The Society of Critical Care Medicine’s (SCCM) In-Training Section is dedicated to assisting and guiding trainees as they progress through training into independent practice. It also aims to foster career development following this transition. To further this mission, members contribute articles addressing emerging issues in critical care training and career development; these submissions are authored by in-training professionals under the guidance of a mentor. For additional information about the In-Training Section or this project, please e-mail SCCM In-Training Section Chair Utpal Bhalala, MD, at email@example.com or Member-at-Large Erik Vakil, MD, at firstname.lastname@example.org.
The need for more patient-centered care has been a primary focus of operations among many healthcare systems.(1,2) Patient-centered care is a multidimensional concept that addresses patients’ needs for information, views the patient as a whole person, promotes concordance, and enhances the provider–patient relationship.(3) However, there is variability in the proficiency of healthcare professionals to achieve an understanding of patient and coworker perspectives in the delivery of patient-centered care.(4,5) Individual differences in the personal characteristics of professionals may account for at least some of this variation. Common complaints about healthcare providers relate to poor communication rather than clinical competence. Optimizing communication is consistently targeted for policy and practice changes in healthcare.
Work-related stress and stress-filled environments may lead to error, poor morale, poor concentration, fatigue, absenteeism, impaired team function, communication breakdown, failure to collaborate, and suboptimal patient-centered care. In particular, intensive care units (ICUs) are one of the most stressful environments in healthcare, due in part to the high patient acuity and frequent need for end-of-life care.(6,7) These stresses may have negative effects on care delivery in the ICU and the mental health and performance of healthcare professionals.(6-10)
Emotional intelligence (EI) is the ability to monitor one's own and other people's emotions, to discriminate between different emotions and label them appropriately and to use this information to guide thinking and behavior.(11,12) Although many definitions of EI have been postulated, one of the most accepted is a set of abilities (verbal and nonverbal) that enable a person to generate, recognize, express, understand, and evaluate emotions in order to guide thinking and action and successfully cope with environmental demands and pressures(12); this is a concept that can be divided into five core areas(12):
• Self-awareness – the ability to know one's emotions, strengths, weaknesses, drives, values, and goals, and recognize their impact on others while using gut feelings to guide decisions
• Self-regulation – controlling or redirecting one's disruptive emotions and impulses and adapting to changing circumstances
• Self-motivation – being driven to achieve for the sake of achievement
• Social skill – managing relationships to move people in the desired direction
• Social awareness (empathy) – considering other people's feelings, especially when making decisions
Fernandez et al stated that EI skills are grounded in personal competence, upon which are built the skills for social competence, including social awareness and relationship management.(13) EI is one such personal characteristic and is commonly discussed as having a potential role in healthcare.(8) It has been suggested that it is important for effectively delivering patient-centered care.(8-16) Outside of healthcare, EI has been widely cited as an attribute that can improve the quality of work and increase productivity and success.(17-21)
While the evidence for applications of EI in real-world settings is sparse, some data suggest EI may be related to job performance and satisfaction.(22,23) Evidence shows that provider satisfaction is linked with enhanced ability to identify emotional expressions, higher ratings of social support and satisfaction with social support, more effective mood management,(24) better adaptation to stress(25) and better social interaction, and patient satisfaction.(26) Studies have shown that people with high EI have greater mental health, exemplary job performance and more potent leadership skills. For the most senior team members, almost 80% of variation in performance is predicted by EI.(27) Top performers average 30% higher in markers of EI, and methods of developing these skills have become more widely coveted in the past few decades. In addition, data characterizing neural mechanisms of emotional intelligence are evolving.(27-31)
Insights into one’s own and others’ emotions, as described by models of EI, may be why some practitioners appear to be better at delivering patient-centered care than others.(32) Skills in EI help healthcare leaders in the ICU understand, engage and motivate their teams. They are essential for dealing with conflict and creating workable solutions to complex problems. EI skills strongly impact the culture of multidisciplinary medicine.(12)
1. Department of Health. SoSf. NHS Plan. London: Stationery Office, 2000.
2. Mayer T, Cates RJ. Service excellence in health care. JAMA. 1999;282:1281-1283.
3. Stewart M. Towards a global definition of patient centred care. BMJ. 2001;322:444-445.
4. Birks YF, Watt IS. Emotional intelligence and patient-centred care. J R Soc Med. 2007;100(8): 368-374.
5. Amendolair D. Emotional intelligence: essential for developing nurse leaders. Nurse Lead. 2003;1:25-27.
6. Nooryan K, Gasparyan K, Sharif F, Zoladl M. Controlling anxiety in physicians and nurses working in intensive care units using emotional intelligence items as an anxiety management tool in Iran. Int J Gen Med. 2012;5:5-10.
7. Mayer JD, Salovey P. Emotional intelligence. Imagin Cogn Pers.1990;9:185-211.
8. Chacko J, Raju HR, Singh MK, Mishra RC. Critical incidents in a multidisciplinary intensive care unit. Anaesth Intensive Care. 2007;35(3): 382-386.
9. Dominique P. Stressful intensive care unit medical crisis: how individual responses impact on team performance. Crit Care Med. 2009;37(4):1250-1251.
10. Osmon S, Harris CB, Dunagan WC, Prentice D, Fraser VJ, Kollef MH. Care unit experience reporting of medical errors: an intensive care unit experience. Crit Care Med. 2004;32:727-733.
11. Coleman A.. A Dictionary of Psychology. 3rd ed. Oxford, UK: Oxford University Press; 2008.
12. Goleman D. Working with Emotional Intelligence. New York, NY: Bantam Books; 1998.
13. Fernandez CSP, Peterson HB, Holmstrőm SW, Connolly AM. Developing emotional intelligence for healthcare leaders. In: Di Fabio A, ed. Emotional Intelligence - New Perspectives and Applications.
14. Cadman C, Brewer J. Emotional intelligence: a vital prerequisite for recruitment in nursing. J Nurs Manag. 2001;9:321-324.
15. Elam CL. Use of ‘emotional intelligence’ as one measure of medical school applicants’ noncognitive characteristics. Acad Med. 2000;75:445-446.
16. Freshwater D. Impact of emotional abuse on the individual [editorial]. J Psychiatr Ment Health Nurs. 2004;11:505-507.
17. Epstein RM, Hundert EM. Defining and assessing professional competence. JAMA. 2002;287:226-225.
18. Schwartz RW, Tumblin TF. The power of servant leadership to transform health care organisations for the 21st-century economy. Arch Surg. 2002;137:1419-1427.
19. Lewis N, Rees C, Hudson N. Helping medical students identify their emotional intelligence. Med Educ. 2004;38:563.
20. Herbert R, Edgar L. Emotional intelligence: a primal dimension of nursing leadership? Nurs Leadersh (Tor Ont). 2004;17:56-63.
21. Bellack JP. Emotional intelligence: a missing ingredient? J Nurs Educ. 1999;38:3-4.
22. Wong C-S, Law KS. The effects of leader and follower emotional intelligence on performance and attitude: an exploratory study. Leader Q. 2002;13:243-274.
23. Jordan PJ, Ashkanasy NM, Hartel CEJ, Hooper GS. Workgroup emotional intelligence: scale development and relationship to team process effectiveness and goal focus. Hum Res Manag Rev. 2002;12:195-214.
24. Ciarrochi JV, Chan AYC, Caputi P. A critical evaluation of the emotional intelligence construct. Pers Individ Dif. 2000;28:539-561.
25. Ciarrochi J, Deane FP, Anderson S. Emotional intelligence moderates the relationship between stress and mental health. Pers Individ Dif. 2002;32:197-209.
26. Lopes PN, Brackett MA, Nezleck JB, Schutz A, Sellin I, Salovey P. Emotional intelligence and social interaction. Pers Soc Psychol Bull. 2004;30:1018-1034.
27. Six Seconds. http://www.6seconds.org. Accessed November 2, 2014.
28. Barbey AK, Colom R, Grafman J. Distributed neural system for emotional intelligence revealed by lesion mapping. Soc Cogn Affect Neurosci. 2014;9(3):265-272.
29. Yates D. Researchers map emotional intelligence in the brain. Champaign, IL: University of Illinois News Bureau, January 22, 2013.
30. Scientists complete 1st map of 'emotional intelligence' in the brain. US News and World Report. January 28, 2013.
31. Van Rooy DL, Viswesvaran C. Emotional intelligence: a meta-analytic investigation of predictive validity and nomological net. J Vocat Behav. 2004;65:71-95.
32. Howie JGR, Heaney DJ, Maxwell M, Walker JJ, Freeman GK, Rai R. Quality of general practice consultations: cross sectional survey. BMJ. 1999;319:738–743.