2024 Capstone Projects
Kevin Armknecht - Decline in Compassionate Care in Hospice and Palliative Care
Recently, hospice and palliative care have been fading away from allowing employees to practice compassionate care, a trend that has negatively affected patients. This is due to ownership transitioning away from not-for-profit organizations and into the hands of for-profit companies. For-profit companies are less focused on providing compassionate care and more focused on expanding profitability. Through research on the topic via case studies and articles, it is evident that for-profit companies are the root of the issue and require increased oversight and stipulations. This is necessary due to their exploitation of a vulnerable population, whom for-profit companies have total control over. In addition, it is evident that compassionate care does make a difference in the quality of death, perceived by the family, and that for-profit centers are driving the recent downturn in compassionate care in hospice and palliative care.
Amanda Arnold - Compassionate and Effective Communication with Patients with Intellectual and Developmental Disabilities
National studies point to significant disparities in healthcare received by people with intellectual and developmental disabilities (IDDs). Communication difficulties between physicians and people withIDDs can profoundly affect the experience of care by both parties in the caring relationship. These challenges, along with negative physician perspectives on the population, contribute to patients not receiving the care that they need. This study was conducted to determine ways in which compassionate physicians may provide better care to their patients with IDDs. A literature review of sample surveys and prior systematic literature reviews was conducted for this paper. For further insight, an interview was held with a doctor who works at a residential facility for people with severe IDDs. Studies have shown that many physicians lack confidence in caring for this population and/or are demotivated to do so due to communication issues or the effort involved in such encounters. By altering their internal dispositions and actions, compassionately-driven physicians can strengthen caring relationships and improve the quality of care experienced by patients with IDDs. Literature shows that recognition of a patient’s dignity increases the motivation of a doctor to relieve their suffering. Physicians can utilize a variety of nonverbal cues to indicate their desire to communicate with the patient. Caring interactions can be enhanced by the use of alternate and augmented communication methods (AACs), which allow both the doctor and patient to express their goals for the appointment. The literature contained a number of models that physicians may find useful to implement in seeking to improve healthcare. Compassionate communication with patients with IDDs is achievable through a variety of methods and can help strengthen a doctor-patient relationship. In order for this improvement to occur, the research suggests that increased interactions of medical students with patients with IDDs need to be emphasized in medical education.
Sophia Baker - Infertility Experienced by Female Physicians and the Underlying Sexism in Maternal Health within Medical Education
Sexism is an ongoing prevalent issue worldwide that transcends education, race, and socioeconomic status. The field of medicine is not excluded from this. In fact, medical schools and residencies were primarily men until just recently in 2017, when the number of women surpassed the number of men in medical school. However, despite this increase, the policies and standards regarding women’s health and maternal support have not reflected the shift. In fact, nearly nothing has changed regarding maternal health care policies for students and residents. Within this capstone, I aim to analyze the intersection of infertility experienced by female physicians and the underlying sexism within the United States medical education. Infertility among female physicians remains a largely unexplored topic within the medical community, and must be addressed. Through individual, institutional, and national lenses, I will highlight the struggles faced by female physicians and students, investigate the barriers they face in order to advocate and amplify the impact that is felt by all as a consequence of these issues. In recent years, the landscape of medicine has witnessed a remarkable surge in the representation of women, with increasing numbers joining the ranks of medical schools and professional practice. Despite this recent trend, female physicians encounter a unique set of challenges. One such challenge that has burdened females in medicine is the prevalence of infertility experienced among female physicians, a topic that transcends beyond medicine into a broader discourse on women's reproductive health and rights. The medical profession, often perceived as a host for scientific advancement and compassionate care, ironically harbors deeply ingrained biases and discriminatory practices, particularly concerning maternal health. Within the realms of medical education, female physicians confront subtle yet pervasive manifestations of sexism that arise in various forms, from unequal access to reproductive healthcare services to implicit biases influencing clinical decision-making. These disparities not only impede the professional advancement and well-being of female physicians but also perpetuate inequities in patient care and outcomes. By unmasking these challenges, I hope to catalyze change within the medical community, deriving from both policy implementation and advocating for compassion within the field in order to protect female physicians promoting an inclusive healthcare system for both patients and professionals alike.
Ella Batz - Maximizing the Physician-Physician Assistant Relationship from a Perspective of Well-Being, Job Satisfaction, and Compassionate Patient Care
The relationship between a physician assistant and their supervising physician is a key component of healthcare, as it underlies various factors of provider well-being, job satisfaction, and compassionate patient care. This research paper investigates the dynamics and impacts of this relationship, exploring how positive and negative components of this relationship alter career satisfaction, burnout, and stress among physician assistant providers. It highlights professional identity, clinical efficiency, mentorship, liability concerns, and trust as key factors in shaping the physician-PA relationship. By analyzing and supplementing the relevant literature, this research paper aims to highlight the importance of interactive communication and trust, providing insight and recommendations on how to most successfully optimize the physician-PA relationship to provide quality and safe patient care. Recommendations for supervising physicians include building trust and facilitating collaboration in this professional relationship to effectively support the development of a PA’s professional identity and career. PAs themselves are encouraged to advocate for themselves, openly communicating with their supervising physicians about their abilities. Ultimately, maximizing the physician-PA relationship most importantly involves prioritizing open, interactive communication and trust, which in turn will have a positive impact on well-being, career satisfaction, and compassionate patient care.
Ryan Benevento - Analyzing Female Infertility Through a Compassion Science Lens: Implications for the Patient, Physician, and Course of Treatment
This research paper examines the experiences of women struggling with infertility through a compassion science lens. The biopsychosocial effects of infertility on the patient, including emotional, interpersonal, social, and cultural factors, are defined and analyzed. The social stigma associated with childlessness is also addressed and it becomes clear that this societal attitude underscores the creation of negative self-schemas in patients. The physician-patient relationship is considered in light of these elements and the challenges they pose to treatment. Based on these findings, the question of why compassion science must be integrated into female infertility treatment and what this might entail is explored in tandem with consideration of the biopsychosocial model. It becomes evident that the integration of compassionate care in medicine is essential to maximizing patient outcomes in female infertility treatment. An exemplary model of this phenomenon is explored in the analysis of Self-Compassion-Based Programs for Infertility and the direct improvements seen in enrolled patients. Despite these findings, the treatment methods presented in this research paper are underutilized in practice. Advocacy for the expansion of compassion science within women's healthcare is essential to address these insufficiencies in care and improve the experiences of those struggling with infertility.
Margaret Berquist - New Drugs, New Methods? The Role of Compassion Science in Addiction Treatment
This literature survey and analysis argues for the necessity of compassionate care inaddiction treatment in America, particularly in light of the emergence of new, deadly drugs such as fentanyl and xylazine. Despite successful compassion-based approaches for the treatment of addiction to traditional substances like alcohol and opiates, the infiltration of these new compounds poses significant challenges, straining already limited healthcare resources. The essay explores the biological mechanisms of drug dependency, community harm reduction strategies, and potential scientific advancements for novel treatments. Focusing on the case of Philadelphia, where xylazine has become an increasingly prevalent adulterant in drug-related fatalities, this essay examines how these drugs have altered the landscape of the street-drug market, leading to cheaper and potentially more lethal products. Efforts to combat addiction in Philadelphia and other major urban centers involve collaboration with affected communities, highlighting the importance of listening to the perspectives of current and former drug users. These findings underscore the need for compassionate, evidence-based interventions to address the evolving challenges of addiction in America, and the necessity for clinicians to engage with harm-reduction strategies.
Ava Bidner - Compassion in Mental Health Care: Navigating the Effects of COVID-19 on the Mental Health of Children and Adolescents
While the COVID-19 pandemic impacted the mental health of people of all ages and demographics globally, particularly devastating psychological effects are clear among children and adolescents. The youth mental health crisis, which was experiencing a steady incline before the pandemic, reached concerning heights during quarantine and continues to exist now, in the years following. Disruptions to education, social isolation, lack of development of communication skills, negative home life, and excessive technology use have all contributed to the rise in mental health problems among youth in the U.S., with anxiety, depression, obsessive-compulsive disorder, and eating disorders all increasing in prevalence and severity (among many other disorders). Although, in hindsight, the best treatments would have likely included shortening quarantine, preventing school closures, and developing policies that prioritize both physical and mental health, the recommended solutions now include: reducing the stigma around mental health, increasing mental health monitoring, improving funding for mental health resources, filling the gap in acess to providers, and implementing alternative treatment options in addition to mainstream mental health care. Compassionate mental health care should be prioritized in all settings, particularly the emergency department, and all providers should receive basic training on mental health and the science of compassion. As the U.S. continues to navigate the lasting effects of the pandemic, likely for years and even decades to come, the mental and psychological well-being of children and adolescents must be studied, understood, prioritized as these experiences during major development may echo throughout the rest of their lives.
Kylie Boyer - Facing Medical School with a Learning Disability
Learning disabilities among young children are highly recognized by the general population and educational leaders. However, students entering medical school with a learning disability are too frequently overlooked, misjudged, or mistreated. Because such a vast population of young students have learning disabilities, there is a large group of people with a learning disability who have the potential to be wonderful doctors. Thus, this is an important topic that deserves attention to ensure success of the next generation of physicians. There is little research on the overall prevalence and experiences as well as what can be done for these students to have better opportunities and outcomes. The little research that has been done will be discussed in this paper, but there is certainly much more that can and should be studied. This paper will describe what a learning disability is and the incidence of learning disabilities, both generally and in medical school specifically. Then, it will highlight the experiences of those with learning disabilities in medical school and what kind of effects they may have, both on education and on mental health. Finally, although very little research is done on the experiences of physicians with learning disabilities, what has been studied will be discussed here. The overall goal of this paper is to bring attention to current and future medical students with learning disabilities so that they can have a positive educational experience in which they are treated with compassion so they may go on to be compassionate clinicians.
Ethan Boyle - Effects of Transcutaneous Vagal Nerve Stimulation on Adolescent Emotion Dysregulation and Suicide Ideation
Adolescents with emotion dysregulation, suicide ideation, and non-suicidal self-injury (NSSI) tendencies indicate significant dysfunction in adulthood and require effective and accessible treatments. Transcutaneous vagal nerve stimulation (tVNS) is an alternative treatment that non-invasively stimulates the vagus nerve and may reduce negative physiological symptoms. Adolescents aged 13-17 were randomly split into tVNS and control groups. They participated in neurological and behavioral measurements recorded over 60 days at a pretreatment, posttreatment, and 30-day follow-up visit. A repeated measures ANOVA showed a significant interaction effect between groups and time. This indicates tVNS was effective in reducing emotion dysregulation and provided greater access to emotion regulation strategies. A main effect of time for anxiety, depressive, and hyperactivity subscores indicates that participation in the visits helped to relieve anxiety and depression over time. No statistical significance was observed for suicide ideation and non-suicidal self-injury (NSSI) tendencies. Adolescents self-reported a low perceived effectiveness and treatment adherence of tVNS as well as demonstrated higher stress before a visit compared to after. Adolescents treated with tVNS showed greater use of emotion regulation strategies which can lead to long-term improvements in suicide ideation, NSSI, and emotion regulation in adulthood.
Leah Brucal (class 2025) - Seeing Clearly: A Discussion on Clinical Practices of Compassion Science and Accompaniment in Medicine
In an era of medicine plagued by the deficits of current healthcare systems and practices that negatively impact clinicians and patients, there is an urgent need for approaches healthcare providers can use to serve their patients given such circumstances. The science of compassion and accompaniment are two models often used in separate realms or fields of expertise. For example, the science of compassion is a relatively new field of study that emphasizes the biology, psychology, and neuroscience of compassion and its effects on clinical practice.
Accompaniment is often a term used to describe the method by which individuals approach serving the poor and vulnerable, mostly associated with the fields of philosophy and theology. There is a current lack of studies that explore the interaction between the science of compassion and accompaniment. Thus, this paper thoroughly explores each model’s development, usage, and importance in clinical care. It draws upon literature from leading experts in the science of compassion, caring science, compassionomics, liberation theology, and social justice in medicine. However, we must acknowledge the limitations of the science of compassion and accompaniment when practiced individually. Given the limitations and benefits of each approach, there is a compelling need for healthcare providers to employ both models in clinical practice. Further implementation or discussion of either model at each stage of medical training should take place so that each lens informs the other. A new age and improved practice of clinical care is on the horizon when these two lenses are used together.
Jillian Brunner - Optimizing Postpartum Patient Care: Comprehensive Physician Interventions from Pregnancy to Parenthood
The postpartum period is a critical phase in a woman's journey through motherhood, yet it is often characterized by gaps and challenges in care delivery, contributing to adverse maternal outcomes and diminished maternal and child well-being. This paper examines the prevailing gaps in postpartum care, explores their detrimental effects on mothers, and proposes evidence-based strategies informed by compassion science to address these pressing issues. Historically, postpartum care has shifted focus from maternal well-being to immediate infant care, neglecting the physical and emotional needs of mothers. Studies highlight disparities in attention paid to maternal concerns compared to infant welfare, exacerbated by the absence of comprehensive national reporting systems on postpartum maternal health in the United States. The consequences of inadequate care extend to maternal mental health, breastfeeding support, and overall well-being, necessitating a reevaluation of postpartum healthcare practices. Compassion science offers insights into transforming postpartum care delivery by emphasizing authenticity, empathy, and shared decision-making. Integrating these principles into healthcare systems can enhance the quality, effectiveness, and humaneness of postpartum care delivery, ultimately improving patient outcomes and fostering trust and communication between healthcare providers and mothers. A paradigm shift to compassion is required to prioritize maternal well-being throughout the perinatal period. Advocating for comprehensive, compassionate postpartum care and implementing evidence-based interventions are essential steps towards improving maternal outcomes and promoting the well-being of mothers and their families. Through compassion, healthcare providers, policymakers, and stakeholders can create a healthcare system that values and supports mothers during this vulnerable and transformative time in their lives. To thoroughly examine these critical issues, a comprehensive literature search was performed, evaluating current research and prevailing practices in postpartum care.
Isabella Cattaneo - Disparities Between African American and White Breast Cancer Patients: The Impact of Patient-Physician Relationships
In the United States, there is a stark five-year survival disparity between African American and White breast cancer patients. This disparity may be created by a multitude of factors like slight biological differences by race, history of medical mistrust of African Americans, differences in access to care, and others. However, these factors cannot be actively changed by physicians; one potential causative factor that physicians can work towards altering is the patient-physician relationship. This project examined the factors of the patient-physician relationship that differ by patient race, with some of the most important being patient-centered communication and trust in the treating physician. These factors can have a significant effect on a patient’s adherence to recommended treatment, specifically adjuvant endocrine therapy (hormone therapy after surgery). Women who adhere to the recommended treatment for the entirety of the regimen have significantly increased long-term survival rates. African American breast cancer patients report starkly different patient-physician relationship experiences than White patients, and this project studied how the factors that comprise this relationship influence adherence to treatment and ultimate long-term survival.
Madeline Chiang - Mitigating Physician Burnout in Emergency Medicine Through Societal, Organizational, and Individual Interventions
Emergency Medicine (EM) is a medical specialty focused on addressing acute injuries and illnesses in the high-pressure setting of the Emergency Department (ED) of hospitals. With millions of visits annually in the United States of America alone, EM physicians face unique challenges, including high patient volumes and diverse medical emergencies. However, this demanding environment places them at significant risk of burnout which can negatively affect physicians and their institutions. This research paper explores burnout among EM physicians, investigating its definition, historical context, causes, and consequences as well as mitigating burnout through effective interventions. A PubMed literature review of relevant articles on the topic has been conducted to investigate how to mitigate physician burnout in the ED through societal, organizational, and individual solutions. The causes of burnout include electronic health records, work schedules, societal pressures and expectations, and loss of autonomy, which can lead to an impact on patient care, the healthcare system, and EM physicians. To mitigate burnout, societal, organizational, and individual solutions should be considered. Implementing these proactive strategies are essential steps toward mitigating burnout in EM physicians to ensure quality patient care and sustain a resilient healthcare workforce for the future.
Isalina Colsman - The Vitality of Compassionate Care in Treating Mental Distress and Disorders in Refugees Living in Germany
Since 2015, Germany has been hosting some of the highest numbers of refugees of any country in the world, and this population is at increased risk of mental health problems and psychological distress than the general population. The many risk factors associated with poor mental health among refugees and asylum seekers demand an assessment of past and current approaches to improving their mental health and an evaluation of the strengths and weaknesses of these approaches. This paper is a comphrehensive literature review aimed to compile the most relevant risk factors into coherent categories of preflight, flight, and resettlement using a literature-based review and to accordingly identify ways in which Germany has addressed or can further improve mitigating those factors. An interview with the Minister of Labor and Social Affairs in the German state of Bavaria at the time of the refugee crisis in 2015 and 2016, Frau Emilia Müller, provided insight into how the German government processed refugees during the crisis and established programs that prioritized maintaining the dignity of refugees. Many of the ways in which Germany prioritized dignity focused on ease of assimilation to a new country, which inherently supported refugees’ mental well-being. This thorough analysis revealed the importance of incorporating compassion into the care provided by health care professionals to refugees and asylum seekers. With this population’s trauma and uniquely vulnerable position in society, a person-centered approach to mental health care with a well-educated, well-supported interdisciplinary team must be implemented to address the issue of poor mental health among refugees and asylum seekers in Germany and across the world.
Lily Darman - Examining Compassion in Pediatric Surgical Oncology
Pediatric surgical oncology is a complex medical subspecialty that intertwines three complex but rewarding fields in healthcare. Each of these fields presents with its own unique challenges and rewards, making this interdisciplinary field one that requires compassion, resilience, and a love for one’s career. This paper explores how pediatrics, surgery and oncology intersect to form a medical discipline that is centered around close relationships between health care providers, patients, and families. To begin with, this paper will cover the fundamentals of these three specialties separately, noting the aspects of each that shape careers in pediatric surgical oncology. This will then transition to why compassion is essential in this subspecialty, and how this can make a monumental difference in patient care. Next, this paper will address several barriers that are prevalent in this area of medicine when attempting to deliver compassionate care. Finally, this will culminate in a discussion of how healthcare organizations can overcome these barriers to facilitate and embed compassion in entire healthcare systems and ultimately improve the care of patients and families during what may be the most challenging times of their lives.
Savannah Dean - Animal-Assisted Therapies in Healthcare and in the Community
Animal-assisted interventions represent an exciting approach to healthcare and wellness in the evolving field of compassionate care in medicine. This literary review looks at a comprehensive examination of animal-assisted interventions, spanning historical origins, current applications, ethical considerations, legal frameworks, and future directions. The paper will draw on historical precedents and contemporary practices in the diverse variety of animal-assisted interventions, including service animals, therapy dogs, equine-assisted therapy, and animal-assisted education. Each type of animal-assisted intervention is explored in the context of its unique contributions treating patients with compassionate medical practices. Additionally, the review emphaisizes the need for further research to deepen our understanding of the mechanisms and efficacy of animal-assisted interventions to determine the best practices for physicians and patients.
Hailey Dieck - The Opioid Epidemic: Caring For Patients Battling Drug Abuse With A Focus On Anesthesiologists
The opioid epidemic is one of the most severe public health crises in America. This has been a battle in the streets of America, with both adult and adolescent patients for decades. The specifics of these drugs have increased as people gain new ways to synthesize more potent drugs and obtain availability to more medications being sold while little is done to prevent this issue at the state or governmental levels. Every subset of Americans is affected by this epidemic through personal drug abuse or family and friends: old, young, wealthy, homeless, and even physicians. Different drugs such as narcotics, depressants, and stimulants react to the body in unique ways, giving the user different experiences and also different withdrawal symptoms. Some drugs allow for the desired eutopic high feeling while others increase energy and attention (Mayo Clinic, 2024). In this paper, I shall relay the prevalence and impact of drug abuse and discuss the best route of care from a physician’s perspective. Drugs heavily influence the brain after chronic use which disrupts systems such as behavior and pain management. Anesthesiologists must therefore have an extensive grasp of different drugs and their effects on the body to give their patients the best care possible.
Marah Dokmak (class of 2025) - Guided Hearts: Exploring the Islamic Integration in Medicine
This capstone project is aimed to delve into the Islamic perspective on medicine. It will serve as an exploration on how Islam can be a foundation for Muslim doctors, influencing their approach to healthcare. It will further investigate the influence of Islam on medical practice on both the patient and the physician, emphasizing the principles and values of Islam and how they can be integrated in the medical practice. The capstone will underline the integration of Islamic input in medicine as a bridge for common goals, where religious principles align with the universal pursuit of well being. It aims to demonstrate the inclusive nature of Muslim doctors in their medical practice, emphasizing the commitment to treating all individuals, regardless of their background, with equal respect and care. By exploring the verses of the Quran and the life of the Prophet Mohammad (PBUH), the role of compassion and mercy are more understood. This research examines the positive influence of Islam and its enhancement to the role of Muslim doctors in the field. It seeks to showcase how these principles contribute to a healthcare environment where diversity is embraced, fostering a practice with the roles of faith and science towards well-being for all.
Grace Driewer - The Coexistence of Cutting and Compassion: An Analysis of the Stereotypical Surgeon Through a Compassionate Care Lens
The medical field, and surgeons in particular, are no exception to stereotyping. Today’s society often thinks of surgeons as cold, unemotional, and abrasive technicians who only care about the cutting, not the patient. It promotes the idea that there is no room for compassion in surgery. This paper analyzes surgical stereotypes through a compassionate care lens. It will evaluate the origins of the stereotype, investigate how these ideas have continued to permeate society throughout time, and examine the impact that these stereotypes have had on the surgical field . A scientific evaluation of the issue reveals the necessity for compassion in surgery; the evidence calls for a surgical rebranding to reflect more accurately what is needed of an effective and successful surgeon. Finally, the paper addresses how compassionate care can be implemented in order to facilitate better surgical outcomes and more fruitful surgeon-patient relationships.
Emma Eckstein - Compassion Based Health Initiatives Within the Intellectually Disabled Community
Physical health issues such as obesity, diabetes, cardiovascular disease, anxiety and depression, and high blood pressure are all increasingly prevalent in the community of adults with intellectual disabilities. A lack of adequate health promotion and targeted interventions contribute significantly to these problems. Perceived barriers to engaging in healthy behaviors include things such as a lack of transportation, financial constraints, lack of social support, and a lack of autonomy in group living facilities (Bodde and Seo, 2009). Utilizing a multifaceted approach which includes in-home interventions, educational support, and governmental assistance will best allow public health and disability experts to implement effective and compassionate initiatives. Additionally, supporting caregivers financially, emotionally, and mentally in ways that can reduce levels of caregiver burnout will allow them to treat themselves and their residents with compassion. Analysis of compassion-centric approaches will inform best practices for public health and disability professionals working in complex societal, organizational, and systemic environments. Disparities between the intellectually disabled community and the general population are drastic, but they are not irreconcilable as long as an evidence-based, compassionate approach is used.
Victoria Elliott - The HEART of cardiac transplantation procedures
With approximately 3,700 heart transplants performed each year in the United States alone, heart transplantation remains the gold standard treatment for patients facing end-stage heart failure, offering them a chance for a renewed life. However, this transformative journey also presents a series of challenges that not only affect the physical health of patients, but also their emotional well-being, sense of personal identity, and social interactions. In this capstone project, I will explore the expected patient experience of heart transplant as outlined by medical literature, providing a history on how the transplantation process itself works, and compare this to the lived experiences of heart transplant recipients through analysis of interview accounts, highlighting the realities and complexities they face before, during, and after transplantation. I will also examine the various predictors of health outcomes following heart transplantation and propose strategies for implementing a more compassionate approach to the transplant process. With the current state of cardiology placing a heavier emphasis on procedural expertise and efficiency rather than the emotional and psychological needs of the patient, this paper seeks to examine how a patient-centered approach during heart transplantation procedures that addresses psychological distress, medication compliance, and social support networks can lead to improved treatment compliance, improved patient well-being and feelings of support, and overall better patient outcomes following transplantation.
Shaker Erbini - Increasing Cultural Competence in Healthcare for Muslim Patients: A Compassionate Caring Perspective
Muslims living in the U.S. do not always experience accommodation for their religious beliefs in the clinical setting. A literature review was conducted to identify the challenges that Muslim patients encounter when they engage with the healthcare system in the U.S. It was found that Islam’s teachings offer a lot of practical alternatives to manage these challenges, even going as far as to remove any religious obligations in cases of absolute necessity or harm to the patient’s health. Accommodations on the part of the healthcare system would further mitigate these challenges. Consequently, specific recommendations to accommodate Muslim patients are offered for both the healthcare provider at the micro level and the healthcare system at the macro level. The challenges and recommendations are discussed through the lens of the compassionate caring paradigm. Clinicians cannot be compassionately caring without being culturally competent, so the goal of the present paper is to provide practical guidance to increase cultural competence in healthcare for Muslim patients in the U.S.
Caroline Flyke - Clinician Compassion and its Influence on Patients’ Diabetes Outcomes
In this review, I assess 25 peer-reviewed scientific articles concerning the impact of clinician compassion on patients’ diabetes management over time. Diabetes is a condition affecting over one in ten individuals in the United States, classified by consistently increased blood glucose levels. A quantified measure of glucose levels over a three-month period is known as an individuals’ A1c. The greater the A1c, the more an individual had increased glucose in the blood during that time period and is at higher risk for complications related to diabetes like neuropathy, blindness, loss of circulation in the feet, and several other biological problems. My primary goal in conducting this research was to determine the potential positive impact of clinician compassion and communication on patients’ management. Through my research, I have determined that the more compassionate the clinician, the more likely it is that the patient will have better diabetes management and a lower A1c. Additionally, the better a communicator and empath that a clinician is, the better their patient outcomes. Greater clinician compassion, empathy, and communication were found to be consistently correlated with better patient social, emotional, behavioral, and biological outcomes. Further, patients who saw their clinicians working in collaborative, welcoming, and inclusive environments were found to have overall better diabetes management, more consistency of care, and overall improved health. In light of this research, I recommend that clinicians involved in diabetes management receive greater training in the field of compassion science, with an emphasis on communication skills and empathy.
Maria Frech - The Professional Relationship Between Doctors and Nurses: How Consistent Communication Provides Coordinated Care
This analysis of the nurse-physician relationship emphasizes the importance of open communication among healthcare professionals to provide coordinated care to the patient. In examining the individual roles of nurses and physicians and how they work together through interviews with four nurses and four doctors as well as a review of scholarly articles, collegial relationships were found to be the most productive because they emphasize working as a team rather than in a hierarchical structure, which can make nurses feel unappreciated, unheard, and disrespected. These feelings can inhibit effective communication and lead to burnout, which can come at a cost to the patient. Interprofessional education, team-building exercises, and respectful, empathetic communication can enhance communication because they promote mutual understanding. Both nurses and physicians have a responsibility to create an environment where effective communication can occur because taking care of the patient is the common goal of all parties
Liliana Froehner - Language Barriers as an Obstacle to Compassionate Healthcare
Communication between healthcare workers and their patients serves as the foundation of their relationship and guides them towards a mutual understanding. But what happens when English is not ones’ primary spoken language? A comprehensive literature review and analysis was performed in order to investigate the impacts that language barriers have on both patients and physicians and the nuances of choosing an interpretive service. In the United States, patients who face language barriers are less likely to be insured, and are dissuaded from seeking care due to anxiety surrounding this obstacle. Due to this block in communication, patients with limited English proficiency face physical and mental burdens, decreased understanding of diagnosis and treatment, higher monetary costs, and greater risk of complications when interacting with the healthcare system. Even for clinicians in the compassionate mindset, language barriers impose an additional stressor which may interfere with the delivery of care. Physicians must focus on non-verbal communication and emphasizing their commitment to aiding their patients. To advance patient care, interpretive services must be made more accessible. In addition, physicians and healthcare providers should take extra time with patients to ensure that all communication is understood.
Megan Gallian - Chronically Misunderstood: The Need for Compassionate, Comprehensive Care for Long-COVID Patients Experiencing Chronic Illness and Medically Unexplained Symptoms
For patients with Long-COVID experiencing chronic illness and medically unexplained symptoms, there are endless amounts of barriers against them in the healthcare system, whether it be diagnostically, relationally, or medically. With the frequent dismissal of patient symptoms as a solely psychiatric condition and diagnostic ambiguities of Long-COVID, it has become increasingly complicated for long-haulers to receive appropriate and adequate care. Studies have shown a significant decline in quality of life scores in long-haulers across all domains, with one study indicating increased anxiety, depression, discomfort, pain, and limited daily activities (Shah et al., 2021). Patients with Long-COVID experience a vast array of symptoms, including cardiovascular, digestive, respiratory, and nervous systems (Zeng et al., 2022). With the diversity in symptoms and the lack of a cure, physicians have been found to distance themselves from their chronically ill patients because of fearing in developing empathy fatigue or perceiving themselves as a failure in not solving the reason behind the patient’s condition (Stone, 2014). With this, engaging deeply with the medical knowledge (i.e. the proposed neurobiological mechanisms) of Long-COVID can serve as a reset and recovery technique for clinicians to maintain a compassionate mental state in accordance with the Clinician Compassion Mental State Process (Vachon, 2018).
John Gunaldo - Analyzing the Benefits Compassionate Care Programs in Graduate Medical Education
Over the last decades, medicine has slowly been losing its emphasis on compassion. Due to changes in culture in healthcare systems, physicians and other providers have been moved away from an emphasis of compassion and empathy in their practice. In turn, patients have been experiencing less satisfaction in the care that they receive, and clinicians are experiencing more burnout and less fulfillment in their careers. In order to combat these problems, increased compassion in healthcare settings have been shown to improve the overall patient experience while giving clinicians a buffer against burnout. This essay provides an exploration into the implementation of compassion training into medical school curriculum. With medical school being the first official mark of postgraduate medical training, students ought to be exposed to compassionate environments and training courses in order to change the course of healthcare in the future. Implementing didactic lectures and experiential learning sessions such as Schwartz rounds, medical students today can form the new wave of clinicians who center their career on compassion in healthcare settings. In sum, adding compassion training into the medical curriculum enhances the experience of the student, provides more compassionate care to patients, and better reinforces the mission of medical schools across the country.
Grace Haak - Storytelling for Healing: Narrative Medicine as a Tool for Elevating Patient-Physician Connections
Narrative medicine is the culminating connection of healthcare, clinical practice, humanities, literature, and the arts. Its purpose is to express the lived experiences of patients and caregivers in a manner beyond the clinical setting. Rita Charon is credited as the pioneer of this field, articulating that the discipline of narrative medicine is not only an academic discipline; perhaps more importantly, it is designed to holistically approach healthcare, giving voice to the most vulnerable and suffering through storytelling. The mediums utilized in this field extend anywhere from written works to dramas, and yet the underlying notion that remains for all narrative medicine pieces is an engagement in empathy. This paper explores the many facets of narrative medicine and its impact on healthcare practices, focusing on its revolutionary role in enhancing patient-physician relationships, mitigating caregiver burnout, and improving communication in a medical environment. Like all aspects of compassionate care, narrative medicine is rooted in the biopsychosocial model, and its integration into medical education has proven to be indispensable. When incorporated into curriculum, students and physicians are exposed to a fresh perspective on what it means to enter into the human experience of medicine, bridging the equally requisite concepts of empathy and expertise. A comprehensive literature search was performed to evaluate these concepts, and the goal of this paper is to combine those findings with personal accounts in order to portray narrative medicine as a powerful tool to reveal the journeys of both patients and physicians alike.
Cameron Hagy - Using Compassionate Care to Alleviate Dental Anxiety
No one particularly enjoys going to the dentist. A huge percentage of Americans experience fear and anxiety just thinking about being in the office with high-pitched drills and intimidating instruments. Throughout this paper, four main topics are covered: why people are afraid of the dentist, the role of communication between dentists and their patients, how music can be used as a therapeutic to alleviate dental anxiety, and the financial burden faced by people going to the dentist. Many studies, journals, and interviews with dentists will be cited to explore how compassionate care in dentistry can be used to alleviate the fear and anxiety faced by patients who need oral care. Understanding where dentophobia and dental anxiety come from is crucial to combat them in a clinical setting. The theme of compassionate, caring communication is key to the dentist-patient relationship and the most important way in which compassion science can be implemented by modern-day dentists to help reduce the psychological toll that visiting the dentist can have on a patient. A large part of combating dentophobia is by giving children a positive experience at the office that affects their view of the office for the rest of their lives. Dr. Laura, a pediatric dentist, shared many of her tips and techniques on the best ways to ensure children leave her practice on a good note and are not afraid to come back. The financial burden that plagues dentistry today is also explored, and solutions are proposed to help those in underserved, low-socioeconomic communities gain better access to dental care because cost and availability also play a large role in the anxiety faced by many when thinking about going to the dentist. This paper constitutes a comprehensive literature search into these issues that currently plague modern dentistry.
Zachary Hahn - Pediatric Biomedical Ethics: Creating a Mindset to Best Serve Patients
Treating minors can create difficult situations for physicians. A child’s level of maturity may not be evident and there is the addition of a caregiver into the doctor-patient relationship. Examining pediatric medical ethics can provide guidance to physicians on navigating difficult situations. This paper looks at several common situations that physicians face when treating children and ways that these situations can be addressed in an ethics-based manner. By looking at common scenarios, the goal is that physicians can understand the recurring ethical principles that are looking to be upheld. Understanding these ethical principles can help a physician create an ethics-based mindset that upholds the dignity of patients. The intersection of compassion and ethics will also be looked at to provide guidance on creating a mindset that will provide the best possible care to patients.
Alyssa Harduby - Exploring the Role of Cultural Competency Practices in Promoting Compassionate Care in Medicine
As patient populations in the United States become increasingly diverse, healthcare providers have a responsibility to demonstrate cultural competence during their patient encounters. Cross-cultural interactions between the provider and patient are critical exchanges with the potential for serious misunderstandings. In order to avoid such complications, and to demonstrate compassionate care toward their patients, clinicians should take steps to increase their cultural knowledge and awareness. There are barriers to demonstrating cultural competence including stereotyping and implicit biases on the part of clinicians, a lack of standardized cultural competency training and assessment across healthcare institutions, and learner resistance from medical students. However, there are strategies on the provider level and on the system level that can combat these obstacles. Clinicians can foster cultural humility and self-awareness through informal experiences with others from different cultural backgrounds as well as through formal cultural competence education. When participating in formal training, it is important for clinicians to be cautious of categorical training styles that may inadvertently perpetuate cultural stereotypes. Other frameworks place the focus on direct exposure to diverse patient populations, which may mitigate the risk of stereotyping. Healthcare organizations also have responsibility to foster cultural competence by creating culturally diverse healthcare teams, hiring on-call interpreters, and providing culturally tailored signage and educational materials to their patients. Through joint efforts from clinicians and healthcare organizations, cultural competence has the power to address health disparities that affect the most vulnerable patient groups.
Joseph Heitzmann - Confronting the Healthcare Accessibility Crisis through the Compassion of Street Medicine
The American healthcare system is one that implements private healthcare, which ultimately leaves an estimated 78 million Americans with compromised or no access to quality healthcare. These individuals are said to be facing barriers to healthcare access. This paper explores the causes and consequences of healthcare barriers, specifically through the lens of the homeless population. The homeless population is disproportionately affected by these barriers, as many homeless individuals do not know how or do not want to utilize the healthcare system. Some current solutions rely upon pharmacological and psychosocial interventions, which have been shown to alleviate some of the stress faced by the homeless population; however, they often fail in their ability to reach the homeless population on a scale that would effectively change outcomes for homeless communities. Street medicine is a developing field of healthcare that implements both intervention methods, among others, to distribute healthcare to these otherwise unreachable populations. This paper aims to propose street medicine as an optimized solution for reaching homeless populations through the vessel of compassionate caring. This is supported by both anecdotal and experimental evidence provided by numerous studies, as well as by the tellings of a doctor who founded a street medicine program in South Bend, Indiana. This evidence indicates that street medicine succeeds due to its inherent altruistic character while improving both patient outcomes and physician perspective.
Kristina Holmen - Orthopedic Oncology and Breaking Bad News
Every physician will encounter some level of breaking bad news (BBN) conversations throughout their career. Current surveys of patients show that only about half of patients are satisfied with the way bad news has been conveyed to them (Al-Johani et al., 2022). In the world of oncology, those conversations occur much more frequently in a physician’s career because of the nature of a cancer diagnosis. It is imperative that physicians master the art of breaking bad news because impacts not only the patient, but also a physician’s longevity in their career and ability to avoid burnout. This paper utilizes research-proven BBN skills and applies them to several case studies. Each case demonstrates the effective application of some BBN techniques in very serious conversations with patients. Following both cases is an application of the SPIKES protocol to highlight the effectiveness of SPIKES as a BBN technique that can apply to many scenarios. While SPIKES is very effective, research shows there is still room for improvement and additional support that could be provided to patients which would further improve the BBN experience. Finally, a description of what to avoid when breaking bad news is included to provide further direction on what is not effective in these conversations. Ultimately, effectively navigating breaking bad news conversations is crucial to providing the best care for patients while protecting physicians from burnout. Cultivating effective BBN skills will be profoundly beneficial for everyone involved in the care experience.
Dylan Hotter - Compassion: A Treatment for Depression and the Neuroscience Behind It
Compassion, although sometimes given a weak definition without a scientific background, is an important aspect in treating depression. This paper focused on its use as a treatment in depression, its scientific background, and also discussed some possible solutions for depression using compassion. First, a clear description of depression was given, followed by some commonly used treatment types such as cognitive behavioral therapy (CBT), psychodynamic psychotherapy (PDP), the use of specific serotonin reuptake inhibitors (SSRIs), and transcranial magnetic stimulation (TMS). While these treatments have success, this paper focused on the emergence of compassion and its importance in therapies such as compassion-focused therapy (CFT) and the installation of self-compassion. Next, the neurological background and effects of compassion are discussed, citing pathways such as mirror neurons, the vagus nerve, and PAG as important aspects of a compassionate mindset. Many exciting studies were analyzed and important pathways were found as a part of this project, ultimately leading to the positive conclusion that compassionately-based treatment methods help in treating depression.
Megan Howley - Combating the Medical Malpractice Crisis in Obstetrics and Gynecology: The Science of Compassion Approach
Medical malpractice litigation is a prevalent issue for physicians of all specialties, but especially for those who practice obstetrics and gynecology. As the specialty with one of the highest rates of malpractice claims, OB/GYNs are frequently subjected to the distress and lowered self-esteem that comes with being sued. Additionally, this field is inflicted with the cycle of defensive medicine and high insurance premiums that deter OB/GYNs from the field, thereby increasing the cost and invasiveness of care but decreasing the accessibility of women’s healthcare. Therefore, many have claimed that the medical liability system is in a crisis. While this prevalence of lawsuits may insinuate that many physicians simply do not meet the standard of care, the majority of malpractice claims are dropped or dismissed, indicating that some other factors contribute to the high rate of claims. Some of the proposed factors are patients’ unrealistic expectations and the rise of blaming culture, but these components overlook the heart of the medical system: the doctor-patient relationship. As many sources convey, patients often litigate due to deficiencies in the doctor-patient relationship, such as ineffective communication. Informed by Polyvagal Theory, the biopsychosocial model of medicine, and the balanced compassionate caring model of emotional engagement, the science of compassion offers a promising way to address the malpractice crisis in obstetrics and gynecology through its focus on the doctor-patient relationship. By attending to both patients’ and physicians’ needs through patient-centered medicine, applying the compassionate caring approach to obstetrics and gynecology may enhance the doctor-patient relationship and thereby reduce litigation rates.
Olivia Hsin - Integrated Approaches to ADHD Management in Minority Children: Challenges and Strategies
Attention-Deficit/Hyperactivity Disorder (ADHD) presents significant management challenges that are compounded within minority communities by disparities in diagnosis and treatment. Thiscapstone project explores ADHD care for minority children, advocating for integrated care models that engages healthcare providers, educational institutions, and families. Highlighting therisks of generalizing experiences, this study examines the cultural and systemic barriers that contribute to the underdiagnosis and overdiagnosis of Asian and African American children,respectively. It proposes culturally sensitive practices and improved collaborative frameworks to enhance the standard of ADHD care. With a focus on the concept of “competemility”, asynthesis of cultural competency and humility, the project showcases the need for healthcare providers to adapt strategies that culturally resonant and acknowledge the dynamic influences onhealth behaviors (Stubbe, 2020).
Nikki Iamonaco - Federally Qualified Health Centers: Benefits, Challenges, and Improvements through Compassionate Care
Federally Qualified Health Centers (FQHCs) are non-profit primary care clinics that provide quality care to medically underserved populations (Eswaramoorthy, 2020). Over recent years, these health centers have continued to grow in number, size, and services provided, now serving over 27 million patients annually (Bruckner et al., 2019). This paper aims to investigate the role and benefits of FQHCs in disadvantaged communities, as well as the challenges these clinics are facing and possible solutions. To address this, a comprehensive medical literature search was performed, gathering evidence from multiple recently published studies. This revealed that FQHCs provide crucial safety-net care, resulting in saved money, disease prevention, social services support, and ultimately, improved healthcare outcomes for patients. Further, this research identified key issues these clinics are facing: staffing shortages, physician burnout, and appointment availability. Effective solutions to these barriers could be through compassionate care, community-based efforts, and organizational changes, helping to elevate the already life-changing care that millions of patients receive at FQHCs
Caroline Isemann - Is Compassion in Prison Medicine Possible? An Argument for Why it is Not Only Possible, but Necessary
The goal of this paper is to prove that compassionate care, while incredibly challenging in correctional medicine, is both possible and necessary. To establish the argument compassionate care will be defined according to the work of Dr. Dominic Vachon. Throughout the paper, numerous empirical studies will be cited showing the importance of compassionate care in medicine. The current correctional medicine model within the United States is reviewed. Then, real-life experiences within the prison are littered throughout the paper including an interview with a correctional nurse at one of the best facilities in America. The obstacles to a compassionate mindset in prison are thoroughly explored with resolutions supplied at the end of the paper. The main conclusion is the necessity for improvements in correctional medicine. The solutions supplied include an increase in transparency, formal education for correctional medicine workers on compassion science, as well as a government-funded program to get good doctors into correctional medicine.
Raemier Javelosa - Investigating a Potential Framework for Patient-Centered Care and the Intersection with Multicultural, Underserved Communities
Patient-centered care (PCC) is one of many major developments in the shift from the biomedical to the biopsychosocial model. PCC places a humanizing lens on the delivery of care by incorporating dignity and respect into clinical encounters, granting patients the control and confidence necessary to make informed decisions for their health. There is currently no standardized PCC framework that exists, but some literature continue to explore recurrent themes on what this entails based on patient data. For example, the Picker Institute/Commonwealth Fund identified eight core components of PCC, which have been cited across multiple studies seeking to enhance the quality of care. Incorporating patients into the treatment or care process has been shown to promote better health outcomes, increase patient satisfaction, and surprisingly, reduce health costs. However, several barriers exist that prevent the complete integration and delivery of PCC in the United States. These barriers include, but are not limited to, inadequate information collection, patient mistrust, an organizational culture and training regime that do not foster PCC, and the lack of financial incentives. The discussion of literature then transitions into emphasizing how the effects of reducing such barriers are especially challenging with multicultural, underserved patient populations (MUPs). Facilitating the engagement of MUPs all starts with improving cultural competency as a central facet to better address health inequities in research, training, and practice. Unfortunately, individuals who are impacted disproportionately by health disparities are not usually involved in health care research seeking to effectively unite PCC and cultural competency. Nonetheless, a constant strive to identify current and emergent barriers that make PCC inaccessible can help to create an adaptable framework that addresses socio-cultural issues within different levels of the health care system.
Julia Jensen - Compassionate Care for Chronic Stress: Understanding Neurobiological Changes and Healing Through Biopsychosocial Treatment
Chronic stress is a serious condition that has severe physical, physiological, and social consequences for people. However, there are not many sources that physicians can reference that include the pathology of chronic stress, the relevant treatment options, and how to approach those suffering from it. This paper compiles both current information on the pathology of chronic stress as well as appropriate interventions and treatment options, which vary depending on the patient. Chronic stress is caused by both direct and indirect pathways that lead to allostatic load on the brain and body, leading to elevated activity of the hypothalamic-pituitary-adrenal axis (HPA axis). This occurs because the hippocampus and prefrontal cortex, which suppress the stress response, begin to decrease in size. In contrast, many parts of the amygdala increase in size, which stimulate a stress response. The different interventions and treatment options for chronic stress include cognitive therapy, behavioral and lifestyle changes, and biomedical treatments. When healthcare providers assess patients for chronic stress, they should be compassionate, while listening to the patients’ verbal and nonverbal communication. This will allow the providers to build a therapeutic relationship with the patients, while identifying which intervention and treatment options can best fit the patients’ lifestyle, without causing unneeded, additional stress.
Amber Jun - Uncovering the Significance of Nonverbal Communication in the Light of Technological Advancements for Delivering Care with Compassion
The patient-physician relationship is a fundamental cornerstone of healthcare delivery. The quality of this relationship dictates patient satisfaction, adherence to treatment, and overall health outcomes. While medical science has made leaps and bounds in the past century, the study of the nature of the patient-physician relationship and the science of compassion has been relatively slow. This thesis delves into the interdependent web of factors surrounding technology and nonverbal communication that impact the essential patient-physician relationship and provides a comprehensive analysis at the individual, interpersonal, and systemic level through a review of published works regarding patient satisfaction and healthcare relationships. The consequences of these influencing factors on healthcare outcomes will investigate how a strong and appropriate patient-physician relationship can enhance patient satisfaction. The findings and conclusions of this investigation emphasize the importance of a patient-centered approach in modern medicine, and highlight the need for ongoing research, policy reform, and better refined medical education to support and nurture the use of technology in establishing the patient- physician relationship. The paper will explore the intersection of technology and nonverbal communication in a past, present, and future framework by examining the intimate relationship between the two in the context of traditional clinical practice, errors in revolutionary technologies in use today, and the movement towards telemedicine consultations.
Stephen Kasko - Alternative Medicine and Refusal of Treatment in Oncology
Respect for autonomy is an important aspect of providing compassionate care to patients. However, within oncology respecting autonomy can prove difficult when patients refuse treatment or express interest in pursuing alternative or complementary medicine. Additionally, the physical and emotional burdens associated with cancer care often result in poor adherence to treatment. These issues are complicated by the rising mistrust in our healthcare system, which threatens the clinician-patient relationship. This paper focuses on the current drivers of medical mistrust and how these drivers impact the relationship between oncologists and their patients, with a particular focus on the medically underserved and other marginalized communities. In addition, patient perspectives on complementary and alternative treatments, as well as treatment refusal, are discussed in order to explore how oncologists can best support these patients. Review of medical literature revealed that oncologists are typically reluctant to bring up these subjects with patients. However, normalizing these discussions within oncology can provide a framework for addressing these topics using a collaborative approach that respects patient autonomy while minimizing the harm associated with these issues. Working with patients on these topics helps strengthen the clinician-patient relationship and improve the delivery of compassionate care.
Matthew Kianpour - Salud, Stress, and Healthcare Seclusion: A Mixed Methods Study of Psychological Stress of Latina Mothers in South Bend, Indiana
This mixed-methods study delves into the psychological stress experienced by Latina mothers in South Bend, Indiana, shedding light on the intricate intersection of social determinants of health (SDOH), systemic discrimination, and healthcare disparities. Drawing on a sample of fifteen Latina women, data were collected through a combination of qualitative surveys and quantitative measures, including Cohen's 10-item Perceived Stress Scale (PSS-10) Cohen et al., 1983). Results indicate that Latina mothers in South Bend experience heightened levels of perceived stress compared to normative values, with factors such as migration status, socioeconomic status, and access to healthcare playing pivotal roles in shaping their stress experiences. The study reveals a complex interplay of structural inequalities, systemic racism, and socioeconomic barriers that exacerbate psychological distress among Latina mothers. Despite being the largest minority group in the U.S., Latinos/as face significant challenges in accessing affordable and equitable healthcare, with disparities in income, employment opportunities, and insurance coverage contributing to their healthcare seclusion. Furthermore, fears of deportation, systemic xenophobia, and cultural barriers further compound their reluctance to engage with the healthcare system. However, amidst these challenges, Federally Qualified Health Centers (FQHCs) and compassionate healthcare emerge as crucial mechanisms for bridging the gap in healthcare access, providing vital services to marginalized populations and fostering supportive patient-physician relationships. By prioritizing compassionate care and addressing the root causes of healthcare disparities, Latina mothers can be empowered to navigate their healthcare journeys with resilience and agency.
Emma Lee Pack - How Compassion Science Can Be Used in the Return to Play Process For Young Injured Athletes
Injuries are a common occurrence in sports, that can have a significant and detrimental impact on the lives of young elite athletes. At a time when a person's mental health is most vulnerable, it is imperative these athletes readily have access to the treatment they need physiologically and psychologically to regain their health during a time of need. Without the proper guidance and protocols in place, an athlete will often rush their treatment plan in an eagerness to return to play, doing more harm than good. It is up to caretakers to work with the athlete, address their desires, and educate them on the importance of gradual progression during the return to play process. By using the model of balanced compassionate care in their practice, a physician can address these concerns and provide optimal care with the right level of emotional involvement that protects both the physician and the patient. In the field of sports medicine, many discrepancies exist in the jargon used and factors considered when deciding if an athlete is capable of returning to play. In order to remedy this, a toolkit defining the basic parameters and jargon used by sports medicine professionals should be created while providing physicians with helpful tools in assessing the various types of musculoskeletal, head, cervical spine, cardiovascular, and psychological injuries an athlete can experience. By consulting this toolkit, physicians can help standardize a very complicated field while being able to operate in a more consistent manner that helps create more reliable and better tools for the future. Utilizing a compassionate and collaborative approach when treating young elite athletes will allow them to optimize their return in a safe and effective way.
Matthew Long - The United States Veteran Population in the Civilian Healthcare System As Both Patient and Provider
The United States Armed Forces and healthcare system represent two fundamental pillars of American society. At the intersection of these organizations rests a unique and substantial population of veteran patients who rely on the civilian side of the healthcare system. Despite the distinctive culture, experience, and patient history of this group, many civilian healthcare providers are uninformed of, or unequipped to recognize, the defining characteristics of this population. These elements of the veteran patient population are critical for providing comprehensive and compassionate healthcare. Identifying a patient's military status informs the healthcare team of several key factors that should influence their care. The factors include, but are not limited to, how veterans may interact in the healthcare setting, what diseases they may suffer from, and how to best communicate with them in the medical setting. Here, through a comprehensive literature review and analysis, a framework for implementing compassionate care for the retired military population in civilian healthcare is built. The medical experience of active service members, common veteran health conditions, and physician hesitancy toward screening for military status are examined. From there, veteran-specific communication strategies and systematic changes to both the healthcare system and medical education are outlined. Ultimately, the introduction of medically trained veterans into the civilian healthcare system is proposed as an approach to improve healthcare delivery to the US Veteran and civilian populations. Further research must be conducted to refine veteran-specific communication strategies and implement effective education and awareness programs about veteran patients and their needs.
Shannon Lyden - Managing the Psychosocial Needs of Parents in Pediatric Healthcare
Pediatric healthcare is a unique medical specialty in which the patient’s parents play a vital role throughout the healthcare process. Whether a child is acutely hospitalized for a medical condition, suffers from a chronic illness, or is medically fragile, significant stressors are imposed on a parent. This paper aims to explore these stressors and their impact on the well-being of parents. The psychosocial needs of a parent will be analyzed and related to the context of parenting a child with a chronic or severe illness. Further, I aim to raise awareness of the various ways that healthcare professionals can proactively contribute to managing the psychosocial needs of parents in pediatric care through a lens of compassionate care in medicine. Various techniques in the communication between the healthcare provider and parent will be elaborated. Various ways in which a healthcare provider can assist parents in navigating through this difficult time, including fostering connections with other parents of pediatric patients, will be considered. Finally, I will discuss further steps that a healthcare provider can take to advocate for their patient’s parents and promote the development of programs and facilities that cater to managing their psychosocial needs.Mechanics, Healers, or Both? Examining Compassion in Surgical Fields
Elizabeth Lucas - Mechanics, Healers, or Both? Examining Compassion in Surgical Fields
Are surgeons really the least compassionate physicians? A common assumption both within and outside of the health professions is that surgeons only care about working on the patient, not connecting with them or demonstrating compassion. As a potential future surgeon and current Compassionate Care in Medicine minor, I examine this assumption across surgical specialties (and in the field in general), including orthopedic, pediatric, trauma, and neurosurgery. I conducted this analysis using a thorough literature review, and synthesizing some of the key conclusions which apply to the principles of compassion and empathy. From this, the research shows that each field encounters unique aspects and challenges of compassion according to the different demands that they present. While surgeons do struggle with compassion fatigue and burnout, many are becoming aware of this and beginning to work toward improvement. Despite the differences among sub-specialties, there are five themes of compassion that stand out in them all: communication skills, systemic concerns, patient autonomy, the need for a support system, and the necessity of formal training in the areas of empathy and compassion. Luckily, compassion science offers insight on these, and using my knowledge I have targeted some main strategies for combating the challenges that come with a career in surgery: a strong mindset, balancing efficiency and quality, collegial support, and recovery techniques. Surgeons do not have to lack compassion, and my background in compassion science will help me to be part of the generation that changes those stereotype
Julia Maloney - How to Address the Psychological Needs of Injured Athletes
Injured athletes face a great deal of consequences from their injury that many people are not aware of. It is very common that injured athletes experience psychological difficulties on top of the physical factors that can delay their recovery. If their psychological responses are not addressed properly, then this can lead to a greater chance of re-injury and long term, harmful consequences. In order to heal the body, the mind must also be healed. Developing the right psychological reactions can not only enhance the recovery process, but also prevents injured athletes from being injured again. Thus, incorporating interventions that address psychological recovery from sports injuries is essential to reduce the resulting negative psychological consequences and prevent more from arising. This paper elaborates on the psychological response of injured athletes, how this affects the recovery process, and how rehabilitation professionals should address these psychological needs. Not only do injured athletes’ mindsets greatly affect the recovery process, but rehabilitation professionals’ mindsets do, too. Too much and too little of a connection for a rehabilitation professional with the team can be dangerous. It is essential for rehabilitation professionals to be in an optimum level of emotional engagement with injured athletes to ensure they remain in the zone of balanced compassionate care. The ability of rehabilitation professionals to establish a connection with injured athletes and build rapport is crucial to fostering a positive attitude toward recovery. Interventions that address injured athletes’ competence, autonomy, and relatedness needs will guarantee a holistic recovery. Social support has proven to be one of the most effective interventions for injured athletes due to the amount of personal time rehabilitation professionals spend with injured athletes and the unique bonds they form as a result.
Ryven Mangundayao - Providing Compassionate Care in Cross-cultural Contexts
In the rapidly evolving American healthcare landscape, the quality of patient care is increasingly contingent upon the cultural competence of clinicians. Especially in multicultural settings, culturally competent, patient-focused, and compassionate care is paramount for improving health outcomes across diverse patient populations and fostering trust in the clinician-patient relationship. Leveraging insights from recent medical literature, this paper explores the application of the polyvagal theory and clinician compassion mindset in cross-cultural contexts, advocating for the integration of extensive cultural competency education within medical curriculums and residency programs. This research evaluates the clinician's capacity to acknowledge and adapt to a variety of cultural health beliefs and navigates strategies to bolster communication and establish trust across different cultural patient groups. Furthermore, a standardized cultural competency training model is proposed, as well as the potential of digital resources, such as e-learning platforms, an online database, and a mobile application, to support the development and practice of compassionate care principles. By adopting a standardized education model that places cultural competence at its core, complemented by these digital resources and continuous learning, the aim is to support and train compassionate, culturally intelligent healthcare professionals who can adeptly handle cultural nuances and address the intricate needs of America's diverse patient populace with due empathy and respect. This approach reflects the critical need for clinicians to not only excel in clinical skills but also to engage effectively with the multifaceted cultural dimensions of the patients they serve, with compassion as the guiding principle.
Usaid Mazhar - Practicing Patient-Centered Care in the Disabled Patient Population
Compassionate caring has grown to become a core value of medical professionals and institutions as they seek to improve medical outcomes and success. Patient-centered care is one of the most important aspects of compassionate caring. It involves ensuring patients feel heard and empowered to lead patient-physician interactions and assigns particular importance to effective communication between patients and physicians. However, in several cases, because of disability, patients lack the sensory or motor capabilities necessary to guide patient-physician interactions and properly communicate with their healthcare providers. This issue is personally relevant and already significant considering the many millions of people worldwide and in the United States believed to suffer from disability and is expected to become only more prevalent with the aging population and increase in chronic and disabling disease and health adverse activities. Currently, the most significant barriers faced by disabled patients in obtaining patient-centered care relate to a lack of access to health insurance and transportation to commute to and from healthcare spaces, inadequate structural and organizational accommodations and medical equipment, power imbalances leading to disrespectful interactions, and substantial communication gaps. To address the current barriers, a comprehensive medical literature search and analysis was done to address these topics. I proposed macro-level changes large-scale healthcare organizations (LSHOs) could implement and micro-level methods individual medical practitioners could use. In terms of macro-level changes LSHOs could enact, I suggested the following: 1) reforming medical schoolcurricula; 2) administering short-term educational interventions; 3) increasing representation of the disabled population in the healthcare workforce itself; 4) instituting structural and organizational accommodations. In regards to micro-level techniques individual medical practitioners could employ, I recommended the following: 1) High-Tech Augmentative Alternative Communication (HT-AAC), specifically Eye-Tracking Computer Systems (ETCs), and Brain Computer Interfacing (BCIs) for patients with motor disabilities; 2) note-writing and communication via American Sign Language (ASL) either directly between patients and physicians or indirectly through an in-person or virtual language interpreter for mute and deaf patients; 3) the Braille language system for blind patients.
Ethan Meunier - Compassionate Care for Children with Chronic Conditions
Pediatric chronic disease is an area of relevant medical concern, affecting 27% of children in the United States and being responsible for around 50% of pediatric healthcare visits. Children with chronic conditions face a unique set of concerns in comparison to other children and other adults with chronic conditions; burnout, social isolation, and identity issues are important concerns. Similarly, healthcare providers caring for children with chronic conditions also face special challenges compared to other providers; burnout, patient adherence, and disclosure of information are areas of main concern. Facing these issues directly is important to ensure patient wellbeing and satisfaction as well as healthcare provider wellbeing and satisfaction. By improving communication skills, simplifying treatment plans, and providing empathy and psychological support for the patient, healthcare providers can work towards ensuring better outcomes for children with chronic conditions.
Alexa Mistichelli - Compassion in End-of-Life Care
Patients who face death and dying have unique needs and circumstances that a physician or healthcare provider must address. For end-of-life care to be effective, compassion must be central in every patient-physician interaction. In this research paper, compassion in end-of-life situations will be discussed through several lenses. First, a compassion science core concept, the compassion mental state, will be applied to end-of-life care to emphasize the importance of compassionate care. Then, the skill of good communication is highlighted as a way that compassion can manifest in end-of-life care, including suggested training improvements. Finally, spirituality is explored, from the perspectives of patient needs, the role of the physician in addressing those needs, and the physician’s own spirituality
Meagan Moore - A Compassionate Care Approach to Addressing Barriers in Pediatric Medicine
In this paper, four barriers to pediatric medicine—financial, locational, educational, and trust—and their effects on parental accessibility will be explored. Financial barriers are focused around differing types of insurance, and possible solutions include free clinics and expanding public insurance networks. Locational barriers were focused around rural pediatric medicine and increasing telemedicine and outreach clinics may help mitigate them. Educational barriers are centered around the vaccination debate, and using pre-screening surveys of parental beliefs about vaccines and a standardized discussion approach may help physicians in these conversations. Medical mistrust stems from any experience of discomfort in medicine and is largely prevented and resolved by building a trusting parent-physician relationship. Lastly, the compassionate care concepts of Polyvagal Theory and Therapeutic Alliance can serve as models for building a trusting parent-physician relationship and its beneficial effects on patient care and health outcomes.
Liam Mott - Combating PTSD in Military Veterans in the Medical Profession
Post-Traumatic Stress disorder (PTSD) remains a significant concern among military veterans, affecting up to 30% of individuals who have served. Addressing the unique challenges of Veterans with PTSD requires a multifaceted approach, emphasizing empathy, diverse treatment options, and overcoming barriers to care. Psychiatrists play a central role in this, integrating alternative treatment methods with a variety of prescription drugs, therapies, and meditations working in unison. While current methods of treatment have shown improvement in symptoms of PTSD among patients, further updates, and improvements to both physicians’ interactions and physician treatments need to be incorporated to provide the best possible treatment. This paper via a comprehensive literature search and analysis looks to provide an overview of PTSD among veterans in its historical context, neurobiological basis, and provide an expansion on the current model of treatment to provide the best compassion facilitated treatment possible for patients.
Cassidy Mullen - Compassionate Care in Treating, Managing, and Diagnosing Sports Injuries in Female Athletes: The Impact of the Compassionate Physician on Maintaining Female Participation in Sports and Enhancing the Physical and Mental Well-Being of Women and Girls
A deficiency in compassionate care for the female athlete contributes to an imbalance in the participation of girls and women in sports at all levels compared to men. Previous research has demonstrated that sports participation improves the physical health and mental wellbeing of girls. As a result, it is essential that a physician whose job it is to care for a patient’s health, consider how their care prevents or enables girls’ participation in athletics. Research in the field of sports medicine has historically, almost exclusively, focused on understanding male physiology and athletic experience. Research is beginning to show that injuries can be prevented when we apply emerging knowledge and research about the uniqueness of female endocrinology and physiology to medical care and physical therapy. Furthermore, increased physician awareness of the female psychosocial experience can improve a physician’s quality of care toward the female athlete. This paper will explore the female patient psychosocial experience including subjugation to bias and unintentional discrimination in order to highlight the need to compassionate care for female athletes in medicine. Furthermore, this paper will investigate aspects of the female physiology and psychosocial experience that contribute to injury and diminished female sports participation. Lastly, suggestions will be made on ways that compassionate care in medicine can contribute to promoting the well-being of girls and women through injury prevention and by encouraging sports participation.
Ella Murphy - Evolving Patient Care in Chronic Disease Management: Navigating Through Compassion and Communication
With conditions like heart disease, diabetes, and hypertension leading as primary causes of death and disability, chronic disease represents a significant global health crisis to be addressed. This capstone project explores the need for a paradigm shift toward a more personalized, patient-centered approach to managing chronic diseases that aligns with the central tenets of compassionate care. It will also highlight the pivotal role of patient behavior and the clinician-patient relationship in treating and preventing chronic disease. Traditional medical models, characterized by a paternalistic approach, fail to address the psychosocial and behavioral aspects that are critical to effective chronic disease management. By exploring the significance of compassionate care and what it entails, this capstone paper advocates for the necessity of patient-centered communication and collaborative goal-setting as strategies for improving clinical outcomes through patient adherence. This comprehensive review argues that to respond to the chronic disease epidemic effectively, healthcare professionals must move beyond outdated models to embrace compassionate care practices that prioritize information flow, trust, and patient empowerment, all of which support behavioral change. The urgency of integrating these approaches is underscored by the escalating prevalence of chronic disease and the shortage of healthcare workers, necessitating a reevaluation of medical education and practice to better meet the challenges of chronic disease management in a rapidly evolving healthcare landscape.
Mary Musselman - Exploring the Significance of Inner Speech in Patient-Doctor Interactions: Knowing the Self to Heal the Self
This paper explores the dynamics of inner speech, especially within the context of the patient-doctor relationship. Theories on the nature of inner speech, the potential mechanisms of how inner speech works, and the evolution over an individual's lifetime are discussed, and then placed in the healthcare setting. Discussion surrounding inner speech is larely centered in developmental theories, such as Vygotsky’s. However, in terms of real life application of its study, inner speech is often overlooked, especially in the field of medicine. The literature discussing the implications of harnessing ones ability to listen to their inner speech in helping them make decisions makes this topic worthy of research and further development. Furthermore, special attention to its ability to shape the patient-doctor diagnosis could be essential to delving deeper into the root cause of patient issues. This paper will unveil the essential role inner speech plays in shaping an individual’s emotions, behaviors, and perceptions during medical consultation and how this knowledge can help providers communicate fully with their patients to promote lasting health and well-being. Through a comprehensive review of the literature, this paper will address inner speech from a scientific perspective, how inner speech is being compromised, and what are the potential solutions, especially those specific to healthcare professions that can be used to address the disconnect.
Sandy Seungyeon Nam - Practice of Compassionate Care by Certified Child Life Specialists in Pediatric Care: The Hidden Supporters in Pediatrics
Pediatric care is often a collaborative effort between the primary care team, the patient, the guardian, and the certified child life specialists. Although the significance of the position is not sufficiently recognized, the child life specialists play an integral role in helping the children adapt to the new medical settings and adhere to medical care. Through a comprehensive literature review including sources from PubMed and personal experiences, this paper attempts to reveal and underscore the true benefits of having a child life specialist in the course of treatment for pediatric patients in varying situations.
Elizabeth Nava - Compassionate Perspectives on Trauma: Overcoming Mental Health Obstacles in Latino Immigrant Communities
This capstone project conducts a comprehensive review and analysis, facilitated by a thorough search of the PubMed literature, to investigate the profound impact of trauma on Latino immigrants and the challenges they encounter within the healthcare system. Through a lens of compassion, the paper examines the experiences of individuals whose journeys exemplify the complexities of trauma and the inadequacies of current healthcare practices in meeting their needs. Additionally, it emphasizes the critical role of empathy and understanding in fostering a supportive patient-clinician relationship and addresses the systemic barriers that hinder access to quality care. By prioritizing culturally sensitive approaches and implementing trauma-informed care practices, healthcare professionals can create safe spaces where patients feel valued and respected, thus promoting healing.
Kayla Nguyen - Adapting to Compassionate Caring Principles to Better Serve the Needs of Patients with Rare Diseases
According to the National Organizations for Rare Disorders (NORD), a rare disease in the United States is one that affects fewer than 200,000 Americans. Other countries have similar definitions, but they can vary due to the unique population size of every country. While the number of individuals who might share the same rare disease are small, about ten percent of people in the United States have a rare disease (NORD, 2024). With 1 in 10 people being affected, not including caregivers, this shows how crucial it is for there be compassionate physicians who are able to understand the perspectives of those with or involved with a rare disease. Moreover, since so little is known about many rare diseases due to factors such as there being few patients with the disease, a lack of research available, and difficulty in receiving a diagnosis, the journey to proper care for someone with a rare disease can be much more difficult. This paper will explore the complications and experiences of the rare disease community in the United States, as well as provide background on techniques for compassionate caring. By reviewing the current literature, this paper will analyze exactly how physicians best demonstrate compassion for nonverbal or dependent rare disease patients and their caregivers and propose new ideas for the. In the current field where there can be a great deal of unknown for rare disease patients and their families, it is important to know how to utilize compassionate caring practices to best serve the needs of the patients. While the principles of compassionate care are the same for rare disease patients as for any kind of patient, it is important to know how to further adapt these practices to serve the needs of the patients with rare diseases will greatly improve patient and physician satisfaction, and potentially even patient outcomes.
Tess Noonan - Compassionate Caring in the Emergency Department
Compassionate caring in the emergency department is an important topic that is under-researched. There are several barriers to providing compassionate care in the emergency department including a limited previous patient-clinician relationship, highly stressful and emotional situations, violence, a diversity of patients, and a wide range of medical issues. Despite all of these barriers, it is extremely important to establish a positive relationship between doctors and every patient that comes into the emergency room. This is necessary for both better patient outcomes and for preventing burnout in emergency medicine doctors. Establishing an effective and compassionate relationship between doctors and patients can be done by implementing a combination of individual and organizational strategies. Individual strategies to overcome these barriers include establishing a personal connection with the patient, talking the patient through the treatment they are receiving, sitting down in the patient's room, avoiding medical jargon, and matching the patients’ communication. Organizational strategies to overcome these barriers include a focus on consistent communication between members of the healthcare team, an emphasis on shift-change communication, and limiting the amount of patients a doctor sees each shift. The emergency department can also serve as an excellent setting to change the problematic health behaviors of patients. A visit to the emergency department can cause patients to experience an emotional “wake-up call” about their health behaviors and if emergency medicine doctors are diligent, they can use this experience to change a patient’s life for the better.
Michael Oblich - Overcoming Differential Barriers to Compassionate Care: How Medical Specialization and Training Stage Impact Compassion and Burnout
The provision of compassionate care has routinely been reported to improve outcomes for both patients and physicians. While its importance has been well-established at the clinical level, less investigation has been conducted into how compassion is developed and maintained during medical training. This paper provides a comprehensive review of primary literature, as well as select review articles and secondary sources, specifically investigating barriers to compassion at the medical student and resident level. It will also cover how specialization and experience level impact barriers to compassion in attending physicians. Finally, four potential interventions to help those in medical training overcome barriers to compassion (increasing self-compassion, Balint training, empathic communication/motivational interviewing training, and role-playing) are discussed in detail.
Ashley Oh - A Review of Compassion in Hospice Care: Outcomes and Methods
The topic of compassionate care has become increasingly important in the realm of hospice care, as it has shown a positive correlation with clinical outcomes. Compassionate care in hospice focuses on comfort and quality of life for the patient, as well as supporting the patient’s family members. This review studies the multifaceted nature of compassionate care within hospice care, specifically what this kind of care looks like, in practice, and its outcomes. It emphasizes the importance of recognizing patients' impending death, creating a collaborative interdisciplinary team, communicating effectively, and involving both the patients and their families in the decision-making processes. These aspects of compassionate care within hospice allows for increased quality of life, pain management, patient and family satisfaction, and reduced cost expenses and invasive care. Future goals may focus on refining communication strategies, strengthening interdisciplinary strategies, and implementing targeted interventions to address the evolving needs of patients and families. By continuing to advance our understanding of compassionate care, we can strive towards improving the end-of-life experiences and outcomes for those under hospice care.
Emily Patterson - Patient-Centered Practice of American Gynecological Visits and Procedures
Adequately practicing gynecologists should not be “gems” and gynecological patients should not feel as though gynecological care is a burden (it does not necessarily need to be a highlight of one’s day but nonetheless the patient visit should not be traumatizing). Humanity is the core of healthcare thus should not be forgotten nor neglected. Lived experiences are evidence of humanity and should be valued. Lived experiences are commonly shared through word of mouth and more recently shared on online platforms. One chain of comments from an online platform, rich with negative experiences from gynecological patients, is found on the website “Crunk Feminist Collective” under These Days I Hate Going to the Gynecologist. Gynecology visits should not reasonably result in negative experiences. In order to change this negative reputation of gynecological healthcare to positive, individual well-being should be prioritized. Within American gynecological practices this should include a sensitive, patient-centered approach, built on mandatory informed consent, patient-included decision-making, and a holistic understanding of each patient’s specific needs, as well as each patient’s cultural background. These factors are necessary throughout all aspects of gynecological visits and procedures regardless of patient’s social determinants of health as well as socioeconomic background.
Sarah Petersen - The Role of Physical Touch in Compassionate Care
Physical touch has played a vital role in medicine for many years. The physical examination itself requires the use of touch between patients and their clinicians. But beyond using touch to obtain medical information, it is also an effective form of nonverbal communication, transcending language barriers to connect patients with their providers. Touch is an essential component of compassionate care, allowing the clinician to understand, empathize, and respond to the discomfort of their patients. Yet few medical schools (7.1%) educate their students on the use of expressive touch as a therapeutic agent (Older, 1984). Thus, the purpose of this comprehensive literature review is to elucidate the impact of physical touch in medicine and analyze how these effects contribute to compassionate care. The current body of research demonstrates that there are numerous benefits to the use of touch in the consultation. It has been shown to improve communication through nonverbal cues, bolster clinician empathy, and it strengthens the relationships between patients and clinicians. Additionally, physical touch has been proven to improve medication compliance, reduce patient pain and anxiety, and increase patient satisfaction. Lastly, physical touch is not welcomed in all patients, such as survivors of sexual assault, or individuals concerned about infections disease transmission like COVID-19. Therefore, sensitivity around the use of physical touch must be maintained. Regarding the application of physical touch, the literature showed that handshakes are acceptable and expected from patients. Reassuring touch was most acceptable at a proximal position on the arm; the back was the next most popular location. Lastly, in general, women tend to have a more positive response to touch while men are more ambivalent. Ultimately, physical touch presents itself as a powerful tool to deliver compassionate, patient-centered care—but only if administered appropriately, prioritizing the patient’s respect and autonomy.
Mary Clare Powell - Compassionate Care in Palliative Care Nursing
This capstone project provides important research and information on the palliative care nurse. After defining palliative care as a unique specialty of medicine, this project works to define the unique roles and responsibilities of the palliative care nurse. The nature of this research will also highlight the science of compassionate care in medicine as it seamlessly integrates itself into a higher standard of palliative care. This review of the literature ultimately ends with an explicit outline of communication techniques palliative care nurses can implement in order to serve in the helping profession from a place rooted in compassion. The compilation of literature was conducted using a variety of sources who engaged in reviews and discussions of trials ran with controlled groups, case studies, qualitative studies, and expert literature and discussion. The capstone project ultimately serves to highlight the compassionate care of the palliative care nursing profession and suggest techniques to incorporate such a standard of care in future practices.
Nikki Reinhardt - Applying a Compassionate, Patient-Centered Mindset to the Surgical Experience: Implications for Patient and Clinician Benefits
This review explores the often overlooked role of compassionate care in surgical practice, which seems juxtaposed due to the clinical stereotype of surgeons and the emotional needs of patients anticipating surgery. While patient-centered care has been increasingly discerned in relation to other medical specialties, its role and potential benefits in surgery explicitly has been underexplored. We will examine the unique challenges of surgery, examining patient fears and how they may be mitigated by patient-centered care. Patients’ anxieties about surgery, including the procedure, recovery, social implications, and healthcare team competency are heightened by the relationship that is established between surgeons and patients. Trust across this divide has implications for the patient’s health outcome and for the surgeon themselves, which enhances the need for effective communication and support. Drawing from the ideas of polyvagal theory, the neurobiological basis of compassion and its ability to promote positive medical results makes the need for understanding how best to emotionally support surgical patients a top priority. Acknowledging emotions in the inexpressive world of surgery does not come without resistance, but we will address the misconceptions and research-based benefits that patient-centered care in this world would provide. The findings of this compilation advocate for continuing the growing shift towards a compassionate care model in surgery, highlighting its profound impact on patient outcomes, surgeon well-being, and the entire perioperative experience.
Chris Rizkalli - Health Care in Lebanon: A System in Crisis in the Aftermath of the COVID-19 Pandemic, Beirut Port Explosion, and Economic Instability
Increasingly, research indicates that compassionate medical care leads to improved patient outcomes. The benefits of compassionate care not only apply to patients, but physicians as well. Studies show that clinicians that practice compassion experience less emotional exhaustion and higher psychological vitality, in addition to lower rates of burnout. Developing countries often face a "compassion crisis" due to limited resources, leading to dissatisfaction among patients. Factors such as lack of social support, outdated medical practices, and mental health stigma contribute to this crisis. Lebanon faces numerous challenges in its healthcare system, including economic instability and a lack of resources. These issues are exacerbated by events like the COVID-19 pandemic and the Beirut port explosion. Stigma surrounding mental health further complicates healthcare delivery in Lebanon and other developing countries. Lack of awareness and social acceptance of mental illnesses lead to underdiagnosis and undertreatment in patients and clinicians alike. This stigma, compounded with the challenges to Lebanon’s healthcare system, oversees high rates of burnout among physicians. Beginning in 2019, the emigration of physicians from Lebanon reflects the dire state of the healthcare system and broader socio-economic challenges. A restructuring of Lebanon’s health care system is vital to prevent its collapse. This restructuring necessitates the prioritization of compassion at the forefront. Compassionate leadership from an organization perspective, healthcare reforms, and support for healthcare professionals is pivotal in addressing the Lebanese healthcare crisis. This capstone project performs a literature review of the concerning the above topics and explores their significance and consequence for Lebanese health care.
Heather Roland - Exploring Compassionate Care in the United States’ Government Public Health System
The goal of public health is to enhance the physical, mental, and social well-being of communities. To accomplish this, public health efforts focus on developing preventative health measures and improving health equity through education, interventions, and policy. In the United States, the bureaucratic public health system encapsulates a wide array of services within the Department of Health and Human Services. Public health initiatives impact the health outcomes of all individuals, so the challenges of declining trust in public health institutions, shifting cultural values, and workforce shortages can have widespread effects. Therefore, collaborative efforts and systematic changes are necessary to address the ever-changing needs of the American public to promote the well-being of all individuals and should be informed by a compassionate framework. This paper explores the intrinsic intersection between the mission of public health and compassion, offering insight on how to structure compassionate public health interventions and practice public health compassionately to improve health in the United States. Compassion-informed public health allows practitioners to establish trust and better respond to the diverse needs of communities while improving patient outcomes and reducing burnout. By embracing compassion, public health can navigate contemporary challenges and shape policies that genuinely enhance the well-being of both individuals and communities.
Stevie Sampedro - Child and Adolescent Psychiatry: The Rise in Mental Health Issues
Mental health issues have a profound impact on daily living, especially for developing minds. This capstone project aims to address the reasons that contribute to the current rise in mental illness for the pediatric population and how compassionate caring principles can be implemented throughout the practice of psychiatry. The moral implications of a psychiatric diagnosis on youth are reviewed, as a diagnostic label can have serious repercussions on a youth’s future as well as their understanding of self. Next, the reasons that the pediatric population encounters difficulty with seeking out or accessing care are addressed because a lack of proper mental health care can significantly increase the rise in mental illness. Several environmental and health-care factors are reviewed as contributors to the rise, including but not limited to general environmental factors, the COVID-19 pandemic, diagnostic challenges and overdiagnosis, overmedicalization, and the lack of strong relations between pediatricians/PCPs and pediatric psychiatrists. Future directions of care are discussed, including three specific models as well as general approaches, in order to review the direction pediatric psychiatry hopes to follow to help combat this rise in mental health issues. Research on balanced compassionate caring and empathy is incorporated throughout the paper to reveal the importance of these principles for the most adequate and successful care of patients. Additionally, the research is reviewed in regards to how they can be applied in areas that compassionate caring and empathy may prove to be lacking. Overall, individualized, compassionate child and adolescent psychiatric care can significantly impact the youth of the world in a positive manner, possibly completely changing their future life course.
Valeria Sanchez - Applying the Compassion Science Model when faced with Language and Cultural Barriers
The compassion science model and the study of compassionate care in medicine derived from it can be used as the means to help overcome language and cultural barriers to medical care. As the population of the United States becomes increasingly diverse in its demographic composition, many areas of society, most especially healthcare, are affected. One such implication is the need for healthcare providers to care for patients who speak different languages and who may come from different cultural backgrounds. The tools required to provide medical care in the face of language and cultural barriers have been found through this comprehensive literature review and analysis to go beyond those that are already being applied in many healthcare systems. The compassion science model provides a psychological and biological basis for the need for compassionate care in medicine. From it stems practices that have proven to improve patient satisfaction and medical outcomes while reducing physician burnout. These practices can also be applied in the face of language and cultural barriers. Compassion science can and should be used along with the methods for overcoming language and cultural barriers discussed in past work in order to provide proper care for patients who may speak different languages or come from different cultures than their providers. This topic can be further explored by delving into other practices derived from compassionate care in medicine that have not been included here and eventually gathering empirical data when these practices are applied in the face of language and cultural barriers.
Annie Cate Schmidt - The Role of Compassionate Care in Improving the Experience and Wellbeing of Bone Marrow Transplant Patients
Bone Marrow Transplantation (BMT) is a medical procedure used to treat a variety of hematologic, oncologic, and metabolic disorders. While it can be lifesaving, it is a life uprooting treatment and is linked to patient anxiety, PTSD, and depression. However, existing cancer care and BMT resources are oriented toward the necessary focus of survival and acute care, leaving patients with limited support in addressing the severe psychological and lifestyle impacts. This study aimed to conduct a comprehensive literature search, analyzing data to elucidate the multifaceted experience of BMT patients and provide actionable tools for enhancing wellbeing across various realms of a BMT patient’s experience.
This was performed through analysis of the polyvagal theory, examining the stages of a BMT journey, and delving into patient narratives of diagnosis and illness experiences. The diagnosis brings a whirlwind of treatment options within a tight decision window, compounded by geographical constraints on access to treatments. Chief concerns for BMT patients revolved around the fear of death and concerns regarding long-term treatment side effects. It is important for physicians to probe these worries to leverage resources such as chaplains, palliative care, or psychiatry to help address these existential concerns and provide holistic support. It was also found that the effective delivery of patient education over intervals and utilization of palliative care resources throughout treatment are crucial elements to patient wellbeing.
The literature shows that the quality of care and support received during the BMT process was directly correlated with the patient outcomes after the transplant. Comprehensive care should encompass managing physical symptoms, addressing life changes outside the hospital, and supporting psychological effects of a BMT. To provide this care, physicians must both learn what the patients are going through and be aware of their own behavior and emotions to effectively support patients. After this, the provider can create a deeper relationship with the patient by empathizing and customizing patient care and education.
Ashley Schmidt - A Good Death: Compassionate Care and Euthanasia in Veterinary Medicine
Euthanasia is a humane practice that comes up frequently within the veterinary profession. Despite the humanity behind the practice, euthanasia remains an emotionally charged subject that can give rise to many powerful emotions, both in the client and in the practicing veterinarian themselves. A failure to properly navigate these emotions can lead to a state of compassion fatigue, exhaustion as a result of intense caregiving. A comprehensive literature review was performed to investigate different medical counseling approaches for the topic of euthanasia and potential solutions to buffering against compassion fatigue in veterinary medicine. Veterinarians should be aware of the ethical guidelines behind the practice of euthanasia and the importance of respecting the human-animal bond. A client may present with many adverse emotions upon presentation of the topic of euthanasia, but veterinarians should always act with the aim of preserving the therapeutic relationship. Clients should determine the pace and flow of the conversation and their wishes should be respected at all costs. Veterinarians should properly deal with their own emotions when the time is appropriate. Veterinarians should be aware of the different causes, signs, and consequences of compassion fatigue. Solutions to buffering against compassion fatigue may include building personal and organizational resilience, establishing a strong network of social support, and reconnecting with one’s initial passion for the profession. A reform of the veterinary school curriculum would also be beneficial to the mental health of future veterinarians. Veterinarians should utilize the suggestions outlined in this paper to continue to practice with compassionate care and to maintain a state of compassion satisfaction.
Elizabeth Sheddy - Utilizing Compassionate Care to Confront the Barriers Facing Latino LEP Patients
In modern American society, the standard patient population is quickly diversifying as immigration to the United States rises. With this rise comes an increase in the number of patients with limited English proficiency (LEP), predominantly among Latinos. This demographic shift presents significant healthcare challenges, including compromised care, reduced patient satisfaction, and adverse medical outcomes. A comprehensive literature review and analysis was performed to address the linguistic and cultural barriers facing LEP patients with the goal of providing compassionate care to all patients. A range of studies on Latino patient care including multiple-method studies, cross-sectional surveys, and systematic reviews of randomized trials were reviewed. The review explores various dimensions of language and cultural barriers including how verbal, nonverbal, and cultural nuances complicate patient-provider interactions. Additionally, it dives into how cultural values like machismo, familism, and fatalism as well as fear of deportation influence healthcare behaviors amongst Latinos and further complicate the accessibility and effectiveness of healthcare services. The role of compassionate care is emphasized as a critical approach to overcoming these barriers, specifically focusing on integrating empathy, combining top-down and bottom-up processing, utilizing polyvagal theory, and enhancing cultural competence to improve patient-provider interactions. Proposed strategies to implement compassionate care and overcome these barriers include professional interpreters, use of advanced technology and AI in medical settings, and above all employment of multilingual providers. Training and education in cultural competency is also highlighted as essential for improving healthcare interactions and outcomes for LEP patients. In conclusion, this review emphasizes the urgent need for systemic changes in the healthcare system to address and dismantle language and cultural barriers facing Latino patients. By fostering an environment of compassion and understanding, healthcare providers can ensure more equitable and effective care for all patients, regardless of their language abilities or cultural backgrounds. Importantly, future research must delve into efficient and effective implementation of these strategies in healthcare facilities to broaden access to compassionate care.
Sarah Snelson - School Counselors and Students with Disabilities Through the lens of Compassionate Care
Individuals with disabilities face a number of challenges throughout their lives, one of which is their experience in the education system. School counselors are one of the most important clinicians responsible for providing support to students with disabilities throughout their time in the school setting. In order to do this effectively, counselors must use methods provided by compassion science to ensure their students are in a relaxed and socially engaged state, and to ensure they themselves do not fall victim to burnout. The problem being addressed in this comprehensive literature analysis and review is that school counselors are falling short of their role in providing support and services to students with disabilities. This paper discusses the reasons for this problem, most significant of which is a serious lack of education specific to students with disabilities in the curriculum of school counselors. This creates a lack of self confidence in the clinician’s ability to provide adequate services to students with disabilities, which can have a negative impact on their interactions with these students. Additionally, school counselors themselves experience high levels of stress, and also may have conscious or unconscious biases towards students with disabilities. These problems considered, I will also discuss potential solutions to the educational gaps, a recommendation to expand transition services, and providing psychosocial support to school counselors. These are all aspects that will hopefully improve the qualifications of the counselor as well as the experience of school for students with disabilities in the future.
Karina Solman - Fixing Smiles, One Relationship at a Time: An Exploration of Polyvagal Theory as a Preventative Measure against
In recent years, there has been an ongoing swithc from the bio-techno-centric paradigm to a compassion-centric paradigm in healthcare. One key component od compassionate care that plays a crucial role in patient-clinician dynamics medicine in Polyvagal Theory: the neurophysicoloical foundation of the patient-caregiver interaction where the patient assesses the environment around themm and detremines whether he/she is safe. There exists a knowledge gap on this archetype in the field of dentistry; few to no dental schools emphasize compassion in their curricula, so emerging dentists lack knowledge about real-life scenarios and how to effectively communicate with their patients, particularly those experiencing dental anxiety. Especially with the prevalence of dental anxiety affecting up to 61%of children and 52% of adults, it is essential to take actions to establish trustworthy dentist-patient relationships in order to combat the visious cycle of poor oral health that begins with patients'unwillingness to attenddental checkups (Kida Minja & Kahabuka, 2019). A breath of research illustrates that dental anxiety can stem from patient, provider, or environmental causes, all of which can be significantly quelles when dentists understand and are aware of patient concerns and informed about hoe to successfully comunicate with patients to foster open, meaningful relationshipswith them. This paper will provide a comprehensive reviewof the implications of Polyvagal Theory in dental anxiety, the essentially of the dentist-patient relationship, and ways in which dental anxiety can be addresses in a fruitful manner. It will conclude with a suggestion of action steps for implementation moving foreard for dental professionals in-training to best serve theircommunities both orally and holistically.
Jewel Soucek - Improving Physician Approaches to Treating Pregnant Women with Substance-Use Disorder
Pregnant women with substance use disorder embody a unique group of patients who oftentimes lack adequate medical care as a potential result of societal stigma or other barriers to healthcare. Therefore, the prenatal period presents obstetricians with the perfect opportunity to provide holistic, person-centered care and address the varying healthcare needs of these women. This paper utilizes current literature establishing care guidelines for pregnant women with substance use disorder to evaluate methods to improve patient outcomes through a compassion science lens. Obstetricians can establish person-centered care by internally facilitating compassion with reframing methods rooted in the sentiment that addiction is a disease, monitoring internal language use, and remaining self-aware of biases that may arise. Once an OB/GYN maintains this compassion mental state, they can convey compassion for their patients by employing non-judgmental language and shared decision making. Non-judgmental language prepares the obstetrician for motivational interviewing and harm reduction practices, both which further demonstrate genuine caring for the patient and a hope to achieve positive health outcomes for the mother and her baby. Physicians must establish their clinic as a safe environment to create trusting relationships that lead to increased adherence to treatment plans and better patient outcomes. Societal changes, including reduced punitive legislation and OB/GYN-mediated addiction treatment, will facilitate the role of physicians in caring for their patients. Since pregnant women experiencing substance use disorder require thorough medical attention, obstetricians must prepare themselves to exercise compassion throughout prenatal care to accomplish positive outcomes for both mothers and babies.
Kevin Stein - Providing Compassionate Care for those Experiencing Chronic Homelessness
The number of individuals experiencing homelessness and suffering from chronic homelessness across the United States is increasing. Specifically, those suffering from chronic homelessness are defined to be those who have been experiencing homelessness for at least a year - or repeatedly - while struggling with a disabling condition such as a serious mental illness, substance use disorder, or physical disability (National Alliance to End Homelessness). Increased rates of mental illness and drug addiction is shown to be associated with this population and has been correlated primarily with poor health outcomes for the individual and secondarily with detrimental societal consequences. This comprehensive literature review and analysis examines San Fracisco’s homelessness crisis and aims to present how an increase in primary care intervention may be an effective solution. In doing so, this paper offers real-life examples from San Francisco's St. Anthony Foundation demonstrating how compassionate science may instill within patients the intrinsic motivation to better their living situations. Ultimately, each patient is highly unique and one’s path to experiencing homelessness or becoming chronically homelessness is unparalleled to any other. Therefore, the primary-care physician must compassionately engage with the patient in such a way that articulates both an empathetic understanding and personal significance to the patient. In this way, the physician may cultivate an environment of trust allowing the patient to generate a resilience that fuels a desire to cooperate with the physician.
Elijah Tan - Bridging Medicine and Research with Compasssion
Medicine and research share inseparable intersections, as evidenced by the unified effort of the scientific community to put forth a COVID-19 vaccine for the health and safety of the population. Nevertheless, issues with trusting experts, scrutinizing the accuracy of online information, and fearing the unknowns of the pandemic underscore the need for skills in addition to competency with medical knowledge. Additionally, compassionate caring in medicine has yet to realize the full potential of benefits. Compassion and communication are just as important in research, which can advance medical knowledge and patient care. Physician-scientists are uniquely positioned to address needs in scientific research and in clinical practice. They are aptly poised to bridge gaps between patients, scientists, and clinicians. For example, effectively practicing communication and compassion can address some of the contemporary concerns in medicine and research. Difficult conversations exist in all specialties, including cancer and surgery. Thus, it is of particular interest to investigate how compassion and communication contribute to the success of a physician-scientist in bridging medicine and research.
Natalie Tihansky - Compassionate Caring: Trauma-Informed Care Addressing Domestic Violence and Sexual Assault
Sexual assault and domestic violence are very prevalent issues in society that affect an unnervingly large amount of the population, leaving lasting impacts on one’s life. Many survivors are left with adverse effects to their physical, psychological, and emotional well-being. Nearly every individual who undergoes the traumas of sexual assault or domestic violence will receive healthcare either immediately, shortly after, or at some point in the future following the incident. In order to ensure that individuals who are affected by these traumas receive the best care possible, healthcare organizations and workers need to be able to recognize what trauma symptoms might look like, understand how trauma can affect an individual, and implement practices to make patients feel safe in a healthcare setting. Trauma will look different and manifest in different ways for each individual patient. So it is vital for healthcare organizations to take proactive steps and implement educational and training programs for all workers on the fundamentals of trauma-informed care. By training healthcare professionals on how to properly recognize, acknowledge, and then provide care to individuals who have fallen victim to these acts, it will foster an environment that promotes the safety and well-being for all individuals. Through the training of healthcare professionals for trauma-informed care, compassionate caring will serve as the core and fundamental principles to guide clinicians. Not only will successfully implementing trauma-informed care through a compassionate caring lens benefit the patients, but it will also benefit all healthcare workers as well. A comprehensive literature review and search was conducted in order to address these issues and gain insight into the challenges that healthcare faces in relation to providing trauma-informed care. The purpose of this paper is to investigate and discuss the barriers and challenges that healthcare workers face when trying to provide trauma-informed care, while then providing possible solutions on how to overcome these issues through implementing compassionate caring principles into everyday practices. Using the principles ofcompassionate caring to bridge the gap between challenges faced when providing trauma-informed care is the ultimate goal of this pape
Emma Westrick - Analyzing Organ Donation Through a Compassionate Lens
The following capstone utilizes the science of compassion to analyze the approach of the United States towards organ donation. Healthcare in the United States currently suffers from two scarcities, one of compassion and one of donated organs. Therefore, a comprehensive Pubmed mediated literature search was performed to address the current organ shortage crisis via the route of compassionate medical care. Compassion, defined as noticing suffering in an individual and being sparked into action to alleviate said suffering, plays a critical role in providing high quality medical care. However, despite moments of recent progression away from a traditional biomedically centered healthcare system, the persistence of outdated medical policies greatly limits the impact of the genuinely compassionate physician. In regards to healthcare policy outlining organ donation consent, the current opt-in policy of the United States stands as a hindrance towards a full optimization and utilization of organ transplantation as a life-saving technology as well as the possibility for compassion grounded high quality medical care. An exponentially growing drought in donated organs nationwide amounts to thousands of Americans dying each year waiting for a matching organ to arise. In turn, the severe scarcity of available organs results in the inability to fully establish organ transplantation as a reliable life-saving procedure. Furthermore, the lack of an adequate supply of the critical input necessary for organ transplantation ultimately makes the goal of compassionate medicine, being to provide the highest quality medical care, essentially unattainable. In revising the United States approach regarding organ donation with the intent of more accurately resembling the goal of compassionate medical care, policy decision makers must consider adopting the notion of presumed consent held within an opt-out organ donation policy. In establishing consent towards donation as the default assumption, policy will more accurately mirror public opinion and the mission of compassionate care in medicine as well as, ultimately, increase the number of organs available for transplantation.
Sofia Zitella - The US Maternal Mortality Rate through the Lens of Compassionate Caring
The US maternal mortality rate is increasing rapidly, and this especially affects Black women. The US is the only highly developed country with a growing maternal mortality rate, and the reasons for this climbing rate are multifactorial. In this paper, I examine many factors that increase the maternal mortality rate: access to prenatal care (especially for vulnerable mothers), underutilization of postnatal care, underutilization of Advance Care Practitioners, and the OB GYN shortage. I further explain why Black women are so disproportionately affected: genetic predisposition, the epigenetic effects of racial trauma, physician implicit bias, lack of physician racial diversity, and birthing location. I lastly examine aspects of the solution: improving postnatal care provision and standardization, improving physician-patient relationships through unbiased care, increasing resources for Black mothers, bias training integrated into medical education, and growing the body of related research and laws. I expand into how we can improve this issue for Black women: innovative methods to connect Black mothers to trusted physicians, improving and standardizing implicit bias training, increased funding for research, and laws that create increased access to and a higher standard of care. The maternal mortality crisis is a result of multiple issues in the US healthcare system, but this crisis can be improved through small, targeted interventions.
