Oxford Empathy Project - final programme

Empathy in Healthcare:

3rd Biennial Colloquium (Virtual)

11th – 12th November 2021

Revised Programme

From the Faculty of Philosophy, University of Oxford | Department of  Philosophy Faculty of Philosophy (@PhilFacOx) | Twitter

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Table of Contents

Overview

3

About the Keynote Speakers

5

Schedule

Day 1

  • Session I. 09:00—11:30 London

(18:00—20:30 Sydney, 10:00—12:30 Paris, 11:00—13:30 Istanbul)

  • Session II. 14:00—17:15 London

(23:00—02:15 Sydney, 15:00—18:15 Paris, 16:00—19:15 Istanbul)

Day 2

  • Session III. 09:00—11:30 London

(18:00—20:30 Sydney, 10:00—12:30 Paris, 11:00—13:30 Istanbul)

  • Session IV. 14:00—16:50 London

(23:00—01:50 Sydney, 15:00—17:50 Paris, 16:00—18:50 Istanbul)

9

Session Overviews

11

Satellite Events

  • Satellite Event 1. Empathic Intervision for Peer Support & Peer Learning, Tuesday 16 November, 15:00 - 18:00 (GMT)
  • Satellite Event 2. Empathy Circle to Discuss the Oxford Empathy Programme Colloquium Experience, Thursday 11th November, 17:00-20:00 (GMT), Friday 12th November, 17:00-20:00 (GMT), Saturday 13th November, 18:00-20:00 (GMT)

 

Overview

Empathic care is an invaluable tool in the modern practitioner’s arsenal; it is essential in improving outcomes for patients, in reducing burnout for healthcare practitioners and boosting care satisfaction for both parties. Barriers to this, however, can range from revolutionary technology to lack of diversity. This 3rd biennial meeting with its related colloquium themes will address different ways we can overcome these barriers to empathic care. Led by internationally renowned speakers, the colloquium will give its attendees the opportunity to learn about the cutting-edge research related to empathy and to interact both with like-minded people and international leaders in the field.

The virtual event will be interactive with a combination of keynote lectures, panels, and workshops. Between lectures and panels, the organizers will lead a series of exercises to promote self-empathy.

Conference Social Media Links:

@OxEmCare

The timings will be Australasia, Europe, and US friendly.

Themes and Keynote Speakers:

  1. Empathy and Special Abilities: Dinesh Palipana. People with special abilities offer a unique perspective through which to view the healthcare system, and how to improve its empathy. This keynote will give the audience an inspiring perspective on this important area.
  2. Introducing Empathy into Medical School Curricula: Rachel Winter. Empathy has become a core part of the Leicester Medical School Curriculum, and this speaker will discuss how they overcame barriers to achieve this.
  3. ‘Smiling on the Telephone’: Digital Interventions to Promote Empathy: Felicity Bishop. The COVID-19 pandemic and its aftermath have changed the way patients communicate with their healthcare practitioners, with telephone and video replacing face-to-face consultations. What are the barriers and facilitators to tele- and video-empathy? Felicity Bishop will review the latest evidence in this area and how her research group is using it to improve empathy in healthcare.
  4. Self-Empathy, Technology and Ageing: Muir Gray and James Gutierrez. Technology, ranging from care- and chat-bots to video consultations, are making inroads into medical care. How can these tools improve self-empathy?
  5. Empathy amongst colleagues: using Integrative Empathy for professional peer support in South Africa: Lidewij Niezink and Katherine Train. While empathy is often thought of in terms of doctor-patient encounters, these speakers will show how empathy practice for peer support and learning is just as important.

Aims for the Meeting:

  1. Explore the role of humans for promoting empathy in the digital age.
  2. Interact with the growing global network of empathy researchers and practitioners.
  3. Explore the latest and most evidence-based ways to practice, teach, and embed empathy within changing healthcare settings.

Aims for Delegates:

  1. Better understand the cutting-edge evidence about empathy in healthcare.
  2. Enrich perspectives about empathy from a special ability and developing nation perspective.
  3. Increase collaborations through interactive learning.

Questions: For any questions please email: OxfordEmpathy2021@gmail.com

 

About the Keynote Speakers

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<p>Description automatically generatedDr. Dinesh Palipana. Dinesh was the first quadriplegic medical intern in Queensland, and the second person to graduate medical school with quadriplegia in Australia. Dinesh earned a Bachelor of Laws (LLB), prior to completing his Doctor of Medicine (MD) at the Griffith University. He has completed an Advanced Clerkship in Radiology at the Harvard University. Halfway through medical school, he was involved in a catastrophic motor vehicle accident that caused a cervical spinal cord injury. As a result of his injury and experiences, Dinesh has been an advocate for disability. He is a founding member of Doctors with Disabilities Australia. Dinesh is currently a doctor at the Gold Coast University Hospital. He is a senior lecturer at the Griffith University and adjunct research fellow at the Menzies Health Institute of Queensland. He has research interests in spinal cord injury, particularly with novel rehabilitation techniques. Dinesh is the Gold Coast University Hospital’s representative in the Australian Medical Association Queensland’s Council of Doctors in Training. He is a member of the scientific advisory committee of the Perry Cross Spinal Research Foundation, disability advisory council at Griffith University, and the Ambassador Council at the Hopkins Centre. He is an ambassador for Physical Disability Australia. He is a doctor for the Gold Coast Titans physical disability rugby team. Dinesh was the Gold Coast Hospital and Health Service’s Junior Doctor of the Year in 2018. He was awarded the Medal of the Order of Australia in 2019. He was the third Australian to be awarded a Henry Viscardi Achievement Award. He was the 2021 Queensland Australian of the Year.

ImageDr Rachel Winter is an Academic Clinical Lecturer in medical education and a psychiatrist in training. She leads on the Medicine with Foundation Year at Leicester Medical School, a 'year 0' for medical students from less advantaged backgrounds which seeks to increase diversity and level the playing field in accessing careers in medicine. She is currently undertaking a PhD seeking to understand how empathy can be nurtured in healthcare students and practitioners with the aim of creating a national curriculum framework in clinical empathy for undergraduate medical education.

Dr Felicity Bishop's photoDr. Felicity Bishop is a health psychologist leading an interdisciplinary programme of mixed methods research around complementary therapies and placebo effects in health care within Psychology at the University of Southampton. She teaches a wide range of courses including Introduction to Health Psychology, Psychology and the Delivery of Health Care, and Applied Qualitative Research Methods. She is an associate editor of the British Journal of Health Psychology, and a member of the Board of Directors of the International Society of Traditional, Complementary & Integrative Medicine Researchers. Based upon an intensive research practice in health care, Dr. Bishop’s belief in the power and veracity of placebo effects helps her pursue the valuable question whether these effects can be harnessed ethically to improve healthcare.

Muir Gray celebrates 75 years and talks the Elixir of LifeSir Muir Gray. ​Muir Gray began the first phase of his professional career in 1971 focused on disease prevention, for example on helping people stop smoking. He also developed a local, then national programme of work to promote health in old age, at a time before the implications of population ageing had been recognized. Based on work in Oxford, he developed a number of national initiatives, particularly designed to prevent hospital admission and facilitate hospital discharge, including preventing hypothermia, publishing a Fabian Society report on the relationship between housing and poverty and the excess winter death, that took place in the United Kingdom. He was the Secretary of ASH Action on Smoking and Health. Then he developed all the screening programmes in the NHS, for pregnant women, children, adults and older people. For example, offering men aged sixty five screening for abdominal aortic aneurysm and, for both men and women, screening for colorectal cancer. He also developed services to bring knowledge to patients and professionals. Working on the principle that the delivery of clean clear knowledge was analogous to the provision of clean clear water, he saw the organization and delivery of knowledge as a public health service. For example, developing NHS Choices www.nhs.uk, which now has over 40 million visits a month, and setting up the Centre for Evidence Based Medicine in Oxford. During this period, he was appointed as the Chief Knowledge Officer of the NHS and was awarded both a CBE and later a Knighthood for services for the NHS. He is a Visiting Professor in Knowledge Management in the Nuffield Department of Surgery, and a Professor in the Nuffield Department of Primary Care Health Sciences where he leads work on Evidence Based Medicine and Value. He set up charities to promote urban walking and an Oxford based Centre for Sustainable Healthcare. He set up the Centre for Sustainable Healthcare and Better Value Healthcare and has published a series of How To Handbooks for example, How `to Get Better Value Healthcare, How To Build Healthcare Systems and How To Create the Right Healthcare Culture. His hobby is ageing and how to cope with it. Here is what he says about his health "I am a fairly typical healthy 76 year old, I had an attack of polio when I was seven, which left my right leg a little thinner than my left, but I could still play sport. Then at 12, I developed acute kidney failure but in the days before dialysis was lucky enough to recover. Also, I grew up in a filthy city, Glasgow, before the Clean Air Act, and my parents smoked. This will be typical of many people who are 70 plus today. Then about seven years ago, I had a heart attack, although at 'low risk' but made a very good recovery, thanks to a stent in one of my arteries. To stay healthy, I try to walk briskly using the www.nhs.uk/oneyou app, eat a Mediterranean diet, minimize stress and sleep eight hours a night, and every year I try to take more action against ageing. For example, by increasing the time spent stretching. Since then I have had two adventures. I tripped running for a train, which was late and broke 7 ribs, 5 of them in two places, then a year later, I developed severe sciatica and am still a little weak in my left leg.

James Gutierrez, MDJames Gutierrez is a native of Youngstown, Ohio, and attended University and Medical School at Case Western Reserve University in Cleveland, Ohio. He trained as a general internal medicine physician and has 25 years of primary care practice experience in the greater Cleveland community. He has also served in a number of leadership roles with Cleveland Clinic, including quality leader, department chair, Medicare accountable care organization president and medical director, and board of governors / medical executive committee member. James has been a member of the Cleveland Clinic London executive team since September 2018 as chief of quality, safety and patient experience. In this role, he leads a team that oversees governance, CQC registration and readiness, quality, safety, information governance, infection control and prevention, health and safety, integrated risk, and patient experience. The team embodies the ‘patients first’ ethos of Cleveland Clinic, and is laying the foundation for a just and safe culture for patients, families, and caregivers at Cleveland Clinic London.

Lidewij W . Niezink | Independent Scholar - Academia.edu

Dr Lidewij Niezink has been working on the development of empathy theory and practice for nearly 20 years. She writes, consults, trains and speaks on empathy for scientific, professional and lay publics. Dr Niezink teaches Applied Psychology and works as an independent empathy scholar focusing on integrating practice based experiential methods with fundamental and applied research. She holds a PhD from the University of Groningen, The Netherlands and publishes in national and international (academic) books and journals. Dr Niezink was a fellow of the Mind and Life Summer Research Institute in 2007 and was elected a Fellow of the International Center for Compassionate Organizations (ICCO) in 2013 before joining the International Center as the Director of Research. Her work now focuses on empathy praxis. Together with Dr Katherine Train she founded Empathic Intervision (www.empathicintervision.com).

Katherine Train (@katherine_train) | TwitterDr Katherine Train is an independent practitioner and researcher. Since 2005 she has been researching, developing learning material and presenting training on professional development, wellbeing, presence, empathy, compassion fatigue and burnout in various sectors. When training as a pharmacist, she realized she had technical expertise, but lacked skills to adequately understand her patients. This led to a directed exploration of these capacities, as a coaching training and as research towards a masters and PhD degree. Her research interest has been in the application of empathy in organizations in South Africa whilst the country is emerging as a new democracy with its cultural and resource diversity and history of social upheaval. She holds a PhD from Graduate School of Business, University of Cape Town. Together with Dr Lidewij Niezink she founded Empathic Intervision (www.empathicintervision.com).

Together, Drs Niezink & Train develop evidence-based Integrated Empathy interventions and education for diverse organizations to identify opportunities and co-create solutions to challenges. They are currently writing a book on Integrative Empathy, combining research from science in psychology, philosophy, social neuroscience, the arts and anthropology. They can be reached at info@empathicintervision.com

 

Organizing Committee:

 

 

Schedule

Session 1 (November 11)

09:00—11:30 London (18:00—20:15 Sydney, 10:00—12:15 Paris, 11:00—13:15 Istanbul)

Timings

Session

Speaker(s)

9:00-

9:05

Welcome

Jeremy Howick

9:05 –

9:45

Plenary 1. Empathy and Special Abilities

Dinesh Palipana

(Chair: Jeremy Howick)

9:45 – 10:00

Self-Empathy Break: Self-Empathy Scavenger Hunt

India Pinker

10:00-11:00

Parallel Sessions: Evidence-Based Empathy in the Digital Age

Presentations (15 min + 5 min Q&A)

(Chair : Rachel Winter)

Workshop (60 mins)

(Chair: Mine Özyurt Kılıç)

Where’s the Empathy in EBM? Incorporating Patient Values and Preferences in Healthcare: Highlights from a Systematic Review of Qualitative Evidence, Michael Tringale

Challenges of Empathic Care without a Doctor (GP), Tanja Petrovic

Mindfulness for Medical Student Resilience and Well-Being, Georgie Budd

Weaving Empathy in Physical and Digital Spaces, Naomi Toland

11:00-

11:30

Networking event in small groups

India Pinker

 

Session 2 (November 11)

14:00—17:15 London (23:00—02:15 Sydney, 15:00—18:15 Paris, 16:00—19:15 Istanbul)

Timings

Session

Speaker(s)

14:00-

14:05

Welcome and Summary of Empathy Scavenger Hunt

India Pinker

14:05-

14:45

Plenary 2. Integrating Empathy as a Core Part of the Medical School Curriculum

Rachel Winter

(Chair: India Pinker)

14:45 – 15:00

Self-Empathy Break: Moveathon

India Pinker

15:00-

16:00

Parallel Sessions: Empathy in Medical Education and Beyond

(15 min + 5 min Q&A)

Chair: Amy Price

Chair: Katherine Train

Conceptualization and Use of Therapeutic Empathy and Compassion in Physical Medicine and Rehabilitation Settings: A Scoping Review Protocol, Stephanie Posa

An Educational Intervention focused on Teaching Qualified Empathy to Social Work Students in Finland, Eija Raatikainen

Two-week “Virtual” Pre-Medical Program increases Empathy, Clinical and Communication Skills: A Mixed Methods Evaluation Study, Ujwal Srivista Amy Price, and Larry Chu

Empathy in Healthcare and the Implementation of Patients' Rights, Aline Albuquerque

Building a Culture of Empathy-based Healthcare: How to Start? Denise Furnaletto

Can Clinical Empathy Survive? Distress, Burnout and Malignant Duty in the Age of Covid-19 Jodi Halpern

16:00-

16:45

Plenary 3. Smiling through the Telephone

Felicity Bishop

(Chair: Jeremy Howick)

16:45-

17:15

Networking event in small groups

Lidewij Niezink

Session 3: November 12

09:00—11:30 London (18:00—20:30 Sydney, 10:00—12:30 Paris, 11:00—13:30 Istanbul)

Timings

Session

Speaker(s)

9:00-

9:05

Welcome

Jeremy Howick

9:05 –

9:45

Plenary 4. Self-Empathy and Ageing

Muir Gray

(Chair: Jeremy Howick)

9:45 – 10:00

Self-Empathy Break

10:00-

11:00

Parallel Sessions: Literature and Other Empathy Enhancing Tools

(15 min + 5 min Q&A)

Chair: Lidewij Niezink

Chair: Mine Ozyurt

Communication with Older Adults – “Only Connect...!” Mathias Schloegl

Imaging an Ideal Hospital for the 21st Century – with Compassions and Empathy at its Core Rachit Mohan

Absent Bodies. (Psycho)Therapeutic Empathy during Covid-19 Valeria Bizzari

Temporarily Depressed Women via Novels: Suicide Prevention for New Mothers via World Literature: Elif Şafak’s “Siyah Süt” [“Black Milk”] And Fuani Marino’s “Svegliami a Mezzanotte” [“Wake Me Up In The Midnight”] Fazila Derya Agis

Understanding Empathy in Diverse Cultural Settings: Challenges and Opportunities Nathan Wiltshire

Using Empathy Maps to encourage Empathetic Communication in Healthcare, Patrick Cairns, India Pinker, Dr Evelyn Watson, Dr Andrew Ward, Dr Anita Laidlaw

11:00-

11:30

Self-Empathy Tool

Empathy through Literature

Mine Özyurt Kılıç

 

Session 4: November 12

14:00—16:45 London (23:00—01:45 Sydney, 15:00—17:45 Paris, 16:00—18:45 Istanbul)

Timings

Session

Speaker(s)

14:00-

14:05

Welcome and Summary of Self-Empathy Tools

Mine Özyurt Kılıç

14:05-

14:45

Plenary 5. Integrative Empathy: Five Empathy Skills in Cancer Care in South Africa

Lidewij Niezink  Katherine Train

(Chair: Mine Özyurt Kılıç)

14:45 – 15:00

Self-Empathy Break

15:00-

16:20

Presentations: Making Empathy Flourish in the Midst of a Global Pandemic (15 min + 5 min Q&A)

Workshop

Chair: Mine Özyurt Kılıç

Chair: India Pinker

Empathic Unsettlement and Apathetic Rigidity amongst Healthcare Workers in India: Insights into Personal Accounts of Covid-19 Survivors

Fatma Elham

Psychedelic Assisted Psychotherapy Practices and Human Caring Science: Towards a Care-Informed Model of Treatment Andrew Penn

Why we need Empathy for Good Diagnoses Ashley Kennedy

Pandemic Grief, Social Mending, and the Japanese Art of Kintsugi Theme linked to empathy, aging, and the digital age Kathleen Price and Amy Price

What are Empathy Maps and How could they develop Empathy in Medical Settings? India Pinker*, Patrick Cairns**, Dr Evelyn Watson*, Dr Andrew Ward***, Dr Anita Laidlaw*

16:20—16:40

Networking session

Lidewij Niezink

16:40-

16:50

Closing Remarks

Jeremy Howick

Session Overviews

Day I: Session I

Plenary I. Empathy and Special Abilities

Dinesh Palipana

Abstract: The esteemed Australian journalist Kerry O'Brien asked in 2021, can empathy be taught to medical students? This question gave me much to think about.

I experienced a spinal cord injury causing quadriplegia halfway through medical school. Before the injury, I had no idea what life was like for someone with a spinal cord injury. I had little understanding of what it was like to be a patient. I certainly had no grasp of the intensive care journey from a patient’s eyes.

Today, I wonder. Am I a better doctor for having gone through that experience? If I didn't, will I be more prone to be a part of the machinery of medicine rather than feel for the experience of my patients?

Parallel Sessions: Evidence-Based Empathy in the Digital Age

Presentation: Where’s the Empathy in EBM? Incorporating Patient Values and Preferences in Healthcare: Highlights from a Systematic Review of Qualitative Evidence

Michael Tringale

Background: Evidence-based medicine (EBM) calls for healthcare professionals (HCPs) to integrate patient values and preferences for optimal patient-centered care, but evidence of how HCPs actually do this is underrepresented in the literature.

Aims: To conduct a systematic review of qualitative evidence examining HCP approaches to values integration.

Methods: Twelve databases were searched for qualitative evidence between 2000 and 2020 describing HCP behaviors, attitudes, perceptions, experiences, perspectives, and opinions related to values integration. A meta-aggregation approach was used for synthesis and analysis.

Results: Included thirty five records involving 1,006 HCPs and 1,843 HCP-patient encounters. Over 150 approaches to values integration were identified – with numerous references to empathy and empathetic behaviors – which were thematically analyzed and synthesized into four main themes:

  1. Approaches of Concern referring to behaviours that demonstrate concern for the patient as a person and concern for diseases and their effects;
  2. Approaches of Competence referring to competencies at addressing diseases, understanding research evidence, and managing patient outcomes;
  3. Approaches of Communication referring to communicating with the patient as a partner, sharing information and evidence, and managing patient engagement; and,
  4. Approaches of Congruence referring to tailoring care for individual patients and maintaining flexibility and balance.

Conclusion: HCPs incorporate patient values and preferences in health care through various approaches of Concern, Competence, Communication, and Congruence with empathy having a role throughout.

Presentation: Empathy in Healthcare and the Implementation of Patients’ Rights

Aline Albuquerque

Empathy in healthcare is linked to movements towards the centrality of the patient, shared decision-making, and patients' rights. Empathy is a central element in the realization of patients' rights, as it has an epistemic function in moral deliberation. Then, it has strong connections with human morality, a topic of significant importance for studies in the field of right’s implementation. The implementation of patients' rights is essential to increase the quality of care and the efficiency of health systems. Even in countries that have had patients’ rights law for a long time, implementation is still a challenge. And the difficulty is greater, especially in countries like Brazil, where there is no law on patients' rights. This theoretical research contributes to the implementation of patients' rights, through the study of the role of empathy in moral judgment and its role in such an implementation process. This research aims to develop a theoretical framework that supports the interconnections between empathy in healthcare and patients' rights, based on studies on empathy and morality, to contribute to the construction of a new culture in healthcare based on the paradigm of the patient as a subject of rights and the protagonist of the clinical relationship.

Presentation: Conceptualization and Use of Therapeutic Empathy and Compassion in Physical Medicine and Rehabilitation Settings: A Scoping Review Protocol

Stephanie Posa

This scoping review examines the literature on the conceptualization and use of therapeutic empathy and/or compassion in physical medicine and rehabilitation (PM&R).

Relevant studies were identified through five electronic databases (CINAHL, Cochrane Library, EMBASE, MEDLINE and PEDRO). Included studies reported on quantitative, qualitative or mixed-methods research with primary data on the conceptualization or use of therapeutic empathy and/or compassion in PM&R. 26 studies were included (n=4,498); 14 quantitative, 6 mixed-methods, 6 qualitative. Higher perceived empathy in rehabilitation Health Care Providers (HCPs) correlated with increased treatment satisfaction, acceptance, adherence, and goal attainment among patients.  Self-compassion training for patients was associated with improvements in anxiety, depression and quality of life. Empathy, compassion fatigue and compassion satisfaction among HCP’s varied by practice setting, sex, and years of experience. Qualitatively, empathy and/or compassion was conceptualized as both intrinsic (a state of understanding) and exhibitory (delivered through action). While some studies examined how empathy and/or compassion was enacted in PM&R, others addressed how empathy and/or compassion were desirable in PM&R and worth facilitating through various interventions. Both empathy and compassion are valued by rehabilitation patients and their HCPs alike. Future research should evaluate the effectiveness of therapeutic empathy and compassion on patient outcomes in PM&R.

Presentation: Challenges of Empathic Care without a Doctor (GP)

Tanja Petrovic

Access to GP is one of the obstacles to Empathic Care.

In the healthcare system, where GP has a gatekeeper role, finding your own doctor is crucial. However, due to an increasing lack of new GPs' inflow into the system, along with negative consequences of an agreement between the government and the doctor's Union, lowering the minimum number of patients per doctor brought about an enormous pressure on patients and doctors in some area in Slovenia.

Consequently, many doctors refuse new patients, with their personal decision in line with the agreement. Nevertheless, on the patient's side, the situation can lead to a breach of rights. Having in mind both sides, there is a pending question if this practice leads to an empathic care at all, as some of the patients cannot find their GP, and are treated on ad hoc basis. What are the possibilities for more humane encounters, on a personal (doctors) and systemic level? Particularly, in epidemic times, with novel barriers to seeing your doctor personally, not just virtually, access to primary health care is significantly narrowed and shifted into a new reality.

Workshop: Weaving Empathy in Physical and Digital Spaces

Naomi Toland

Empathy is a personal journey that can open doors into our own lives and the lives of those around us. I believe conversations where we navigate a topic together helps grow perspectives and fosters empathy as we can explore different points of view and get insights similar to or different from our own. I plan to create a workshop with a panel/ Q & A style format for this interactive workshop where I will have two guests in the session with me and we will bring insights from the virtual audience into the conversation as well.  The question we will explore is 'How can we weave empathy into our day to day lives, physically and digitally?'   I envisage this workshop linking to theme 3 of the colloquium, 'Smiling through the telephone.' with Felicity Bishop looking at ways we can 'Explore the role of humans for promoting empathy in the digital age' and how that is similar or different to physical spaces.

 

Day I: Session II

Plenary 2. Integrating Empathy as a Core Part of the Medical School Curriculum

Rachel Winter

Abstract: The University of Leicester offers students from less advantaged backgrounds the opportunity to study medicine. The curriculum for these students includes an empathy-focused curriculum, which has received great feedback and has been challenging to implement. This talk discusses why evidence-based empathy training is central to our curriculum and how we implemented and evaluated our programme, from design to delivery and beyond. Feedback from students and faculty has helped shape our future direction and allowed us to overcome barriers in providing a strong patient-centred foundation for our students. We have emerging evidence that what we teach remains with them as they continue their journey through medical school.

Parallel Sessions: Empathy in Medical Education and Beyond

Presentation: Mindfulness for Medical Student Resilience and Well-Being

Georgie Budd

Background: Medical students have been repeatedly demonstrated to have high levels of stress, anxiety, depression and burnout as they progress and graduate. This was evident pre-pandemic, but this recent emergency has increased stress globally, with simultaneous acknowledgment of the negative impact on mental health and overall wellbeing. A recent and growing body of evidence connects high stress levels with increased mental and physical health complaints, and in students this correlates with decreased attendance and ultimately poor academic performance. Mindfulness programmes have already been successfully implemented in a number of highly-stressed populations for treatment of mental distress, and have gained widespread popularity during the difficulties of the past year. Objective: Implementation of 5 weeks Enhanced Stress Resilience Training (ESRT) for medical students. ESRT is an abbreviated mindfulness-based intervention (MBI) promoting positive psychology, body presence, relaxation and awareness; with the aim of fostering much needed resilience. Methods: We are comparing this intervention group to an active control weekly discussion group using a number of psychological parameters in addition to heart rate variability (HRV). Additionally, qualitative interviews and evaluations will be collected from ESRT groups.

While at first glance this may not seem directly related to empathy, what I am keen to talk about and draw attention to in my presentation would be the link between mental distress in medical students, (and by extension junior doctors) and the rising levels of burnout. Burnout is known to decrease physician empathy and this directly impact patients’ care. The research on resilience identifies factors that are integral in the practice of mindfulness including positive outlook, purpose and self-efficacy. It is my hope that but using mindfulness training we can foster a culture of self-empathy to combat burnout, as well as impact the empathetic ‘reserve’ of the staff.

Presentation: An Educational Intervention focused on Teaching Qualified Empathy to Social Work Students in Finland

Eija Raatikainen

The aim of the presentation is to describe an educational intervention focused on teaching Qualified Empathic (Raatikainen etc. 2017; 2021) skills to social work students in higher education at Metropolia University of Applied Sciences in Finland. The study was a case study, designed to explore the students' experiences of their one semester long educational intervention (n = 20). Our research question was: How do students construct Qualified Empathy as a dimension of their own professional expertise? Study is based on the one semester long intervention for first-year Bachelor of Social Services students was to enable them to increase their awareness of a variety of cultures and practices encountered in social pedagogical work and to support the development of their ability to interact empathically with clients. The results of the study demonstrate the progress areas of the students' Qualified Empathy skills. The development stages in the three progress areas are: (1) from emotional reaction to emotional response, (2) from understanding to empathic acting and (3) from client perspective to a more systemic approach. Implications of the results for Social Services students are discussed.

Presentation: Two-week “Virtual” Pre-Medical Program increases Empathy, Clinical and Communication Skills: A Mixed Methods Evaluation Study

Ujwal Srivista, Amy Price, and Larry Chu

Background:  Stanford Medicine’s Clinical Science, Technology and Medicine Summer Internship (SASI) is a two-week internship for high school and undergraduate students to inspire learners to be compassionate healthcare providers. Research demonstrates that physician expressed empathy increases patient satisfaction, improves treatment adherence, and decreases malpractice. Yet competencies for teaching empathy to pre-medical students are uncommon.  

 

Objective:  This study measured changes in clinical competencies, communication skills, and empathy pre- and post-SASI participation.   

 

Methods:  Forty-one Core Track only (CT) with thirty-nine Core + Research Track (RT) SASI participants received clinical instruction and interacted directly with patients. RT participants received additional instruction in research. All participants completed online pre-and post-surveys about knowledge and skills assessment (KSA). We assessed empathy using the Consultation and Relational Empathy (CARE) measure. A subset of focus groups explored empathy. Pre-and post- KSA and CARE measure scores were compared using paired T-tests and a linear regression model.  Focus groups were analyzed thematically.  

 

Results:   Both tracks improved empathy scores (CT: p < 0.001; RT: p = 0.007). Both tracks improved KSA scores (CT: p < 0.001; RT: p < 0.001), specifically questions related to surgical skills, epinephrine pen usage, x-ray image interpretation, and synthesizing information to problem solve. CT participants improved communication skills as well.    

 

Conclusion:   Pre-graduate healthcare internships with mentorship, hands-on interaction and patient involvement may improve empathy, communication and clinical skills. 

 

Disclosure: This research was presented at Stanford University and is based on the manuscript  “Two-week *virtual* pre-medical program increases empathy, clinical and communication skills: a mixed methods evaluation study” This paper is currently in review at JMIR Med-Ed and the publication is expected before the Oxford Empathy Programme.

Presentation: Building a Culture of Empathy-based Healthcare: How to Start?

Denise Furnaletto

Introduction: This study aimed to map themes related to empathy in health care.

Method: Based on the question ‘What concepts, approaches, and challenges about empathic health care are available in the scientific literature?’, a scoping review was conducted in the PubMed, Web of Science, Cochrane, Scopus, CINAHL, PsycINFO, Embase, Medline, Virtual Health Library (VHL) and Google Scholar databases. The inclusion criteria were types of studies (primary and secondary) and language (English, Spanish, or Portuguese). The search strategy used the terms ‘empathy’, ‘compassion’, ‘altruism’, ‘health care’, ‘professional’, ‘patient’, and ‘professional-patient relationships’.

Results and discussion: From a total of 32,317 articles, 891 were retrieved and 142 were included for analysis. Regarding conceptual aspects, there was a consensus that empathy is a complex multidimensional concept that involves cognitive, affective, and behavioral aspects. The main approaches to the theme are related to evaluation, training, and professional education. Some challenges for an empathic practice in health are related to psychic, emotional, and physical exhaustion of professionals and students.

Final considerations: The evidence found may subsidize the plan of action for the implementation of a line of teaching and research with emphasis on empathic care at the Health Sciences Faculty of the University of Brasilia, Brazil.

Presentation: Using Empathy Maps to encourage Empathetic Communication in Healthcare

Patrick Cairns

Therapeutic empathy involves understanding the patient, communicating that understanding and acting in a helpful way. Higher therapeutic empathy has been linked to improved patient health outcomes and treatment adherence, as well as lower burnout in health professionals. Despite this, medical students and doctors have the lowest patient-rated empathy among all healthcare professionals, and some evidence has suggested empathy may decline as one progresses through Medical School. This presentation will explore the use of a novel tool to encourage empathetic communication: an empathy map. Empathy maps were originally used in business to develop consumer profiles, and involve asking questions about a person’s lived experience, emotions and thoughts. They have been introduced into communication skills curriculums in a number of medical schools across the UK. This presentation will describe the different ways they are being used in different medical schools, as well as research that is currently under way related to their use and efficacy. It is hoped empathy maps may prove a useful teaching tool for all healthcare professionals and help promote more patient-centered healthcare interactions.

Workshop: What are Empathy Maps and How could they develop Empathy in Medical Settings?

India Pinker*, Patrick Cairns**, Dr Evelyn Watson*, Dr Andrew Ward***, Dr Anita Laidlaw*

“Despite being a cornerstone of patient-centered care, there is increasing concern that empathy is not being sufficiently demonstrated by healthcare professionals. It is vital that health professional education enables students to develop empathy for patients throughout their career.

Initially developed within service industries, empathy maps assist developers to understand customer perspectives. Research at the Universities of St Andrews, Aarhus and Leicester is being conducted to assess their impact on empathy in medical students and health professionals following their introduction in medical training. This workshop will introduce empathy mapping conceptually, and encourage attendees to consider its use in health professional education.

The workshop will consist of:

·     Introduction to empathy maps and examples of their current integration in medical curricula

·     Interactive exercise to illustrate their use.

·     Group discussion of how they could be further integrated in health professional education.

Timeline:

- Background to empathy maps and their implementation: 5 mins

- Patient interview (Video): 10 mins

- Breakout rooms exercise – small group work to complete an empathy maps from the observed patient interview: 30 mins

- Discussion on empathy map use in health professional education: 15 mins”

Plenary 3. Smiling through the Telephone: digital interventions to promote empathy

Felicity Bishop

Empathic communication and positive messages are important components of ‘placebo’ effects and can improve patient satisfaction and health outcomes. Communicating empathy and optimism to patients within consultations may also enhance the effects of verum, i.e., non-placebo, treatments such as those delivered routinely in primary care. Our team have used the person-based approach to plan, develop, and optimize an online intervention – ‘Empathico’ - to help primary healthcare practitioners enhance their communication of clinical empathy and realistic optimism during consultations.  As part of this work, and partly motivated by the COVID-19 pandemic-triggered acceleration of shifts to telephone-consultations, we have explored the communication of empathy and positive messages in telephone consultations.  We have conducted a rapid review of 8 studies (527 patients and 20 practitioners) about empathy in telephone consultations.  We have also conducted a large survey of patients and smaller, in-depth, qualitative analyses of patients’ and practitioners’ experiences of empathy and positive messages in telephone consultations.  Overall, our findings suggest that practitioners can express, and patients do experience, empathy and positive messages in telephone consultations.  But practitioners would value additional support to help them feel confident in overcoming the challenges posed by the loss of non-verbal cues and touch.  This talk will further describe this programme of work and our approach to helping primary care practitioners to ‘smile on the telephone’. 

Day 2: Session III

Plenary 4. Self-Empathy and Ageing

Muir Gray & James Gutierrez

I am a fairly typical healthy 76 year old, I had an attack of polio when I was seven which left my right leg a little thinner than my left, but I could still play sport, then at 12 I developed acute kidney failure but in the days before dialysis was lucky enough to recover. Also, I grew up in a filthy city, Glasgow before the Clean Air Act, and my parents smoked. This will be typical of many people who are 70 plus today.  Then about seven years ago I had heart attack, although at 'low risk' but made a very good recovery, thanks to a stent in one of my arteries. To stay healthy I try to walk briskly using the www.nhs.uk/oneyou app, eat a mediterranean diet, minimise stress and sleep eight hours a night, and every year I try to take more action against ageing for example by increasing the time spent stretching. since then I have had two adventures. I tripped running for a train , which was late and broke 7 ribs, 5 of them in two places, then a year later I developed severe sciatica and am still a little weak in my left leg. In this plenary talk I will discuss the relationship between healthy ageing and empathy.

James Gutierrez will complement Muir Gray’s talk by discussing the importance of empathy and ageing at the Cleveland Clinic London.

Presentations: Literature as an Empathy Enhancing Tool

Communication with Older Adults – “Only Connect...!”

Mathias Schloegl

E. M. Forster said it many years ago in Howard’s End, “Only connect...!”. From where I sit, communication is more than talking to the patients. It’s even more than listening. We need to open our eyes AND our heart in order to see and experience what the patient might want to tell and/or show us. Based on previous experiences with patients I will cover three topics:

 a)  Verbal and Vocal Disruptive Behaviors (VDB)

VDB are important clinical features in dementia because they frequently signal discomfort experienced by an older adults and because they are disturbing to caregivers, thereby affecting the care of elderly persons manifesting them.

 b)  Unmet Needs

 The Unmet Needs Model states that problem behaviors of people with dementia result from unmet needs stemming from a decreased ability to communicate those needs and to provide for oneself.

 c)   Communicating through the Mask

 In my recently published paper in the Journal of the American Geriatrics Society, I’ve suggested a concrete approach to effectively overcome the communication barriers created by the pandemic.

Why we need Empathy for Good Diagnoses

Ashley Kennedy

The starting point of, and the foundation for, the process of clinical diagnosis is the relationship between the patient and the physician. This means that before gathering clinical evidence, or performing, evaluating, and interpreting diagnostic tests, this relationship must be established. Here, I will argue that this relationship ought to be one of mutual respect and shared decision-making between the patient and the physician as well one of empathy on the part of physician. I argue that this is the case not simply because we want doctors to be nice to their patients (although we do) but because an empathic, caring attitude on the part of the physician actually facilitates more accurate diagnoses by encouraging a pluralistic view of what counts as evidence towards a diagnosis.

Psychedelic Assisted Psychotherapy Practices and Human Caring Science: Towards a Care-Informed Model of Treatment

Andrew Penn

Psychotherapy using psychedelic medicines as catalysts are likely to be available in the next 5 years. These treatments must be embedded in a psychotherapeutic relationship. But what should that relationship model look like? Drawing from a theory of human caring developed for nursing, the presenter will apply the principles of empathy, trust, inter-subjectivity, spiritual intelligence, and the care of the physical body in psychedelic therapy. This presentation will be based upon a theoretical/hypothesis generating paper by the same name published in the Journal of Humanistic Psychology (Penn, et al 2021).

Temporarily Depressed Women via Novels: Suicide Prevention for New Mothers via World Literature: Elif Şafak’s “Siyah Süt” [“Black Milk”] And Fuani Marino’s “Svegliami a Mezzanotte” [“Wake Me Up In The Midnight”]

Fazila Derya Agis

The Turkish female author Elif Şafak suffered from a post-birth syndrome and had suicidal thoughts; for this reason, she published an autobiographical novel entitled “SİYAH SÜT” [“BLACK MILK”] in 2007, accordingly. Similarly, the Italian female author Fuani Marino suffered from a post-birth syndrome that made her try to commit suicide at the age of 32 in 2012, and she published a book entitled “SVEGLIAMI A MEZZANOTTE” [“WAKE ME UP IN THE MIDNIGHT”] in 2019.

Thus, this study will focus on how positive thinking about natural elements, meals, and arts as an online therapy strategy may help suicidal people recover from their negative mental states, analyzing the cognitive linguistic word games and metaphors used in these two works one of which is in Turkish, and the other of which is in Italian.

Besides, analyzing the two novels representing two different women’s post-birth depression, this study will propose “the Eco-Food-Art Therapy” in five ways to humans to take refuge in nature against unjust gender discrimination and unacceptable traditional norms imposed by society, as well as during personal identity crises linked to gender-based biological syndromes such as premenstrual and post-birth syndromes, and hormonal imbalances in relation to the medical terminology and depression metaphors used in the two novels by building empathy towards women suffering from hormonal changes:

1)    One must enjoy the environment and protect it;

2)    One must befriend animals;

3)    One must try to communicate with plants;

4)    One must deal with arts to cope with her or his extreme emotions, and

5)    One must choose healthy nutrients to deal with her or his negative emotions.

Understanding Empathy in Diverse Cultural Settings: Challenges and Opportunities

Nathan Wiltshire

In recent years, there has been a growing interest in empathy within healthcare; to understand patient needs and support therapeutic outcomes. This has inspired a significant body of research to define and measure empathy. Amidst this promising development, there has been limited discussion of whether empathy should be treated the same in diverse cultural settings. More than an issue of translation, culture has long been recognized as a significant influence in a person's everyday experience of the world. Correspondingly, researchers have reported divergence from prevailing Western-cultural constructs of empathy with, for example, ideas of self and community, how people relate to and understand others, and conflicting motivations for empathy (e.g. see Hollan, 2017).

Notwithstanding this complexity, a popular relational measure of empathy in healthcare,

Consultation and Relational Empathy (CARE) (Mercer et al, 2004), is increasingly used around the world. This presentation aims to inspire consideration of cultural factors at the heart of empathy-related experiences. Firstly, I will provide a first-hand account of a failed

inter-cultural empathy research project in India; secondly, explore empirical commentary from researchers using CARE in diverse cultural settings; thirdly, discuss recent literature on culture and empathy. I argue the need to better understand people's real-world relational experiences, which might inform a more culturally-responsive approach to empathy.

 

Day 2: Session VI

Plenary 5. Integrative Empathy: Five Empathy Skills in Cancer Care in South Africa

Lidewij Niezink and Katherine Train

Lidewij Niezink and Katherine Train. While empathy is often thought of in terms of doctor-patient encounters, these speakers will show how empathy practice for peer support and learning is just as important.

Presentations: Making Empathy Flourish in the Midst of a Global Pandemic

Empathic Unsettlement and Apathetic Rigidity amongst Healthcare Workers in India: Insights into Personal Accounts of Covid-19 Survivors

Fatma Elham

Contributing to a timely subject: Empathy in Healthcare, this presentation would explore the two concepts related to the responses of healthcare workers (especially paramedics) in India against the life-threating ongoing pandemic situations there. Dominick LaCapra, informed by Trauma Studies’ engagement with proximity, perception, and trauma’s transmission across generations, artists, witnesses, etc., has advanced a notion of empathizing where despite being responsive to the sufferers’ predicament; witnesses remain conscious of their position and distance.  Now teasing out the relevant features and deploying his concept - “empathic unsettlement” as a framework to read the select distressing narratives of Covid-19 Survivors (published in popular Indian newspapers: The Wire and The Hindu), this presentation will explicate the precipitation of muted trauma amongst healthcare workers during their association with Covid-19 patients. It will propose the concept namely: “Apathetic Rigidity,” which would focus on the vacuity of sensitivity and the absence of ethical concern amongst them that hinders the arousal of empathic response to sufferers’ awful circumstances, extreme events, and individual/collective traumas.

Absent Bodies. (Psycho)Therapeutic Empathy during Covid-19

Valeria Bizzari

Introduction: My aim is to analyze the therapeutic meeting which, during the months of lockdown, has undergone a considerable transformation, as it moved mostly to the virtual modality. The scarce literature on this subject is divided between those who  maintain  that  the  screen  establishes  a relational distance  (Disengagement  theory)  between  the  patient  and  the  therapist  and  those  who instead consider it an element that facilitates communication (Stimulation theory).

Method: Utilizing a qualitative and phenomenologically informed interview, which allowed me to collect the testimonies of therapists and patients, I will try to understand if and how the fundamental components of therapeutic empathy and the psychotherapeutic encounter itself have changed.

Results: I  will  describe  how  the  lack  of  bodily  resonance  affects  therapy  and  emphasize  the centrality  of  often-underestimated  elements  such  as  atmosphere  and  setting. The  themes  that  have been  emerged  and  seem  to  register  the  main  changes  are:  diagnostic  difficulties,  the  prevalence  of the narrative element, atmosphere, embodiment, quality of the relationship, trust and setting.

Conclusion: I will argue that what is missing is indeed an embodied trust which is necessary for an empathic therapeutic relationship.  In fact, psychotherapy is not an exchange of words; it is communication between bodies.   

Imaging an Ideal Hospital for the 21st Century – with Compassions and Empathy at its Core

Rachit Mohan

During the ongoing Covid-19 pandemic, having lost multiple family members, I learnt first and what many people have already noted - the healthcare industry needs to grow is in the area of providing “compassionate care”. As medical technologies and solutions get more advanced and expensive, patients rely increasingly on expert opinion. The entire healthcare system will be a fragile one, if patients follow the expert’s opinions just out of necessity. Instead, if the patient not only follows but also trusts the expert’s opinions, then the system will be more stable and “agreeable” for all the participants involved.

In this presentation, I will talk about an ideal healthcare delivery place such as a hospital wherein compassionate care forms its core – one that I hope to establish one day. Empathy and compassion are related concepts. According to many people, empathy is a basic necessity for compassion. This talk will focus on the role of empathy in this idealized hospital, especially in critical care. To sketch out this hospital, I will draw heavily from published research in notable journals. As a newcomer, I hope to start a dialogue about the possibility and the practicality of such an institution.

Can Clinical Empathy Survive? Distress, Burnout and Malignant Duty in the Age of Covid-19

Jodi Halpern

Medical professionals have ethical obligations to empathize with and not abandon patients, which together put them at outsized risk for burnout and sympathetic distress during the Covid-19 crisis. Doctors and nurses are again working in overburdened hospitals with inadequate supplies due in part to politics interfering with public health. Faced with their own deteriorating mental health, and increasingly alienated by public behavior based on misinformation and fear, clinicians have begun to talk about their virtue of loyalty being exploited. The virtuous nature of medical professionalism becomes a force that traps workers in clinical environments that undermine their ethical goals, exposes them to psychological injury, and precludes them from striking or protesting. Yet the Covid-19 crisis has actually only exacerbated a number of systemic and cultural issues long present in medicine, and the emerging difficulties are also opportunities for change. The crisis may catalyze a necessary restructuring of the medical system, a restructuring centered on securing and maintaining the clinical conditions required to provide genuinely empathic care.

Pandemic Grief, Social Mending, and the Japanese Art of Kintsugi Theme linked to empathy, aging, and the digital age

Kathleen Price and Amy Price

Thesis Statement : Grief is an opportunity to offer empathy by honouring brokenness to support healing

Question: What is Deep Empathy and how can we practice this?

Learners Take Home Points

  1. They will learn practical ways to interact with people who are harmed where there is hopelessness and bitterness to rebuild trust and hope. 
  2. The presenters will share what to do when there is no happy ending
  3. Learners will find the secret power of community reframe hearts, minds and events to embrace what is and to rebuild futures even in the face of a pandemic. 

We dedicate this presentation as a memorial to Amy’s husband and Kathleen’s dad, a man of faith and kindness, who was all about making a compassionate difference wherever he found himself. We knew him together through decades of life’s adventures, struggles and compassionate experiences.

This presentation will be based partially on “My pandemic grief and the Japanese art of kintsugi” published by The BMJ, published August 10, 2021.

Satellite Events

The conference also has two satellite events that require separate registration. See details below:

Satellite Event 1: Empathic Intervision for Peer Support & Peer Learning

When: Tuesday 16 November, 15:00 - 18:00 (GMT)

Title

Facilitator(s)

Empathic Intervision for Peer Support & Peer Learning

Dr. Lidewij Niezink & Dr. Katherine Train

Co-Founders, Empathic Intervision

Description:

Empathic Intervision puts empathy into practice. While there is extensive emphasis on empathy with patients and clients, inter-collegial empathy practices, to support and learn from each other, is less common. In this workshop, we will introduce Integrative Empathy as a way to remedy that problem. Integrative Empathy helps explore complicated, complex or stressful situations: with patients, with colleagues in professional learning and support groups, or as members of a multidisciplinary team. Integrative Empathy makes use of five distinct, but interconnected elements of empathy. These elements are things to do, each with a practice and consequences for our attitudes and behaviours. Want to know more? Come and join us!

To secure your place:

You can secure a place by contacting us at info@empathicintervision.com

Registration Fee – GBP 75

We will run the workshop with a maximum of 12 participants.

Website:

www.empathicintervision.com

 

Satellite Event 2: Empathy Circle to Discuss the Oxford Empathy Programme Colloquium Experience

When: Thursday 11th November, 17:00-20:00 (GMT), Friday 12th November, 17:00-20:00 (GMT), Saturday 13th November, 18:00-20:00 (GMT)

Title

Facilitator(s)

Empathy Circle to Discuss the Oxford Empathy Programme Colloquium Experience

Edwin Rutsch

Director of the Center for Building a Culture of Empathy.

Description:

THURSDAY 11/11 and FRIDAY 12/11

Edwin Rutsch and team will facilitate Empathy Circles Thursday and Friday right after the Colloquium to discuss your insights and learnings from the Colloquium, and how might we train empathy in healthcare? or whatever is alive for you.

This is an opportunity to use empathy to meet, connect and dialogue with fellow participants. An Empathy Circle is a structured dialogue process that effectively supports meaningful and constructive dialogue. An Empathy Circle increases mutual understanding and connection by ensuring that each person feels fully heard to their satisfaction. The practice is the most effective gateway practice for learning, practicing and deepening listening and empathy skills, as well as nurturing an empathic way of being.

SATURDAY, 13/11
Edwin Rutsch and team will facilitate an Empathy Circle for participants of the Oxford Empathy Programme Colloquium to discuss their experiences, insights and learnings from the Colloquium.  There will also be a short introduction to the 5 week Empathy Circle Facilitation Training.

Empathy Circles: http://www.EmpathyCircle.com


Prepare by Seeing: How to Empathy Circle: http://bit.ly/EC-How

To secure your place:

No registration needed, just drop-in to Zoom Room:   https://zoom.us/j/9896109339

Unlimited group size.

Website:

http://cultureofempathy.com