Medical students "taught how to practice empathy by following clever mnemonics" - NEJM

C. Nicholas Cuneo, M.D. in the NEJM: "With every faux interaction I felt myself being forced to shed another layer of authenticity, and I quickly grew to dread the whole tedious charade.

PEARLS, it spelled out: Partnership, Empathy, Apology, Respect, Legitimization, and Support.

With a smirk, I tossed it in the trash."

Better understanding and educational approach are needed.

--

Just as a side note, here is an overview of some empathy/communication mnemonics with the corresponding references:

"PEARLS – which stands for partnership, empathy, apology/acknowledgment, respect, legitimation, and support"
https://www.mdedge.com/familypracticenews/article/88977/neurology/use-pearls-build-relationships-patients

"The NURSE mnemonic is a useful memory aid to assist you to comprehensively and appropriately respond to patients’ emotions"
https://www.stepsforward.org/modules/empathetic-listening

The NURSE mnemonic has been reproduced from Back A, Arnold R, Tulsky J. Mastering communication with seriously ill patients: balancing honesty with empathy and hope. Cambridge University Press; 2009 Mar 2.

"The 4 C's"
https://defenceupdate.mdanational.com.au/Articles/empathic-communication

"BATHE Mnemonic"
https://fpnotebook.com/Psych/Exam/BthTchnq.htm

Communicate with H.E.A.R.T®
https://my.clevelandclinic.org/departments/patient-experience/depts/experience-partners/training/communicate-with-heart

The H.E.A.R.T. program consists of 3 training modules: S.T.A.R.T. with Heart® focuses on nine key expected services behaviors to use in every interaction with patient, families and other employees. Respond with H.E.A.R.T.® is an innovative model for service recovery providing employees with tools to help consistently address patient concerns. Answer with H.E.A.R.T.® delivers training for exceptional phone service and crucial factors for de-escalating challenging calls.

R.E.D.E. to Communicate
https://my.clevelandclinic.org/departments/patient-experience/depts/experience-partners/training/rede-to-communicate

References:

https://www.nejm.org/doi/full/10.1056/NEJMp1808397

Lifespan vs. healthspan: "I'LL do it" mnemonic

Epigenetics

"Tthere is nobody who disputes that epigenetics predicts life span”. Aging eight or more years faster than your calendar age equates to twice the typical risk of dying, while aging seven years slower is associated with half the risk of death, Horvath says.

"Life span predictor" clock

His lab has developed a "life span predictor" they named it after the Grim Reaper: DNAm GrimAge. The epigenetic clock is more accurate the younger a person is. It’s especially inaccurate for the very old. “At this point, we don’t have any evidence that it’s clinically useful, because there are big error bars.”

Seed of the clock is strongly influenced by underlying genes: 40% of the ticking rate is determined by genetic inheritance, and the rest by lifestyle and luck: "I'LL do it" mnemonic:

Inheritance
Lifestyle
Luck

Eating a healthy diet including lots of vegetables and fish is associated with slower epigenetic aging. Sleep deprication speeds the clock. The big suprise: Regular exercise won’t add much more than a few months to your life! You probably spend way more time exercising that the time you are going to get at the end of your lifespan.

Nobody really knows about timing of the final day

From his opponents: Diane Meier, a professor of geriatrics and palliative medicine at the Icahn School of Medicine at Mount Sinai in New York City: “I haven’t seen any of these purported predictive algorithms be precise in terms of timing of death—to the contrary,” says . “People live for a really long time with a very high burden of disease and frailty.”

References:

Want to know when you’re going to die?
https://www.technologyreview.com/s/612256/want-to-know-when-youre-going-to-die/

4 personality types based on new data

Researchers from Northwestern University sifted through data from more than 1.5 million questionnaire respondents to find at least four distinct clusters of personality types exist — average, reserved, self-centered, and role model — challenging existing paradigms in psychology. Read more here: https://news.northwestern.edu/stories/2018/september/are-you-average-reserved-self-centered-or-a-role-model/

The personality types are based on 5 widely-accepted basic character traits - you can run a simple test created by Jordan Peterson for Dr Oz here: https://www.doctoroz.com/quiz/quiz-whats-your-personality-type?quiz=true

The simple test is more manageable than the full 100-plus questionnaire.

Video: Dr. Jordan Peterson Shares a Quiz to Help You Accomplish Your Goals:



References:

https://www.scientificamerican.com/article/the-internet-knows-you-better-than-your-spouse-does/

From Cambridge University:

https://applymagicsauce.com/
https://discovermyprofile.com/

fNIRS brain scans could identify novice from experienced surgeons

From WSJ:

Researchers studied surgeons as they performed surgical simulations and found they could identify novice from experienced surgeons by analyzing brain scans taken as the physicians worked.

Prefrontal cortex, the part of the brain involved in planning complex behaviors was more active in the novices. Skilled surgeons had more activity in the motor cortex, which is important for movement. The researchers, who developed a machine-learning system to analyze the scans, also showed that training resulted in a shift toward higher activity in the motor cortex.

Simple mnemonic:

Prefrontal cortex
Planning
Pre-proficient level

Motor cortex
Masters

The scans were not MRIs but fNIRS, short for functional near-infrared spectroscopy. A person wears a skull cap embedded with tiny lasers that beam near-infrared light into the skull. Some of that light reflects back out and can be captured by a detector placed nearby. The quality of the detected light gives scientists clues as to whether blood flowing to the brain is oxygenated or not. An increase in oxygenated blood suggests more brain activity.

References:

Brain Scans Can Detect Who Has Better Skills - WSJ
https://www.wsj.com/articles/brain-scans-can-detect-who-has-better-skills-1538589600