• autism
• cerebral palsy
• emotion knowledge
• emotion regulation
• neurodevelopmental disorders
• neurotypical children
• proprioception
• proprioceptive reactive behavior
• social responsiveness

• PID2020-114967GA-I00 Ministerio de Ciencia, Innovacióny Universidades (Spain)

• Abstract concepts
• Autonomic nervous system
• Autonomic reactivity
• Embodied empathy
• Embodiment
• Empathy
• Interoception
• Meditation

• Humans
• Empathy/physiology
• Meditation
• Male
• Female
• Adult
• Autonomic Nervous System/physiology
• Interoception/physiology
• Young Adult
• Awareness/physiology
• Middle Aged
• Emotions/physiology

• Empathy
• Humanities
• Narrative medicine
• Parallel medical records
• Residents
• Standardized resident training

• Humans
• Empathy
• Narrative Medicine
• Students, Medical
• Knowledge
• Neurology

• Henan Medical Education Research Project
• Joint Construction Project of Henan Medical Science and Technology Project

• philosophy
• philosophy of medicine/health care
• philosophy of science
• physiotherapist
• rehabilitation medicine including disability

• Humans
• Physical Therapy Modalities
• Physical Therapists

Improving clinical reasoning techniques is the right way to facilitate decision-making from prognostic, diagnostic, and therapeutic points of view. However, the process to do that is to fill knowledge gaps by studying and growing experience and knowing some cognitive aspects to raise the awareness of thinking mechanisms to avoid cognitive errors through correct educational training. This article examines clinical approaches and educational gaps in training medical students and young doctors. The authors explore the core elements of clinical reasoning, including metacognition, reasoning errors and cognitive biases, reasoning strategies, and ways to improve decision-making. The article addresses the dual-process theory of thought and the new Default Mode Network (DMN) theory. The reader may consider the article a first-level guide to deepen how to think and not what to think, knowing that this synthesis results from years of study and reasoning in clinical practice and educational settings.

• Embodied learning
• biomechanics
• interprofessional learning
• trauma
• visualization

• Biomechanical Phenomena
• Cooperative Behavior
• Humans
• Interprofessional Relations
• Students
• Technology

A recent meta-analysis revealed that mental health and baseline psychological impairment affect the quality of life and outcomes in different chronic conditions. Implementing mental health care in physical care services is still insufficient. Thus, interdisciplinary communication across treatment providers is essential. The standardized language provided by the diagnostic statistical manual favors a clear conceptualization. However, this approach might not focus on the individual, as thinking in categories might impede recognizing the continuum from healthy to diseased. Psychoanalytic theory is concerned with an individual’s unconscious conflictual wishes and motivations, manifested through enactments like psychic symptoms or (maladaptive) behavior with long-term consequences if not considered. Such modifiable internal and external factors often are inadequately treated. However, together with the physical chronic condition constraints, these factors determine degrees of freedom for a self-determined existence. The effect of therapeutic interventions, and especially therapy adherence, relies on a solid therapeutic relationship. Outcome and process research still investigates the mechanism of change in psychotherapeutic treatments with psychanalysis’s focus on attachment problems. This article examines existing knowledge about the mechanism of change in psychoanalysis under the consideration of current trends emerging from psychotherapy research. A clinical example is discussed. Additionally, further directions for research are given. The theoretical frame in psychoanalytic therapies is the affect-cognitive interface. Subliminal affect-perception is enabled via awareness of subjective meanings in oneself and the other; shaping this awareness is the main intervention point. The interactional ingredients, the patient’s inherent bioenvironmental history meeting the clinician, are relevant variables. Several intrinsic, subliminal parameters relevant for changing behavior are observed. Therapeutic interventions aim at supporting the internalization of the superego’s functions and at making this ability available in moments of self-reflection. By supporting mentalization abilities, a better understanding of oneself and higher self-regulation (including emotional regulation) can lead to better judgments (application of formal logic and abstract thinking). Thus, this facilitates enduring behavior change with presumably positive effects on mental and physical health.

• Chronic disease
• Psychological impairment
• Psychoanalysis
• Facial microexpressions
• Memory reconsolidation
• Reflection
• Relationship
• Resilience

Healthcare professionals need to be prepared to promote healthy lifestyles and care for patients. By focusing on what students should be able to perform one day as clinicians, we can bridge the gap between mere theoretical knowledge and its practical application. Gender aspects in clinical medicine also have to be considered when speaking of personalized medicine and learning curricula.

To determine sets of intellectual, personal, social, and emotional abilities that comprise core qualifications in medicine for performing well in anamnesis-taking, in order to identify training needs.

An analysis of training clinicians’ conceptions with respect to optimal medical history taking was performed. The chosen study design also aimed to assess gender effects. Structured interviews with supervising clinicians were carried out in a descriptive study at the Medical University of Vienna. Results were analyzed by conducting a qualitative computer-assisted content analysis of the interviews. Inductive category formation was applied. The main questions posed to the supervisors dealt with (1) Observed competencies of students in medical history taking; and (2) The supervisor’s own conceptions of "ideal medical history taking".

A total of 33 training clinicians (n = 33), engaged in supervising medical students according to the MedUni Vienna’s curriculum standards, agreed to be enrolled in the study and met inclusion criteria. The qualitative content analysis revealed the following themes relevant to taking an anamnesis: (1) Knowledge; (2) Soft skills (relationship-building abilities, trust, and attitude); (3) Methodical skills (structuring, precision, and completeness of information gathering); and (4) Environmental/contextual factors (language barrier, time pressure, interruptions). Overall, health care professionals consider empathy and attitude as critical features concerning the quality of medical history taking. When looking at physicians’ theoretical conceptions, more general practitioners and psychiatrists mentioned attitude and empathy in the context of "ideal medical history taking", with a higher percentage of females. With respect to observations of students’ history taking, a positive impact from attitude and empathy was mainly described by male health care professionals, whereas no predominance of specialty was found. Representatives of general medicine and internal medicine, when observing medical students, more often emphasized a negative impact on history taking when students lacked attitude or showed non-empathetic behavior; no gender-specific difference was detected for this finding.

The analysis reveals that for clinicians engaged in medical student education, only a combination of skills, including adequate knowledge and methodical implementations, is supposed to guarantee acceptable performance. This study’s findings support the importance of concepts like relationship building, attitude, and empathy. However, there may be contextual factors in play as well, and transference of theoretical concepts into the clinical setting might prove challenging.

• Medical history taking
• Attitude
• Empathy
• Training
• Physicians’ view

The field of the sciences of the mind is evolving fast. With the diversification of knowledge and accumulation of data, often lacking integration and reproducibility, questions arise. The role of critical thinking and research is evident. As the science of the unconscious, psychoanalysis provides a method and theory to understand human minds and mentalities, helping the patient know his mind and transform action into reflection. Mental activities, including social skills, develop in the social context, depending on the social environment’s demands and resources put onto the individual. Encoding emotional signals, markers of meaning for the individual, is ontogenetically necessary and has influences on memory encoding. Beyond theoretical understanding, implicit relational knowledge is actualized in the therapeutic setting. With a strong focus on experiencing emotional reconsolidation of memories, previous relationships’ repercussions are enriched with broadening viewpoints in the analytic environment. The long-term effects of psychotherapeutic treatments have been examined. A sufficient explanation of the specific factors contributing to success or an answer when an impact is lacking is still under investigation. When investigating subliminal and implicit mechanisms leading to memory reconsolidation and the formation of functional object relations and interaction patterns, the focus is set on affective interplay and processing prior/during and after social interactions. The present paper discusses which parameters might contribute to the reshaping of memories and the linkage of memory with the emotional load of experience. Providing insights into such dynamic mental phenomena could enhance process research by investigating moment by moment interactions in psychoanalysis, treatment, and learning processes. Due to the research subject’s complexity, different research methods and integration of associated research fields are required.

• Psychoanalysis
• Hermeneutic circle
• Evidence-based medicine
• Bias
• Affective interplay
• Micro-process

This paper argues for a comprehensive conception of empathy as comprising epistemic, affective, and motivational elements and introduces the ancient Stoic theory of attachment (Greek, oikeiōsis) as a model for describing the embodied, emotional response to others that we take to be distinctive of empathy. Our argument entails that in order to provide a suitable conceptual framework for the interdisciplinary study of empathy one must extend the scope of recent “simulationalist” and “enactivist” accounts of empathy in two important respects. First, against the enactivist assumption that human mindreading capacities primarily rely on an immediate, quasi-perceptual understanding of other’s intentional states, we draw on Alfred Schutz’ analysis of social understanding to argue that reflective types of understanding play a distinct, but equally fundamental role in empathic engagements. Second, we insist that empathy also involves an affective response toward the other and their situation (as the empathizer perceives this). We suggest analyzing this response in terms of the Stoic concepts of attachment, concern, and a fundamental type of prosocial motivation, that can best be described as an “extended partiality.” By way of conclusion, we integrate the above concepts into a comprehensive conceptual framework for the study of empathy and briefly relate them to current debates about empathic perception and prosocial motivation. The result, we argue, is an account that stays neutral with regard to the exact nature of the processes involved in producing empathy and can therefore accommodate discussion across theoretical divides—e.g., those between enactivist, simulationalist, and so-called theory-theorist approaches.

• affective intentionality
• attachment
• embodied cognition
• empathy
• phenomenology
• prosocial motivation
• stoicism

• Provoked vestibulodynia
• body awareness
• physiotherapy
• somatocognitive therapy
• therapeutic alliance

• Body language
• Communication
• Dance
• Medical education
• Medical humanities
• Movement
• Patient-doctor interaction

• Curriculum
• Education, Medical
• Education, Medical, Undergraduate
• Humanities
• Humans
• Medicine
• Philosophy

In European higher education, application of information technology, concentration on the learning-processes, consistent implementation, transfer learning, case-based learning, autonomous learning has been extensively studied in the last decade. Educational sciences based on neuroscientific findings use brain-based learning and teaching, including integrated thematic instructions and emotion-theory. Elements essential to this strategy, such as theory and methods for learning, competencies, attitudes, social reality, and a metadiscourse are described herein. Research on learning tends to focus on declarative knowledge, associative learning with conditional stimuli, and procedural knowledge with polythematic/crosslinking thinking. Research on competencies: In research on competencies (e.g., for clinical reasoning, decision-making), intuitive and analytical components are studied. As repeated presentation and exercising of clinical cases is crucial for an efficient learning process, the implementation of interactive scenarios including affectively involving didactics is considered. For competence-development observational methods, questionnaires/item sets or factors have to be targeted and empirically validated. Attitudes and social reality: Clinical decision-making, identification processes and attitudes (“Hidden curriculum”), as well as secondary socialization processes (integration of social norms, values, preparation of role-acquisition, occupational role) are studied via process research, conceptual research, and observational methods. With respect to social reality research, conscious and unconscious bargaining processes have to be taken into account. Methodology: Neuroscience – memory, neuronal, molecular biology, and computer science (Neurocircuits) are integrated into observational process research (e.g., affective-cognitive interface, identification processes) and conceptual research is added and studied on the meta-level, including discussion of research paradigms. This discussion provides ongoing feedback to projects in a hermeneutic circle.

• Social neuroscience
• Case-based learning
• Mixed-method design
• Hidden curriculum
• Socialization
• Research

• Surgery
• medicine
• simulation

• Clinical Competence
• Cognition
• Education, Medical
• Humans
• Learning
• Surgeons

• Education
• Empathy
• Experiential learning
• Qualitative
• Simulation

• Education, Nursing/methods
• Education, Nursing/standards
• Education, Nursing/trends
• Empathy
• Humans
• Perception
• Students, Nursing/psychology

• Attitudes
• Depression
• Education
• Empathy
• Psychiatry

• body
• interoception
• proprioception
• social cognition
• visceroception