What About Empathy? A Qualitative Study Exploring the Role of a Podcast as an Asynchronous Empathy Teaching Tool.

Purpose: Though medical education podcasts are fast gaining popularity, they are overwhelmingly focused on teaching the medical expert role of physicians. We explored how medical learners and educators engaged with and learned from an empathy and communication-focused podcast and sought their recommendations for integrating the podcast into medical curricula. Methods: Six virtual, semi-structured focus groups were conducted with educators and learners within a large urban hospital and university setting. Participants were asked to listen to pre-selected episodes of the About Empathy podcast in advance. Thematic analysis was used to explore experiences and perceptions of empathy teaching and learning. Results: There were 24 participants. We identified six themes related to the podcast and empathy learning: (1) forging connection through stories, (2) creating space to reflect on empathy, (3) shifting perspectives and biases, (4) feeling validated and enabling self-compassion, (5) gaining knowledge and building skills through empathetic communication, and (6) translating new knowledge and skills into practice. Participants highlighted that the podcast's portability and asynchronous nature allowed them to be more fully present, reflective, and intentional in their learning. Discussion: The About Empathy podcast was experienced as a flexible, just-in-time tool that promoted self-agency over one's learning, reflective practice, and knowledge and skill acquisition, particularly with respect to empathic communication. Benefits of asynchronous e-learning tools such as podcasts support a shift to a blended learning model. Challenges finding a curricular home for this empathy-focused podcast require further consideration.

Development of an Advance Care Planning Policy within an Evidenced-Based Evaluation Framework.

Background: As the population is aging and medical advancements enable people to live longer, advance care planning (ACP) becomes increasingly important in guiding future care decisions; however, they are often incomplete or absent from the patient chart. This study describes the development and implementation of an ACP policy in a post-acute care and long-term care setting using a systematic implementation framework. Methods: A process evaluation that parallels the Replicating Effective Programs (REP) framework was used to understand stakeholder experiences with ACP and identify gaps in practice. Physicians, multidisciplinary staff, patients, and substitute decision makers engaged in focus groups and interviews, and completed surveys. A retrospective chart review determined Plan for Life Sustaining Treatment (PLST) form completion rates. Results: Stakeholder feedback identified barriers and facilitators to ACP including a need for staff training, user-friendly resources, and standardization of ACP practice. The PLST form was developed and embedded in the electronic medical record, and had a 92% and an 87% PLST completion rate on 2 pilot units. Conclusion: The study showed the usefulness of the REP model in guiding the evaluation as an effective tool to enhance implementation practices and inform ACP policy development that can be replicated in other organizations.

Major depressive disorder and diabetes: does serotonin bridge the gap?

Major depressive disorder (MDD) is one of the most common psychiatric illnesses worldwide, with reported prevalence rates ranging between 10% and 19%. Pharmacotherapy is a first-line option for the management of MDD and, as a result, the use of antidepressants has increased 4 fold in the last 20 years. Serotonin is the most commonly dysregulated neurotransmitter in the etiology of MDD and this system is the primary focus of most medications used in the treatment of illness. Although antidepressant use in adults increases the risk of developing new onset type 2 diabetes, the mechanisms underlying this association are poorly defined. This review will focus on 1) the evidence from human and animal studies suggesting a link between the use of antidepressants that target serotonin signaling (i.e., SSRIs, serotonin-norepinephrine reuptake inhibitors (SNRIs), serotonin antagonist and reuptake inhibitors (SARIs), and noradrenergic and specific serotonergic antidepressants (NaSSAs)) and increased risk of diabetes, and 2) the mechanisms by which alterations in serotonin signalling by antidepressants can affect glucose homeostasis.