Confidence in adolescent contraceptive counseling among residents and fellows training at the University of Texas Southwestern in Dallas, Texas.

OBJECTIVES: Evaluate trainees' perceptions of past training and confidence in counseling about five contraceptive methods. STUDY DESIGN: Trainees completed an online survey in 2020. Logistic regressions evaluated the relationship between participant characteristics and confidence. RESULTS: Among 227 respondents (63% response rate), pediatric trainees reported the least confidence in counseling across each contraceptive method. Past training and confidence were associated. CONCLUSIONS: Gaps in training should be addressed to improve confidence in contraceptive counseling among pediatricians in reproductively restricted states.

Infection prevention and control and related practices in African neonatal units: The Pan-African neonatal care assessment study (PANCAS).

BACKGROUND: The burden of neonatal mortality is primarily borne by low- and middle-income countries (LMICs), including deaths due to healthcare-associated infections (HAIs). Few studies have assessed infection prevention and control (IP&C) practices in African units caring for small and/or sick newborns aimed to reduce HAIs. METHODS: We performed a mixed-methods study composed of a survey and virtual tour to assess IP&C and related practices. We created a survey composed of multiple-choice and open-ended questions delivered to site respondents via Zoom or video equivalent. Respondents provided a virtual tour of their unit via video and the study team used a checklist to evaluate specific practices. RESULTS: We recruited 45 units caring for small and sick newborns in 20 African countries. Opportunities to optimize hand hygiene, Water, Sanitation and Hygiene (WASH) practices, Kangaroo Mother Care, and IP&C training were noted. The virtual tour offered further understanding of IP&C challenges unique to individual sites. All respondents expressed the need for additional space, equipment, supplies, education, and IP&C staff and emphasized that attention to maternal comfort was important to IP&C success. DISCUSSION: This study identified opportunities to improve IP&C practices using low-cost measures including further education and peer support through learning collaboratives. Virtual tours can be used to provide site-specific assessment and feedback from peers, IP&C specialists and environmental engineering experts.

The COVID-19 pandemic and mental health in Kazakhstan.

The COVID-19 pandemic had significant impacts on mental health. We examined factors associated with symptoms of depression and anxiety during the COVID-19 pandemic in Kazakhstan. We surveyed 991 adults in Kazakhstan in July 2021 using multistage stratified sampling. Depression and anxiety were measured with the Patient Health Questionnaire-4. We conducted logistic regression to assess associations between depression and anxiety and sociobehavioral factors. Overall, 12.01% reported depressive symptoms and 8.38% anxiety. Higher likelihood of depression was associated with being female (AOR: 1.64; 95% CI [1.05, 2.55]), having experience with COVID-19 in the social environment (AOR: 1.85; 95% CI [1.1-3.14]), experiencing food insecurity (AOR: 1.80; 95% CI [1.11-2.89]), increased family conflict (AOR: 2.43; 95% CI [1.32-4.48]) and impaired healthcare access (AOR: 2.41; 95% CI [1.32-4.41]). Higher likelihood of anxiety was associated with being female (AOR: 3.43; 95% CI [1.91-6.15]), increased family conflict (AOR: 2.22; 95% CI [1.11-4.44]) and impaired healthcare access (AOR: 2.63; 95% CI [1.36-5.12]). Multiple factors were associated with mental health in Kazakhstan during the COVID-19 pandemic. Further research is needed to determine the extent to which these factors and their associated mental health outcomes may persist.

Longitudinal assessment of COVID-19 vaccine uptake: A two-wave survey of a nationally representative U.S. sample.

Understanding factors that influence those who are initially COVID-19 vaccine hesitant to accept vaccination is valuable for the development of vaccine promotion strategies. Using Ipsos KnowledgePanel®, we conducted a national survey of adults aged 18 and older in the United States. We created a questionnaire to examine factors associated with COVID-19 vaccine uptake over a longitudinal period ("Wave 1" in April 2021 and "Wave 2" in February 2022), and utilized weighted data provided by Ipsos to make the data nationally representative. Overall, 1189 individuals participated in the Wave 1 survey, and 843 participants completed the Wave 2 survey (71.6% retention rate). Those who intended to be vaccinated as soon as possible ("ASAP") were overwhelmingly vaccinated by Wave 2 (96%, 95% CI: 92% to 100%). Of those who initially wished to delay vaccination until there was more experience with it ("Wait and See"), 57% (95% CI: 47% to 67%) were vaccinated at Wave 2. Within the "Wait and See" cohort, those with income <$50,000 and those who had never received the influenza vaccine were significantly less likely to be vaccinated at Wave 2. Among those who initially indicated that they would not receive a COVID-19 vaccine ("Non-Acceptors"), 28% (95% CI: 21% to 36%) were vaccinated at Wave 2. Those who believed COVID-19 was not a major problem in their community were significantly less likely to be vaccinated, while those with more favorable attitudes toward vaccines in general and public health strategies to decrease the impact of COVID-19 were significantly more likely to be vaccinated. Overall, barriers to vaccine uptake for the "Wait and See" cohort appear to be more practical, whereas barriers for the "Non-Acceptor" cohort seem to be more ideological. These findings will help target interventions to improve uptake of COVID-19 boosters and future novel vaccines.

Attitudes about the Provision of Sexual Health Services in an Inpatient Setting.

OBJECTIVE: To examine the relationship between clinicians' attitudes about the appropriateness of providing sexual health services in the inpatient setting and confidence in providing services METHODS: An online survey was emailed to pediatric hospitalists, adolescent medicine, and pediatric and adolescent gynecology societies and directors. Confidence in managing 8 sexual health situations was measured on a 4-point Likert scale, summed, averaged, and dichotomized into confident and not so confident. Participants were asked to rate on a 5-point Likert scale their belief that providing sexual health services in the inpatient setting would be appropriate. An adjusted, multivariate logistic regression identified associations between participant demographic characteristics, professional characteristics, and confidence and attitudes about the appropriateness of providing inpatient sexual health services. RESULTS: Among the 610 participants, the mean age was 40 years. Most were females (79%), non-Hispanic White (71%), and practiced pediatric hospital/general medicine (73%). Most (73%) were not so confident across all 8 confidence items. Overall, 61% "strongly agreed" that providing sexual health services in the inpatient setting was appropriate. Participants who reported younger age, being female, and confidence in providing services were significantly associated with strong agreement that it was appropriate to provide sexual health services in the inpatient setting. Those who identified as Christian non-Catholic were significantly less likely to report strong agreement. CONCLUSION: Most providers strongly agreed that providing sexual health services in the inpatient setting was appropriate, yet most were not so confident in managing sexual health situations. Future studies should focus on addressing concerns and barriers to providing sexual health services.

Factors impacting parental uptake of COVID-19 vaccination for U.S. Children ages 5-17.

COVID-19 vaccination of U.S. children lags behind adult vaccination, but remains critical in mitigating the pandemic. Using a subset of a nationally representative survey, this study examined factors contributing to parental uptake of COVID-19 vaccine for children ages 12-17 and 5-11, stratified by parental COVID-19 vaccination status. Among vaccinated parents, uptake was higher for 12-17-year-olds (78.6%) than 5-11-year-olds (50.7%); only two unvaccinated parents vaccinated their children. Child influenza vaccination was predictive of uptake for both age groups, while side effect concerns remained significant only for younger children. Although parents were more likely to involve adolescents in vaccine decision-making than younger children, this was not predictive of vaccine uptake. These results highlight the importance of addressing the unique and shared concerns parents have regarding COVID-19 vaccination for children of varying ages. Future work should further explore adolescent/child perspectives of involvement in COVID-19 vaccination decision-making to support developmentally appropriate involvement.

Residents and Fellows' Confidence in Prescribing Pre-exposure Prophylaxis (PrEP)

OBJECTIVE: Residents and fellows are often the first health.ßcare providers to discuss sexual health and prevention with adolescents and young adults at academic institutions. This study characterized when learners in Pediatrics, Obstetrics and Gynecology, and Family Medicine believed that one should receive training in pre-exposure prophylaxis (PrEP) and it described confidence in prescribing PrEP. METHODS: Learners at a large, urban, southern academic center completed an online survey about adolescent sexual health services. Measures included whether participants were taught how to prescribe PrEP and how to do so in a confidential manner. Confidence in these two behaviors was measured with a Likert scale and dichotomized for bivariate analysis. RESULTS: Among the 228 respondents (63% response rate), most learners preferred sexual health communication to be emphasized early in medical school and throughout training. Overall, 44% reported being ..únot confident at all..Ñ in prescribing PrEP, and 22% were ..únot confident at all..Ñ in prescribing in a confidential manner. Those who reported ..únot confident at all" in prescribing PrEP were more likely in pediatrics (51%) than family medicine (23%) or obstetrics-gynecology (35%) (P.ß<.ß.01). Those who had been taught how to prescribe were more confident in prescribing PrEP (P.ß..±.ß.01) and prescribing in a confidential manner (P.ß<.ß.01). CONCLUSIONS: Given the continued high rates of new human immunodeficiency virus infections among adolescents, effective communication with patients eligible for PrEP is critical. Future studies should evaluate and inform tailored curricula about the importance of PrEP and build communication skills around confidential prescribing.

COVID-19 vaccine uptake and attitudes towards mandates in a nationally representative U.S. sample.

Widespread uptake of COVID-19 vaccination is vital to curtailing the pandemic, yet rates remain suboptimal in the U.S. Vaccine mandates have previously been successful, but are controversial. An April 2021 survey of a nationally representative sample (N = 1208) examined vaccine uptake, attitudes, and sociodemographic characteristics. Sixty-seven percent were vaccine acceptors, 14% wait-and-see, and 19% non-acceptors. Compared to wait-and-see and non-acceptors, acceptors were more likely to have a household member over age 65, have received a flu shot, have positive COVID-19 vaccine attitudes, and view COVID-19 vaccination as beneficial. Mandate support was higher among respondents who were vaccine acceptors, had positive views about COVID-19 vaccines, believed in COVID-19 preventive strategies, perceived COVID-19 as severe, were liberal, resided in the Northeast, were non-White, and had incomes < $75,000. Public health campaigns should target attitudes that appear to drive hesitancy and prepare for varying mandate support based on demographics, COVID-19 vaccine attitudes, and the scope of the mandate.

The impact of financial incentives on COVID-19 vaccination intention among a sample of U.S. adults.

Financial incentives are one of several strategies that have been explored to enhance COVID-19 vaccine uptake. Although widely discussed, it is unclear how much of an incentive and for which subset of individuals incentives would be effective. This study explored the impact of hypothetical $600 or $1200 incentives on COVID-19 vaccination intention. From a nationally representative panel of U.S. adults, 346 individuals reported hesitance towards COVID-19 vaccination and were then asked about their willingness to accept a vaccine if offered hypothetical incentives. Results indicated 26.89% would get vaccinated if offered $600, and 30.06% if offered $1200. In the multivariable model that included sociodemographic and attitudinal predictors of vaccine uptake, those classified as 'wait-and-see' compared to those classified as non-acceptors were more likely to accept COVID-19 vaccines when given financial incentives, and those who believed more strongly in the benefits of COVID-19 vaccines were more likely to accept a vaccine when first offered hypothetical $600 and then $1200 incentives. Individuals unsure if they ever had COVID-19 were significantly less likely to be willing to get the vaccine for $1200 as compared to those who believed they previously had COVID-19. These results suggest that financial incentives can increase intention to receive a COVID-19 vaccine.

Development and performance of a point-of-care rapid antigen test for detection of SARS-COV-2 variants.

Background: SARS-CoV-2 antigen-based tests are well-calibrated to infectiousness and have a critical role to play in the COVID-19 public health response. We report the development and performance of a unique lateral flow immunoassay (LFA). Methods: Combinations of several monoclonal antibodies targeting multiple antigenic sites on the SARS-CoV-2 nucleocapsid protein (NP) were isolated, evaluated, and chosen for the development of a LFA termed CoV-SCAN (BioMedomics, Inc.). Clinical point-of-care studies in symptomatic and asymptomatic individuals were conducted to evaluate positive predictive agreement (PPA) and negative predictive agreement (NPA) with RT-PCR as comparator. Results: In laboratory testing, CoV-SCAN detected 14 recombinant N-proteins of SARS-CoV-2 variants with sensitivity in the range of 0.2-3.2 ng/mL, and 10 authentic SARS-CoV-2 variants with sensitivity in the range of 1.6-12.5 TCID50/swab. No cross reactivity was observed with other human coronaviruses or other respiratory pathogens. In clinical point-of-care testing on 148 individuals over age 2 with symptoms of ≤5 days, PPA was 87.2% (CI 95: 78.3-94.8%) and NPA was 100% (CI 95: 94.2-100%). In another 884 asymptomatic individuals, PPA was 85.7% (CI 95: 42.1-99.6%) and 99.7% (99.0-99.9%). Overall, CoV-SCAN detected over 97.2% of specimens with CT values <30 and 93.8% of nasal swab specimens with the Omicron variant, even within the first 2 days after symptom onset. Conclusions: The unique construction of CoV-SCAN using two pairs of monoclonal antibodies has resulted in a test with high performance that remains durable across multiple variants in both laboratory and clinical evaluations. CoV-SCAN should identify almost all individuals harboring infectious SARS-CoV-2. Summary: Unique construction of a point-of-care rapid antigen test using two pairs of monoclonal antibodies has led to good performance that remained durable across multiple variants in laboratory and clinical evaluations. Test should identify almost all individuals harboring infectious SARS-CoV-2.

Impact of Breastfeeding Support Services on Mothers' Breastfeeding Experiences When Provided by an MD/IBCLC in the Pediatric Medical Home.

Addressing breastfeeding issues enables mothers to reach their breastfeeding goals. We embedded a breastfeeding consultation service run by a pediatrician/International Board Certified Lactation Consultant (MD/IBCLC) in a medical home. This mixed-methods study investigated breastfeeding preparedness and the service's perceived benefits. Mothers with breastfeeding issues/concerns identified at well-baby appointments were referred to the service. Telephone interviews and chart reviews were conducted with 28 participating mothers approximately 1 month after the visits. Breastfeeding Self-Efficacy Scale scores improved significantly from the time of the in-person appointment to 1 month later. Most mothers felt unprepared for breastfeeding despite prenatal efforts. Trust in the pediatrician's recommendation, easy access, and insurance coverage were key factors in seeking the service. Reassurance provided by the MD/IBCLC increased mothers' confidence to breastfeed. The COVID-19 pandemic heightened feelings of isolation and anxiety due to lack of hands-on support from friends and family during the birth hospitalization and when at home.

Provider and staff crisis well-being associated with trust in leadership and baseline burnout.

BACKGROUND: The impact of the coronavirus 2019 (COVID-19) pandemic on the emotional health of health care workers continues to be an area of active research. However, few studies have focused on those working in pediatrics and its subspecialties, as well as ancillary and non-patient-facing staff. The purpose of this study was to determine the prevalence and associated predictors of burnout and emotional well-being of providers and staff. METHODS: An anonymous electronic survey was developed evaluating demographics, pandemic experiences, possible predictor variables, and three main outcomes of burnout, psychological distress, and perceived stress. Pediatric hematology oncology (PHO) chiefs and program directors across the country were invited to participate and disseminate the survey to their programs. RESULTS: A total of 682/1950 (35% of invited) individuals responded to all predictor and outcome variables. Over half reported high levels of burnout and some reported moderate/high levels of distress. Prepandemic burnout and decreased trust in leadership were associated with all three outcomes. Additional predictors included having a child ≤18 years at home, hospital role, and worrying about patient care or relationship with their patients. The majority (n = 444/682, 65.5%) reported that their institution had made COVID-19-related mental health resources available. However, only 6.5% (n = 44/682) reported utilizing these resources. CONCLUSIONS: While the majority of PHO providers and staff were resilient during the early stages of the COVID-19 pandemic, many reported high levels of burnout, yet few are utilizing institutional resources. This study has highlighted several actionable areas to help identify and address factors that are wearing down the emotional well-being of providers and staff.

Supporting Health-Care Workers and Patients in Quarantine Wards: Evidence From a Survey of Frontline Health-Care Workers and Inpatients With COVID-19 in Wuhan, China.

Objective: Frontline health-care workers and patients with COVID-19 have been identified as high-risk groups for psychological problems. Experience of working or staying in quarantine wards generated psychological stressors for health-care workers and patients with COVID-19. The present study aimed to investigate the psychological symptoms of hospitalized patients with COVID-19 and the health-care workers treating them during the outbreak period, examine the effects of psychological stressors on mental health in both populations and perceived coping resources for both sides. Methods: Three hundred and eleven health-care workers working in a COVID-19 designated hospital in Wuhan, China, and 148 hospitalized patients with COVID-19 in the same hospital participated in this cross-sectional survey conducted in February 2020. Psychological symptoms, psychological stressors, and perceived coping resources were reported by both groups. Results: Thirty-three percent of health-care workers and 35.2% of patients with COVID-19 had significant psychological symptoms that were indicative of a high risk for psychological disorders. Pandemic-related psychological stressors contributed to psychological symptoms for both populations. Concern about patients was one aspect of psychological stressors of frontline health-care workers and both groups perceived support from the opposite side as an important external coping resource. Conclusion: The results shed light on the need to provide psychological support to both frontline health-care workers and patients with COVID-19 and suggest enhancing the treatment alliance might be effective to improve mental health for both populations during the crisis.

Improving the Transition of Adolescents from Disadvantaged Backgrounds from Pediatric to Adult Primary Care Providers.

BACKGROUND: The lack of structured transition interventions for adolescents aging out of pediatric care is associated with poor health outcomes. METHODS: We assessed the effectiveness of a transition protocol that aimed to improve the transfer of adolescents to adult primary care. Chart reviews were conducted on 21- and 22-year-old patients seen 18 months before and after protocol implementation. Completion of an adult medicine appointment scheduled within 6 months from the last pediatric visit was the primary outcome of interest. FINDINGS: In pre-implementation period, 20.9% of patients versus 39.3% in post-implementation period were transferred. Transfer was higher in patients who had a dedicated transition visit, had a transition order placed, and were tracked during the transfer process. DISCUSSION: A transition protocol can increase the number of adolescents who transfer to adult care. Once a patient is ready to transition, a dedicated transition visit is ideal; however, providers should incorporate transition care during any clinical encounter. While an electronic transition order can facilitate appointment scheduling, patient tracking and appointment reminders can help ensure appointment completion. In addition, all clinical staff should receive transition training and clinicians should be frequently reminded about the need to transition their patients. However, even with these efforts to support transition, the majority of patients did not do so, which indicates a continued need to develop and evaluate transition interventions. PRACTICE IMPLICATIONS: Implementing a transition protocol in pediatric clinics can improve the transition of adolescents aging out of pediatric care and may diminish gaps in medical care that can be associated with poor health outcomes.

Well-Being of Pediatric Hematology Oncology Providers and Staff During the COVID-19 Pandemic in the New York and New Jersey Epicenter.

PURPOSE: The COVID-19 pandemic has significantly affected the well-being of healthcare workers to varying degrees. The aim of the current study was to investigate how the pandemic has affected the burnout, stress, and emotional well-being of pediatric hematology oncology (PHO) providers and staff in the New York and New Jersey epicenter. METHODS: The study was conducted in June 2020 during the pandemic through an electronic survey. The survey contained questions surrounding demographics, pandemic experiences, and validated burnout, stress, and emotional well-being measures. RESULTS: Two hundred fifty-two PHO providers and staff responded to the survey. Overall, half of the participants reported high levels of burnout, average stress scores were in the mild-moderate range, and the majority scored in the none-to-mild symptomatology range for their well-being. Self-reported burnout levels before the pandemic and geographic work location were statistically significant risk factors for all outcomes. Additional predictors for some outcomes included hospital role, lack of trust in leadership, and deployment. The majority of participants (87.0%) reported that their hospitals had made mental health resources related to COVID-19 available to them but only 8.4% reported having used them. CONCLUSION: PHO providers and staff in the NYC/NJ area are experiencing a range of emotional experiences during the COVID-19 pandemic, but the majority are not using current resources. With the continuation of the pandemic, we must continue efforts to improve provider and staff distress to mitigate the degree of potential negative short-term and long-term impact.

Persistent Impostor Phenomenon Is Associated With Distress in Medical Students.

BACKGROUND AND OBJECTIVES: Medical student distress and mental health needs are critical issues in undergraduate medical education. The imposter phenomenon (IP), defined as inappropriate feelings of inadequacy among high achievers is linked to psychological distress. We investigated the prevalence of IP among first-year medical school students and its association with personality measures that affect interpersonal relationships and well-being. METHODS: Two hundred fifty-seven students at a large, urban, northeastern medical school completed the Clance Impostor Phenomenon Scale (CIPS), Jefferson Scale of Empathy, Self-Compassion Scale, and Zuckerman-Kuhlman Personality Questionnaire immediately before beginning their first year of medical school. At the end of their first year, 182 of these students again completed the CIPS. RESULTS: Eighty-seven percent of the entering students reported high or very high degrees of IP. Students with higher IP scores had significantly lower mean scores on self-compassion, sociability self-esteem (P<.0001 for all), and getting along with peers (P=.03). Lower IP scores were related to lower mean scores on neuroticism/anxiety and loneliness (P<.001 for both). Women obtained a higher mean IP score than men. IP scores at the end of the school year increased significantly compared with the beginning of the year (P<.001), both in frequency and intensity of IP. CONCLUSIONS: IP was common in matriculating first-year medical students and significantly increased at year's end. Higher IP scores were significantly associated with lower scores for self-compassion, sociability, self-esteem, and higher scores on neuroticism/anxiety.

"I've Weathered Really Horrible Storms Long Before This ": The Experiences of Parents Caring for Children with Hematological and Oncological Conditions during the Early Months of the COVID-19 Pandemic in the U.S.

The societal impact of COVID-19 is vast, thus it is imperative to understand how vulnerable groups, such as children with chronic medical conditions are affected. This understanding can prepare psychologists and other healthcare providers to meet their current and future needs. A convenience sample of 11 parents of children with hematological/oncological conditions was recruited. They participated in semi-structured interviews on the effect of the COVID-19 pandemic on their children. Qualitative analysis identified common themes. Parental responses focused on the pandemic's impact on children's general daily life and healthcare. Themes of caution, uncertainty, adaptation, and the role of the healthcare providers and early medical experiences emerged. Concerns about vulnerability, changes in routine, the importance of virtual connections, and the pivotal role of providers have implications for children with and without medical conditions. The adaptation and resilience of the families provide a sense of hope in an uncertain time.

Research Participation of Minor Adolescents in Foster Care.

STUDY OBJECTIVE: In this study we evaluated published studies about foster care to: (1) determine the types of data used; (2) describe the degree to which a sexual/reproductive health topic was addressed; and (3) describe the consent process. DESIGN: Analysis of published literature. SETTING: PubMed was searched using "foster care" for English articles published between January 1, 2017 and September 4, 2019. PARTICIPANTS: None. INTERVENTIONS: None. MAIN OUTCOME MEASURES: Articles were coded into 4 data source categories: primary, secondary, peripheral, or perspective data. Articles with a primary data source were coded for participant ages: only 9 years old and younger, 10- to 17-year-olds (minor adolescents), and only 18 years old and older. Articles using a secondary data source were coded for the source of the data registry. All articles were coded for presence of a sexual/reproductive health outcome. The primary data articles that included minor adolescents were coded for the study topic and consent process. RESULTS: Of the 176 articles about foster care, 72/176 (41%) used primary data, 53/176 (30%) used secondary data, and 51/176 (29%) used peripheral/perspective data. Forty-eight of the primary data articles included minor adolescents. Secondary data sources included few national research surveys. Sexual/reproductive health outcomes were measured in 17 articles, 4 of which used primary data. The consent process for minor adolescents varied and had no consistent pattern across studies. CONCLUSION: Research on best practices for consent processes and use of registries could be developed to increase research on sexual/reproductive health outcomes among adolescents in foster care.

Linguistic analysis of empathy in medical school admission essays.

OBJECTIVES: This study aimed to determine whether words used in medical school admissions essays can predict physician empathy. METHODS: A computational form of linguistic analysis was used for the content analysis of medical school admissions essays. Words in medical school admissions essays were computationally grouped into 20 'topics' which were then correlated with scores on the Jefferson Scale of Empathy. The study sample included 1,805 matriculants (between 2008-2015) at a single medical college in the North East of the United States who wrote an admissions essay and completed the Jefferson Scale of Empathy at matriculation. RESULTS: After correcting for multiple comparisons and controlling for gender, the Jefferson Scale of Empathy scores significantly correlated with a linguistic topic (r = .074, p < .05). This topic was comprised of specific words used in essays such as "understanding," "compassion," "empathy," "feeling," and "trust." These words are related to themes emphasized in both theoretical writing and empirical studies on physician empathy. CONCLUSIONS: This study demonstrates that physician empathy can be predicted from medical school admission essays. The implications of this methodological capability, i.e. to quantitatively associate linguistic features or words with psychometric outcomes, bears on the future of medical education research and admissions. In particular, these findings suggest that those responsible for medical school admissions could identify more empathetic applicants based on the language of their application essays.