TY - JOUR
T1 - Coming in Warm
T2 - Qualitative Study and Concept Map to Cultivate Patient-centered Empathy in Emergency Care
AU - Pettit, Katie E.
AU - Rattray, Nicholas A.
AU - Wang, Hao
AU - Stuckey, Shanna
AU - Mark Courtney, D.
AU - Messman, Anne M.
AU - Kline, Jeffrey A.
N1 - Funding Information:
From the 1Department of Emergency Medicine, Indiana University School of Medicine, Indianapolis, IN; the 2VA HSR&D Center for Health Information and Communication, Roudebush VA Medical Center and Regenstrief Institute, Inc., Indianapolis, IN; the 3Department of Emergency Medicine, John Peter Smith Health Network, Ft. Worth, TX; the Center for Urban and Multicultural Education (CUME), School of Education at Indiana University–Purdue University Indianapolis, Indianapolis IN; the Department of Emergency Medicine, Feinberg School of Medicine, Northwestern University Chicago, IL; and the 6Department of Emergency Medicine, Wayne State University School of Medicine, Detroit, MI. Received November 26, 2018; revision received January 21, 2019; accepted February 4, 2019. Supported by a Lilly Foundation Physician Scientist Initiative. JAK reports grant money to Indiana University School of Medicine to conduct research conceived and written by JAK from Bristol Meyer Squibb and Janssen Pharmaceuticals. The other authors have no potential conflicts to disclose. Author contributions: KEP—study concept and design, acquisition of data, analysis and interpretation of data, and drafting of the manuscript; NAR—acquisition of data, analysis and interpretation of data, and critical revision of the manuscript for important intellectual content; HW—acquisition of data and critical revision of the manuscript for important intellectual content; SS—acquisition of data, analysis and interpretation of data, and drafting of the manuscript; DMC—acquisition of data, analysis and interpretation of data, and critical revision of the manuscript for important intellectual content; AMM—critical revision of the manuscript for important intellectual content; and JAK—study concept and design, acquisition of data, analysis and interpretation of data, drafting of the manuscript, critical revision of the manuscript for important intellectual content, and acquisition of funding. Supervising Editor: Daniel J. Egan, MD, FACEP. Address for correspondence: Jeffrey A. Kline; e-mail: jefkline@iu.edu. Reprints will not be available. AEM EDUCATION AND TRAINING 2019;3:136–144
PY - 2019
Y1 - 2019
N2 - Background: Increased empathy may improve patient perceptions and outcomes. No training tool has been derived to teach empathy to emergency care providers. Accordingly, we engaged patients to assist in creating a concept map to teach empathy to emergency care providers. Methods: We recruited patients, patient caretakers and patient advocates with emergency department experience to participate in three separate focus groups (n = 18 participants). Facilitators guided discussion about behaviors that physicians should demonstrate to rapidly create trust; enhance patient perception that the physician understood the patient's point of view, needs, concerns, and fears; and optimize patient/caregiver understanding of their experience. Verbatim transcripts from the three focus groups were read by the authors, and by consensus, five major themes with 10 minor themes were identified. After creating a codebook with thematic definitions, one author reviewed all transcripts to a library of verbatim excerpts coded by theme. To test for inter-rater reliability, two other authors similarly coded a random sample of 40% of the transcripts. Authors independently chose excerpts that represented consensus and strong emotional responses from participants. Results: Approximately 90% of opinions and preferences fell within 15 themes, with five central themes: provider transparency, acknowledgment of patient's emotions, provider disposition, trust in physician, and listening. Participants also highlighted the need for authenticity, context, and individuality to enhance empathic communication. For empathy map content, patients offered example behaviors that promote perceptions of physician warmth, respect, physical touch, knowledge of medical history, explanation of tests, transparency, and treating patients as partners. The resulting concept map was named the “Empathy Circle.”. Conclusions: Focus group participants emphasized themes and tangible behaviors to improve empathy in emergency care. These were incorporated into the Empathy Circle, a novel concept map that can serve as the framework to teach empathy to emergency care providers.
AB - Background: Increased empathy may improve patient perceptions and outcomes. No training tool has been derived to teach empathy to emergency care providers. Accordingly, we engaged patients to assist in creating a concept map to teach empathy to emergency care providers. Methods: We recruited patients, patient caretakers and patient advocates with emergency department experience to participate in three separate focus groups (n = 18 participants). Facilitators guided discussion about behaviors that physicians should demonstrate to rapidly create trust; enhance patient perception that the physician understood the patient's point of view, needs, concerns, and fears; and optimize patient/caregiver understanding of their experience. Verbatim transcripts from the three focus groups were read by the authors, and by consensus, five major themes with 10 minor themes were identified. After creating a codebook with thematic definitions, one author reviewed all transcripts to a library of verbatim excerpts coded by theme. To test for inter-rater reliability, two other authors similarly coded a random sample of 40% of the transcripts. Authors independently chose excerpts that represented consensus and strong emotional responses from participants. Results: Approximately 90% of opinions and preferences fell within 15 themes, with five central themes: provider transparency, acknowledgment of patient's emotions, provider disposition, trust in physician, and listening. Participants also highlighted the need for authenticity, context, and individuality to enhance empathic communication. For empathy map content, patients offered example behaviors that promote perceptions of physician warmth, respect, physical touch, knowledge of medical history, explanation of tests, transparency, and treating patients as partners. The resulting concept map was named the “Empathy Circle.”. Conclusions: Focus group participants emphasized themes and tangible behaviors to improve empathy in emergency care. These were incorporated into the Empathy Circle, a novel concept map that can serve as the framework to teach empathy to emergency care providers.
UR - http://www.scopus.com/inward/record.url?scp=85063611849&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85063611849&partnerID=8YFLogxK
U2 - 10.1002/aet2.10328
DO - 10.1002/aet2.10328
M3 - Article
C2 - 31008425
AN - SCOPUS:85063611849
JO - AEM Education and Training
JF - AEM Education and Training
SN - 2472-5390
ER -