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Did the Pandemic Enhance Empathy?

Research by Midwestern University College of Pharmacy professors explored the pandemic’s effect on students’ emotional intelligence.

By Jane E. Rooney

Many questions linger about the ongoing COVID-19 pandemic and its lasting effects on students, the workforce, the economy, and the mental and physical repercussions that are still coming to light. When classes were forced to go virtual, students missed out on face-to-face connections with peers as well as professors and patients. While the situation had its drawbacks, including increased stress and isolation, in many instances faculty quickly adapted to develop creative solutions and students demonstrated compassion as everyone endured struggles together. Several Midwestern University College of Pharmacy professors wanted to investigate the role the pandemic played in changes to students’ emotional intelligence. Using responses from an Emotional Intelligence Appraisal (EIA) self-assessment to determine changes from August 2019 to July 2020, the professors published their findings, “Impact of the COVID-19 Pandemic on the Emotional Intelligence of Student Pharmacist Leaders,” in the January 2022 issue of the American Journal of Pharmaceutical Education.

Two of the paper’s authors, Dr. Kellie Goodlet, assistant professor, pharmacy practice, and Dr. Erin Raney, professor, pharmacy practice, noted that prior to the pandemic, progression through the college’s Leadership Development Program was associated with increased EIA scores. Regarding the outcomes they expected to see, “One hypothesis was that we would see more variability in the change from initial to final EIA scores, whereby some students would see significant increases while others would see decreases due to increased isolation and stress caused by the uncertainty of the pandemic,” Goodlet said. “But we saw greater increases in EIA scores pretty much across the board, and most significantly for the emotional intelligence skill of relationship management, which involves using awareness of personal emotions and the emotions of others to communicate effectively.”

Increased emotional intelligence, she continued, “has been associated with improved communication, conflict management, resiliency and job satisfaction, which we believe to be important skills for healthcare professionals. The emotional intelligence skill of relationship management, which increased the most for the pandemic cohort, is also associated with the ability to feel empathy toward others and taking the time to really understand where another person is coming from. We believe this supports the potential for this cohort to have more effective interactions with patients and their fellow clinicians.”

It will be interesting to see if we can look at these students to find out how they might have a different perspective on a patient’s experience. It’s a reminder that pharmacy is more than making sure the right medication is prescribed but looking at emotions and meeting patients in the needs of their situation. These students developed their professional identities during a time when we were all challenged in our identities as pharmacists.

Dr. Erin Raney

Capitalizing on Connections

The Leadership Development Program at the Glendale campus of Midwestern University College of Pharmacy, a voluntary cocurricular program that spans six academic quarters within an accelerated, three-year Pharm.D. curriculum, includes an EIA self-assessment at the beginning and end of the program. Raney, a member of the faculty team that designed the program, supported a longitudinal experience to allow students to continue to develop themselves and explore their strengths while they maintained a leadership position. “The concept of emotional intelligence and self-reflection at the beginning and the end fit well with leadership training,” she explained. “After attending quarterly seminars on various leadership concepts, students get feedback from a faculty mentor on their individual written reflections. That mentor works through the growth and development of the student and helps them create a plan to continue on in their development after the program.”

Reflections and feedback from students in the post-program survey indicated that “some did find that the pandemic allowed them to have intense practice in terms of self-awareness and managing emotions,” Raney continued. “We found that a big part of emotional intelligence is managing yourself and your emotions and being aware of others and how to manage those relationships. We thought there would be a negative impact on their ability to interact with each other. But it really provided this wonderful opportunity to grow in that area to be aware in terms of the struggles of what others were going through and finding connection in that.”

Cultivating emotional intelligence can help pharmacists improve interactions with patients as well as other healthcare providers. “Developing EI enhances leadership opportunities and strategies. EI is embedded into pharmacy practice,” Raney said. “Whether it’s a difficult patient to work with or a challenging situation managing a health condition, being able to handle those things professionally is core to EI. A pharmacist has to be able to pick up on cues from patients and other members of the healthcare team. They need to be able to detect if a patient is having an emotional [response] and be able to connect with the patient and manage that relationship. In practice with patients and other providers, the leadership that a pharmacist needs to show would be enhanced with high levels of EI.”

Goodlet pointed out that the EIA score increases were most pronounced for relationship management, with the increase for the pandemic group representing a doubling over the non-pandemic group. “One hypothesis for this mentioned in the paper is that the pandemic may have underscored the value of social relationships. With in-person gatherings limited, students may have had to proactively seek out opportunities to strengthen their personal relationships, and subsequently may have been more present and focused during their interactions in order to make the most of them,” Goodlet noted. “Conversely, no difference in the change in social awareness (the other EIA skill related to social competence) was observed. But this made sense given the potential increased difficulty in reading others’ emotions during lockdown and during the time we all were a bit ‘mask blind’ and had difficulty reading expressions.”

Raney added, “It was a difficult time of transition and to have students reflect on that as an area of growth and strength building was a positive finding.” One thing that the pandemic highlighted, she continued, is that “compassion is essential to connect with a patient in their healthcare experience. Having students go through a challenging experience while they are learning is very humbling. I hope that it will help them in the long term. It will be interesting to see if we can look at these students to find out how they might have a different perspective on a patient’s experience. It’s a reminder that pharmacy is more than making sure the right medication is prescribed but looking at emotions and meeting patients in the needs of their situation. These students developed their professional identities during a time when we were all challenged in our identities as pharmacists.”

With guided self-reflection and mentor support, challenges can yield opportunities for positive personal growth even during an event as uncertain and upending as a global pandemic. Being an effective pharmacist requires not only a solid foundational clinical knowledge, but the skills needed to apply and communicate this knowledge to patients and the interdisciplinary team.

Dr. Kellie Goodlet

Weaving EI Into Educational Experiences

Goodlet and Raney see an opportunity to incorporate emotional intelligence in pharmacy school curricula. Students could identify their baseline emotional intelligence using a measurement tool early on in leadership or introductory courses. “It could be developed through rotations and clinical aspects. In a classroom setting it would require a lot of connectivity. Many students are working with faculty advisors so that’s an opportunity to weave it through the curriculum,” Raney suggested. “The way we did it through a voluntary extracurricular opportunity, we found that for a student to identify their EI score it’s helpful for them to have a long period of time to practice it. Whether it’s over one year or an entire three- or four-year program, they take the concepts and actively use them and reflect on that. Having mentorship from a faculty member is very helpful. A longitudinal mentorship allows students to see patterns and enables them to develop further.”

Goodlet agreed that giving students space and time to build these skills is crucial to their professional growth and something that pharmacy schools can help nurture. “It is important to offer time for guided reflection within the curriculum to allow students to process and reflect upon their experiences,” she said. “As noted in the paper, with guided self-reflection and mentor support, challenges can yield opportunities for positive personal growth even during an event as uncertain and upending as a global pandemic. Being an effective pharmacist requires not only a solid foundational clinical knowledge, but the skills needed to apply and communicate this knowledge to patients and the interdisciplinary team. Emphasis on emotional intelligence supports the development of these skills, as well as the fostering of personal resiliency to support professional wellness.”

The paper’s authors concluded that despite the upheaval caused by the pandemic, continued support from pharmacy faculty helped students build resilience. Lessons from the pandemic can be applied in the future when difficult circumstances arise. “If we are challenged further with pandemics or situations where the norm is turned upside down, we shouldn’t give up as educators to still push the students to grow through that,” Raney said. “Instead of seeing a difficult situation as an indication that we have to put things to the side, continuing to push through could be an opportunity to help students develop. A lot of them had important individual growth. Having that mentorship during that time was still really important.”

Goodlet noted that she was impressed by the resiliency that the students demonstrated. “I found it notable how students commented how beneficial it was just to take the time to pause and reflect,” she said. “Healthcare is a high-intensity, fast-paced profession, and it is common for us to adopt that intensity and go-go-go mental state both in and out of work. The stay-at-home order during the early pandemic may have allowed some of these students to slow down and breathe…‘I’m at home, I’m not going out, what do I do now?’ And this is where I think the students’ experiences in the leadership development program came into play, as they have all worked with faculty mentors to hone and develop their self-reflection skills throughout the program, which may have given them the framework needed to identify and process their emotions without becoming overwhelmed by them.”

Jane E. Rooney is managing editor of Academic Pharmacy Now.

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