclosure and understanding in a client interview where the students took the roles of either a lawyer or client in a dispute resolution context. The results revealed that the client's perception of their lawyer's perspective-taking increased their trust in the lawyer, which increased their self-disclosure, which subsequently helped the clients to gain a better understanding of their situation. The results illustrate the importance of the key relational aspects during consultation and accords with similar findings in the procedural justice and mentalising literature. The findings could have powerful implications for rethinking the purpose and aims of the lawyer-client interview and helping lawyers to reshape the outcomes.

Looking beyond the mirror: Psychological distress; disordered eating, weight and shape concerns; and maladaptive eating habits in lawyers and law students.

Research indicates that, in comparison to professionals and University students in other disciplines, lawyers and law students may be at greater risk of experiencing high levels of psychological distress. There is also a large body of literature supporting an association between stress, anxiety and depression and unhealthy eating. This article reports on the results of a study of Australian legal professionals and law students that evidence a positive association between psychological distress; disordered eating, weight and shape concerns; and maladaptive eating habits in lawyers and law students. Additionally, this study confirms a positive link between frequency of exercise and subjective physical well-being, that in turn is associated with enhanced emotional well-being. Based on the results of this study, we suggest simple yet effective strategies law firms and law schools might adopt to support the mental health of their staff and students.

I understand you feel that way, but I feel this way: the benefits of I-language and communicating perspective during conflict.

Using hypothetical scenarios, we provided participants with potential opening statements to a conflict discussion that varied on I/you language and communicated perspective. Participants rated the likelihood that the recipient of the statement would react in a defensive manner. Using I-language and communicating perspective were both found to reduce perceptions of hostility. Statements that communicated both self- and other-perspective using I-language (e.g. 'I understand why you might feel that way, but I feel this way, so I think the situation is unfair') were rated as the best strategy to open a conflict discussion. Simple acts of initial language use can reduce the chances that conflict discussion will descend into a downward spiral of hostility.

Using dual eye tracking to uncover personal gaze patterns during social interaction.

We report the personal eye gaze patterns of people engaged in face-to-face getting acquainted conversation. Considerable differences between individuals are underscored by a stability of eye gaze patterns within individuals. Results suggest the existence of an eye-mouth gaze continuum. This continuum includes some people showing a strong preference for eye gaze, some with a strong preference for mouth gaze, and others distributing their gaze between the eyes and mouth to varying extents. Additionally, we found evidence of within-participant consistency not just for location preference but also for the duration of fixations upon the eye and mouth regions. We also estimate that during a 4-minute getting acquainted conversation mutual face gaze constitutes about 60% of conversation that occurs via typically brief instances of 2.2 seconds. Mutual eye contact ranged from 0-45% of conversation, via very brief instances. This was despite participants subjectively perceiving eye contact occurring for about 70% of conversation. We argue that the subjective perception of eye contact is a product of mutual face gaze instead of actual mutual eye contact. We also outline the fast activity of gaze movements upon various locations both on and off face during a typical face-to-face conversation.

Stick or Switch: A Selection Heuristic Predicts when People Take the Perspective of Others or Communicate Egocentrically.

This paper examines a cognitive mechanism that drives perspective-taking and egocentrism in interpersonal communication. Using a conceptual referential communication task, in which participants describe a range of abstract geometric shapes, Experiment 1 shows that perspective-taking and egocentric communication are frequent communication strategies. Experiment 2 tests a selection heuristic account of perspective-taking and egocentric communication. It uses participants' shape description ratings to predict their communication strategy. Participants' communication strategy was predicted by how informative they perceived the different shape descriptions to be. When participants' personal shape description was perceived to be more informative than their addressee's shape description, there was a strong bias to communicate egocentrically. By contrast, when their addressee's shape description was perceived to be more informative, there was a strong bias to take their addressee's perspective. When the shape descriptions were perceived to be equally informative, there was a moderate bias to communicate egocentrically. This simple, but powerful, selection heuristic may be critical to the cumulative cultural evolution of human communication systems, and cumulative cultural evolution more generally.