Improving Empathy and Relational Skills

Study Overview
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Brief Summary
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Our research hypothesis is that residents who participate in the empathy and relational skills training modules will significantly improve in these skills as compared to a control group of residents who receive residency training as usual that includes the current standard training in the doctor-patient relationship. To evaluate this hypothesis, we will use a two-pronged approach to assessment. The first prong is the residents' self assessment of empathy and the second is from the patients' perspective.

Detailed Description
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The study design is a randomized controlled trial assigning resident physicians (N=100) to either: (a) empathy and relational skills training; or (b) control group receiving standard residency training as usual. Over the course of six weeks, each resident physician in the experimental group will receive three 60-minute training sessions focused on empathy and relational skills (the residents assigned to the control condition will receive standard residency training as usual). The emerging neuroscience of emotions and empathy has provided the neurobiological and physiological bases for our Empathy Training Modules to enhance patient-doctor communication. These innovative modules provide the basic science and video modeling for empathy training. Based on cutting edge mirror neuron research, our training modules offer a novel approach to empathy and relational skills training that teaches physicians about the neurobiology and physiology of emotions in difficult or stressful patient interactions. We have developed professionally produced high definition training modules that portray difficult patient-physician interactions. Importantly, these videos also include physiological displays of emotion for both members of the dyad so that one can easily observe the degree to which patient and physician are physiologically concordant or discordant with one another. The empathy training is conducted at a deeper level of physiological awareness and regulation that promises to be more effective than traditional didactic teaching by integrating the technology of psychophysiology. The goal of raising awareness of physiologic indices during a patient-doctor interaction is to present an objective measure of emotional response to both explicit and implicit stimuli, which promises to be a powerful teaching tool to enhance empathic physician behaviors.

Official Title
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Improving Empathy and Relational Skills in Resident Physicians: A Randomized Controlled Trial

Conditions
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Empathy

Intervention / Treatment
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* Behavioral: Empathy Training Modules
* Behavioral: Residency Training as usual


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: All medical and surgical residents who are based at Massachusetts General Hospital will be eligible to participate in the study. Exclusion Criteria: Residents who are rotating at sites other then Massachusetts General Hospital Residents who are on rotations that do not include clinical care

Ages Eligible for Study
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Minimum Age: 20 Years
Maximum Age: 60 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Design Details

Allocation: Randomized
Intervention Model: Single Group Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Experimental Group<br>The experimental group receives Empathy Training. The control Group receives residency training as usual | Behavioral: Empathy Training Modules<br>* The Empathy Training Modules utilize translational research in emotion expression basic science, physiology of emotions, decoding facial expressions and self-regulation skills as pertaining to management of medical and surgical patients.<br>* Other names: E.M.P.A.T.H.Y. (TM);|
| Active Comparator: Control Group<br>The control group receives residency training as usual | Behavioral: Residency Training as usual<br>* Residents will receive their typical didactic and clinical education<br>* Other names: Residency Training;|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Consultation and Relational Empathy Measure (CARE) measure | At baseline: (1) Residents will complete the CARE measure (2) 10 patients in each resident's clinic will rate their encounter using the CARE Measure; (3) Residents will receive the Empathy and Relational Training Modules or residency training as usual. At the six-week endpoint: (4) residents will complete the CARE measure and (5) patients will complete the CARE measure after the clinic visit. | Up to 5 weeks (this is an average) | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Jefferson Empathy Scale Mehrabian Balanced Emotional Empathy Scale (BEES) (30 items) 2.Jefferson Empathy Scale (20 items 3. Neuroscience of Emotions Assessment 4. Ekman Facial Expression Decoding Assessment | The Mehrabian BEES Measures baseline empathy. The Jefferson Scale measures physician attitudes about the importance of empathy in clinical medical care. The Neuroscience of Emotions Test measures knowledge of basic science of emotions. The Ekman test measures ability to decode subtle facial expressions. | Prospective | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Empathy