공감과 다른 인적특성과 긍정적인 사회적 영향력으로 의과대학에서 잠재적 리더를 찾아낼 수 있을까? (Acad Med, 2015)

공감과 다른 인적특성과 긍정적인 사회적 영향력으로 의과대학에서 잠재적 리더를 찾아낼 수 있을까? (Acad Med, 2015)

Can Empathy, Other Personality Attributes, and Level of Positive Social Influence in Medical School Identify Potential Leaders in Medicine?

Mohammadreza Hojat, PhD, Barret Michalec, PhD, J. Jon Veloski, MS, and Mark L. Tykocinski, MD

리더십 학자들에 따르면 긍정적인 사회적 영향은 효과적인 리더십의 핵심 특징이다. 리더십은 개인이 함께 공동의 목표를 위해서 일할 때 상호관계적 상호작용으로부터 나온다. Eberly 등은 리더십을 '사회적 네트워크 분석을 통해서 밝힐 수 있는 사회적 영향력의 행사'라고 정의했다. 이러한 접근법은 잠재적 리더를 밝혀내는데 활용되어왔다.

Positive social influence, according to leadership scholars, is a core feature of effective leadership.1–3 Leadership emerges from interpersonal interactions that occur when individuals work together to achieve a common goal.3 Eberly and colleagues1 have defined leadership as an exertion of social influence that can be examined through social network analysis. This approach has also been used to identify the emergence of potential leaders.4–6

효과적인 리더에 대한 또 다른 접근은 리더의 개인적 특성에 대한 분석이다.

Another approach to identifying effective leaders is studying leaders’ personality attributes.1 For example,

• certain cognitive abilities,
• empathy,
• emotional intelligence,
• sociability,
• tolerance of ambiguity, and
• social appraisal skills

have been reported to foster effective leadership across a variety of situations.7–12

특히 개인의 "관계-지향적" 특성, 즉 공감empathy, 적극적 참여active engagement, 자기 확신self-confidence 등은 효과적인 리더십에 기여하는 것으로 보고되고 있다. 반대로 "참여적 스타일engaging style" 리더십과는 상반되는 특성도 있는데, 고립isolation, 고독loneliness, 신경증neuroticism, 충동impulsiveness, 공격성aggression 등이 사회적 관계에 해로워서 효과적인 리더십에도 해롭다고 보고된 바 있다.

In particular, “relationship-oriented” personality attributes such as empathy,7–9,12,13 active engagement,14 and self-confidence14 have been reported as being conducive to effective leadership.11,15–19 In contrast, there are other personality attributes that are at odds with the “engaging style” of leadership.20 For example, isolation, loneliness, neuroticism, impulsiveness, and aggression have been reported as being detrimental to social relationships21,22 and, by extension, to effective leadership.1–3

리더십에 관한 이들 연구는 개인의 특징에 초점을 두고, 리더십의 개인주의적 모델에 초점을 두고 있다.

Much of the previous research on leadership has focused on the personality profile, or the individualistic model of leadership.7–11

리더십이 '사회적 영향력의 행사'라는 가정하에, 그리고 사회적 영향력은 개인적 특성들의 함수라는 가정하에 본 연구를 수행

On the basis of the assumptions that leadership is an exertion of social influence1–3 and that social influence is a function of pertinent personality attributes,7–19 we designed this study

Method

참여자

Participants

긍정적 사회적 영향의 측정

Instrument to measure positive social influence

관계-형성적(relationship-building) 인적 특성 측정

Instruments to measure engaging (relationship-building) personality attributes

공감

Empathy.

We used the Jefferson Scale of Empathy (JSE), a 20-item validated instrument specifically developed to measure empathy in the context of patient care in medical and other health professions students and practitioners. We used the S version of the JSE, which was developed for administration to medical students.24 Evidence in support of the JSE’s validity25–29 and reliability25,29 has been reported, and the instrument has been translated into 43 languages and used in more than 60 countries.30 The possible score range is 20 to 140; a higher score on this scale indicates a greater orientation toward empathic engagement in patient care. The typical Cronbach alpha coefficient for this instrument, which has been reported in many studies, hovers around 0.75.24,25,29,30

사회성

Sociability.

We used a seven-item scale from the short form of the Zuckerman– Kuhlman Personality Questionnaire (ZKPQ) to measure sociability.31,32 (The ZKPQ was developed to measure five basic factors of personality that have a strong biological–evolutionary basis.31) Evidence in support of the validity and reliability of this scale in male (α = 0.78) and female (α = 0.79) college students has been reported.31 A higher score on this scale indicates a more sociable personality.

활동성

Activity.

We used a seven-item scale from the short form of the ZKPQ that measures a tendency to be active and to prefer challenging work.31 Evidence in support of the validity and reliability of this scale in male (α = 0.67) and female (α = 0.72) college students has been reported.31 A higher score on this scale indicates a higher degree of preference for challenging work.

자기존중

Self-esteem.

We used an abridged, five-item version of the Rosenberg Self- Esteem Scale,33 which is a measure of the self-acceptance aspect of self-esteem.34 This abridged scale has been used with medical and other health professions students.35–37 The reliability coefficient of this abridged scale among health professions students has been reported as 0.72.36 A higher score on this scale indicates a higher degree of self-esteem.

관계-회피성 인적 특성 측정

Instruments to measure disengaging personality attributes

고독

Loneliness.

We used an abridged, five- item version of the UCLA Loneliness Scale, which is a global measure of loneliness experiences.38 The abridged version has been used previously with medical and other health professions students,35,36 and its psychometric support in medical students has been reported.37 The reliability coefficient of the abridged scale among health professions students has been reported as 0.87.36 A higher score on this scale indicates a greater experience of loneliness and a lack of satisfaction with social relationships.

신경증

Neuroticism.

We used a seven-item scale from the short form of the ZKPQ that measures a tendency to be tense, to worry, to be overly sensitive to criticism, to be easily upset, and to be obsessively indecisive.31 Evidence in support of validity and reliability of this scale in male (α = 0.70) and female (α = 0.72) college students has been reported.31 A higher score on this scale indicates a more neurotic personality.

공격성

Aggression-hostility.

We used a seven- item scale from the short form of the ZKPQ that measures a tendency to express verbal aggression and to show rudeness, thoughtlessness, vengefulness, spitefulness, a quick temper, and impatient behavior.31 Evidence in support of the validity and reliability of this scale in male (α = 0.66) and female (α = 0.67) college students has been reported.31 A higher score on this scale indicates a higher degree of aggression and hostility.

충동

Impulsive sensation seeking.

We used a seven-item scale from the short form of the ZKPQ that measures a tendency to act quickly on impulse without planning, often in response to a need for thrills and excitement, change, and novelty.31 Evidence in support of validity and reliability of this scale in male (α = 0.62) and female (α = 0.71) college students has been reported.31 A higher score on this scale indicates a higher degree of impulsiveness and thrill-seeking behavior.

절차

Procedures

IRB

This study, determined to be exempt from review by the Thomas Jefferson University institutional review board, was conducted with graduating medical students between 2011 and 2013 as part of the Jefferson Longitudinal Study of Medical Education.39,40

학생 명단을 주고 "어떤 반 동료가 당신의 전문적/개인적 성장에 유의미한 긍정적인 영향을 주었나요?" 라고 질문하고, 복수의 학생을 선택할 수 있게 함.

To identify students’ degree of positive social influence among their peers, we asked students in each graduating class to complete a peer nomination instrument, which included the names of all students in the class listed in alphabetical order. Students were told that these nominations would be used in a study designed to enhance understanding of personal connections. The instrument’s instructions asked students to think back on their medical school experiences and respond to the following question: “Which of your classmates had significant positive influences on your professional and personal development?” The instructions specified that students were to consider all of their classmates who had positive influences on them and to check as many names as they deemed necessary.

통계 분석

Statistical analyses

We used multivariate analysis of variance, followed by univariate analyses of variance and Duncan post hoc multiple range tests, to examine the significance of the difference between the top and bottom influencers (the independent variable) on each of the dependent variables (empathy, sociability, activity, self-esteem, loneliness, neuroticism, aggression-hostility, and impulsive sensation seeking). We also calculated Cohen d as an estimate of the effect size of the differences.41,42

Results

고찰

Discussion

 

가장 많은 영향력을 가진 학생집단은 더 공감적/사회적/적극적이었다. 성공적 리더십의 관계-지향적 특성과 맞는다.

Our findings suggest that students identified as the top influencers (i.e., those with the most positive influence nominations from their peers) are more empathic, sociable, and active than the bottom influencers (i.e., those with the fewest nominations). These personality attributes are indicative of an engaging, relationship-building personality, which is a prominent feature of successful leadership.7–9,11,12,14–19,43

긍정적인 사회적 영향과 높은 공감 사이의 정적 관계는 이전 연구와도 일치함. 프로페셔널리즘을 갖추었다고 동료에 의해서 많이 지명받은 학생이 JSE에서 높았다. 긍정적인 사회적 영향력과 공감 사이의 관계가 있으며, 공감적 리더는 팔로워의 일체감belonging에 대한 요구를 고려할 수 있는 사람이며, 팔로워의 소속감에 대한 요구를 자극하며, 팔로워의 감정을 인지하고, 팔로워의 우려를 이해하며, 이타적 행동으로 팔로워와 관계를 맺는다.

Our finding of a significant association between positive social influence and higher empathy is consistent with the findings of a previous study in which medical students who were nominated by their peers as displaying qualities related to professionalism obtained a significantly higher mean score on the JSE than their classmates.44 This significant association between positive social influence—described as the foundation of leadership2—and empathy was expected, given previous findings that empathic leaders are able to take into consideration their followers’ needs for belongingness,7 to stimulate their followers’ needs for affiliation,45 to recognize their followers’ emotions,13 to understand their followers’ concerns,19 and to make connections with their followers through altruistic action.8

이전 연구에서 긍정적 사회적 영향력을 미치는 의사들이 간호사로부터 환자 진료와 관계된 정보를 얻을 가능성이 더 높고, 진료의 질이 따라서 더 높아짐을 보여준 바 있다. 이는 긍정적 사회적 영향력이 더 나은 임상 결과를 가져다줌을 시사한다. 또한 긍정적인 영향을 주는 것으로 동료로부터 인정받는 것이 교수들이 학생의 임상적 역량에 대해 평가한 것과 유의미한 연관이 있었다.

Prior work has shown that physicians who exert positive social influence are more likely to receive pertinent information from nurses, consequently resulting in higher-quality patient care,46 which suggests that positive social influence can lead to better clinical outcomes. Additionally, in a recent study, we found a statistically significant association between peer recognition of positive influence and faculty ratings of medical students’ clinical competence in third-year core clinical clerkships.47

인성검사도구를 시행한 시점과 동료 지명 검사를 시행한 시점 사이의 간격이 제한점이 된다. 의과대학생의 인적특성이 의과대학 기간동안 변할 수 있다. 이러한 의견도 타당하나, 본 연구에 사용된 핵심 인적특성 - ZKPQ로 측정한 것들 - 이 생물-진화론적 토대를 두고 있기에, 특정한 개입 없이 쉽게 바뀌지 않기에 이런 시간 간격의 효과는 제한적이었을 것이다. 의과대학 기간 동안 이러한 측면에 목표를 둔 체계적인 프로그램은 없었음.

The time interval between the administration of the personality assessment instruments and the peer nomination instrument may be considered another limitation of this study. It could be argued that medical students’ personality attributes may have changed during medical school. Although there is merit to this argument, the effect of the time interval may be mitigated by the fact that some of the key personality attributes used in this study, such as those measured by the ZKPQ, have a biological–evolutionary basis31 and are not easily amenable to change without intervention. In addition, because there were no systematic or goal-directed programs to change students’ personality attributes during medical school, any changes would likely be random, rather than systematic, and thus would not substantially confound our findings.

효과크기가 좋게 봐줘야 중등도 정도여서 임상적(실용적) 유의미성이 있다고 보기 어려울 수 있다.

Because the effect size estimates were, at best, moderate, it could be argued that the clinical (practical) significance of our findings would be questionable.41,42

효과크기가 작긴 하나 평균적인 인성 연구와 비추어 보면 실망할 정도로 작은 것은 아니다.

However, the range of effect size estimates of statistically significant differences in our study (from 0.21 to 0.57) should not be discouraging, given that the average effect size estimate in personality research, according to a large meta-analytic study, is 0.21,48 and the average validity coefficient in undergraduate medical education research is 0.30.49

동료 지명Peer nomination은 의과대학생의 프로페셔널리즘의 지표로서도 유용했으며, 간호대학에서도 잠재적 리더를 선발하는데 권고된 바 있다. 의과대학의 잠재적 리더를 찾고, 효과적인 리더십을 배양해주는 것은 전문직과 사회를 위하여 좋을 것이다.

Peer nomination has also been found to be an indicator of qualities that are related to professionalism in medical students44 and in medical practice,50 and it has been recommended as a method for selecting potential nursing leaders.51 Identifying potential leaders in medicine and cultivating qualities that foster effective leadership in physicians-in-training would be beneficial to the profession and to society at large.52,53

 

함의 

Implications

 

긍정적인 사회적 영향력과 효과적인 리더십을 촉진하는 형성적 인성 사이에 유의미한 관계가 있다. 이러한 결과는 의과대학의 잠재적 리더를 양성farming하는 것보다 탐색identifying하는 것이 더 유용함을 시사한다. 이러한 탐색-기반 접근법은 의과대학으로부터 새로운 교육 프로그램을 설계하고 자원을 할당하는 부담을 줄여준다.

In addition, our findings, which suggest a significant link between positive social influence and engaging personality attributes that foster effective leadership (e.g., empathy), have important implications for identifying, rather than “farming,”47 potential leaders in medical school. Not only may this identification- based approach relieve schools from the burden of designing and allocating resources for a new educational program (as in a more traditional cultivation- based approach),

31 Zuckerman M. Zuckerman–Kuhlman Personality Questionnaire (ZKPQ): An alternative five-factorial model. In: de Raad B, Perugini M, eds. Big Five Assessment. Seattle, Wash: Hogrefe & Huber Publishers; 2002:377–396.

49 Ferguson E, James D, Madeley L. Factors associated with success in medical school: Systematic review of the literature. BMJ. 2002;324:952–957.

39 Gonnella JS, Hojat M, Veloski J. AM last page. The Jefferson longitudinal study of medical education. Acad Med. 2011;86:404.

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Acad Med. 2015 Apr;90(4):505-10. doi: 10.1097/ACM.0000000000000652.

Can empathy, other personality attributes, and level of positive social influence in medical school identifypotential leaders in medicine?

Hojat M1, Michalec B, Veloski JJ, Tykocinski ML.

Author information

• 1Dr. Hojat is research professor of psychiatry and human behavior, Department of Psychiatry and Human Behavior, and director, Jefferson Longitudinal Study of Medical Education, Center for Research in Medical Education and Health Care, Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, Pennsylvania. Dr. Michalec is assistant professor, Department of Sociology, University of Delaware, Newark, Delaware. Mr. Veloski is director, Medical Education Division, Center for Research in Medical Education and Health Care, Sidney Kimmel MedicalCollege at Thomas Jefferson University, Philadelphia, Pennsylvania. Dr. Tykocinski is provost and executive vice president for academic affairs, Thomas Jefferson University, and Anthony F. and Gertrude M. De Palma Dean and Professor of Pathology, Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, Pennsylvania.

Abstract

PURPOSE:

To test the hypotheses that medical students recognized by peers as the most positive social influencers would score (1) high on measures of engaging personality attributes that are conducive to relationship building (empathy, sociability, activity, self-esteem), and (2) low on disengaging personality attributes that are detrimental to interpersonal relationships (loneliness, neuroticism, aggression-hostility, impulsive sensation seeking).

METHOD:

The study included 666 Jefferson Medical College students who graduated in 2011-2013. Students used a peer nomination instrument toidentify classmates who had a positive influence on their professional and personal development. At matriculation, these students had completed a survey that included the Jefferson Scale of Empathy and Zuckerman-Kuhlman Personality Questionnaire short form and abridged versions of the Rosenberg Self-Esteem Scale and UCLA Loneliness Scale. In multivariate analyses of variance, the method of contrasted groups was used to compare the personality attributes of students nominated most frequently by their peers as positive influencers (top influencers [top 25% in their class distribution], n = 176) with those of students nominated least frequently (bottom influencers [bottom 25%], n = 171).

RESULTS:

The top influencers scored significantly higher on empathy, sociability, and activity and significantly lower on loneliness compared with the bottom influencers. However, the effect size estimates of the differences were moderate at best.

CONCLUSIONS:

The research hypotheses were partially confirmed. Positive social influencers appear to possess personality attributes conducive to relationship building, which is an important feature of effective leadership. The findings have implications for identifying and training potentialleaders in medicine.

PMID:

 

25629944

 

[PubMed - indexed for MEDLINE]