More on Emotions in Medical Education and Practice

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Emotions are an inseparable and inherent component of medical education and lifelong clinical practice. McConnell et al1 demonstrate a seesaw relationship between emotions and learning performance: Increased emotional load of any kind was associated with poorer acquisition and transfer of new knowledge. They distinguish, though, between incidental emotions studied and integral emotions—those associated with the target task. Since some readers may put down the article feeling that emotions are noxious, it is important to differentiate between the potentially interfering role of emotions (or any other source of stress or distraction) on the learning process—a relatively short-term endeavor—and their immensely valuable role in patient encounters, which take up most of physicians’ careers.
Physicians’ emotions during clinical encounters are abundant and diverse, encompassing a whole spectrum from positive (empathy, curiosity, satisfaction) to negative (irritation, disappointment, fatigue). However, patients’ own reports as well as many studies of patients in myriad settings have confirmed that emotions in clinical encounters tend to be neglected2–4 for many reasons.
Concentration on biomedical issues to the exclusion of emotions, in particular empathy and compassion, may fail the patient. In contrast, encouraging and making use of positive emotions for the mutual benefit of patients and providers alike may strongly enhance clinical performance and facilitate patient and physician satisfaction, relationship, trust, adherence, and health outcomes.5 This entails being attuned to the patient’s emotions and reacting with understanding, compassion, and support—central components of each encounter. On the other hand, yielding to negative emotions appears to impede performance and increase burnout, creating a vicious cycle.6
Along with McConnell and colleagues’ important research on the effect of emotions on processing and retaining new information, much more effort should be concentrated on promoting more personal care through acknowledging, studying, and training physicians in the skills that have been shown to enhance emotional involvement with patients,6,7 thus improving quality of care and the patient’s experience of care.
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