In recent years, conflicts between doctors and patients have occurred from time to time. The sources of conflict are diverse. We can't teach students to change the concept of every patient, but we can teach students skills to help them better deal with clinical conflicts. After all, a good patient–physician relationship is an important component of the successful health care [1]. Understanding and compassion are more likely to improve the patient–physician relationship as well as patient trust, satisfaction, and compliance, and to lead to better outcomes in clinical practice [2, 3]. Corroborating the importance of caring in the medical profession, integrative reviews have shown that health care professionals with more emotional intelligence (EI) are more compassionate, considerate, caring, and able to manage emotions in others; they are thus more likely to create good patient–physician relationships [4]. As the abilities to form and maintain good patient–physician relationships and communicate effectively are important skills that medical students should possess, EI is gaining attention as an important aspect of medical education [5]. However, few studies focus on curriculum design and explore the impact of EI training on students based on medical education curriculum. Many researchers have highlighted the benefits of EI-based education, which may contribute to the teaching of professionalism and communication skills in medicine, although some research has shown that the role of EI training in medical education remains uncertain [6]. Further research is needed before the wholesale adoption of EI education in any course can be recommended [7]. The aim of this study was thus to evaluate the impact of a team-based learning (TBL) EI intervention among undergraduate medical and nursing students.
Medical students may experience significant psychological and emotional challenges related to their future work environment, medical training, academic pressure [8], and the desire to achieve work–life balance [9], which manifests in some cases as burnout, depression, and/or anxiety. This risk is concerning because distressed medical students rarely seek help, and tend to have poor academic performance, misuse substances, have decreased empathy, and have suicidal ideation. Much research has shown that different grades, educational levels, and other factors are related to different EI levels, and that performance in the emotional management of others is a significant predictor of students’ teamwork skills. Mayer and Salovey [10] considered EI to consist of a set of abilities, defining it as ‘‘the ability to monitor one’s own and others’ emotions, to discriminate among them and to use the information to guide one’s thinking and actions’’ (p. 190). The Accreditation Council for Graduate Medical Education defined EI competency as assessment skills of interpersonal and communication competencies, professional behavior, and patient care. In general, EI is the ability to get along and build good relationships with others. EI is considered to be a predictor of effective communication, interpersonal sensitivity, stress perception, happiness enhancement, and the promotion of academic success and teamwork [11–13], and influenced by Personality and empathy [2]. Thus, EI is a crucial performance-related skill for medical students [14].
Current research shows that the emotional intelligence level of medical students changes with age and grade. A cross-sectional study conducted in Canada revealed a significant difference in total EI scores between nursing students in years 1 and 4, favoring the latter [15]. Foster, K et al [16] used an EI inventory to evaluate Australian health care students before registration, and found that their mean EI scores were lower than normative means. Another research demonstrated that females had higher mean EI scores. The EI score and the number of extracurricular activities is positively related [17]. EI is an ability-based skill that is malleable via training. It is conceptualized as an ability that can be taught, learned, and promoted. EI may be good to address the specific aspects of the patient–physician relationship that are not working well. In clinical work, medical students need better emotional intelligence to solve some non-technical problems. For this reason, various researchers have suggested that EI education is a crucial component that should be valued, even prior to medical education, to facilitate medical students’ future skill development [14]. Some researchers have argued that EI has a protective effect against stress among health care students, and should be emphasized more in these students’ curricula [16]. A class credit intervention based on the stress in intensive care units had a protective effect on nursing students through increased stress perception and communication skills [18]. However, that study was based on an EI intervention implemented in a specific stressful environment.
EI interventions have been demonstrated to affect aggression and empathy among adolescents, it could reduce aggression and enhance one’s empathy. [19, 20]. Given the lengthy intervention periods, however, the observed effects cannot be attributed definitively to the development of EI skills. There is a need for a flexible emotional curriculum intervention to help medical students effectively improve their EI.
TBL is an active learning strategy that focuses on teamwork, student accountability, and team application exercises. It is a structured form of small group learning that can be scaled up for delivery in large classes [21]. It was first developed by Larry Michaelsen in the late 1970s at the University of Oklahoma business school [22]. TBL keeps the class together while students apply the content to specific problems in small groups during the learning process. It consists of three stages: student preparation, readiness assurance, and application. Many studies have demonstrated the effects of such programs in preparing students for teamwork [23], clinical practice, and communication [24]. TBL is commonly applied in medical education and has been shown to increase confidence, leading to the development of professional and clinical behaviors that are characteristic in high-quality practice [25]. However, the effects of TBL in improving medical students’ EI and communication ability and enhancing their interest in learning in medical courses should be further investigated.