Learning from the implementation of clinical empathy training: an explorative qualitative study in search of the barriers and facilitators

Abstract Background Amid concerns about the decline of empathy during the clinical training of medical clerks, evidence that empathy improves patient outcomes suggests some potential for teaching empathy in ways that will affect the knowledge, attitude and behaviour of medical clerks. This potential...

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Main Authors: Luca C. Barak, Giliam Kuijpers, Lotte Hoeijmakers, Fedde Scheele
Format: Article
Language:English
Published: BMC 2022-11-01
Series:BMC Medical Education
Subjects:
Online Access:https://doi.org/10.1186/s12909-022-03877-8
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author Luca C. Barak
Giliam Kuijpers
Lotte Hoeijmakers
Fedde Scheele
author_facet Luca C. Barak
Giliam Kuijpers
Lotte Hoeijmakers
Fedde Scheele
author_sort Luca C. Barak
collection DOAJ
description Abstract Background Amid concerns about the decline of empathy during the clinical training of medical clerks, evidence that empathy improves patient outcomes suggests some potential for teaching empathy in ways that will affect the knowledge, attitude and behaviour of medical clerks. This potential alone cannot, however, guarantee the success of educational innovations to introduce empathy to the medical curriculum. This research aims to identify the barriers and facilitators of the implementation of a specific clinical initiative to enhance the empathy skills of clerks, namely the training of clerks to act as a ‘MedGezel’ or ‘medical coach’. Method We conducted an explorative qualitative study based on interview data collected and analyzed using reflexive thematic analysis and the readiness for change theory. We conducted semi-structured interviews with relevant stakeholders in this particular qualitative study. Thematic analysis was based on open and axial coding using ATLAS.ti 9, which facilitated the emergence of common themes of interest and meaning for the study. Results A total of 13 relevant stakeholders participated as interviewees in our study. The data was collected from April to June 2021. Our analysis generated 6 main themes which can provide insights into why the implementation of the MedGezel educational innovation failed so far. The following themes emerged: the case for change: why change?; practical necessity; leadership; management and resources; staff culture; and alignment with the corporate strategy. Discussion The implementation failure can be partially explained as resulting from the personal attitudes and choices of participants, who struggled to reconcile a vision that they liked with side effects that they feared. While participants repeatedly mentioned management and leadership issues, these organizational issues seemed less important as they could be easily resolved in practice. What was more important and fatal for the initiative was its lack of alignment with staff culture, despite its alignment with corporate strategy. Conclusion This investigation into the barriers and facilitators influencing the implementation of the MedGezel program identified 6 explanatory themes, the most impactful one being staff culture.
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spelling doaj.art-339623e0b0554f39b61944c311b544e72022-12-22T03:44:01ZengBMCBMC Medical Education1472-69202022-11-0122111210.1186/s12909-022-03877-8Learning from the implementation of clinical empathy training: an explorative qualitative study in search of the barriers and facilitatorsLuca C. Barak0Giliam Kuijpers1Lotte Hoeijmakers2Fedde Scheele3OLVG HospitalSocial enterprise MedGezel, and OLVG hospitalOLVG HospitalAthena Institute, VU University Amsterdam, and Amsterdam UMCAbstract Background Amid concerns about the decline of empathy during the clinical training of medical clerks, evidence that empathy improves patient outcomes suggests some potential for teaching empathy in ways that will affect the knowledge, attitude and behaviour of medical clerks. This potential alone cannot, however, guarantee the success of educational innovations to introduce empathy to the medical curriculum. This research aims to identify the barriers and facilitators of the implementation of a specific clinical initiative to enhance the empathy skills of clerks, namely the training of clerks to act as a ‘MedGezel’ or ‘medical coach’. Method We conducted an explorative qualitative study based on interview data collected and analyzed using reflexive thematic analysis and the readiness for change theory. We conducted semi-structured interviews with relevant stakeholders in this particular qualitative study. Thematic analysis was based on open and axial coding using ATLAS.ti 9, which facilitated the emergence of common themes of interest and meaning for the study. Results A total of 13 relevant stakeholders participated as interviewees in our study. The data was collected from April to June 2021. Our analysis generated 6 main themes which can provide insights into why the implementation of the MedGezel educational innovation failed so far. The following themes emerged: the case for change: why change?; practical necessity; leadership; management and resources; staff culture; and alignment with the corporate strategy. Discussion The implementation failure can be partially explained as resulting from the personal attitudes and choices of participants, who struggled to reconcile a vision that they liked with side effects that they feared. While participants repeatedly mentioned management and leadership issues, these organizational issues seemed less important as they could be easily resolved in practice. What was more important and fatal for the initiative was its lack of alignment with staff culture, despite its alignment with corporate strategy. Conclusion This investigation into the barriers and facilitators influencing the implementation of the MedGezel program identified 6 explanatory themes, the most impactful one being staff culture.https://doi.org/10.1186/s12909-022-03877-8Empathy trainingEmpathy skillsStaff culture
spellingShingle Luca C. Barak
Giliam Kuijpers
Lotte Hoeijmakers
Fedde Scheele
Learning from the implementation of clinical empathy training: an explorative qualitative study in search of the barriers and facilitators
BMC Medical Education
Empathy training
Empathy skills
Staff culture
title Learning from the implementation of clinical empathy training: an explorative qualitative study in search of the barriers and facilitators
title_full Learning from the implementation of clinical empathy training: an explorative qualitative study in search of the barriers and facilitators
title_fullStr Learning from the implementation of clinical empathy training: an explorative qualitative study in search of the barriers and facilitators
title_full_unstemmed Learning from the implementation of clinical empathy training: an explorative qualitative study in search of the barriers and facilitators
title_short Learning from the implementation of clinical empathy training: an explorative qualitative study in search of the barriers and facilitators
title_sort learning from the implementation of clinical empathy training an explorative qualitative study in search of the barriers and facilitators
topic Empathy training
Empathy skills
Staff culture
url https://doi.org/10.1186/s12909-022-03877-8
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