The double edge sword of John Henryism: Impact on patients' health in the People's Republic of China.

The People's Republic of China has experienced extraordinary economic growth, which is associated with increases in chronic health stressors. We examined the impact of John Henryism-a coping mechanism-on various health indicators in a sample of patients (n = 642) in China. John Henryism significantly related to increased medical adherence (B=.03,p<.001) and health-promotional behaviors (B=.02,p<.001). John Henryism predicted several indicators of psychological health through social support. John Henryism was also related to increased alcoholism (B=.04,p<.05). The findings highlight the complexity and paradoxical implications of John Henryism on health. Implications are discussed in relation to China's epidemiological and age demographic shifts.

Insisting on the Healer's Art: The Implications of Required Participation in a Medical School Course on Values and Humanism.

THEORY: Elective courses, by definition, allow medical students to self-select for participation in the class. In a small-group learning setting, students uninterested or not ready for a particular learning topic might change the educational experience ("poison the well") for those students most interested in the topic. It is not known how medical students required to take a course in humanism (that they otherwise would not have elected to take) might be impacted by the course or how their presence might affect students originally interested in the course. HYPOTHESES: Medical students in a required course on humanism and values in medicine will have different experiences based on whether a particular student might have or not have elected to enroll in the course. Students uninterested in taking a course in humanism and values, but required to enroll, will limit the benefit of the course for those students originally interested in participating. METHOD: In 2012, all 1st-year students at a U.S. medical school were required to take the Healer's Art, an elective on professional values and humanism offered at more than 90 other schools in the United States and internationally. Students completed pre/postcourse surveys assessing emotional exhaustion, work engagement, positive emotions, and cynicism. We analyzed differences between those who would have elected to take the course (Elective students) and those who would not have elected to take it (Required students). RESULTS: Elective students did not differ from Required students in baseline demographic characteristics, emotional exhaustion, work engagement, or positive emotions. At baseline, Elective students did report feeling safer to talk openly, a greater sense of community, and higher levels of cynicism. Over time, there were no differences in course evaluations or outcomes between Elective and Required students. CONCLUSIONS: Required students do not differ greatly from those who would have elected to take Healer's Art, and all students appear to have similar experiences in the course.