The use of emotional intelligence capabilities in clinical reasoning and decision-making: A qualitative, exploratory study.

AIMS AND OBJECTIVES: To explore clinical nurses' experiences of using emotional intelligence capabilities during clinical reasoning and decision-making. BACKGROUND: There has been little research exploring whether, or how, nurses employ emotional intelligence (EI) in clinical reasoning and decision-making. DESIGN: Qualitative phase of a larger mixed-methods study. METHODS: Semistructured qualitative interviews with a purposive sample of registered nurses (n = 12) following EI training and coaching. Constructivist thematic analysis was employed to analyse the narrative transcripts. RESULTS: Three themes emerged: the sensibility to engage EI capabilities in clinical contexts, motivation to actively engage with emotions in clinical decision-making and incorporating emotional and technical perspectives in decision-making. CONCLUSION: Continuing to separate cognition and emotion in research, theorising and scholarship on clinical reasoning is counterproductive. RELEVANCE TO CLINICAL PRACTICE: Understanding more about nurses' use of EI has the potential to improve the calibre of decisions, and the safety and quality of care delivered.

Increasing nurses' emotional intelligence with a brief intervention.

BACKGROUND: Emotional intelligence (EI) is associated with a wide range of personal, professional and social benefits with numerous applications evident for nursing education and clinical practice. Despite growing support for increasing the focus on EI in nursing and nurse education, empirical evidence for the effectiveness of training to increase EI is sparse. The aim with this study was to test the effect of a brief EI training program for registered nurses. METHODS: We conducted a cross-site quasi-experimental study measuring nurses' EI pre- (T1) and three months post- (T2) EI training with a matched (untrained) control group (total n = 60). EI training consisted of a five-hour workshop, a 30-minute one-on-one feedback session, and an individualised follow-up reminder sent via SMS. RESULTS: Training resulted in a significant increase in EI scores over baseline levels for the trained group while scores for the control group did not increase. CONCLUSION: This pilot study has provided clear evidence of the applicability and efficacy of a low-cost training intervention for nursing staff in a real world setting.

The role of emotion in clinical decision making: an integrative literature review.

BACKGROUND: Traditionally, clinical decision making has been perceived as a purely rational and cognitive process. Recently, a number of authors have linked emotional intelligence (EI) to clinical decision making (CDM) and calls have been made for an increased focus on EI skills for clinicians. The objective of this integrative literature review was to identify and synthesise the empirical evidence for a role of emotion in CDM. METHODS: A systematic search of the bibliographic databases PubMed, PsychINFO, and CINAHL (EBSCO) was conducted to identify empirical studies of clinician populations. Search terms were focused to identify studies reporting clinician emotion OR clinician emotional intelligence OR emotional competence AND clinical decision making OR clinical reasoning. RESULTS: Twenty three papers were retained for synthesis. These represented empirical work from qualitative, quantitative, and mixed-methods approaches and comprised work with a focus on experienced emotion and on skills associated with emotional intelligence. The studies examined nurses (10), physicians (7), occupational therapists (1), physiotherapists (1), mixed clinician samples (3), and unspecified infectious disease experts (1). We identified two main themes in the context of clinical decision making: the subjective experience of emotion; and, the application of emotion and cognition in CDM. Sub-themes under the subjective experience of emotion were: emotional response to contextual pressures; emotional responses to others; and, intentional exclusion of emotion from CDM. Under the application of emotion and cognition in CDM, sub-themes were: compassionate emotional labour - responsiveness to patient emotion within CDM; interdisciplinary tension regarding the significance and meaning of emotion in CDM; and, emotion and moral judgement. CONCLUSIONS: Clinicians' experienced emotions can and do affect clinical decision making, although acknowledgement of that is far from universal. Importantly, this occurs in the in the absence of a clear theoretical framework and educational preparation may not reflect the importance of emotional competence to effective CDM.

Dusted community: piloting a virtual peer-to-peer support community for people with an asbestos-related diagnosis and their families.

Individuals with an asbestos-related diagnosis and their carers face burdens including debilitating and life-limiting physical symptoms and medico-legal stressors. Feelings of social isolation are common. Increasing social connectedness can lead to increased feelings of personal empowerment and may inhibit chronic stress responses. The authors report on the development, via a process of participatory action research, of an online peer-to-peer support group, and the first 30-day test phase of this virtual community. Initial indications are that individuals with an asbestos-related diagnosis and their carers can benefit, in psychosocial terms, from membership of an on-line support group comprised of experientially similar others.

Outcomes of Emotional Intelligence Training for Surgeons in a Real-World Setting: a Mixed Methods Study.

OBJECTIVE: The objective was to assess, improve and re-assess Emotional Intelligence (EI) in a group of junior and senior surgeons in a real-world setting. DESIGN: This was a mixed methods study. An EI education program was delivered through a series of webinars. The program drew from the central concepts of emotional intelligence: Motivation, empathy, social skills, self-knowledge, and self-control. There was also a component of professional development. EI assessment was performed pre- and post-intervention using the Mayer-Salovey-Caruso Emotional Intelligence Test (MSCEIT) and a series of targeted questions. Qualitative assessment was performed by means of structured interviews examining uptake in techniques, understanding of EI, and its effect on personal and professional life. SETTING: The Australia and New Zealand Training Board in Colorectal Surgery administers a 2-year bi-national training program in teaching hospitals in Australia and New Zealand and runs a series of educational webinars throughout the training program. The "EI series" was part of this educational program. PARTICIPANTS: Webinars were attended by 35 junior surgeons and 8 senior surgeons RESULTS: Self-perceived knowledge and use of EI increased from a mean of 3.6 to 6.5 (p<0.0001). There was a significant difference between experiential (94) and strategic (101) scores (p=0.005). There was a nonsignificant improvement (98.04-100.6, p=0.16), in the pre-post MSCEIT among the junior surgeons and no change for senior surgeons. Seventy-eight percent (25/32) of surgeons interviewed reported using any new EI strategies. Seventy-five percent actively stopped and considered what other people in a clinical scenario may be thinking; 78% commenced metacognition; 81% practiced the process of self-regulation; 66% had begun to recognise and use emotions as data; and, 47% had actively practiced the process of self-distancing CONCLUSION: This study demonstrated the feasibility and utility of delivering EI training in an online format to a group of time-poor surgeons in a real-world setting.

Emotional intelligence as a mechanism to build resilience and non-technical skills in undergraduate nurses undertaking clinical placement.

The environments in which nursing work is undertaken can be highly stressful and complex with resultant harmful outcomes for the health of both nurses and patients reported. Undergraduate nursing students are particularly challenged when on clinical placement through having only partially developed work capabilities, with wide claims that these nurses remain underprepared for work even upon graduation. Over time undergraduate nursing education has arguably not prioritized developing resilience and other non-technical skills required to respond effectively to these challenges. This paper reports findings from a qualitative study of student nurses who received training and coaching in emotional intelligence, a well-established correlate of resilience, just prior to undertaking a mental health or medical/surgical clinical placement. Of that cohort, 12 agreed to qualitative semi-structured interviews that sought to better understand how these students used the knowledge and capabilities from the training within clinical placement contexts. Four themes emerged from the thematic analysis of the interviews: (1) greater experiences of resilience; (2) responding positively to mental health consumers; (3) experiences of greater empathy and compassion; and (4) experiences of improved non-technical work skills. Implications from these findings suggest that student and patient experiences of nursing placement, and mental health nursing placements in particular, would be enhanced by pre-placement emotional intelligence training and coaching. Such training will support nursing graduates to be work-ready upon entering the workforce.

Qualitative study of peer workers within the 'Partners in Recovery' programme in regional Australia.

In Australia and internationally, Peer Workers are increasingly being incorporated into the mental health workforce. Underpinning this trend is the conviction that the inclusion of workers with lived experience in overcoming mental health challenges is central to transforming service delivery. Given there are few identified Australian studies into the experiences of Peer Workers, this paper reports findings from qualitative interviews conducted in a Partners In Recovery programme in one regional area in Australia. The interviews formed part of a larger mixed-method study evaluating Peer Worker roles in the programme. Thematic analysis of interview transcripts with Peer Workers and other staff employed in the programme (n = 22) was undertaken. Central to the five themes that emerged was the concept of lived experience expertise in overcoming mental health challenges. The themes were: (i) role variance, (ii) the challenges and opportunities for Peer Worker, (iii) the processes Peer Workers employed as they attempted to shape an identify and language, (iv) the inconsistencies and challenges of employing lived experience as a defining feature of the peer worker role, and (v) the nature of trust arising from lived experience relationships. From this study, it is evident that the Peer Worker role remains underdeveloped. The difficulties experienced by Peer Workers in establishing a homogenous identity and role is not unique. The process and lack of clarity around role identity revealed from the narratives, parallels the experiences of Mental Health Nursing.

Emotional intelligence and perceived stress of Australian pre-registration healthcare students: A multi-disciplinary cross-sectional study.

BACKGROUND: Healthcare students can experience high levels of stress. Emotional intelligence can moderate stress and increase wellbeing however there has been no prior research on the relationship between emotional intelligence and stress in Australian healthcare students. OBJECTIVES: To measure emotional intelligence (EI) and perceived stress (PS) in final year healthcare students (nursing, pharmacy and dentistry), and to explore the relationships between EI, PS and discipline. DESIGN AND SETTING: A cross sectional survey of pre-registration healthcare students at a metropolitan university in Australia. PARTICIPANTS: 203 pre-registration final year healthcare students (n = 58 nursing; n = 112 pharmacy; n = 34 dentistry). METHODS: Emotional Intelligence was measured using the GENOS Emotional Intelligence Inventory (Concise Version) and stress was measured using the Perceived Stress Scale (PSS). RESULTS: A significant negative correlation was found between EI and PS in nursing and pharmacy students. No difference was found in EI across disciplines. Mean EI scores were lower than normative means. PS was significantly higher than the normative mean for pharmacy and dentistry students and higher than nursing students. CONCLUSIONS: Emotional intelligence can have a protective effect against stress for healthcare students and can be increased via targeted educational interventions. To support student wellbeing there is a clear need for pre-registration healthcare curricula to include educational components on strengthening EI.

Emotional intelligence increases over time: A longitudinal study of Australian pre-registration nursing students.

BACKGROUND: Emotional intelligence (EI) has been associated with positive outcomes for nursing students. Higher EI is associated with personal wellbeing and stress management, higher academic performance, stronger nursing leadership and practice performance, and greater patient safety. While there is an increasing body of evidence on nursing students' EI, there is minimal evidence on EI over time during pre-registration programs. OBJECTIVES: To measure EI in pre-registration nursing students from program commencement to conclusion to ascertain EI over time and examine the relationship between EI and academic performance. DESIGN AND SETTING: Longitudinal repeated measures study between March 2010-February 2013 at a metropolitan university in Australia. PARTICIPANTS: 111 nursing students (74.8% female) contributed data on at least two occasions. Participants were enrolled in a pre-registration Master of Nursing degree. Half the cohort (55.0%) comprised Graduate Entry students who completed the course in two years full time. The other 45% were enrolled in an undergraduate degree in arts, science or health science, combined with the same pre-registration Master of Nursing Degree. These students completed their Combined Degree program in four years full time. Participants had a mean age of 24.7years (SD=7.36). METHODS: EI was measured for commencing students (T1) using the Assessing Emotions Scale (AES), then a further three times: end of first year (T2; 9 months follow up); beginning of second year (12 months follow up; T3) and end of the program (T4; 24/36 months follow up). RESULTS: Students' EI was found to increase across the program; one subscale of EI (managing others' emotions) was related to higher academic performance; and there was a significant increase in the Utilising Emotions subscale scores over time. CONCLUSIONS: Pre-registration nurse education contributes to strengthening students' EI over time. Specific EI education scaffolded throughout programs is recommended in pre-registration curricula.