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media n EI score wa s 110 — 10 points higher t ha n t he genera l popu lation's average score. "The areas that our residents [scored] h ig hest i n i ncluded ... i ntrapersona l skills, empathy a nd impulse control," Dr. Sha hid says. " Their lower scores were i n t he a rea s of a s ser t ivene s s , independence a nd f lexibilit y." Cer ta i n scores seemed dependent upon t he nu mb er of yea r s of t r a i n- i n g resident s ha d complet ed . W hen resea rchers compa red t he scores of residents in their f irst and second years of t r a i n i n g w it h t hose of re sident s in t heir t hird a nd four t h yea rs, t hey found va riations in asser tiveness a nd empathy. Junior residents had a higher media n composite empathy score, 116, and lower assertiveness score, 100, than more senior residents, who had scores of 110 a nd 109, respectively. CONTRADICTORY CHARACTERISTICS? The discrepancy in empathy and asser- tiveness scores may lead some to assume that as asser tiveness increases, empa- thy natura l ly decrea ses. The authors note t hat t his pa r ticu la r hy pot hesis ha s not been st ud ied , i nd icat i n g a n avenue for f u r t her resea rch . At t h is poi nt , D r. Sh a h id b el ieve s it i s d i f- f icu lt to say whet her or not t here's a direct correlation bet ween increa ses i n a s s er t iv en e s s a n d de c r e a s e s i n empat hy, but he does not believe t he traits are contradictory. Rather, he feels rising asser tiveness scores ma ke sense because sen ior resident s have more conf idence in their abilities. Decreases i n empat hy, he says, cou ld be a cop- ing mecha nism physicia ns develop as they ta ke on g reater responsibilit y for patient ca re. B u r n ou t m a y a l s o pl a y a r ol e i n declining empathy levels. A 2017 study publ i s hed i n C ure u s t h at sou g ht t o determine a baseline EI score for Indian postg raduate medica l students found that overa ll EI scores decrease as physi- cia ns' work loads increase. "A statistica lly significant difference wa s obser ved bet ween postg raduate students who worked around 48 hours p e r w e e k a n d t h o s e w h o w o r k e d more tha n 96 hours per [week]," says Rajkrishna Ravikumar, MD (Community Med ici ne), who wa s i nvolved i n t he C u re u s s t ud y a nd pr a c t ic e s a t t he University College of Medica l Sciences a nd GTB Hospita l in Delhi. "Simi la r results were observed between residents who had night duty hours and emergency duty hours." Work load modif ications t hat g ive physicia ns more time to spend w it h their fa milies a nd pa r ticipate in rec- reationa l activities may play a key role in helping them manage their emotions. Pa r ticipating in workshops a nd other activities designed to improve EI (see "Incorporating Emotiona l Intelligence into Medica l Training " above) may a lso en ha nce patient ca re a nd m i n i m ize physician burnout. " EI is a skill that ca n be developed and improved," Dr. Shahid says. "I think starting to improve and develop those skills early in medica l education at the medica l student or residency level is very important, so that when physicians leave training and start practicing in the rea l world a nd sta r t interacting with patients and other providers, they have these skills that allow them to work well and effectively within [their] teams." ■ Incorporating Emotional Intelligence into Medical Training A N A RTICLE FOR the University of California Berkeley's Greater Good Magazine, published by the Greater Good Science Center, makes the case that stress impedes empathy. Following this line of thinking, learning to effec- tively manage stress may help physicians become more empathetic and better read patients' emotional cues. At Loyola University Chicago, Ramzan Shahid, MD, FA AP, Loyola Medicine pediatrician and Division Director of General Pediatrics, Residency Program Director of Pediatrics, and an Associate Professor in the Department of Pediatrics at Stritch School of Medicine, recently tested a curriculum designed to improve residents' emotional intelligence (EI) scores. Residents completed a baseline assessment of their EI. They then participated in two, two-hour workshops that touched on ways to enhance their self-awareness, self- management, social awareness and overall social skills. Preliminary results reveal that residents scored higher on EI questionnaires after the training, particularly in areas related to burnout and resilience, and experienced improvements in their stress management skills, stress tolerance and overall wellness. M D N E W S . C O M /// M D N E W S L O N G I S L A N D ■ 2 017 2 7

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