"The good physician treats the disease; the great physician treats the patient with the disease"
Sir William Osler (1849-1919)
In these enduring words, Sir William Osler, a revered figure in the history of medical education, spoke a timeless truth: compassionate, patient-centred care is a hallmark of great healthcare.
The ability to connect with patients on a personal level, understand their needs and preferences, and respond with empathy is what distinguishes a good doctor from a great one.
The NHS recognises this by mandating values-based recruitment to ensure that healthcare workers embody essential values. Yet, defining and measuring these values and qualities has remained a complex challenge—until now.
In a new publication in the journal Medical Education, Professor Paul Tiffin, a Professor of Health Services and Workforce Research at Hull York Medical School, in collaboration with Dr Richard Roberts, a leading US-based Emotional Intelligence researcher, have conceptualised the qualities and skills needed for person-centred care.
Professor Paul Tiffin, whose publication with Dr Richard Roberts could help define the healthcare professionals of tomorrow
Professor Paul Tiffin, whose publication with Dr Richard Roberts could help define the healthcare professionals of tomorrow
Their work is based on a literature review of existing studies in emotional intelligence, and Professor Tiffin’s own extensive research on the effectiveness of situational judgment tests (SJTs) in health staff selection. His contributions shed light on the usefulness, and potential weaknesses, of SJTs when choosing people for clinical roles.
At the core of Professor Tiffin's research is the recognition that being a successful healthcare professional requires more than academic excellence. Emotional intelligence, the ability to recognise and manage one's own emotions, empathise with others and effectively navigate the social world, is a cross-cutting requirement in healthcare.
The conceptualisation proposes modifications to an existing model of emotional intelligence, making it relevant to delivering person-centred care. This model identifies, and relates, several key socioemotional skills and traits- ‘the elementary particles’ of emotional intelligence - which are required to deliver compassionate, person-centred care.
This model is intended to serve as a clear roadmap for future research. This should feed into a more robust, scientific approach to both choosing and training healthcare staff in relation to the essential personal qualities required.
Professor Tiffin explained, “This modified model provides traits and abilities that can be targeted in both medical selection and educational settings.
“Medical selection could use this approach to screen out candidates with low levels of traits less amenable to training. Educators can also develop programmes that nurture the skills and attitudes representing the facets of emotional intelligence that we know can be taught to some extent.”
Understanding what personal qualities should be selected for, and developed by medical educators
There is mounting evidence that person-centred care is associated with improved patient experiences and, in some instances, better clinical outcomes.
The paper highlights how existing research has shown that higher levels of emotional intelligence in clinicians are associated with improved patient-clinician relationships, enhanced teamwork, and, most importantly, are essential to patient-centred care.1 Clinicians with higher levels of emotional intelligence have a reduced risk of burnout2 and tend to have patients that are more satisfied with their care.3
To identify and nurture the ideal qualities in prospective medicine students, the paper highlighted that the existing literature revealed ‘there is confusion of terminology and conceptualisation about the relevant traits, skills and abilities that are relevant to the professional and effective practice of medicine’. Thus, the authors observed that recruitment often emphasised desirable values, often mandated by policies like the NHS values-based recruitment, but could neither define nor measure these.
Various strategies are used in medical selection to support values-based recruitment. These include interviews, personal statements, and SJTs – the latter of which assesses knowledge of interpersonal effectiveness by presenting candidates with social scenarios that challenge personal and professional judgment.
Professor Tiffin explained, “The concept of 'values' itself is complex, challenging to categorise, and difficult to measure. To ensure that medical educators can effectively choose and develop individuals capable of consistently delivering person-centred care, a more explicit and detailed conceptualisation of the relevant traits and abilities is needed.
“Our proposed approach to improving person-centred care is to apply what has been learned from several decades of emotional intelligence research.”
The model for predicting person-centred care
At the heart of the research is the extension is an existing ‘cascading model’ of emotional intelligence.4
The original model assesses the relationships between different facets of emotional intelligence, such as ‘emotion regulation’ and ‘emotional understanding’, and their relationship with performance in jobs that involve emotional labour.
The modified model proposed in the new study adapts the original model to make it more relevant to the delivery of person-centred care within the healthcare profession. Instead of ‘job performance’, the modified model uses ‘person-centred care’ as the workplace activity of interest. It places greater importance on ‘emotion regulation’ by considering it as a mediator between ‘emotional understanding’ and ‘interpersonal effectiveness’.
Additionally, the adapted model introduces the ‘Big Five’ personality traits, particularly highlighting the role of ‘agreeableness’ (the degree to which pleasing others is perceived as important) in delivering person-centred care. This modification acknowledges the significance of personality traits in healthcare professionals who need to understand and cater to patients’ emotional and non-emotional needs.
Professor Tiffin explained, “The adapted model refines and tailors the original cascading model of emotional intelligence to better address the specific requirements of healthcare professionals delivering person-centred care, making it more relevant and practical for this context.
“We are already starting to apply this model when constructing SJTs for the recruitment of dementia care workers in an NIHR funded study led by Dr Mark Wilberforce, here at the University of York.
“Moreover, we intend to use this model as a template when designing digital training for mental health clinicians as part of research relating to young people’s Crisis Services.”
As the medical community evolves, this research reminds us that it's not just academic excellence but also emotional intelligence that could define the healthcare professionals of tomorrow.
The research article, The cross-cutting edge: medical selection and education viewed through the lens of emotional intelligence, is published in Medical Education.
For more information about the paper, contact Professor Paul Tiffin. Professor Tiffin is a member of the Health Professions Education Unit.
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