Pub Date : 2025-06-06DOI: 10.1016/j.pecinn.2025.100408
Michael Soh , Dolores Mullikin , Steven J. Durning , Jerusalem Merkebu
Objective
This study explores how, if at all, engaged curiosity - a genuine, emotionally engaged interest in learning more about the complexity of another's particular emotional perspective - emerges in the clinical reasoning process and its relationship with contextual factors and clinical reasoning performance.
Methods
Think-alouds transcripts from nineteen physicians in internal medicine from three military training facilities were thematically analyzed for instances of engaged curiosity and examined through the lens of contextual factors and clinical reasoning performance.
Results
Our findings indicate that engaged curiosity can be likened to placeholders that physicians employ early on to “bookmark” sources of patient concern. These sources, or hot spots, deserve follow up, particularly when cognitive resources are unavailable to “attend” to a deeper understanding of the patient's experience.
Conclusion
Engaged curiosity provides a unique lens for better understanding the relationship between empathy and clinical reasoning and warrants further research on its impact on the patient and their care.
Innovation
Engaged curiosity could serve as a novel way to train physicians to think and engage more empathically with their patients.
{"title":"Engaged curiosity: “Hot spots” for clinical reasoning in complex patient encounters","authors":"Michael Soh , Dolores Mullikin , Steven J. Durning , Jerusalem Merkebu","doi":"10.1016/j.pecinn.2025.100408","DOIUrl":"10.1016/j.pecinn.2025.100408","url":null,"abstract":"<div><h3>Objective</h3><div>This study explores how, if at all, engaged curiosity - a genuine, emotionally engaged interest in learning more about the complexity of another's particular emotional perspective - emerges in the clinical reasoning process and its relationship with contextual factors and clinical reasoning performance.</div></div><div><h3>Methods</h3><div>Think-alouds transcripts from nineteen physicians in internal medicine from three military training facilities were thematically analyzed for instances of engaged curiosity and examined through the lens of contextual factors and clinical reasoning performance.</div></div><div><h3>Results</h3><div>Our findings indicate that engaged curiosity can be likened to placeholders that physicians employ early on to “bookmark” sources of patient concern. These sources, or hot spots, deserve follow up, particularly when cognitive resources are unavailable to “attend” to a deeper understanding of the patient's experience.</div></div><div><h3>Conclusion</h3><div>Engaged curiosity provides a unique lens for better understanding the relationship between empathy and clinical reasoning and warrants further research on its impact on the patient and their care.</div></div><div><h3>Innovation</h3><div>Engaged curiosity could serve as a novel way to train physicians to think and engage more empathically with their patients.</div></div>","PeriodicalId":74407,"journal":{"name":"PEC innovation","volume":"7 ","pages":"Article 100408"},"PeriodicalIF":0.0,"publicationDate":"2025-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144254654","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-06-01DOI: 10.1016/j.pecinn.2025.100407
Rachel C. Forcino , Terry Sturke , Mary P. McGowan , Amanda N. Perry , Shoshana H. Bardach , Vikrant S. Vaze , Kerrilynn C. Hennessey
Background
Familial hypercholesterolemia (FH) is a genetic condition which elevates cholesterol levels and increases risk of premature cardiac events. Medical treatment greatly reduces those risks. However, in the United States, FH is markedly underdiagnosed. We aimed to design and evaluate direct outreach and referral to specialty care for patients with an elevated risk of FH identified through application of a machine learning model and expert review of the electronic health record in a rural United States health system.
Methods
Two sets of interviews: (1) seeking advice for designing outreach from a convenience sample comprising health professionals and members of the public both with and without FH and (2)) evaluating the outreach with a convenience sample of health professionals and patients who received the outreach. Two researchers conducted each interview. Thematic analysis included investigator triangulation.
Results
We conducted 15 pre-outreach interviews and 32 post-outreach interviews. Most members of the public felt the outreach should be initiated by the patient's primary care clinician, while health professionals recommended outreach directly from a lipid specialist after notifying the primary care clinician. Outreach ultimately included primary care clinician notification; a mailed letter from lipid specialists to the patient indicating partnership with primary care; a message sent through the online patient portal; and a telephone call(s) from a lipid specialist to the patient. Phone calls were most impactful in prompting a clinical evaluation for FH. We identified 4 themes: (1) Both patients and clinical team members supported direct-to-patient outreach about FH; (2) Phone calls from lipid specialists to patients were considered high-value; (3) The importance of primary care team member involvement was perceived differently between pre- and post-outreach phases; and (4)) Outreach had a broader impact beyond the individual patients reached, including family screening.
Innovation
This study provides key insights into the acceptable design and use of machine learning and electronic health record data for direct-to-patient outreach.
Conclusions
Partnership with the target population led to direct-to-patient FH outreach that was acceptable to most recipients. High-touch engagement by lipid specialists included repeat phone calls, which maximized patients' response but are unlikely to be sustained in routine practice.
{"title":"A novel outreach approach for identification of familial hypercholesterolemia: Interview-based formative evaluation to improve healthcare access and quality","authors":"Rachel C. Forcino , Terry Sturke , Mary P. McGowan , Amanda N. Perry , Shoshana H. Bardach , Vikrant S. Vaze , Kerrilynn C. Hennessey","doi":"10.1016/j.pecinn.2025.100407","DOIUrl":"10.1016/j.pecinn.2025.100407","url":null,"abstract":"<div><h3>Background</h3><div>Familial hypercholesterolemia (FH) is a genetic condition which elevates cholesterol levels and increases risk of premature cardiac events. Medical treatment greatly reduces those risks. However, in the United States, FH is markedly underdiagnosed. We aimed to design and evaluate direct outreach and referral to specialty care for patients with an elevated risk of FH identified through application of a machine learning model and expert review of the electronic health record in a rural United States health system.</div></div><div><h3>Methods</h3><div>Two sets of interviews: (1) seeking advice for designing outreach from a convenience sample comprising health professionals and members of the public both with and without FH and (2)) evaluating the outreach with a convenience sample of health professionals and patients who received the outreach. Two researchers conducted each interview. Thematic analysis included investigator triangulation.</div></div><div><h3>Results</h3><div>We conducted 15 pre-outreach interviews and 32 post-outreach interviews. Most members of the public felt the outreach should be initiated by the patient's primary care clinician, while health professionals recommended outreach directly from a lipid specialist after notifying the primary care clinician. Outreach ultimately included primary care clinician notification; a mailed letter from lipid specialists to the patient indicating partnership with primary care; a message sent through the online patient portal; and a telephone call(s) from a lipid specialist to the patient. Phone calls were most impactful in prompting a clinical evaluation for FH. We identified 4 themes: (1) Both patients and clinical team members supported direct-to-patient outreach about FH; (2) Phone calls from lipid specialists to patients were considered high-value; (3) The importance of primary care team member involvement was perceived differently between pre- and post-outreach phases; and (4)) Outreach had a broader impact beyond the individual patients reached, including family screening.</div></div><div><h3>Innovation</h3><div>This study provides key insights into the acceptable design and use of machine learning and electronic health record data for direct-to-patient outreach.</div></div><div><h3>Conclusions</h3><div>Partnership with the target population led to direct-to-patient FH outreach that was acceptable to most recipients. High-touch engagement by lipid specialists included repeat phone calls, which maximized patients' response but are unlikely to be sustained in routine practice.</div></div>","PeriodicalId":74407,"journal":{"name":"PEC innovation","volume":"6 ","pages":"Article 100407"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144204892","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-05-25DOI: 10.1016/j.pecinn.2025.100405
Bob C. Mulder , Hylkje Algra , Esther Cruijsen , J. Marianne Geleijnse , Renate M. Winkels , Willemieke Kroeze
Objective
This article reports the findings of focus-group discussions with healthcare providers concerning the facilitators and barriers they experience when engaging in therapeutic patient education (TPE).
Methods
Five focus-group discussions were held with a total of 21 primary and secondary healthcare providers. Discussions were moderated using a topic list that was co-created with healthcare providers. All discussions were recorded, transcribed verbatim and analysed thematically.
Results
Healthcare providers consider TPE important, but it requires long-term, continuous effort in order to be effective. They sometimes doubt its effectiveness and their own efficacy. Moreover, healthcare providers experience a lack of a supportive environment. Overall, their experiences could be captured in four categories of determinants of engaging in TPE: Capabilities, Motivation, Physical Context and Social Context.
Conclusion
Therapeutic patient education requires healthcare providers to be capable and motivated. To maintain the continuous effort needed, healthcare providers need to be supported both socially (e.g. by colleagues and management) and physically (e.g. through communication infrastructure).
Innovation
In contrast to previous studies focusing on the motivation and capability of healthcare providers to perform TPE, this study contributes to innovation in health communication by identifying social and physical factors that determine whether TPE is delivered continuously under actual or perceived constraints in terms of time and effectiveness.
{"title":"Beyond motivation: Creating supportive healthcare environments for engaging in therapeutic patient education according to healthcare providers","authors":"Bob C. Mulder , Hylkje Algra , Esther Cruijsen , J. Marianne Geleijnse , Renate M. Winkels , Willemieke Kroeze","doi":"10.1016/j.pecinn.2025.100405","DOIUrl":"10.1016/j.pecinn.2025.100405","url":null,"abstract":"<div><h3>Objective</h3><div>This article reports the findings of focus-group discussions with healthcare providers concerning the facilitators and barriers they experience when engaging in therapeutic patient education (TPE).</div></div><div><h3>Methods</h3><div>Five focus-group discussions were held with a total of 21 primary and secondary healthcare providers. Discussions were moderated using a topic list that was co-created with healthcare providers. All discussions were recorded, transcribed verbatim and analysed thematically.</div></div><div><h3>Results</h3><div>Healthcare providers consider TPE important, but it requires long-term, continuous effort in order to be effective. They sometimes doubt its effectiveness and their own efficacy. Moreover, healthcare providers experience a lack of a supportive environment. Overall, their experiences could be captured in four categories of determinants of engaging in TPE: Capabilities, Motivation, Physical Context and Social Context.</div></div><div><h3>Conclusion</h3><div>Therapeutic patient education requires healthcare providers to be capable and motivated. To maintain the continuous effort needed, healthcare providers need to be supported both socially (e.g. by colleagues and management) and physically (e.g. through communication infrastructure).</div></div><div><h3>Innovation</h3><div>In contrast to previous studies focusing on the motivation and capability of healthcare providers to perform TPE, this study contributes to innovation in health communication by identifying social and physical factors that determine whether TPE is delivered continuously under actual or perceived constraints in terms of time and effectiveness.</div></div>","PeriodicalId":74407,"journal":{"name":"PEC innovation","volume":"6 ","pages":"Article 100405"},"PeriodicalIF":0.0,"publicationDate":"2025-05-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144169444","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-05-24DOI: 10.1016/j.pecinn.2025.100406
Karl Charlton , Tripta Rathour , Emma Burrow
Objective
Frailty is of increasing importance for healthcare systems as well as the personalised care agenda. Despite the evolving body of research exploring frailty and falls in the ambulance setting, the voices of frail older adults who use ambulance services, are seldom heard. Through first-hand accounts, this study set out to describe the experiences and perceptions of frailty for a cohort of older adults.
Methods
A descriptive phenomenological study involving eight participants with frailty who used a regional English National Health Service (NHS) ambulance service following a fall, conducted between July 2022–February 2023.
Results
Accounts from older adults highlight different perceptions of frailty and attitudes towards ageing. Frailty and falls were experienced through varying perceptions of identity and self, underpinned by acceptance, or otherwise, of an altered sense of embodiment and a life with limits.
Conclusion
Older adults generally hold negative perceptions of frailty, falls and ageing, but also challenged the negative terms frequently used to describe frailty, suggesting some frail older adults remain positive and still value life. Paramedics are likely to require further training and support to manage patients with frailty effectively and improve patient experience.
Innovation
This study uniquely explores frailty and falls through the stories of older adults using an NHS ambulance service. It highlights that older adults in this setting often differ from the older population in general, have a higher frailty prevalence than patients in other settings and appear to view the future with greater pessimism.
{"title":"Perceptions of frailty and falls in older adults using an English regional ambulance service: A descriptive phenomenological study","authors":"Karl Charlton , Tripta Rathour , Emma Burrow","doi":"10.1016/j.pecinn.2025.100406","DOIUrl":"10.1016/j.pecinn.2025.100406","url":null,"abstract":"<div><h3>Objective</h3><div>Frailty is of increasing importance for healthcare systems as well as the personalised care agenda. Despite the evolving body of research exploring frailty and falls in the ambulance setting, the voices of frail older adults who use ambulance services, are seldom heard. Through first-hand accounts, this study set out to describe the experiences and perceptions of frailty for a cohort of older adults.</div></div><div><h3>Methods</h3><div>A descriptive phenomenological study involving eight participants with frailty who used a regional English National Health Service (NHS) ambulance service following a fall, conducted between July 2022–February 2023.</div></div><div><h3>Results</h3><div>Accounts from older adults highlight different perceptions of frailty and attitudes towards ageing. Frailty and falls were experienced through varying perceptions of identity and self<em>,</em> underpinned by acceptance, or otherwise, of an altered sense of embodiment and a life with limits<em>.</em></div></div><div><h3>Conclusion</h3><div>Older adults generally hold negative perceptions of frailty, falls and ageing, but also challenged the negative terms frequently used to describe frailty, suggesting some frail older adults remain positive and still value life. Paramedics are likely to require further training and support to manage patients with frailty effectively and improve patient experience.</div></div><div><h3>Innovation</h3><div>This study uniquely explores frailty and falls through the stories of older adults using an NHS ambulance service. It highlights that older adults in this setting often differ from the older population in general, have a higher frailty prevalence than patients in other settings and appear to view the future with greater pessimism.</div></div>","PeriodicalId":74407,"journal":{"name":"PEC innovation","volume":"6 ","pages":"Article 100406"},"PeriodicalIF":0.0,"publicationDate":"2025-05-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144154369","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-05-18DOI: 10.1016/j.pecinn.2025.100404
Vera Voorwinde , Ingrid H.M. Steenhuis , Ignace M.C. Janssen , Valerie M. Monpellier , Maartje M. van Stralen
Objective
To systematically re-develop a blended-care intervention addressing weight recurrence after metabolic bariatric surgery (MBS). Weight recurrence poses a significant longterm challenge for around 20–30 % of MBS patients. The intervention aims to improve weight outcomes and enhance patient well-being. This study describes the novel application of the Intervention Mapping (IM) protocol, integrating scientific evidence and stakeholder input.
Methods
The six-step IM protocol guided the development process, ensuring the active involvement of patients and healthcare professionals. A comprehensive needs assessment using quantitative, qualitative, and literature-based approaches informed the creation of a logic model of the problem (Step 1) and a logic model of change (Step 2). Program outcomes and objectives were formulated through collaborative brainstorming and design-thinking sessions, leading to intervention design (Step 3). The intervention was co-produced with patients, implementers, and an app developer (Step 4). Detailed implementation (Step 5) and evaluation (Step 6) plans were subsequently developed.
Results
The IM process yielded a blended-care intervention grounded in theoretical frameworks and evidence-based methods. The intervention actively involved the target population and implementers, addressing key determinants of weight recurrence.
Conclusion
The IM protocol demonstrated utility in designing a tailored, theory-based intervention post-MBS. The process emphasized the value of integrating stakeholder perspectives and highlighted the feasibility of co-creating an evidence-informed intervention.
Innovation
This intervention incorporates newly developed elements in a novel blended-care structure. Future evaluation is necessary to determine its effectiveness in achieving the desired outcomes.
{"title":"Getting back on track: Development of a blended-care intervention for weight recurrence after metabolic bariatric surgery using intervention mapping","authors":"Vera Voorwinde , Ingrid H.M. Steenhuis , Ignace M.C. Janssen , Valerie M. Monpellier , Maartje M. van Stralen","doi":"10.1016/j.pecinn.2025.100404","DOIUrl":"10.1016/j.pecinn.2025.100404","url":null,"abstract":"<div><h3>Objective</h3><div>To systematically re-develop a blended-care intervention addressing weight recurrence after metabolic bariatric surgery (MBS). Weight recurrence poses a significant longterm challenge for around 20–30 % of MBS patients. The intervention aims to improve weight outcomes and enhance patient well-being. This study describes the novel application of the Intervention Mapping (IM) protocol, integrating scientific evidence and stakeholder input.</div></div><div><h3>Methods</h3><div>The six-step IM protocol guided the development process, ensuring the active involvement of patients and healthcare professionals. A comprehensive needs assessment using quantitative, qualitative, and literature-based approaches informed the creation of a logic model of the problem (Step 1) and a logic model of change (Step 2). Program outcomes and objectives were formulated through collaborative brainstorming and design-thinking sessions, leading to intervention design (Step 3). The intervention was co-produced with patients, implementers, and an app developer (Step 4). Detailed implementation (Step 5) and evaluation (Step 6) plans were subsequently developed.</div></div><div><h3>Results</h3><div>The IM process yielded a blended-care intervention grounded in theoretical frameworks and evidence-based methods. The intervention actively involved the target population and implementers, addressing key determinants of weight recurrence.</div></div><div><h3>Conclusion</h3><div>The IM protocol demonstrated utility in designing a tailored, theory-based intervention post-MBS. The process emphasized the value of integrating stakeholder perspectives and highlighted the feasibility of co-creating an evidence-informed intervention.</div></div><div><h3>Innovation</h3><div>This intervention incorporates newly developed elements in a novel blended-care structure. Future evaluation is necessary to determine its effectiveness in achieving the desired outcomes.</div></div>","PeriodicalId":74407,"journal":{"name":"PEC innovation","volume":"6 ","pages":"Article 100404"},"PeriodicalIF":0.0,"publicationDate":"2025-05-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144106301","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
The Roter Interaction Analysis System (RIAS) is widely used to assess communication in clinical settings but has not yet been applied in educational contexts. This study explores the psychometric properties of RIAS in Moroccan school health education, assessing its feasibility, reliability, and validity while examining its potential to improve communication strategies between health educators and students.
Methods
A cross-sectional study was conducted with 36 Moroccan primary school students. Health education session were recorded and analyzed using RIAS to evaluate communication patterns. Two trained raters independently coded the interactions into eight communication behavior categories. Psychometric analyses, including assessments of feasibility (coding versus session duration), inter-rater reliability (using correlation coefficients), and content validity (based on category usage), were conducted to evaluate RIAS's reliability and validity.
Results
RIAS demonstrated feasibility with extended coding times reflecting its comprehensive nature. High inter-rater reliability (ρ = 0.96–1.00, p < 0.01) validated its consistent application. Content validity confirmed adaptability, though challenges with social-emotional utterances and low-frequency categories suggest refinement to align with health education's unique dynamics.
Conclusion: This pilot study demonstrates the feasibility, reliability, and validity of RIAS in Moroccan school health education, highlighting its potential to enhance educator-student communication and improve health education outcomes in diverse cultural settings.
Innovation
This study pioneers the application of RIAS in Moroccan school health education, extending its use beyond clinical contexts. It highlights RIAS's adaptability to diverse, non-Western settings, bridging a gap in communication analysis. Findings provide a foundation for refining RIAS to align with health education and global health promotion strategies.
目的Roter互动分析系统（RIAS）被广泛用于临床环境中的沟通评估，但尚未在教育环境中应用。本研究探讨RIAS在摩洛哥学校健康教育中的心理测量特性，评估其可行性、信度和效度，同时研究其改善健康教育者与学生之间沟通策略的潜力。方法对36名摩洛哥小学生进行横断面调查。使用RIAS对健康教育会话进行记录和分析，评价交流模式。两名训练有素的评分员独立地将互动分为八种沟通行为类别。心理测量分析，包括可行性评估（编码与会话持续时间），评分者间信度（使用相关系数）和内容效度（基于类别使用），进行评估RIAS的信度和效度。结果rias具有可行性，编码时间延长，反映了其全面性。高信度(ρ = 0.96-1.00, p <；0.01)验证了其一致性应用。内容效度证实了适应性，尽管社交情感话语和低频类别的挑战建议改进，以配合健康教育的独特动态。结论：本初步研究证明了RIAS在摩洛哥学校健康教育中的可行性、可靠性和有效性，突出了其在不同文化背景下加强教育者与学生交流和改善健康教育成果的潜力。创新本研究开创了RIAS在摩洛哥学校健康教育中的应用，将其应用范围扩大到临床以外。它突出了RIAS对各种非西方环境的适应性，弥合了沟通分析的差距。研究结果为完善RIAS以配合健康教育和全球健康促进战略提供了基础。
{"title":"Psychometric characteristics of Roter interaction analysis system (RIAS) in the context of health education in a Moroccan school","authors":"Khadija Daoudi, Khaoula Jounaidi, Abdellah Gantare","doi":"10.1016/j.pecinn.2025.100403","DOIUrl":"10.1016/j.pecinn.2025.100403","url":null,"abstract":"<div><h3>Objective</h3><div>The Roter Interaction Analysis System (RIAS) is widely used to assess communication in clinical settings but has not yet been applied in educational contexts. This study explores the psychometric properties of RIAS in Moroccan school health education, assessing its feasibility, reliability, and validity while examining its potential to improve communication strategies between health educators and students.</div></div><div><h3>Methods</h3><div>A cross-sectional study was conducted with 36 Moroccan primary school students. Health education session were recorded and analyzed using RIAS to evaluate communication patterns. Two trained raters independently coded the interactions into eight communication behavior categories. Psychometric analyses, including assessments of feasibility (coding versus session duration), inter-rater reliability (using correlation coefficients), and content validity (based on category usage), were conducted to evaluate RIAS's reliability and validity.</div></div><div><h3>Results</h3><div>RIAS demonstrated feasibility with extended coding times reflecting its comprehensive nature. High inter-rater reliability (ρ = 0.96–1.00, <em>p</em> < 0.01) validated its consistent application. Content validity confirmed adaptability, though challenges with social-emotional utterances and low-frequency categories suggest refinement to align with health education's unique dynamics.</div><div>Conclusion: This pilot study demonstrates the feasibility, reliability, and validity of RIAS in Moroccan school health education, highlighting its potential to enhance educator-student communication and improve health education outcomes in diverse cultural settings.</div></div><div><h3>Innovation</h3><div>This study pioneers the application of RIAS in Moroccan school health education, extending its use beyond clinical contexts. It highlights RIAS's adaptability to diverse, non-Western settings, bridging a gap in communication analysis. Findings provide a foundation for refining RIAS to align with health education and global health promotion strategies.</div></div>","PeriodicalId":74407,"journal":{"name":"PEC innovation","volume":"6 ","pages":"Article 100403"},"PeriodicalIF":0.0,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144138427","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Empathy is crucial in healthcare, facilitating effective communication and improving patient outcomes.
Objective
This study aimed to evaluate the impact of tele-conference training based on the Kalamazoo Consensus Statement (KCS) on the empathy scores of newly hired physicians in a tele-visit simulation course.
Methods
From September 2021 to April 2022, we conducted a randomized controlled trial involving 129 medical doctors from 13 hospitals in north-western Tuscany, with an age range of 31 to 42 years. Partecipants were randomly assigned to a trained group (TG) or a control group (CG). Both groups completed the Toronto Empathy Questionnaire (TEQ) and the Balanced Emotional Empathy Scale (BEES) before (T0) and after (T1) the training. The TG underwent a 12-h online communication training course. The CG only completed the questionnaires without further intervention.
Results
Total sample included 129 partecipants. Results indicated a significant increase in TEQ scores for the TG (55,8 % of total sample; T0: 65.32; T1: 66.42, p = 0.032) and BEES scores (T0: 122.39; T1: 127.50, p = 0.000). The CG (44,2 %) experienced a decrease in TEQ scores (T0: 65.58; T1: 63.75, p = 0.000) but stable BEES scores (T0: 122.16; T1: 120.67, p = 0.317). Female participants consistently exhibited higher empathy scores than males, with training significantly enhancing scores for both genders.
Conclusions
The tele-conference training effectively improved empathy scores among newly hired physicians. We recommend the implementation of KCS-based training to enhance empathy and communication skills in medical practice.
Innovation
The pandemic has accelerated the use of tele-education and telemedicine, though opinions on their effectiveness remain divided. However, studies show that empathy can be enhanced through interactive online training, which offers significant innovations for both healthcare professionals' learning and patient care.
同情心在医疗保健中至关重要，它促进了有效的沟通并改善了患者的预后。目的探讨基于卡拉马祖共识声明（KCS）的远程会议培训对新入职医师远程访视模拟课程共情得分的影响。方法于2021年9月至2022年4月，对来自托斯卡纳西北部13家医院的129名医生进行随机对照试验，年龄31 ~ 42岁。参与者被随机分配到训练组（TG）或对照组（CG）。两组在训练前（T0）和训练后（T1）分别完成多伦多共情问卷（TEQ）和平衡情绪共情量表（BEES）。TG接受了一个12小时的在线交流培训课程。CG只完成问卷，没有进一步的干预。结果共纳入样本129人。结果表明，TG组的TEQ分数显著增加(占总样本的55.8%；T0: 65.32;T1: 66.42, p = 0.032)和BEES评分(T0: 122.39；T1: 127.50, p = 0.000)。对照组（44.2%）TEQ得分下降(T0: 65.58；T1: 63.75, p = 0.000)，但稳定的蜜蜂得分(T0: 122.16；T1: 120.67, p = 0.317)。女性参与者始终表现出比男性更高的同理心得分，训练显著提高了男女的得分。结论电话会议培训有效提高了新入职医师的共情能力。我们建议实施以kcs为基础的培训，以提高医疗实践中的同理心和沟通技巧。创新大流行加速了远程教育和远程医疗的使用，尽管对其有效性的意见仍存在分歧。然而，研究表明，移情可以通过交互式在线培训来增强，这为医疗保健专业人员的学习和患者护理提供了重大创新。
{"title":"Empathy training via Kalamazoo Consensus in remote and in-person medical communication: A randomized controlled trial","authors":"Giovan Battista Previti , Carlo Mazzatenta , Tommaso Bellandi , Francesco Niccolai , Dario Nieri , Valentina Ungaretti , Irene Cavasini , Alessandra Mazzoni , Stefano Maiorano , Luca Di Paolo , Veronica D'Elia , Monica Torre , Licia Matteucci , Guido Miccinesi , Moreno Marcucci , Michela Maielli , Sergio Ardis","doi":"10.1016/j.pecinn.2025.100399","DOIUrl":"10.1016/j.pecinn.2025.100399","url":null,"abstract":"<div><h3>Background</h3><div>Empathy is crucial in healthcare, facilitating effective communication and improving patient outcomes.</div></div><div><h3>Objective</h3><div>This study aimed to evaluate the impact of tele-conference training based on the Kalamazoo Consensus Statement (KCS) on the empathy scores of newly hired physicians in a tele-visit simulation course.</div></div><div><h3>Methods</h3><div>From September 2021 to April 2022, we conducted a randomized controlled trial involving 129 medical doctors from 13 hospitals in north-western Tuscany, with an age range of 31 to 42 years. Partecipants were randomly assigned to a trained group (TG) or a control group (CG). Both groups completed the Toronto Empathy Questionnaire (TEQ) and the Balanced Emotional Empathy Scale (BEES) before (T0) and after (T1) the training. The TG underwent a 12-h online communication training course. The CG only completed the questionnaires without further intervention.</div></div><div><h3>Results</h3><div>Total sample <em>included 129 partecipants.</em> Results indicated a significant increase in TEQ scores for the TG (55,8 % of total sample; T0: 65.32; T1: 66.42, <em>p</em> = 0.032) and BEES scores (T0: 122.39; T1: 127.50, <em>p</em> = 0.000). The CG (44,2 %) experienced a decrease in TEQ scores (T0: 65.58; T1: 63.75, p = 0.000) but stable BEES scores (T0: 122.16; T1: 120.67, <em>p</em> = 0.317). Female participants consistently exhibited higher empathy scores than males, with training significantly enhancing scores for both genders.</div></div><div><h3>Conclusions</h3><div>The tele-conference training effectively improved empathy scores among newly hired physicians. We recommend the implementation of KCS-based training to enhance empathy and communication skills in medical practice.</div></div><div><h3>Innovation</h3><div>The pandemic has accelerated the use of tele-education and telemedicine, though opinions on their effectiveness remain divided. However, studies show that empathy can be enhanced through interactive online training, which offers significant innovations for both healthcare professionals' learning and patient care.</div></div>","PeriodicalId":74407,"journal":{"name":"PEC innovation","volume":"6 ","pages":"Article 100399"},"PeriodicalIF":0.0,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144084189","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-05-10DOI: 10.1016/j.pecinn.2025.100402
Marleah Dean , Bethany Jowers , Claire Conley , Erica Camacho , Whitney Espinel , Kimberly A. Kaphingst
Objective
Previvors—unaffected individuals who have increased risk of cancer due to a pathogenic or likely pathogenic variant in a gene—experience high levels of uncertainty, which is associated with negative outcomes. The ePOWER (empowering Preventive Options for Women Experiencing Risk) intervention is designed to help BRCA1/2 previvors manage their cancer-related uncertainty and make informed health decisions. In this study, we assessed the acceptability of ePOWER using a multiple methods approach.
Methods
Previvors (N = 24) completed individual, semi-structured interviews. Previvors first completed the Treatment Acceptability and Preference Scale (TAPS). Additionally, using a Learner Verification & Revision (LV&R) interviewing approach, we also elicited feedback on whether ePOWER was understandable, salient, and satisfactory to previvors. Acceptability was assessed by quantitative data (TAPS scores) and qualitative data (interviews). In analyzing the interview data and integrating the findings, deductive coding was utilized using LV&R categories and inductive thematic analysis was utilized to capture additional nuances from participants' evaluation.
Results
Adequate acceptability was demonstrated by TAPS scores. 88 % of participants exceeded the a priori acceptability threshold (TAPS ≥3). Deductive coding using LV&R categories also confirmed ePOWER was visually appealing, understandable, persuasive, cultural appropriate, and fostered self-efficacy. Inductive thematic analysis expanded on the LV&R categories and identified two additional themes: (1) relatability and emotional support and (2) useful resource.
Conclusion
ePOWER is an acceptable intervention to help previvors manage cancer-related uncertainty and support decision making.
Innovation
The ePOWER intervention can be shared during healthcare appointments and then utilized continuously by previvors to manage uncertainty and facilitate decisions.
{"title":"Acceptability of the ePOWER intervention: Managing previvors' cancer-related uncertainty and supporting decision making","authors":"Marleah Dean , Bethany Jowers , Claire Conley , Erica Camacho , Whitney Espinel , Kimberly A. Kaphingst","doi":"10.1016/j.pecinn.2025.100402","DOIUrl":"10.1016/j.pecinn.2025.100402","url":null,"abstract":"<div><h3>Objective</h3><div>Previvors—unaffected individuals who have increased risk of cancer due to a pathogenic or likely pathogenic variant in a gene—experience high levels of uncertainty, which is associated with negative outcomes. The ePOWER (empowering Preventive Options for Women Experiencing Risk) intervention is designed to help <em>BRCA1/2</em> previvors manage their cancer-related uncertainty and make informed health decisions. In this study, we assessed the acceptability of ePOWER using a multiple methods approach.</div></div><div><h3>Methods</h3><div>Previvors (<em>N</em> = 24) completed individual, semi-structured interviews. Previvors first completed the Treatment Acceptability and Preference Scale (TAPS). Additionally, using a Learner Verification & Revision (LV&R) interviewing approach, we also elicited feedback on whether ePOWER was understandable, salient, and satisfactory to previvors. Acceptability was assessed by quantitative data (TAPS scores) and qualitative data (interviews). In analyzing the interview data and integrating the findings, deductive coding was utilized using LV&R categories and inductive thematic analysis was utilized to capture additional nuances from participants' evaluation.</div></div><div><h3>Results</h3><div>Adequate acceptability was demonstrated by TAPS scores. 88 % of participants exceeded the a priori acceptability threshold (TAPS ≥3). Deductive coding using LV&R categories also confirmed ePOWER was visually appealing, understandable, persuasive, cultural appropriate, and fostered self-efficacy. Inductive thematic analysis expanded on the LV&R categories and identified two additional themes: (1) relatability and emotional support and (2) useful resource.</div></div><div><h3>Conclusion</h3><div>ePOWER is an acceptable intervention to help previvors manage cancer-related uncertainty and support decision making.</div></div><div><h3>Innovation</h3><div>The ePOWER intervention can be shared during healthcare appointments and then utilized continuously by previvors to manage uncertainty and facilitate decisions.</div></div>","PeriodicalId":74407,"journal":{"name":"PEC innovation","volume":"6 ","pages":"Article 100402"},"PeriodicalIF":0.0,"publicationDate":"2025-05-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143943104","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-05-06DOI: 10.1016/j.pecinn.2025.100400
Julia Jaschke, Sara Söling, Juliane Köberlein-Neu
Objective
This study aimed to pretest and pilot the German version of the Hello conversation game (German: Hey du) to assess its comprehensibility and acceptability. Like the original, Hey du is designed as a low-threshold method to empower people of almost all ages and health conditions to engage in advance care planning (ACP), particularly targeting young/healthy people for whom there are currently few or no ACP programmes.
Methods
The conversation game was systematically translated into German using the TRAPD process and cognitively pretested in 12 interviews. Subsequently, two observational studies were conducted: Hey du was used in 1) a nursing school (n = 16) and 2) with groups of family and friends (n = 50). After completing the game, participants were surveyed regarding the game's acceptability and comprehensibility.
Results
The results of the cognitive pretest and the observational studies show that the conversation game was acceptable and comprehensible in both settings. Most of the participants (>92 %) reported that Hey du helped them come to terms with their own wishes and preferences for medical and nursing care and that they felt comfortable playing the game.
Conclusion
Hey du has the potential to motivate and empower people to deal with ACP.
Innovation
Hey du is the first scientifically supported gamification approach in Germany to introduce ACP to people for whom no systematic ACP programs exist. The game provides a safe forum for people of almost all ages and health conditions to discuss their values regarding life, death, dying and what matters most.
{"title":"Let's talk about death, dying, and what matters most to you in life: Pretest and piloting of a translated and adapted conversation game","authors":"Julia Jaschke, Sara Söling, Juliane Köberlein-Neu","doi":"10.1016/j.pecinn.2025.100400","DOIUrl":"10.1016/j.pecinn.2025.100400","url":null,"abstract":"<div><h3>Objective</h3><div>This study aimed to pretest and pilot the German version of the <em>Hello</em> conversation game (German: <em>Hey du</em>) to assess its comprehensibility and acceptability. Like the original, <em>Hey du</em> is designed as a low-threshold method to empower people of almost all ages and health conditions to engage in advance care planning (ACP), particularly targeting young/healthy people for whom there are currently few or no ACP programmes.</div></div><div><h3>Methods</h3><div>The conversation game was systematically translated into German using the TRAPD process and cognitively pretested in 12 interviews. Subsequently, two observational studies were conducted: <em>Hey du</em> was used in 1) a nursing school (<em>n</em> = 16) and 2) with groups of family and friends (<em>n</em> = 50). After completing the game, participants were surveyed regarding the game's acceptability and comprehensibility.</div></div><div><h3>Results</h3><div>The results of the cognitive pretest and the observational studies show that the conversation game was acceptable and comprehensible in both settings. Most of the participants (>92 %) reported that <em>Hey du</em> helped them come to terms with their own wishes and preferences for medical and nursing care and that they felt comfortable playing the game.</div></div><div><h3>Conclusion</h3><div><em>Hey du</em> has the potential to motivate and empower people to deal with ACP.</div></div><div><h3>Innovation</h3><div><em>Hey du</em> is the first scientifically supported gamification approach in Germany to introduce ACP to people for whom no systematic ACP programs exist. The game provides a safe forum for people of almost all ages and health conditions to discuss their values regarding life, death, dying and what matters most.</div></div>","PeriodicalId":74407,"journal":{"name":"PEC innovation","volume":"6 ","pages":"Article 100400"},"PeriodicalIF":0.0,"publicationDate":"2025-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143928095","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-05-06DOI: 10.1016/j.pecinn.2025.100401
Meghan A. Anderson , Rachel Price , Tori P. Miller , Rajan Lamichhane , Jennie L. Yoost
Objective
The purpose of this study is to determine whether “digital flashcard” graphics on a provider's smartphone are helpful in educating adolescents about reproductive health.
Methods
A randomized study compared the understanding of reproductive health topics among adolescents using digital flashcards during a clinical visit vs counseling as usual (control).
Results
There were 197 subjects (99 flashcards, 98 control) with mean age of 14.7 years. Among subjects in the flashcard group, new patients used more flashcards than return patients (3.48 vs 2.40, p = 0.001). The most frequently used flashcards were 7-day placebo birth control pills, the intrauterine device, internal anatomy and 84-day birth control pills. Among the flashcard group 96.9 % reported they “agreed” or “strongly agreed” that flashcards were helpful in understanding the topics discussed, and 98 % would recommend using them in the future. All subjects experienced an increase in understanding of the topics discussed during clinic, and there was no difference between the flashcard group and control.
Conclusion
Subjects using the digital flashcards during their clinical encounter reported high acceptability.
Innovation
Digital flashcards are accessible via smart phone use and can be easily distributed among providers to assist in reproductive health counseling in adolescents.
目的：本研究的目的是确定供应商智能手机上的“数字抽认卡”图形是否有助于对青少年进行生殖健康教育。方法一项随机研究比较了在临床访问期间使用数字抽认卡与常规咨询（对照组）的青少年对生殖健康主题的理解。结果共纳入197例受试者（抽认卡99张，对照组98张），平均年龄14.7岁。在抽认卡组的受试者中，新患者比复发患者使用更多的抽认卡（3.48 vs 2.40, p = 0.001）。使用最多的卡片是7天安慰剂避孕药、宫内节育器、内部解剖和84天避孕药。在抽认卡组中，96.9%的人表示他们“同意”或“强烈同意”抽认卡有助于理解所讨论的主题，98%的人建议将来使用抽认卡。所有受试者在临床期间对讨论主题的理解都有所增加，抽认卡组与对照组之间没有差异。结论受试者在临床接触中使用数字抽认卡的可接受性较高。创新数字抽认卡可以通过智能手机获得，并且可以很容易地分发给提供者，以协助向青少年提供生殖健康咨询。
{"title":"Use of digital flashcards for reproductive health counseling among adolescents","authors":"Meghan A. Anderson , Rachel Price , Tori P. Miller , Rajan Lamichhane , Jennie L. Yoost","doi":"10.1016/j.pecinn.2025.100401","DOIUrl":"10.1016/j.pecinn.2025.100401","url":null,"abstract":"<div><h3>Objective</h3><div>The purpose of this study is to determine whether “digital flashcard” graphics on a provider's smartphone are helpful in educating adolescents about reproductive health.</div></div><div><h3>Methods</h3><div>A randomized study compared the understanding of reproductive health topics among adolescents using digital flashcards during a clinical visit vs counseling as usual (control).</div></div><div><h3>Results</h3><div>There were 197 subjects (99 flashcards, 98 control) with mean age of 14.7 years. Among subjects in the flashcard group, new patients used more flashcards than return patients (3.48 vs 2.40, <em>p</em> = 0.001). The most frequently used flashcards were 7-day placebo birth control pills, the intrauterine device, internal anatomy and 84-day birth control pills. Among the flashcard group 96.9 % reported they “agreed” or “strongly agreed” that flashcards were helpful in understanding the topics discussed, and 98 % would recommend using them in the future. All subjects experienced an increase in understanding of the topics discussed during clinic, and there was no difference between the flashcard group and control.</div></div><div><h3>Conclusion</h3><div>Subjects using the digital flashcards during their clinical encounter reported high acceptability.</div></div><div><h3>Innovation</h3><div>Digital flashcards are accessible via smart phone use and can be easily distributed among providers to assist in reproductive health counseling in adolescents.</div></div>","PeriodicalId":74407,"journal":{"name":"PEC innovation","volume":"6 ","pages":"Article 100401"},"PeriodicalIF":0.0,"publicationDate":"2025-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144069860","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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