\\n\\n
Released this past November, the list is based on data collected from the Web of Science and highlights some of the world’s most influential scientific minds by naming the researchers whose publications over the previous decade have included a high number of Highly Cited Papers placing them among the top 1% most-cited.
\\n\\nWe wish to congratulate all of the researchers named and especially our authors on this amazing accomplishment! We are happy and proud to share in their success!
Note: Edited in March 2021
\\n"}]',published:!0,mainMedia:{caption:"Highly Cited",originalUrl:"/media/original/117"}},components:[{type:"htmlEditorComponent",content:'IntechOpen is proud to announce that 191 of our authors have made the Clarivate™ Highly Cited Researchers List for 2020, ranking them among the top 1% most-cited.
\n\nThroughout the years, the list has named a total of 261 IntechOpen authors as Highly Cited. Of those researchers, 69 have been featured on the list multiple times.
\n\n\n\nReleased this past November, the list is based on data collected from the Web of Science and highlights some of the world’s most influential scientific minds by naming the researchers whose publications over the previous decade have included a high number of Highly Cited Papers placing them among the top 1% most-cited.
\n\nWe wish to congratulate all of the researchers named and especially our authors on this amazing accomplishment! We are happy and proud to share in their success!
Note: Edited in March 2021
\n'}],latestNews:[{slug:"webinar-introduction-to-open-science-wednesday-18-may-1-pm-cest-20220518",title:"Webinar: Introduction to Open Science | Wednesday 18 May, 1 PM CEST"},{slug:"step-in-the-right-direction-intechopen-launches-a-portfolio-of-open-science-journals-20220414",title:"Step in the Right Direction: IntechOpen Launches a Portfolio of Open Science Journals"},{slug:"let-s-meet-at-london-book-fair-5-7-april-2022-olympia-london-20220321",title:"Let’s meet at London Book Fair, 5-7 April 2022, Olympia London"},{slug:"50-books-published-as-part-of-intechopen-and-knowledge-unlatched-ku-collaboration-20220316",title:"50 Books published as part of IntechOpen and Knowledge Unlatched (KU) Collaboration"},{slug:"intechopen-joins-the-united-nations-sustainable-development-goals-publishers-compact-20221702",title:"IntechOpen joins the United Nations Sustainable Development Goals Publishers Compact"},{slug:"intechopen-signs-exclusive-representation-agreement-with-lsr-libros-servicios-y-representaciones-s-a-de-c-v-20211123",title:"IntechOpen Signs Exclusive Representation Agreement with LSR Libros Servicios y Representaciones S.A. de C.V"},{slug:"intechopen-expands-partnership-with-research4life-20211110",title:"IntechOpen Expands Partnership with Research4Life"},{slug:"introducing-intechopen-book-series-a-new-publishing-format-for-oa-books-20210915",title:"Introducing IntechOpen Book Series - A New Publishing Format for OA Books"}]},book:{item:{type:"book",id:"4605",leadTitle:null,fullTitle:"Lipoproteins - From Bench to Bedside",title:"Lipoproteins",subtitle:"From Bench to Bedside",reviewType:"peer-reviewed",abstract:"In mammalian blood plasma there exist some 6 major lipoprotein classes. Under physiological conditions lipoproteins are certainly beneficial as they transport nutrients and steroids to numerous organs for further metabolism. On the other hand, under pathophysiological conditions most lipoprotein classes promote atherogenesis except of HDL that are considered to be anti-atherogenic. Lipoprotein research is a wide field comprising basic science, analytical methods and clinical investigations. Thus this issue does not raise the claim to give a comprehensive picture of the current knowledge, but rather focuses on specific questions related to animal models in lipoprotein research as well as features of the most atherogenic lipoprotein, Lp(a).",isbn:null,printIsbn:"978-953-51-2178-7",pdfIsbn:"978-953-51-5407-5",doi:"10.5772/59331",price:119,priceEur:129,priceUsd:155,slug:"lipoproteins-from-bench-to-bedside",numberOfPages:164,isOpenForSubmission:!1,isInWos:1,isInBkci:!1,hash:"e5e22c3f2aa33e12a5cb30f6fa3f0845",bookSignature:"Gerhard Kostner and Indumathi Chennamesetty",publishedDate:"October 7th 2015",coverURL:"https://cdn.intechopen.com/books/images_new/4605.jpg",numberOfDownloads:8938,numberOfWosCitations:2,numberOfCrossrefCitations:0,numberOfCrossrefCitationsByBook:1,numberOfDimensionsCitations:3,numberOfDimensionsCitationsByBook:1,hasAltmetrics:0,numberOfTotalCitations:5,isAvailableForWebshopOrdering:!0,dateEndFirstStepPublish:"September 29th 2014",dateEndSecondStepPublish:"October 20th 2014",dateEndThirdStepPublish:"January 24th 2015",dateEndFourthStepPublish:"April 24th 2015",dateEndFifthStepPublish:"May 24th 2015",currentStepOfPublishingProcess:5,indexedIn:"1,2,3,4,5,6",editedByType:"Edited by",kuFlag:!1,featuredMarkup:null,editors:[{id:"135586",title:"Prof.",name:"Gerhard",middleName:null,surname:"Kostner",slug:"gerhard-kostner",fullName:"Gerhard Kostner",profilePictureURL:"https://mts.intechopen.com/storage/users/135586/images/3288_n.jpg",biography:"Gerhard Kostner is Emeritus Full Professor of Biochemistry and Molecular Biology at the Medical University of Graz. After his studies of Chemistry and Physics he got a PhD in Biochemistry and spent two years at OMRF, USA with Pierre Alaupovic and half a year as guest professor at the University of Frankfurt, Germany. Further details of his academic carrier are found in http://www.medunigraz.at/mbbc/cms.php?pageName=GMK",institutionString:null,position:null,outsideEditionCount:0,totalCites:0,totalAuthoredChapters:"1",totalChapterViews:"0",totalEditedBooks:"2",institution:{name:"Medical University of Graz",institutionURL:null,country:{name:"Austria"}}}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,coeditorOne:{id:"246606",title:"Dr.",name:"Indumathi",middleName:null,surname:"Chennamesetty",slug:"indumathi-chennamesetty",fullName:"Indumathi Chennamesetty",profilePictureURL:"https://mts.intechopen.com/storage/users/246606/images/system/246606.jpg",biography:"Dr. Indumathi Chennamsetty is a post doctoral fellow in cardiovascular medicine studying insulin resistance, validating candidate genes identified in a genome-wide association study of insulin resistance. She received her Ph.D. in Molecular Biology studying transcriptional regulation of Lipoprotein(a) from the Institute of Molecular Biology and Biochemistry, Medical University of Graz, Austria. Dr. Chennamsetty research interests are insulin resistance, lipid and lipoprotein metabolism, nuclear receptors and cell signaling.",institutionString:null,position:null,outsideEditionCount:0,totalCites:0,totalAuthoredChapters:"0",totalChapterViews:"0",totalEditedBooks:"0",institution:null},coeditorTwo:null,coeditorThree:null,coeditorFour:null,coeditorFive:null,topics:[{id:"384",title:"Chemical Biology",slug:"chemical-biology"}],chapters:[{id:"49094",title:"Nutritional Modulations Used to Translate a Rabbit Model of Atherosclerosis — A Systematic Review and Meta-analysis",doi:"10.5772/61155",slug:"nutritional-modulations-used-to-translate-a-rabbit-model-of-atherosclerosis-a-systematic-review-and-",totalDownloads:1478,totalCrossrefCites:0,totalDimensionsCites:0,hasAltmetrics:0,abstract:"Dietary cholesterol has been suggested as a cause of dyslipidemic atherosclerosis with scarce convincing evidence. A systematic review and a meta-analysis were conducted in MEDLINE (2004–2015) to screen randomized controlled trials (RCTs) that used cholesterol-fed rabbits as a model of atherosclerosis. A total of 32 RCTs (n = 1104 New Zealand rabbits; 4.37 ± 2.52 months old) reported lipid and lipoprotein outcomes following cholesterol intake (0.98 ± 0.67%) for a duration of 8.90 ± 7.26 weeks. Cholesterol intakes significantly raised combined lipid and lipoprotein outcomes (standardized mean difference) in a random-effect model by 5.618 (95% CI: 4.592, 6.644; P = 0.0001). The value of I2, heterogeneity, was 89.387%, indicating real variation. A subgroup analysis based on the duration and amount of cholesterol feeding in a mixed-effects analysis showed combined heterogeneous effects of 2.788 (95% CI: 2.333, 3.244; P = 0.000; Q = 112.206; df = 14) and 5.538 (95% CI: 4.613, 6.463; P = 0.000; Q = 31.622; df = 6), respectively. Random-effect meta-regression conducted using cholesterol moderator did not support causal effects of dietary cholesterol in inducing atherosclerosis, which may be due to significant publication bias. These high levels of heterogeneity among studies may decline fidelity of this animal model for translation of dyslipidemic atherosclerosis.",signatures:"Isaac Karimi, Danial Naseri and Ferdous Karimizand",downloadPdfUrl:"/chapter/pdf-download/49094",previewPdfUrl:"/chapter/pdf-preview/49094",authors:[{id:"139029",title:"Dr.",name:"Isaac",surname:"Karimi",slug:"isaac-karimi",fullName:"Isaac Karimi"},{id:"176853",title:"Dr.",name:"Danial",surname:"Naseri",slug:"danial-naseri",fullName:"Danial Naseri"}],corrections:null},{id:"49095",title:"Sex and Age Differences in Lipoprotein Metabolism Proatherogenic Changes under the Experimental Metabolic Syndrome in Hamsters",doi:"10.5772/60759",slug:"sex-and-age-differences-in-lipoprotein-metabolism-proatherogenic-changes-under-the-experimental-meta",totalDownloads:1371,totalCrossrefCites:0,totalDimensionsCites:2,hasAltmetrics:0,abstract:"The unbalanced high-calorie diet can be the cause of a number of pathological states, including metabolic syndrome (MS). It is well known that the risk of MS increases with age, but gender differences in age-related lipid metabolism changes under this pathology are not fully understood.",signatures:"A. Zagayko, G. Kravchenko, K. Strelchenko, A. Shkapo and T.\nBriukhanova",downloadPdfUrl:"/chapter/pdf-download/49095",previewPdfUrl:"/chapter/pdf-preview/49095",authors:[{id:"155168",title:"Dr.",name:"Anna",surname:"Kravchenko",slug:"anna-kravchenko",fullName:"Anna Kravchenko"},{id:"155169",title:"Prof.",name:"Andriy",surname:"Zagayko",slug:"andriy-zagayko",fullName:"Andriy Zagayko"},{id:"173762",title:"Dr.",name:"Katerina",surname:"Strelchenko",slug:"katerina-strelchenko",fullName:"Katerina Strelchenko"},{id:"173763",title:"Mr.",name:"Anton",surname:"Shkapo",slug:"anton-shkapo",fullName:"Anton Shkapo"},{id:"173764",title:"Ms.",name:"Tatyana",surname:"Briuhanova",slug:"tatyana-briuhanova",fullName:"Tatyana Briuhanova"}],corrections:null},{id:"48998",title:"Obese Childhood Dyslipidemia Management Beyond Statins — MUFA, PUFA, and Sea-buckthorn Supplements",doi:"10.5772/61001",slug:"obese-childhood-dyslipidemia-management-beyond-statins-mufa-pufa-and-sea-buckthorn-supplements",totalDownloads:1474,totalCrossrefCites:0,totalDimensionsCites:0,hasAltmetrics:0,abstract:"The dyslipidemia pattern usually associated with childhood obesity consists of a combination of elevated triglyceridemia, decreased plasma high density lipoprotein cholesterol concentration and LDL-c concentration at the upper limit of the normal range. This type of dyslipidemia is associated with dense and small LDL, which are proatherogenic. High circulating levels of oxidized LDL were described in extreme pediatric obesity, in children with high fructose intake and are associated with insulin resistance. The worst effect on blood lipids have trans and saturated fatty acids. But the amount of total energy intake plays more important role in lipid profiles. In childhood obesity it seems that insulin resistance precedes the development of the metabolic syndrome feature and insulin resistance is correlated with dyslipidemia. Insulin resistance increases free fatty acid flux to the liver by decreased inhibition of lipolysis and also by increased de novo lipogenesis. Fish oil is rich in eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) and has hypotriglyceridemic effect in comparison to monounsaturated fatty acids. Passive in utero exposure to a hyperlipidemic environment may have programmed these children for accelerated atherosclerosis. The infant formula should be enriched with long chain fatty acids because this supplementation is associated with lower blood pressure during later childhood. In obese children, supplements with Omega-3 polyunsaturated fatty acids improve lipid profile, blood pressure values and inflammatory markers. Omega-3 fatty acids prevent metabolic syndrome, by reducing hepatic steatosis, visceral fat, by reducing serum triglycerides and improving insulin sensitivity. Potentially all compounds of the Sea buckthorn berry, including flavonols, carotenoids, fatty acids, tocopherols and phytosterols can affect the metabolic profile. Special features of the berry oils are high proportions of palmitoleic acid as well as vitamin E, carotenoids, and sterols. The palmitoleic acid stimulates muscle insulin action, suppresses hepatosteatosis and prevent the deleterious effects of saturated fatty acids and high glucose on human pancreatic beta-cell turnover and function. Phenolic compounds and flavonoids from sea buckthorn ameliorate bodyweight, blood glucose, and serum lipid profile. By reducing triglyceridemia and by improving the blood pressure levels, sea buckthorn pulp oil may prevent metabolic syndrome in obese children. The treatment is recommended in hypertriglyceridemic waist phenotype obese children. Omega-3 supplements and sea buckthorn pulp oil supplements reversed the carotid intima media thickness values in obese children and they have beneficial effects in childhood obesity",signatures:"Bogdana Virgolici, Laura Anca Popescu, Horia Virgolici, Daniela\nElena Casariu, Olivia Timnea and Maria Mohora",downloadPdfUrl:"/chapter/pdf-download/48998",previewPdfUrl:"/chapter/pdf-preview/48998",authors:[{id:"173880",title:"Prof.",name:"Mohora",surname:"Maria",slug:"mohora-maria",fullName:"Mohora Maria"},{id:"173984",title:"Dr.",name:"Bogdana",surname:"Virgolici",slug:"bogdana-virgolici",fullName:"Bogdana Virgolici"},{id:"173985",title:"Dr.",name:"Laura",surname:"Popescu",slug:"laura-popescu",fullName:"Laura Popescu"},{id:"173986",title:"Dr.",name:"Horia",surname:"Virgolici",slug:"horia-virgolici",fullName:"Horia Virgolici"},{id:"173987",title:"Dr.",name:"Elena Daniela",surname:"Casariu",slug:"elena-daniela-casariu",fullName:"Elena Daniela Casariu"},{id:"176095",title:"Dr.",name:"Olivia",surname:"Timnea",slug:"olivia-timnea",fullName:"Olivia Timnea"}],corrections:null},{id:"49062",title:"The Assessment of the Atherogenic Lipoprotein Profile in Cardiovascular Diseases by Lipoprint System Analysis",doi:"10.5772/60989",slug:"the-assessment-of-the-atherogenic-lipoprotein-profile-in-cardiovascular-diseases-by-lipoprint-system",totalDownloads:1529,totalCrossrefCites:0,totalDimensionsCites:0,hasAltmetrics:0,abstract:"Research focus: Identification of incidence of an atherogenic lipoprotein phenotype B in four representative diagnoses of cardiovascular diseases: a) arterial hypertension, b) coronary heart disease, c) lower extremity arterial disease, d) ischemic stroke Research methods: A clinical study included 366 patients with a diagnosis of arterial hypertension (n=107), coronary heart disease (n= 104), lower extremity arterial disease (n= 100) and ischemic stroke (n= 55). The control group consisted of 150 healthy normotensive and normolipemic volunteers, all non-smokers, without signs of cardiovascular disease. In all tested individuals (or subjects) lipid parameters in serum: cholesterol and triglycerides were analyzed, using the enzymatic CHOD-PAP method, Roche Diagnostics Germany. Lipoproteins in serum lipoprotein spectrum by Lipoprint LDL system were analyzed and an atherogenic and a non-atherogenic lipoprotein profile idetified. The Score of the Anti-Atherogenic Risk (SAAR) was calculated as the ratio between non-atherogenic and atherogenic lipoproteins. Results: More than 80 percent of tested patients with cardovascular diseases have an atherogenic lipoprotein profile, with a high level of strongly atherogenic small dense LDL. The atherogenic profile was found in arterial hypertension 78.5%, in coronary heart disease in 81.7%, in lower extremity arterial disease in 80 %, and in patients who survived an ischemic stroke in 85%. Main conclusion: The atherogenic lipoprotein profile was found to be the overwhelming lipoprotein profile in tested cardiovascular diseases A new phenomenon- atherogenic normolipidemia - as a risk factor for the development of cardiovascular disease, would be established as a new term used in the diagnostics of dyslipoproteinemias",signatures:"Stanislav Oravec, Kristina Gruber, Andrej Dukat, Peter Gavornik,\nLudovit Gaspar and Elisabeth Dostal",downloadPdfUrl:"/chapter/pdf-download/49062",previewPdfUrl:"/chapter/pdf-preview/49062",authors:[{id:"142445",title:"Prof.",name:"Stanislav",surname:"Oravec",slug:"stanislav-oravec",fullName:"Stanislav Oravec"},{id:"175551",title:"Dr.",name:"Kristina",surname:"Gruber",slug:"kristina-gruber",fullName:"Kristina Gruber"},{id:"175552",title:"Prof.",name:"Andrej",surname:"Dukat",slug:"andrej-dukat",fullName:"Andrej Dukat"},{id:"175553",title:"Prof.",name:"Peter",surname:"Gavornik",slug:"peter-gavornik",fullName:"Peter Gavornik"},{id:"175554",title:"Prof.",name:"Ludovit",surname:"Gaspar",slug:"ludovit-gaspar",fullName:"Ludovit Gaspar"},{id:"175555",title:"Dr.",name:"Elisabeth",surname:"Dostal",slug:"elisabeth-dostal",fullName:"Elisabeth Dostal"}],corrections:null},{id:"49149",title:"Lipoprotein-Associated Phospholipase A2 – Pathophysiological Role and Clinical Significance as a Cardiovascular Biomarker",doi:"10.5772/60608",slug:"lipoprotein-associated-phospholipase-a2-pathophysiological-role-and-clinical-significance-as-a-cardi",totalDownloads:1554,totalCrossrefCites:0,totalDimensionsCites:1,hasAltmetrics:0,abstract:"Within the last decade, a broad range of biomarkers associated with an increased risk for death and cardiovascular/cerebrovascular endpoints have been identified. Epidemiological studies clearly indicate that lipoprotein-associated phospholipase A2 (Lp-PLA2) has the potential to become clinically useful emerging biomarker in the true sense, linking plaque biology with cardiovascular/cerebrovascular event rate. Lipoprotein-associated phospholipase A2 is a specific vascular inflammatory marker, a risk factor, a prognostic biomarker, and also a therapeutic target. This chapter will summarize our current knowledge on Lp-PLA2 with emphasis on its potential pathophysiological mechanisms of action and on clinical relevance as cardiovascular/cerebrovascular biomarker. This chapter gives comprehensive, systematic review of studies assessing the significance of Lp-PLA2 in cardiovascular/cerebrovascular diseases with emphasis on clinical benefit of pharmacologic inhibition of Lp-PLA2.",signatures:"Sanja Stankovic and Milika Asanin",downloadPdfUrl:"/chapter/pdf-download/49149",previewPdfUrl:"/chapter/pdf-preview/49149",authors:[{id:"141765",title:"MSc.",name:"Sanja",surname:"Stankovic",slug:"sanja-stankovic",fullName:"Sanja Stankovic"}],corrections:null},{id:"48844",title:"Lipoprotein(a) — A Hallmark in Atherosclerosis and Cardiovascular Diseases",doi:"10.5772/61078",slug:"lipoprotein-a-a-hallmark-in-atherosclerosis-and-cardiovascular-diseases",totalDownloads:1532,totalCrossrefCites:0,totalDimensionsCites:0,hasAltmetrics:0,abstract:"Lipoprotein(a) [Lp(a)] consists of a low-density lipoprotein (LDL)-like core and apo(a), a large molecular weight glycoprotein. Apo(a) is highly homologous to plasminogen, yet in contrast exhibits a unique size polymorphism that is characterized by an increasing number of kringle-IV (K-IV) repeats. The number of K-IV repeats ranges from n = 2 to n = 40 or even higher. Apo(a) is synthesized almost exclusively in the liver and there is still some debate whether the assembly of Lp(a) from LDL and apo(a) occurs inside the liver cells or in the circulating blood. The plasma Lp(a) concentration is markedly skewed reaching from <1 mg/dl up to >200 mg/dl. The plasma concentration is >90% genetically determined and correlates negatively with the number of K-IV repeats. In the apo(a) promoter, there are numerous response elements for transcription factors and nuclear receptors that regulate apo(a) expression. The HNF4α binding sequence appears to be the most important one in that respect, yet further work needs to be done to unravel the key features of apo(a) biosynthesis under different conditions. Importantly, activation of FXR causes the dissociation of HNF4α α from its response element and in turn a significant downregulation of apo(a) transcription.",signatures:"Indumathi Chennamsetty and Gert M. Kostner",downloadPdfUrl:"/chapter/pdf-download/48844",previewPdfUrl:"/chapter/pdf-preview/48844",authors:[{id:"135586",title:"Prof.",name:"Gerhard",surname:"Kostner",slug:"gerhard-kostner",fullName:"Gerhard Kostner"}],corrections:null}],productType:{id:"1",title:"Edited Volume",chapterContentType:"chapter",authoredCaption:"Edited by"},subseries:null,tags:null},relatedBooks:[{type:"book",id:"2555",title:"Lipoproteins",subtitle:"Role in Health and Diseases",isOpenForSubmission:!1,hash:"30f398afbe882fe1db3d1013952f3f13",slug:"lipoproteins-role-in-health-and-diseases",bookSignature:"Sasa Frank and Gerhard Kostner",coverURL:"https://cdn.intechopen.com/books/images_new/2555.jpg",editedByType:"Edited by",editors:[{id:"135586",title:"Prof.",name:"Gerhard",surname:"Kostner",slug:"gerhard-kostner",fullName:"Gerhard Kostner"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"2553",title:"Lipid Peroxidation",subtitle:null,isOpenForSubmission:!1,hash:"b39734aa940b2d63ae5e8773d3dd5280",slug:"lipid-peroxidation",bookSignature:"Angel Catala",coverURL:"https://cdn.intechopen.com/books/images_new/2553.jpg",editedByType:"Edited by",editors:[{id:"196544",title:"Prof.",name:"Angel",surname:"Catala",slug:"angel-catala",fullName:"Angel Catala"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"2323",title:"Carbohydrates",subtitle:"Comprehensive Studies on Glycobiology and Glycotechnology",isOpenForSubmission:!1,hash:"f7c2e6a3566eee14c9884ad0820a6416",slug:"carbohydrates-comprehensive-studies-on-glycobiology-and-glycotechnology",bookSignature:"Chuan-Fa Chang",coverURL:"https://cdn.intechopen.com/books/images_new/2323.jpg",editedByType:"Edited by",editors:[{id:"145728",title:"Prof.",name:"Chuan-Fa",surname:"Chang",slug:"chuan-fa-chang",fullName:"Chuan-Fa Chang"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"372",title:"Aflatoxins",subtitle:"Biochemistry and Molecular Biology",isOpenForSubmission:!1,hash:"b7f7359995dc5ee04e12df282495f77e",slug:"aflatoxins-biochemistry-and-molecular-biology",bookSignature:"Ramón Gerardo Guevara-González",coverURL:"https://cdn.intechopen.com/books/images_new/372.jpg",editedByType:"Edited by",editors:[{id:"62559",title:"Dr.",name:"Ramon G.",surname:"Guevara-Gonzalez",slug:"ramon-g.-guevara-gonzalez",fullName:"Ramon G. 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Lockhart",authors:[{id:"30552",title:"Dr.",name:"Paul",middleName:"Joseph",surname:"Lockhart",fullName:"Paul Lockhart",slug:"paul-lockhart"},{id:"42192",title:"Ms",name:"Sarah",middleName:"Elizabeth Marie",surname:"Stephenson",fullName:"Sarah Stephenson",slug:"sarah-stephenson"},{id:"42193",title:"Dr.",name:"Juliet",middleName:null,surname:"Taylor",fullName:"Juliet Taylor",slug:"juliet-taylor"}]},{id:"27855",title:"Bilateral Distribution of Oxytocinase Activity in the Medial Prefrontal Cortex of Spontaneously Hypertensive Rats with Experimental Hemiparkinsonism",slug:"bilateral-distribution-of-oxytocinase-activity-in-the-medial-prefrontal-cortex-of-spontaneously-hype",signatures:"Manuel Ramírez, Inmaculada Banegas, Ana Belén Segarra, Rosemary Wangesteen, Marc de Gasparo, Raquel Durán, Francisco Vives, Antonio Martínez, Francisco Alba and Isabel Prieto",authors:[{id:"28744",title:"Prof.",name:"Manuel",middleName:null,surname:"Ramirez-Sanchez",fullName:"Manuel Ramirez-Sanchez",slug:"manuel-ramirez-sanchez"},{id:"32683",title:"Dr.",name:"Inmaculada",middleName:null,surname:"Banegas Font",fullName:"Inmaculada Banegas Font",slug:"inmaculada-banegas-font"},{id:"32684",title:"Dr.",name:"Ana Belén",middleName:null,surname:"Segarra Robles",fullName:"Ana Belén Segarra Robles",slug:"ana-belen-segarra-robles"},{id:"32688",title:"Dr.",name:"Rosemary",middleName:null,surname:"Wangensteen Fuentes",fullName:"Rosemary Wangensteen Fuentes",slug:"rosemary-wangensteen-fuentes"},{id:"32689",title:"Dr.",name:"Raquel",middleName:null,surname:"Durán Ogalla",fullName:"Raquel Durán Ogalla",slug:"raquel-duran-ogalla"},{id:"32690",title:"Dr.",name:"Francisco",middleName:null,surname:"Vives Montero",fullName:"Francisco Vives Montero",slug:"francisco-vives-montero"},{id:"32691",title:"Dr.",name:"Antonio",middleName:null,surname:"Martínez Cañamero",fullName:"Antonio Martínez Cañamero",slug:"antonio-martinez-canamero"},{id:"32692",title:"Dr.",name:"Francisco",middleName:null,surname:"Alba Aragüez",fullName:"Francisco Alba Aragüez",slug:"francisco-alba-araguez"},{id:"32693",title:"Dr.",name:"Isabel",middleName:null,surname:"Prieto Gómez",fullName:"Isabel Prieto Gómez",slug:"isabel-prieto-gomez"},{id:"32694",title:"Dr.",name:"Marc",middleName:null,surname:"de Gasparo",fullName:"Marc de Gasparo",slug:"marc-de-gasparo"}]},{id:"27856",title:"Dictyostelium discoideum: A Model System to Study LRRK2-Mediated Parkinson Disease",slug:"dictyostelium-discoideum-a-model-system-to-study-lrrk2-mediated-parkinson-disease-",signatures:"Arjan Kortholt, Bernd Gilsbach, and Peter J.M. van Haastert",authors:[{id:"37800",title:"Prof.",name:"Peter",middleName:null,surname:"Van Haastert",fullName:"Peter Van Haastert",slug:"peter-van-haastert"},{id:"40511",title:"Dr",name:"Arjan",middleName:null,surname:"Kortholt",fullName:"Arjan Kortholt",slug:"arjan-kortholt"}]},{id:"27857",title:"Comparison of Normal and Parkinsonian Microcircuit Dynamics in the Rodent Striatum",slug:"comparison-of-normal-and-parkinsonian-microcircuit-dynamics-in-the-rodent-striatum",signatures:"O. Jaidar, L. Carrillo-Reid and J. Bargas",authors:[{id:"41529",title:"Dr.",name:"José",middleName:null,surname:"Bargas",fullName:"José Bargas",slug:"jose-bargas"}]},{id:"27858",title:"Animal Models of Parkinson’s Disease Induced by Toxins and Genetic Manipulation",slug:"toxin-induced-and-genetic-animal-models-of-parkinson-s-disease",signatures:"Shin Hisahara and Shun Shimohama",authors:[{id:"36546",title:"Dr.",name:"Shimohama",middleName:null,surname:"Shun",fullName:"Shimohama Shun",slug:"shimohama-shun"},{id:"36551",title:"Dr.",name:"Hisahara",middleName:null,surname:"Shin",fullName:"Hisahara Shin",slug:"hisahara-shin"}]},{id:"27859",title:"Neuroprotective Effects of Herbal Butanol Extracts from Gynostemma pentaphyllum on the Exposure to Chronic Stress in a 6-Hydroxydopamine- Lesioned Rat Model of Parkinson's Disease Treated with or Without L-DOPA",slug:"neuroprotective-effects-of-herbal-butanol-extracts-from-gynostemma-pentaphyllum-on-stressful-exposur",signatures:"Myung Koo Lee, Hyun Sook Choi, Chen Lei, Kwang Hoon Suh, Keon Sung Shin, Seung Hwan Kim, Bang Yeon Hwang and Chong Kil Lee",authors:[{id:"33001",title:"Prof.",name:"Myung Koo",middleName:null,surname:"Lee",fullName:"Myung Koo Lee",slug:"myung-koo-lee"},{id:"41604",title:"Ms",name:"Chen",middleName:null,surname:"Lei",fullName:"Chen Lei",slug:"chen-lei"},{id:"41605",title:"Dr.",name:"Hyun Sook",middleName:null,surname:"Choi",fullName:"Hyun Sook Choi",slug:"hyun-sook-choi"},{id:"41606",title:"BSc",name:"Kwang Hoon",middleName:null,surname:"Suh",fullName:"Kwang Hoon Suh",slug:"kwang-hoon-suh"},{id:"41607",title:"BSc",name:"Kun Seong",middleName:null,surname:"Shin",fullName:"Kun Seong Shin",slug:"kun-seong-shin"},{id:"41608",title:"Dr.",name:"Seung Hwan",middleName:null,surname:"Kim",fullName:"Seung Hwan Kim",slug:"seung-hwan-kim"},{id:"41609",title:"Dr.",name:"Bang Yeon",middleName:null,surname:"Hwang",fullName:"Bang Yeon Hwang",slug:"bang-yeon-hwang"},{id:"41610",title:"Dr.",name:"Chong Kil",middleName:null,surname:"Lee",fullName:"Chong Kil Lee",slug:"chong-kil-lee"}]},{id:"27860",title:"Acetyl-L-Carnitine in Parkinson’s Disease",slug:"acetyl-l-carnitine-in-parkinson-s-disease",signatures:"Maria Stefania Sinicropi, Nicola Rovito, Alessia Carocci and Giuseppe Genchi",authors:[{id:"35771",title:"Prof.",name:"Maria Stefania",middleName:null,surname:"Sinicropi",fullName:"Maria Stefania Sinicropi",slug:"maria-stefania-sinicropi"}]},{id:"27861",title:"Distribution and Regulation of the G Protein- Coupled Receptor Gpr88 in the Striatum: Relevance to Parkinson’s Disease",slug:"distribution-and-regulation-of-the-g-protein-coupled-receptor-gpr88-in-striatum",signatures:"Renaud Massart, Pierre Sokoloff and Jorge Diaz",authors:[{id:"41998",title:"Dr.",name:"Jorge",middleName:null,surname:"Diaz",fullName:"Jorge Diaz",slug:"jorge-diaz"},{id:"42108",title:"Dr.",name:"Renaud",middleName:null,surname:"Massart",fullName:"Renaud Massart",slug:"renaud-massart"},{id:"42109",title:"Mr.",name:"Pierre",middleName:null,surname:"Sokoloff",fullName:"Pierre Sokoloff",slug:"pierre-sokoloff"},{id:"42110",title:"Mr.",name:"Jean-Michel",middleName:null,surname:"Arrang",fullName:"Jean-Michel Arrang",slug:"jean-michel-arrang"}]},{id:"27862",title:"Human Lymphocytes and Drosophila melanogaster as Model System to Study Oxidative Stress in Parkinson's Disease",slug:"human-lymphocytes-and-drosophila-melanogaster-as-model-system-to-study-oxidative-stress-in-parkinson",signatures:"Marlene Jimenez-Del-Rio and Carlos Velez-Pardo",authors:[{id:"29068",title:"Dr.",name:"Marlene",middleName:null,surname:"Jimenez-Del-Rio",fullName:"Marlene Jimenez-Del-Rio",slug:"marlene-jimenez-del-rio"},{id:"29099",title:"Dr.",name:"Carlos",middleName:null,surname:"Velez-Pardo",fullName:"Carlos Velez-Pardo",slug:"carlos-velez-pardo"}]},{id:"27863",title:"Inflammation in Parkinson’s Disease: Causes and Consequences",slug:"inflammation-in-parkinson-s-disease-causes-and-consequences",signatures:"Louise M. Collins, André Toulouse and Yvonne M. Nolan",authors:[{id:"30678",title:"Dr.",name:"Yvonne",middleName:null,surname:"Nolan",fullName:"Yvonne Nolan",slug:"yvonne-nolan"},{id:"40662",title:"Dr",name:"Andre",middleName:null,surname:"Toulouse",fullName:"Andre Toulouse",slug:"andre-toulouse"},{id:"41049",title:"Dr.",name:"Louise",middleName:"M.",surname:"Collins",fullName:"Louise Collins",slug:"louise-collins"}]},{id:"27864",title:"Neurotensin as Modulator of Basal Ganglia- Thalamocortical Motor Circuit – Emerging Evidence for Neurotensin NTS1 Receptor as a Potential Target in Parkinson's Disease",slug:"neurotensin-and-parkinson-s-disease",signatures:"Luca Ferraro, Tiziana Antonelli, Sarah Beggiato, Maria Cristina Tomasini, Antonio Steardo, Kjell Fuxe and Sergio Tanganelli",authors:[{id:"41857",title:"Prof.",name:"Sergio",middleName:null,surname:"Tanganelli",fullName:"Sergio Tanganelli",slug:"sergio-tanganelli"},{id:"41967",title:"Dr.",name:"Maria Cristina",middleName:null,surname:"Tomasini",fullName:"Maria Cristina 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Disease",slug:"the-role-of-the-neuropeptide-substance-p-in-the-pathogenesis-of-parkinson-s-disease",signatures:"Emma Thornton and Robert Vink",authors:[{id:"26898",title:"Dr.",name:"Emma",middleName:null,surname:"Thornton",fullName:"Emma Thornton",slug:"emma-thornton"},{id:"41330",title:"Prof.",name:"Robert",middleName:null,surname:"Vink",fullName:"Robert Vink",slug:"robert-vink"}]},{id:"27867",title:"Noradrenergic Mechanisms in Parkinson’s Disease and L-DOPA-Induced Dyskinesia: Hypothesis and Evidences from Behavioural and Biochemical Studies",slug:"noradrenergic-mechanisms-in-parkinson-s-disease-and-l-dopa-induced-dyskinesia-hypothesis-and-evidenc",signatures:"Amal Alachkar",authors:[{id:"28350",title:"Dr.",name:"Amal",middleName:null,surname:"Alachkar",fullName:"Amal Alachkar",slug:"amal-alachkar"}]},{id:"27868",title:"Mitochondrial Haplogroups Associated with Japanese Parkinson’s Patients",slug:"mitochondrial-haplogroups-associated-with-japanese-parkinson",signatures:"Shigeru 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These changes present new challenges to health systems and require them to adapt to the new and dynamic era of the 21st century.
Macro-level changes and consequent challenges include the digital revolution [1, 2]; the need to work with, and alongside, technological innovations and artificial intelligence (AI) [3]; frequent reforms and changes to regulations (citation removed for blinding); an increase in life expectancy and other demographic changes; and the need to address all of these changes with limited resources and in face of increasing competition within health care organizations [4].
Micro-level challenges include changes in patients’ consumerist approach and in patients’ access to information, as well as changes in the power relations between patients and care- givers, and the entry of younger generations (Generations Y and Z) into the workplace.
In order to address these challenges and effectively carry out these systemic changes and prepare healthcare students and professionals to additional current and future changes, healthcare personnel need to adopt a wide range of new skills, and healthcare systems need to find effective ways to disseminate these skills among present and future employees [5].
Faced with the need to change and modify healthcare systems, one crucial set of skills that has been predominantly referred to is “soft skills”. The term describes skills that are not strictly cognitive or technical [6] and ones that include both intrapersonal and interpersonal competencies [7]. Thus, many of the soft skills which are now referred to as “critical skills” or “core skills”, are included in the concept of Emotional Intelligence (EI).
In its essence, EI involves an optimal combination of emotion and thought and consists of one’s ability to identify, use, understand and manage feelings in oneself and in others [8, 9]. Several models have proposed a set of emotional and social skills and competencies that are related to emotionally intelligent behaviors and outcomes in various fields, and which can be actively developed [10, 11, 12]. Such skills typically include self-awareness, awareness of others (empathy), emotional management (self-regulation) and interpersonal communication.
In recent years, a broad body of research has highlighted the contribution of EI and social–emotional skills to areas such as physical and psychological health; interpersonal relationships; and effectiveness and success in academic studies and in a wide range of organizations, occupations and levels of employment [11, 13, 14, 15]. In particular, a large number of studies have emphasized the importance of SEI for coping with challenges of the 21st century [16].
In the field of medicine, social–emotional skills have been linked to success across a wide range of positions and roles [17]. Noted examples include links to effective performance under pressure, increased commitment to healthcare organizations, positive interpersonal communications, and effective teamwork among medical staff [18]. Additional studies have pointed out correlations between SEI and better doctor–patient relations [19], fewer medical lawsuits [20], empathic treatment [21], precision in medical diagnoses and consequently in treatment [22], lower levels of situation-related anxiety in patients [23], higher levels of patient responsiveness to treatment, increased patient satisfaction and higher patient trust in healthcare staff [24]. Yet despite the clear benefits offered by social–emotional skills in the healthcare professions, the social–emotional skills of medical students have often been noted to be similar or even lower than those of the average population [25], and at times were even noted to decrease during their studies [26].
Consequently, there has been a call to develop social–emotional intelligence among medical students, nursing students and medical management students [27]. Nevertheless, to date, and despite a growing understanding of the importance of social–emotional skills to medical professions, the development of these skills has only captured a limited place in medical school curricula and in the training of healthcare staff.
Until recently, both admissions to healthcare education programs and subsequent academic success were defined primarily on the basis of superior cognitive abilities. Traditional teaching, learning and assessment processes focused on knowledge and on cognitive abilities (citation removed for blinding).
However, in recent years, it has been increasingly recognized that cognitive and professional abilities are not sufficient criteria for success in medical schools and in the medical profession. Consequently, several hospitals have begun incorporating social–emotional skill development efforts as part of ongoing training for their medical teams [28]. Several medical schools have also introduced admission measures that examine candidates’ personal and interpersonal abilities [29] as well as courses for social–emotional skill development [30]. Nevertheless, such efforts are still limited, due to time and overload constraints and to a lingering, mainly cognitive, focus. This paper will introduce the theoretical and methodological underpinning of a novel tool for the development of social–emotional skills, suitable for use among medical students and staff.
In order to integrate the development of social–emotional skills into existing academic and training curricula in a wide field of subjects, a unique Social–Emotional Skill Development tool (SE-SD) that is based on guidelines for effective practices in social–emotional development (e.g. [31, 32]) has been recently developed. This tool is highly suited for healthcare education systems, in particular in light of the above-noted time constraints and the challenges imposed by a predominantly cognitive focus [2, 33].
The SE-SD tool offers a broad perspective on the field of healthcare education and addresses the need for non-cognitive social–emotional skills in the field. In addition, it aims to complement and to work in synergy with existing training tools and to support other professional skills. It can be further viewed more broadly as a method and pedagogy for integrating the development of social–emotional skills in healthcare training. By doing so, it is expected to enable students to cope with a changing healthcare reality and thrive in it.
The SE-SD tool is based on eight underlying principles:
The theoretical framework at the basis of the SE-SD tool is the well-established Bar-On [11] model of Emotional–Social Intelligence. This framework, which addresses both behaviors and outcomes, has been noted to be especially suitable for educational settings [34, 35] and has been employed successfully in the medical arena [36, 37, 38]. It allows for a holistic and inclusive development approach that has been noted especially effective in SEI trainings [39]. Similar to the Bar-On framework and associated tool (EQ-i), the SE-SD tool includes ten skills, nine such as emotional self-awareness and expression, self-regulation, empathy and interpersonal relations, social responsibility, flexibility, stress-tolerance, optimism and self-regard from the original Bar-On model (Figure 1) [11], with the addition of Growth Mindset. All linked to different aspects of various healthcare professions [25]. The SE-SD skills are arranged in 4 major clusters: intrapersonal, inter-personal, adaptability and stress-management, to which the well-being indicator of the original model has been added.
List of essential soft skills for healthcare professions.
In line with the inclusive model at its basis and the wide variety of social–emotional skills it includes, the SE-SD tool addresses a offers a wide range of development assignments and a wide range of methodical tools (such as dedicated articles, video clips, short interviews, reflective questions, real-life experimentation, etc.). This variability is in line with earlier studies where the successful development of social–emotional skills was noted to include both cognitive and emotional components and to require varied and experiential methods [40].
It has been widely acknowledged that SEI development cannot be achieved by means of a single workshop [41, 42, 43, 44] and requires an extensive, routinised, long-term effort that provides time for learning, practicing and achieving development [31]. A curriculum integrated approach allows for such extensive and long-term development efforts as well as for offering a contextual, rather than isolated, experience.
In line with these findings, the SE-SD tool has been designed to be integrated into existing course materials. This integrated approach helps students and instructors overcome time constraints as well as highlights the links between the targeted SEI skills and different aspects of the profession, making the development relevant and meaningful. Integration is achieved through two parallel processes: by linking specific social–emotional skills with the general course material; and through home assignments that target SEI development, are self-paced and are completed and evaluated at different points in time throughout the entire course.
Social–emotional skills have been noted to be relevant across a wide range of roles and positions in the field of healthcare [17].
Accordingly, the SE-SD tool, and in particular the assignments associated with each skill, were structured in a more general manner and therefore can be easily applied to a variety of subjects in the academic curriculum and can be integrated into a variety of healthcare academic courses, disciplines and academic levels.
The SE-SD tool can be used in a modular and “spiral” manner in order to integrate a wide range of skills into different courses throughout the academic program. Such modularity is particularly suited to the development of social–emotional skills, a process noted to involve continuous and lifelong learning [45, 46] and in which links between skills exist [11]. Importantly, while the SE-SD tool can be used in isolation, as part of a single course or a number of courses, a multiyear, spiral SEI development program which corresponds with the desired graduate vision can enhance the overall effectiveness and sustainability of the SEI development process [31] and ultimately contribute to the quality of healthcare professionals.
The nature of healthcare studies supports such modularity as healthcare students may need to employ different SEI skills at different stages of their academic training (pre-clinical and clinical years for example).
Finally, assignments that form part of the SE-SD tool are constructed in a modular fashion, building up from theory to practice. This modular structure is built on the premise that theoretical knowledge provides a foundation for the development of SEI [44] and that effective social–emotional development should follow several steps: the acquisition of a theoretical basis; and an understanding of the concept of EI and the specific SEI skills as they are being targeted, achieved through theoretical assignments. These are followed by gaining understanding of the relevance of the targeted skills to the course material and to future practice through reflective assignments. Practical assignments then provide a step-by-step opportunity to develop and practice newly acquired skills. Ideally, these steps lead to changes in habits, attitudes and behaviors [31, 44].
The SE-SD tool focuses on the process of SEI development rather than on its outcomes. It is assumed that social–emotional development is an on-going life-long process which takes place within relationships (in this case, with the course instructor). It has been demonstrated that relationships that are based on trust, guidance, support and formative feedbacks enhance SEI development [12, 32]. As an inseparable part of the SE-SD tool, therefore, evaluations and feedbacks from course instructors provide formative comments which students can use in order to continue to progress and to refine their development process. All these elements have been noted to enhance SEI development [47] and motivation levels [31].
Academic assignments that integrate the SE-SD tool are evaluated based on their degree of completion and on the students’ level of understanding of several elements: the concept of EI, the specific SEI skills that are being acquired, and the relevance of these skills to the particular healthcare profession at the center of the course. During the active development stage, students are evaluated based on their level of engagement and reflection. The importance of reflective learning has been previously highlighted [44], noting that reflections on thoughts, feelings and behaviors that underlie attitudes and habits, both personal and of others, enhance the development of SEI competencies.
As emotions, thoughts, competencies, behaviors and habits are all unique to each individual, it is recommended that social–emotional development processes include a focus on individual social–emotional skills [12, 48]. To this end, the SE-SD tool allows students to follow their own individual development path at their own pace, to start the development process from their own individual starting point, to focus on their own specific goals and to self-assess their progress. Self-directed processes encourage participants to be personally accountable for their progress and involve them in planning, carrying out and evaluating their own learning experiences. These elements, in turn, were noted to enhance motivation, which is key to social–emotional training success [12].
In order to manage their self-directed learning, students receive “road maps” (either in a digital form or in print) that outline their assignments and set specific points in time for evaluations and feedbacks. The assignments are order-dependent, as each assignment builds on the previous one, and the order in which assignments are offered is pre-determined. While students can follow the development process at their own pace, they are instructed to avoid completing their assignments all at once. This time-paced approach maximizes the effectiveness of the learning process, allowing students time for reflection and practice and providing instructors with at least two opportunities, at two different points in time, to deliver evaluations and feedbacks to students.
The SE-SD tool is both flexible and adaptable. The tool’s flexibility is manifested in the choice of SEI skills that are to be associated with a given course, in the links drawn between these skills and the course materials, in the number of assignments chosen from the selection offered and in the variety of these assignments. The tool offers further flexibility in terms of feedbacks and evaluations: instructors can limit themselves to the two formal evaluations (intermediate and final) that are provided as part of the tool, but may choose to provide additional informal and more frequent feedbacks. Furthermore, additional skills to those offered in the model can be added, consistent with the principles embedded in the tool: designing developmental activities and assignments that would support knowledge acquisition and enhance the understanding of these skills, determining the relevance of the added skill to a particular course, and identifying starting points and goals for each of the participants.
Taken together, these features of the SE-SD allow healthcare education systems to include social–emotional development as a strategic plan for preparing students and workers for a changing professional reality.
Skill-development processes often follow a sequence of stages that have been recognized to contribute to effective development (e.g. [31, 41, 47]). These include: preparation (gaining students’ commitment, identifying needs, and jointly designing a development program); action (implementing the program – introduction and development); and evaluation. In the case of the SE-SD tool and healthcare education settings, these stages have been adapted to meet the specific requirements of various healthcare professions (Figure 2).
Process of model implementation.
The preparation stage begins with the selection of an SEI skill to be developed during a given course. This skill, selected by the course instructor from a list of social–emotional skills offered in the tool (Figure 1), is chosen based on its degree of relevance to the course material and its suitability in terms of the students’ academic level.
The course instructor then plans how to integrate the skill into the course material. For example, if integrated into a course that focuses on patient-caregiver relationships, the instructor may decide to discuss empathy as part of a segment that examines how to deliver difficult news to patients.
Lastly, the course instructor goes over the SE-SD assignment list and chooses assignments that correspond to the selected skill.
When a three-year process is involved, these steps are followed in group discussions where faculty members jointly decide on the skills to be introduced each year and the classes they most fit.
The action stage includes two parts, introduction and development.
This part of the action stage is designed to highlight the relevance and importance of SEI to the students and to promote motivation to participate in the EI development process. The course instructor begins by introducing the concept of social–emotional skills to the students, highlights the relevance of these skills to the course and notes their importance to students’ overall growth and future careers in the 21st century.
Following these introductory remarks, the SE-SD model and tool are presented and the methods by which the development process will be incorporated into the course, both during class and by means of home assignments and their evaluation, are explained. The instructor notes the order by which the assignments are to be completed, the corresponding time frames, and the formative evaluation method by which they would be assessed.
The development part of the action stage relies on individual home assignments that students are asked to carry out throughout the entire course. Students are instructed to complete the assignments in a pre-determined order and can only access subsequent assignments after completing the previous ones. In line with the structure of the SE-SD tool, the assignments include three hierarchical segments: Theoretical background, Exploration, and Practice.
The theoretical background segment aims to provide the students with a solid theoretical basis for personal development. Students learn about the concept of EI and come to understand the targeted SEI skills and the mechanisms by which they may be employed. As part of this segment, students are encouraged to read relevant literature and to watch illustrative video presentations. For example, as part of a background segment on empathy, students may read a paper about the concept, watch a relevant video program, note the distinction between empathy, sympathy and compassion, and find out more about the mechanisms by which empathy is employed and its contribution to the healthcare professions.
During the exploration segment, students proceed to explore the relevance of targeted EI skills to various healthcare professions. By answering a set of guiding questions and/or conducting short interviews with professional in the field, students are able to identify the relevance of any given skill to their course material, to their chosen profession and to present and future life outcomes. Finally, they are asked to identify their own individual starting point with respect to the targeted skill and to define the corresponding goals. The SE-SD tool provides a set of guiding questions and/or a short questionnaire that support this exploration process. For example, in the case of empathy, students are asked to identify links between empathy and healthcare professions, use guiding questions to evaluate the gains they are likely to derive from enhanced empathy, and assess their starting point with regards to the development process using an empathy questionnaire.
The practice segment involves students in a wide range of activities, all aimed at developing the targeted SEI skill. This is the longest segment of the three, in line with Boyatzis [12, 32] who noted the importance of experimenting with new behaviors for an effective social–emotional development process. The assignments that form the core of this segment are designed to develop cognitive, emotional and behavioral components of the targeted skill. For example, in the case of empathy, the students are asked to engage in empathic dialogues, take on another person’s perspective (e.g. a patient or a team member), or examine case studies that center on interactions between patients and caregivers. The culminating assignment includes reflection and self-evaluation.
Finally, during the evaluation segment, students are provided with feedbacks and formative assessments that can help them further develop their social–emotional skills. These feedbacks and evaluations are provided by their course instructors at two points in time during each course: mid-term (which coincides with the goal-setting stage of the development process) and at the end of the course (after all assignments have been completed). These feedbacks are accompanied by self-evaluations.
As noted above, participant students are evaluated based on their level of commitment, efforts and engagement in the development process (as opposed to the level of development that has been achieved); their level of understanding of the targeted EI skill; and the level of personal and professional reflectiveness they demonstrate throughout the entire course.
Furthermore, beyond the mid-term and end-of-term evaluations, instructors can choose to provide additional evaluations and feedbacks in the course of the program, in accordance with available time resources.
In light of the global changes and challenges that face many professionals in the 21st century, there is an increasing understanding that it is of primary importance to develop and foster social–emotional skills, also referred to as “soft skills”, among workers in a wide range of fields. A prominent example is the field of healthcare. Skills that are likely to benefit healthcare professionals may include emotional self-awareness, self-regulation, empathy, and interpersonal relations. These, as well as other social–emotional skills, were noted to improve coping abilities, academic learning and professional effectiveness among both medical teams and healthcare management teams [49, 50].
The importance of social–emotional skills to medical staff and to healthcare systems and their currently limited place in medical school curricula, call for a proactive initiative on the part of academic institutions. Such an initiative should address needs and challenges, both current and future, that face healthcare professionals and can transform medical schools from knowledge providers to leaders of cultural and social changes.
Given the noted difficulties to integrate the development of social–emotional skills into existing curricula in the field of healthcare, we propose a novel and holistic SE-SD tool that integrates social–emotional learning into existing curricula while overcoming time and workload barriers.
Furthermore, the assignments that form part of the SE-SD tool are prepared and provided ahead of time by the tool designers, and therefore instructors do not require any prior expertise in the field of social–emotional learning in order to implement the tool as part of their courses.
Effective implementation of social–emotional skill development programs has been noted to benefit from a supportive climate. It is therefore highly recommended that faculty is included in the proposed social–emotional training process. Social–emotional training is expected to heighten faculty awareness of the importance of the process, increase their willingness to take risks as they implement the SE-SD model in their respective institutions, and enable them to model socially-emotionally behaviors and to ‘walk the talk’ [49]. All these were found to contribute to the development of social–emotional skills in students.
In addition to academic institutions which can take upon themselves to develop social–emotional skills in students and faculty, development of these skills should form an integral part of on-going professional training for both healthcare staff in post-academic settings. Such life-long learning will support earlier development efforts in academic institutions and will insure its sustainability.
Lastly, although research regarding the effectiveness of the SE-SD tool is still a work in progress, we believe that the use of integrative learning methodologies like the one described here would bring healthcare academic institutions and their graduates one step closer towards adapting to the 21st century and meeting its demands.
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