• 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 a 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.

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  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.

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  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.

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  Stephen M. 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.

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  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.

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  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.

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  Ryven E. 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.

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  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.

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  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.

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  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.
  

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  Karina Solman -  Fixing Smiles, One Relationship at a Time: An Exploration of Polyvagal Theory as a Preventative Measure against Dental Anxiety

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. 

 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.

Sodia Zitella - The US Maternal Mortality Rate through the Lens of Compassionate Carin

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.