Clinical Research Details

Descriptive Information
Cynicism and other attitudes toward patients in an Emergency Department in a Middle Eastern tertiary care center

Nicholas Batley

Completed- Has Results


Rana Bachir
Conditions and Keywords
No specific diagnosis
Cynicism, empathy, medical students,residents, interns,attending physicians, patients
Study Design
Basic / Translational
N/A: Not Applicable
Qualitative data collection
N/A: Not Applicable
N/A: Not Applicable
N/A: Not Applicable
Eligibility and IRB
Min: 23

Methods: A total of 30 students, residents and attending physicians at the

American University of Beirut Medical Center were invited to participate. All

participants underwent semi-structured interviews that were recorded, transcribed

and then analyzed for common themes.

Results: More negative emotions were expressed among participants than positive

ones. Negative emotions were more frequently expressed among medical

students, interns and residents than attending physicians. Cynicism in the ED was

commonly reported however, maintenance of professionalism and adequate

patient care were underscored. While empathy was recurrently found among

participants, a trend towards a decrease in empathy with career progression was

noted among attending physicians. Further, negative feelings towards patient families were prominent. Participants tended to categorize patients based on

willingness to cooperate, gender, age, case acuity, ethnic origins and social status.

Conclusions: Cynicism emerged as a prominent theme among medical students

and staff in our study. However, participants were also empathetic. These attitudes

were generally attributed to the peculiar stressors associated with the Lebanese

culture, low acuity cases and “VIP” patients. It is crucial to explore methods in

order to decrease cynicism and improve patient care. Also, the implications of

these attitudes on patient care remain to be discovered.

The sample consisted of 11 medical students (6 fourth year and 5 third year – in a

four year program), 6 interns, 7 residents, and 6 attending physicians for a total of

30 participants (60% males and 40% females) with an average age of 27.5 years.