William T Branch

• MD
• Professor at Emory University

Objectives: Interprofessional (IP) collaboration and effective teamwork remain variable in healthcare organisations. IP bias, assumptions and conflicts limit the capacity of healthcare teams to leverage the expertise of their members to meet growing complexities of patient needs and optimise healthcare outcomes. We aimed to understand how a longit...

Introduction:Developing a collaborative, humanistic interprofessional healthcare culture requires optimal relational skills, respect, interpersonal cohesion, and role clarity. We developed a longitudinal curriculum to engender these skills and values in institutional leaders. We report results of a qualitative study at seven US-based academic healt...

Introduction: The capacity of healthcare professionals to work collaboratively influences faculty and trainees’ professional identity formation, well-being, and care quality. Part of a multi-institutional project*, we created the Faculty Fellowship for Leaders in Humanistic Interprofessional Education at Boston Children’s Hospital/ Harvard Medical...

Rapid changes in healthcare organization and practice environments, increasingly driven by business models and commercial interests, are associated with widespread burnout and dissatisfaction among healthcare professionals and pose barriers to humanistic relationship-centered quality care. Studies show burnout and significant stress currently affec...

Organizational cultures significantly influence faculty and clinician well-being, trainees’ professional identity formation, and the care of patients and families. The ability of interprofessional healthcare teams to work collaboratively is important for safe, high quality, relationship-centered care. A multi-site project, Faculty Development for t...

OBJECTIVE: To explore leadership perspectives on how to maintain high quality efficient care that is also person-centered and humanistic. METHODS: The authors interviewed and collected narrative transcripts from a convenience sample of 32 institutional healthcare leaders at seven U.S. medical schools. The institutional leaders were asked to identif...

When formulating plans for medical treatment, the relationship between the clinician and patient is one of the most important variables that determines whether the plan will be adhered to and succeed. Elements of that relationship transcend the usual transactional nature of most professional encounters in daily life. One such element can be describ...

Objective: To explore leadership perspectives on how to maintain high quality efficient care that is also person-centered and humanistic. Methods: The authors interviewed and collected narrative transcripts from a convenience sample of 32 institutional healthcare leaders at seven U.S. medical schools. The institutional leaders were asked to iden...

I and my colleagues designed and implemented a longitudinal faculty development program to improve humanistic teaching and role modeling at 30 medical schools involving more than 1,000 faculty members and 50 local facilitators. Evaluation demonstrated that participating faculty members who completed our program were superior humanistic teachers com...

Supplementary Material – Table 1. For published article: Rider EA, Gilligan MC, Osterberg LG, Litzelman DK, Plews-Ogan M, Weil AB, Dunne D, Hafler JP, May NB, Derse AR, Frankel RM, Branch WT Jr. Healthcare at the crossroads: The need to shape an organizational culture of humanistic teaching and practice. J Gen Intern Med. 2018;33:1092-1099. doi: 10...

BACKGROUND: Changes in the organization of medical practice have impeded humanistic practice and resulted in widespread physician burnout and dissatisfaction. OBJECTIVE: To identify organizational factors that promote or inhibit humanistic practice of medicine by faculty physicians. DESIGN: From January 1, 2015, through December 31, 2016, faculty f...

Introduction: This study evaluated the effectiveness of the Mentoring and Professionalism in Training (MAP-IT) program, a longitudinal, interprofessional faculty development curriculum designed to enhance clinicians' humanistic mentoring skills, specifically nurses and physicians. Methods: During 2014 to 2016, two consecutive cohorts of nurses a...

The authors describe the first 11 academic years (2005–2006 through 2016–2017) of a longitudinal, small-group faculty development program for strengthening humanistic teaching and role modeling at 30 U.S. and Canadian medical schools that continues today. During the yearlong program, small groups of participating faculty met twice monthly with a lo...

Objective Major reorganizations of medical practice today challenge physicians’ ability to deliver compassionate care. We sought to understand how physicians who completed an intensive faculty development program in medical humanism sustain their humanistic practices. Methods Program completers from 8 U.S. medical schools wrote reflections in answ...

One way practitioners learn ethics is by reflecting on experience. They may reflect in the moment (reflection-in-action) or afterwards (reflection-on-action). We illustrate how a teaching clinician may transform relationships with patients and teach person-centered care through reflective learning. We discuss reflective learning pedagogies and pres...

Objective: We sought to identify and define "highly humanistic" formation narratives, and understand how these events described, together with a reflective learning process, the professional development of physicians in a longitudinal faculty development program. Methods: Qualitative analysis of twenty highly humanistic appreciative inquiry narr...

Objectives: This study was designed to investigate the roles, characteristics and contributions to the educational process of highly influential teachers described retrospectively by faculty members who were former medical students and trainees. Methods: The authors collected 20 appreciative inquiry narratives from a convenience sample of 22 fac...

Journal of Interprofessional Education & Practice, 06/2015; 1(2):68. DOI: 10.1016/j.xjep.2015.07.049 In today's healthcare environments, core values and skilled communication—critical for safe, compassionate, ethical care—do not receive necessary emphasis. The International Charter for Human Values in Healthcare[1,2] delineates values fundamental...

Early morning, I lay on a narrow table. An anesthesiologist, whom I had never met, was peering over me. I had been waiting anxiously to tell the anesthesiologist about my huge cervical spinal bone spur. A wrong positioning of the cervical spine could produce intense pain, the kind I’d experienced before, or worse, result in a weak arm, also experie...

To suggest and describe a practical and theoretical underpinning for teaching professional and humanistic values. The author describes four learning methods that together comprise a model for teaching professional and humanistic values. The author defends this model by citing evidence and relevant literature as well as his extensive experience with...

OBJECTIVES: The human dimensions of healthcare—core values and skilled communication necessary for every healthcare interaction—are fundamental to compassionate, ethical, and safe relationship-centered care. The objectives of this paper are to: describe development of the International Charter for Human Values in Healthcare which delineates core va...

Background: There is increased emphasis on practicing humanism in medicine but explicit methods for faculty development in humanism are rare. Objective: We sought to demonstrate improved faculty teaching and role modeling of humanistic and professional values by participants in a multi-institutional faculty development program as rated by their...

Published in: The International Journal of Whole Person Care. 2014;1:25. DOI: 10.26443/ijwpc.v1i1.25

I served as a medical student and resident in the 1960s. Science as a belief system had reached a pinnacle. Yet Not infrequently in those days, I found myself caring, with little available backup, for a hospital ward filled with sick and dying people. It was a lonely and often frightening responsibility. I began to encounter situations that were at...

This paper aims to honour the Hippocratic Oath in modern practice by providing reflections on the development of ways for doctors to know the whole person that have accrued over the five decades to the present. I present a perspective piece, which includes personal reflections and cites relevant literature. Powerful role models sustained the concep...

The human dimensions of healthcare are fundamental to the practice of compassionate, ethical, and safe relationship-centered care. Effectively communicating the human dimensions of care improves health outcomes. Yet significant gaps exist between communication research, developments in healthcare education, and clinical practice. This interactive...

Published in: The International Journal of Whole Person Care. 2014;1:25.

Available here: http://journals.lww.com/academicmedicine/Fulltext/2013/09000/Compassion___Necessary_but_Not_Sufficient.9.aspx?WT.mc_id=EMxALLx20100222xxFRIEND#

The human dimensions of care are central to the practice of compassionate, ethical, and safe healthcare. This interactive symposium examines how we can enhance the human dimensions of care through improved communication skills to better develop compassion and empathy in healthcare relationships. The symposium presentations represent the work of m...

Excellent healthcare communication considers patient journeys – the experience of the patient, the flow of information – along with the complementarity of medical considerations and interpersonal ones (e.g., empathy, engagement and rapport); the connection between multidisciplinary research and the education, training and practice of healthcare pra...

Faculty development is needed that will influence clinical teachers to better enable them to transmit humanistic values to their learners and colleagues. We sought to understand the processes whereby reflective learning influenced professional growth in a convenience sample of young faculty members. We analyzed appreciative inquiry narratives writt...

The pathway to wisdom is a crooked one. Doctors have many opportunities to become wiser, and may do so in different ways and to different degrees. We suggest several means to facilitate their passage. There remains an additional key step. Seeking wisdom should become embedded in the culture of medicine. This may follow from the types of activities...

To describe the development and psychometric properties of the Humanistic Teaching Practices Effectiveness Questionnaire (HTPE), an instrument that measures the humanistic skills of attending physicians within an academic health center (AHC) department of medicine. From August 2005 through March 2007, the authors distributed the HTPE, along with ot...

Patients want to be treated humanely and as individuals by their care-providers. Many curricula, usually written by university faculty, have been developed to teach physicians such skills. Rarely are patients' actual preferences taken into account when designing curricula. This study was undertaken to identify what hospitalized patients most valued...

This paper describes educational programs designed to create humanistic physicians who are skilled in communicating with patients and committed to professional values. The educational programs addressed these goals in medical students, residents and young faculty members over a 22-year period. Evaluations enhanced understanding and documented outco...

To successfully design and implement longitudinal faculty development programs at five medical schools, and to determine whether faculty participants were perceived to be more effective humanistic teachers. Promising teachers were chosen from volunteers to participate in groups at each of the medical schools. Between September 2004 and September 20...

A profound and moving spirituality provided emotional and psychological support for most terminally ill patients at Grady Memorial Hospital. The authors were able to trace the roots of these patients' spirituality to core beliefs described by African-American theologians. Truly bedrock beliefs often reflected in conversations with the patients at G...

Humanistic care is regarded as important by patients and professional accrediting agencies, but little is known about how attitudes and behaviors in this domain are taught in clinical settings. To answer this question, the authors studied how excellent clinical teachers impart the behaviors and attitudes consistent with humanistic care to their lea...

In recent years, academic health centers have made a considerable effort to encourage medical students and physicians-in-training to consider academic medicine as a career choice. For physicians, selecting a career in academic medicine may be the first hurdle, but the challenge of successfully maintaining an academic career is perhaps a more formid...

Respect is a core value of medical professionalism. Respect for patients often manifests itself as an attitude, of which the physician is only partially self-aware. To teach respect means bringing it fully into consciousness. Physicians then should strive to make respect an inner quality, beyond being a behavior. The author illustrates the depth of...

Although clinical trials have shown that proper management of diabetes can improve outcomes, and treatment guidelines are widespread, glycated hemoglobin (HbA1c) levels in the United States are rising. Since process measures are improving, poor glycemic control may reflect the failure of health care providers to intensify diabetes therapy when indi...

The shift of clinical care and teaching to outpatient settings has challenged ambulatory and community-based teachers. To address this challenge, U.S. internal medicine organizations devised "Faculty Development for General Internal Medicine: Generalist Faculty Teaching in Ambulatory Settings," a national program to train leaders to create local fa...

Principlism, the predominate approach to bioethics, has no foundational principles. This absence of foundations reflects the general intellectual climate of postmodern relativism. Even America's foremost public philosopher, Richard Rorty, whose pragmatism might suggest a philosophy of commonsense, seems to be swimming in the postmodern swamp. Alter...

Critical incident reports are now being widely used in medical education. They are short narrative accounts focusing on the most important professional experiences of medical students, residents, and other learners. As such, critical incident reports are ideally suited for addressing values and attitudes, and teaching professional development. This...

Management of diabetes is frequently suboptimal in primary care settings, where providers often fail to intensify therapy when glucose levels are high, a problem known as clinical inertia. We asked whether interventions targeting clinical inertia can improve outcomes. A controlled trial over a 3-year period was conducted in a municipal hospital pri...

The purpose of this study was to determine whether "clinical inertia"-inadequate intensification of therapy by the provider-could contribute to high A1C levels in patients with type 2 diabetes managed in a primary care site. In a prospective observational study, management was compared in the Medical Clinic, a primary care site supervised by genera...

Although one goal of end-of-life care is to honor the wishes and needs of patients, little research has been done to characterize what is important to seriously ill African American patients at the end of life. To characterize the views of seriously ill African American patients toward end-of- life care. A qualitative study using semistructured, in...

Since diabetes is largely a primary care problem but we know little about management by residents in training--the primary care practitioners of the future--we examined surrogate outcomes reflective of their performance. A seven-week observational study was conducted in a typical training site- a municipal hospital internal medicine resident "conti...

Communication skills and the psychosocial dimensions of patient care are increasingly taught in medical schools and generalist residency programs. Evidence suggests they are not reinforced or optimally implemented in clinical training. The authors present the product of an iterative process that was part of a national faculty development program an...

Humanistic medical care is an important element of quality health care, and teaching humanism is increasingly recognized as an integral component of medical education. The goal of this article is to illustrate a series of tools that are effective in fostering both the provision and teaching of humanistic medical care in the ambulatory setting. Thro...

Awareness of the need for ambulatory care teaching skills training for clinician-educators is increasing. A recent Health Resources and Services Administration (HRSA)-funded national initiative trained 110 teams from U.S. teaching hospitals to implement local faculty development (FD) in teaching skills. To assess the rate of successful implementati...

We describe a half-day workshop to teach third-year medical students three focused end-of-life care skills: breaking bad news, discussing advance directives, and assessing and managing pain. Our workshop included a readers' theater exercise and three role-play exercises. In two of the workshops, faculty members played the role of patients. We used...

Is a renaissance emerging in medical education? One hundred forty-five submissions to the Journal of General Internal Medicine's Education Issue suggests pent-up demand for publication by medical educators. The innovative nature of many submissions suggests that faculty members across the United States and the world are responding creatively to cur...

The medical literature offers little information about how older African Americans view the medical decision-making process. We sought to describe the perspectives of older African American patients in a primary care clinic as they consider a medical decision. We interviewed 25 African American patients older than 50 years who had discussed flexibl...

We compared prior training in 4 areas (general teaching skills, teaching specific content areas, teaching by specific methods and in specific settings, and general professional skills) among community-based teachers based in private practices (N = 61) compared with those in community sites operated by teaching institutions (N = 64) and hospital-bas...

To determine the prevalence, topics, methods, and intensity of ongoing faculty development (FD) in teaching skills. Mailed survey. Two hundred and seventy-seven of the 386 (72%) U.S. teaching hospitals with internal medicine residency programs. Prevalence and characteristics of ongoing FD. One hundred and eight teaching hospitals (39%) reported ong...

To compare evaluations of teaching effectiveness among hospitalist, general medicine, and subspecialist attendings on general medicine wards. Cross-sectional. A large, inner-city, public teaching hospital. A total of 423 medical students and house staff evaluating 63 attending physicians. We measured teaching effectiveness with the McGill Clinical...

We compared prior training in 4 areas (general teaching skills, teaching specific content areas, teaching by specific methods and in specific settings, and general professional skills) among community-based teachers based in private practices (N = 61) compared with those in community sites operated by teaching institutions (N = 64) and hospital-bas...

This study was conducted to determine how time is allocated to diabetes care. Patients with type 2 diabetes who were receiving care from the internal medicine residents were shadowed by research nurses to observe the process of management. The amount of time spent with patients and the care provided were observed and documented. The total time pati...

Cultural competence in the provision of health care is a very important area of investigation and is receiving recognition at multiple levels. Minority groups constitute a significant and growing percentage of our population. However, there has been no commensurate increase in the number of minority physicians. There is a tremendous need for medica...

The internists in the authors' study wrote about miracles and mistakes, sharing their own lives and their patients' lives, witnessing profound experiences, and receiving acknowledgment for a job well done. Through these experiences, they gained a deeper appreciation of what it means to be a human being and a doctor. They learned that their caring a...

M'arket-driven reform of the health care system in .the United States has led to a demmld for changes in medical education. The Sixth Report of the Council on Graduate Medical Education (COGME) states: '~Fhe growth of mmlaged care will magnify the deficiencies of the current educational system, yet will also provide new and essential educational op...

Feedback and reflection are two basic teaching methods used in clinical settings. In this article, the authors explore the distinctions between, and the potential impact of, feedback and reflection in clinical teaching. Feedback is the heart of medical education; different teaching encounters call for different types of feedback. Although most clin...

African Americans have an increased burden of both diabetes and diabetes complications. Since many patients have high glucose levels novel interventions are needed, especially for urban patients with limited resources. In the Grady Diabetes Clinic in Atlanta, a stepped care strategy improves metabolic control. However, most diabetes patients do not...

Too often housestaff speak of residency training as a "test of survival." However, faculty physicians know that these years of training are not lived in a vacuum but are inextricably interwoven into the fabric of residents' personal and professional lives. This paper describes the stories written by primary care housestaff during their 3 years of t...

We sought to identity the choices and the methods used by ambulatory teachers in a qualitative study, using teacher-intern-patient role plays to improve ambulatory teaching. We used repeated performances of a scripted role play; during each iteration, field notes were taken by the authors. Insights garnered at each iteration were incorporated into...

Philosophers who studied moral development have found that individuals normally progress rapidly in early adulthood from a conventional stage in which they base behavior on the norms and values of those around them to a more principled stage where they identify and attempt to live by personal moral values. Available data suggest that many medical s...

Medicine has traditionally focused on relieving patient symptoms. However, in developed countries, maintaining good health increasingly involves management of such problems as hypertension, dyslipidemia, and diabetes, which often have no symptoms. Moreover, abnormal blood pressure, lipid, and glucose values are generally sufficient to warrant treat...

Despite repeated calls to emphasize the humanistic dimensions of care during medical education, these are few known techniques for effective teaching of humanism. We describe the barriers that inhibit humanistic teaching and suggest pragmatic teaching methods to overcome such barriers and teach humanistic care in clinical settings. We began by aski...

Despite repeated calls to emphasize the humanistic dimensions of care during medical education, these are few known techniques for effective teaching of humanism. We describe the barriers that inhibit humanistic teaching and suggest pragmatic teaching methods to overcome such barriers and teach humanistic care in clinical settings. We began by aski...

Despite repeated calls to emphasize the humanistic dimensions of care during medical education, these are few known techniques for effective teaching of humanism. We describe the barriers that inhibit humanistic teaching and suggest pragmatic teaching methods to overcome such barriers and teach humanistic care in clinical settings. We began by aski...

The ethics of caring, though the subject of much recent discussion by philosophers, has hardly been applied to medical ethics and medical education. Based on receptivity (that is, empathy and compassion) toward and taking responsibility for other persons, the ethics of caring has particular relevance to medicine. Caring guides the physician always...

As academic medical centers increasingly deliver care in primary care settings, a new category of faculty-clinician-educators-has emerged. Although the shift of education and patient care to outpatient settings makes the expanded role of clinician-educators necessary, it also presents challenges to clinician-educators themselves and to the institut...

William Osler was not the first clinician-educator, but he established the tradition in North America.1 Interestingly, his students worked in the outpatient department at Johns Hopkins University.2 They were expected to evaluate and present their patients to Osler, and to follow them longitudinally. Osler appears to have placed great weight on the...