We are going to be discussing 2 different studies that were both under the general umbrella of emotion and pain in the medical field and how physicians react to it. The first study that we will look at is a study conducted by the University of Chicago and the Institute of Neuroscience in Taipei. It was used to determine a physician’s response to pain. Jean Decety, who is the Professor of Psychology and Psychiatry at University of Chicago described the situation by saying that because doctors often have to inflict pain as part of the healing process, most develop the ability to not be distracted by suffering. Doctors learn to keep a detached perspective, which seemingly prevents them from getting extremely overwhelmed or stressed, which could eventually impair assistance to patients.
The study analyzed 2 groups, 14 physicians and 14 regular people, who were all tested with a functional MRI. Both groups watched videos where people were pricked with acupuncture needles and then Q-tips, and the video clips were shown in random order. Since research shows that the neural circuit that registers pain is also activated when we see another in pain, they focused heavily on watching this part. When they looked at the regular people, it was clear that the portion of the brain related to pain increased in activity and was under extreme duress during this experiment. However, in the physicians, there was no increase in the activity of brain related to pain. Interestingly enough, there WAS an increase in activity in cognitive control and emotion regulation, which are the frontal areas of the brain. In the end, these results were accounted for by explaining that the mechanisms involving empathy cannot overlap too much between others and yourself, which leads to a personal stress aversive reaction. If you let go of your own emotional concerns, it frees up the processing capacity for sake of the other. The next study that we will be analyzing was conducted at the Jefferson Medical College. 456 students who entered during the years 2002 and 2002 were given the Jefferson Scale of Physician Empathy test at 5 different times of their academic time at this school. First, on orientation day, and then at the end of each academic year. The analysis showed that empathy scores did not change significantly between years 1 and 2. However, in year 3, there was a significant decrease in empathy scores that began a slippery slope that continued until graduation. Across different specialities and genders, patterns of a decreasing score were similar. The authors of the study highlighted the irony that the largest erosion of empathy occurs when the curriculum is focused around patient care. When addressing why this was happening, the authors looked towards several factors. The first being a lack of role models, meaning that other doctors with authority were also exuding a loss of empathy. They also credited it to the stress that most medical students are under, with the high volume of material to learn and pressure of time itself. The study points toward the reality of the ideologies that medical schools promote, like emotional detachment, effective distance, and clinical neutrality. They finally address that students today no longer see the value in the humanistic side of medicine, and just want to get the diagnosis right. CHECK OUT THE STUDIES: http://www-news.uchicago.edu/releases/07/070927.decety.shtml http://journals.lww.com/academicmedicine/Fulltext/2009/09000/The_Devil_is_in_the_Third_Year__A_Longitudinal.12.aspx
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