How much is residents' distress detection performance during a clinical round related to their characteristics?

ABSTRACT

OBJECTIVE: The aim of this study was to investigate residents' characteristics associated with their performance in detecting patients' distress (detection performance). METHODS: Residents' detection performance was assessed in a clinical round. A mean detection performance score was calculated for each resident by comparing residents' rating of patients' distress (VAS) with patients' reported distress (HADS). Residents' characteristics include general (socio-demographic, professional and psychological), detection (self-efficacy, attitudes and outcome expectancies) and performance characteristics (communication skills (LaComm), psychological arousal (STAI) and physiological arousal (heart rate and blood pressure) in a highly emotional and complex simulated interview task). RESULTS: Ninety-four residents and 442 inpatients were included. 30% of the variance in residents' detection performance was related to residents' performance characteristics anxiety level (p=.040) and mean arterial blood pressure (p=.019) before the task; empathy (p=.027) and mean heart rate (p=.043) during the task; mean arterial blood pressure changes (p=.012) during the assessment procedure. CONCLUSION: Residents' detection performance is partly related to their performance characteristics. Psychological and physiological arousals are key characteristics--beside empathic skills--that need to be considered in models designed to determine detection performance. PRACTICE IMPLICATIONS Future interventions designed to improve residents' detection performance should focus notably on their performance characteristics.