Artificial intelligence technologies and compassion in healthcare: A systematic scoping review.

Background: Advances in artificial intelligence (AI) technologies, together with the availability of big data in society, creates uncertainties about how these developments will affect healthcare systems worldwide. Compassion is essential for high-quality healthcare and research shows how prosocial caring behaviors benefit human health and societies. However, the possible association between AI technologies and compassion is under conceptualized and underexplored. Objectives: The aim of this scoping review is to provide a comprehensive depth and a balanced perspective of the emerging topic of AI technologies and compassion, to inform future research and practice. The review questions were: How is compassion discussed in relation to AI technologies in healthcare? How are AI technologies being used to enhance compassion in healthcare? What are the gaps in current knowledge and unexplored potential? What are the key areas where AI technologies could support compassion in healthcare? Materials and methods: A systematic scoping review following five steps of Joanna Briggs Institute methodology. Presentation of the scoping review conforms with PRISMA-ScR (Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews). Eligibility criteria were defined according to 3 concept constructs (AI technologies, compassion, healthcare) developed from the literature and informed by medical subject headings (MeSH) and key words for the electronic searches. Sources of evidence were Web of Science and PubMed databases, articles published in English language 2011-2022. Articles were screened by title/abstract using inclusion/exclusion criteria. Data extracted (author, date of publication, type of article, aim/context of healthcare, key relevant findings, country) was charted using data tables. Thematic analysis used an inductive-deductive approach to generate code categories from the review questions and the data. A multidisciplinary team assessed themes for resonance and relevance to research and practice. Results: Searches identified 3,124 articles. A total of 197 were included after screening. The number of articles has increased over 10 years (2011, n = 1 to 2021, n = 47 and from Jan-Aug 2022 n = 35 articles). Overarching themes related to the review questions were: (1) Developments and debates (7 themes) Concerns about AI ethics, healthcare jobs, and loss of empathy; Human-centered design of AI technologies for healthcare; Optimistic speculation AI technologies will address care gaps; Interrogation of what it means to be human and to care; Recognition of future potential for patient monitoring, virtual proximity, and access to healthcare; Calls for curricula development and healthcare professional education; Implementation of AI applications to enhance health and wellbeing of the healthcare workforce. (2) How AI technologies enhance compassion (10 themes) Empathetic awareness; Empathetic response and relational behavior; Communication skills; Health coaching; Therapeutic interventions; Moral development learning; Clinical knowledge and clinical assessment; Healthcare quality assessment; Therapeutic bond and therapeutic alliance; Providing health information and advice. (3) Gaps in knowledge (4 themes) Educational effectiveness of AI-assisted learning; Patient diversity and AI technologies; Implementation of AI technologies in education and practice settings; Safety and clinical effectiveness of AI technologies. (4) Key areas for development (3 themes) Enriching education, learning and clinical practice; Extending healing spaces; Enhancing healing relationships. Conclusion: There is an association between AI technologies and compassion in healthcare and interest in this association has grown internationally over the last decade. In a range of healthcare contexts, AI technologies are being used to enhance empathetic awareness; empathetic response and relational behavior; communication skills; health coaching; therapeutic interventions; moral development learning; clinical knowledge and clinical assessment; healthcare quality assessment; therapeutic bond and therapeutic alliance; and to provide health information and advice. The findings inform a reconceptualization of compassion as a human-AI system of intelligent caring comprising six elements: (1) Awareness of suffering (e.g., pain, distress, risk, disadvantage); (2) Understanding the suffering (significance, context, rights, responsibilities etc.); (3) Connecting with the suffering (e.g., verbal, physical, signs and symbols); (4) Making a judgment about the suffering (the need to act); (5) Responding with an intention to alleviate the suffering; (6) Attention to the effect and outcomes of the response. These elements can operate at an individual (human or machine) and collective systems level (healthcare organizations or systems) as a cyclical system to alleviate different types of suffering. New and novel approaches to human-AI intelligent caring could enrich education, learning, and clinical practice; extend healing spaces; and enhance healing relationships. Implications: In a complex adaptive system such as healthcare, human-AI intelligent caring will need to be implemented, not as an ideology, but through strategic choices, incentives, regulation, professional education, and training, as well as through joined up thinking about human-AI intelligent caring. Research funders can encourage research and development into the topic of AI technologies and compassion as a system of human-AI intelligent caring. Educators, technologists, and health professionals can inform themselves about the system of human-AI intelligent caring.

Online interprofessional education related to chronic illness for health professionals: a scoping review.

This scoping review focuses on identifying the quantity and quality of research evidence available with regard to online interprofessional education related to chronic disease management. Recent advances have seen the emergence of information communication technology and digital health solutions that may improve monitoring of and self-management of chronic disease. With the growing chronic disease burden globally, and the advancement of information communication technology, digital health solutions may improve chronic disease monitoring and self-management. However, health professionals are slow to utilize this technology in chronic disease management. Online education has the potential to enhance utilization of digital health solutions across interprofessional healthcare teams. This scoping review focuses on online interprofessional education and eLearning strategies used to promote engagement and achievement of learning outcomes between health care professionals in chronic disease management. A systematic search of the literature yielded 3112 papers; 15 studies were included in the review following an independent screening process. The review found very limited research for online interprofessional education related to chronic disease so it is not feasible to comment or draw conclusions in relation to its impact on interprofessional learning, student engagement in education or its impact in practice, services or health outcomes. Research methodology and online eLearning strategies varied across studies, highlighting the need for further rigorous studies that include consistency in online interprofessional education strategies, evaluations and study methods.

Systems thinking: advancing health advocacy training; a perspective from junior family physicians in the Middle East.

Healthcare systems are becoming increasingly complex. Physicians are expected to be agents of change to meet the growing health needs. In the Middle East, young family doctors are subtly creating a space for advocacy. Recognising the need for compulsory advocacy training in undergraduate medical curricula, allows health workers and students a concrete exposure to social determinants of health by carrying out clinical encounters from the hospital setting to outpatient dispensaries in underprivileged areas. At the community level, they organise mobile clinics and engage in collaborative initiatives to provide primary healthcare services to vulnerable populations. To be successful, advocacy practice and training should move towards systems thinking. Family doctors need to engage and collaborate with other stakeholders within the healthcare system and understand the dynamics of the relationships between them. This empowers their role in national health agendas, especially those related to universal health coverage (UHC). Future physicians and all members of primary care teams need to partner with people outside their discipline; the idea of interdisciplinary and interprofessional collaboration should be integrated into their schooling and all forms of vocational training.

Investigating online interprofessional learning and communication using social network analysis: a study protocol.

Interprofessional education (IPE) via the use of online learning environments (OLEs) can help improve patient outcomes, interprofessional attitudes, and behaviors while providing education at a distance. Studies of interprofessional learning often examine communication and its relation to learning outcomes qualitatively. OLEs allow researchers to examine these communication patterns quantitatively, through social network analysis (SNA), and answer questions regarding the nature of communication between interprofessional learners and how this may impact interprofessional attitudes and behaviors. In this paper, we present a study that aims to track interprofessional communication within a cancer care course using SNA and examine how it relates to professional attitudes and collaboration. Using pre and post-course surveys as well as numerous SNA metrics derived from course discussion board posts, we hope to show how communication between interprofessional learners may mediate outcomes. This work will add to the existing IPE literature by providing an added quantitative layer to a largely qualitative literature and encourage future studies in this area.

The use of virtual communities of practice to improve interprofessional collaboration and education: findings from an integrated review.

The recent growth in online technology has led to a rapid increase in the sharing of health related information globally. Health and social care professionals are now using a wide range of virtual communities of practice (VCoPs) for learning, support, continuing professional education, knowledge management and information sharing. In this article, we report the findings from a review of the literature that explored the use of VCoPs by health and social care professionals to determine their potential for interprofessional education and collaboration. We employed integrated review methods to search and identify relevant VCoP articles. We undertook searches of PubMed and Google Scholar from 2000, which after screening, resulted in the inclusion of 19 articles. A thematic analysis generated the following key issues related to the use of VCoPs: 'definitions and approaches', 'technological infrastructure', 'reported benefits', 'participation issues', 'trust and privacy and 'technical ability'. Based on the findings from this review, there is some evidence that VCoPs can offer an informal method of professional and interprofessional development for clinicians, and can decrease social and professional isolation. However, for VCoPs to be successful, issues of privacy, trust, encouragement and technology need to be addressed.

Interprofessional online learning for primary healthcare: findings from a scoping review.

OBJECTIVES: This article presents the findings from a scoping review which explored the nature of interprofessional online learning in primary healthcare. The review was informed by the following questions: What is the nature of evidence on online postgraduate education for primary healthcare interprofessional teams? What learning approaches and study methods are used in this context? What is the range of reported outcomes for primary healthcare learners, their organisations and the care they deliver to patients/clients? SETTING: The review explored the global literature on interprofessional online learning in primary healthcare settings. RESULTS: The review found that the 23 included studies employed a range of different e-learning methods with contrasting course durations, use of theory, participant mix, approaches to accreditation and assessment of learning. Most of the included studies reported outcomes associated with learner reactions and positive changes in participant attitudes/perceptions and improvement in knowledge/skills as a result of engagement in an e-learning course. In contrast, fewer studies reported changes in participant behaviours, changes in organisational practice and improvements to patients/clients. CONCLUSIONS: A number of educational, methodological and outcome implications are be offered. E-learning can enhance an education experience, support development, ease time constraints, overcome geographic limitations and can offer greater flexibility. However, it can also contribute to the isolation of learners and its benefits can be negated by technical problems.

Proanthocyanidin-rich extracts from cranberry fruit (Vaccinium macrocarpon Ait.) selectively inhibit the growth of human pathogenic fungi Candida spp. and Cryptococcus neoformans.

Cranberry ( Vaccinium macrocarpon ) has been shown in clinical studies to reduce infections caused by Escherichia coli and other bacteria, and proanthocyanidins are believed to play a role. The ability of cranberry to inhibit the growth of opportunistic human fungal pathogens that cause oral, skin, respiratory, and systemic infections has not been well-studied. Fractions from whole cranberry fruit were screened for inhibition of five Candida species and Cryptococcus neoformans , a causative agent of fungal meningitis. Candida glabrata , Candida lusitaniae , Candida krusei , and Cryptococcus neoformans showed significant susceptibility to treatment with cranberry proanthocyanidin fractions in a broth microdilution assay, with minimum inhibitory concentrations as low as 1 µg/mL. MALDI-TOF MS analysis of subfractions detected epicatechin oligomers of up to 12 degrees of polymerization. Those containing larger oligomers caused the strongest inhibition. This study suggests that cranberry has potential as an antifungal agent.

Evaluation of 6 candidate genes on chromosome 11q23 for coeliac disease susceptibility: a case control study.

BACKGROUND: Recent whole genome analysis and follow-up studies have identified many new risk variants for coeliac disease (CD, gluten intolerance). The majority of newly associated regions encode candidate genes with a clear functional role in T-cell regulation. Furthermore, the newly discovered risk loci, together with the well established HLA locus, account for less than 50% of the heritability of CD, suggesting that numerous additional loci remain undiscovered. Linkage studies have identified some well-replicated risk regions, most notably chromosome 5q31 and 11q23. METHODS: We have evaluated six candidate genes in one of these regions (11q23), namely CD3E, CD3D, CD3G, IL10RA, THY1 and IL18, as risk factors for CD using a 2-phase candidate gene approach directed at chromosome 11q. 377 CD cases and 349 ethnically matched controls were used in the initial screening, followed by an extended sample of 171 additional coeliac cases and 536 additional controls. RESULTS: Promotor SNPs (-607, -137) in the IL18 gene, which has shown association with several autoimmune diseases, initially suggested association with CD (P < 0.05). Follow-up analyses of an extended sample supported the same, moderate effect (P < 0.05) for one of these. Haplotype analysis of IL18-137/-607 also supported this effect, primarily due to one relatively rare haplotype IL18-607C/-137C (P < 0.0001), which was independently associated in two case-control comparisons. This same haplotype has been noted in rheumatoid arthritis. CONCLUSION: Haplotypes of the IL18 promotor region may contribute to CD risk, consistent with this cytokine's role in maintaining inflammation in active CD.