Background: Empathy is a cornerstone of patient‐centred care. However, empathy levels among health care professionals and medical students are currently suboptimal. An empathy map is a tool which aids in understanding another person’s perspective. Empathy maps have up until now not been used in a medical education setting. Objective: To assess the attitudes towards, applicability and usefulness of empathy maps as part of medical student’s communication skills training. Methods: Empathy map training was introduced to first‐year medical student communication skills training at two UK‐based medical schools. Twenty‐eight participants in total agreed to be interviewed about their experiences using the empathy map, including sixteen students and twelve patient partners who assisted with communication skills training. Results: Medical students and patient partners perceive value in empathy map training. Medical students stated that the empathy map training impacted on their views of empathy and patient‐centredness by highlighting the importance of patient‐centred care. Medical students and patient partners enjoyed the experience of completing the empathy map and had suggestions for how it could be improved in the future. Conclusions: Empathy maps could provide a cost‐effective way to encourage empathic and patient‐centred care in medical education. Furthermore, there is no reason why empathy maps would not aid in any caring profession. Further research is needed to confirm that empathy maps do increase empathy.

Colorful carotenoid ornaments are sexually selected signals of health in many species. In humans too, carotenoids could provide a perceptible cue to health as they impart an attractive yellow-orange color to skin. Increasing carotenoid pigmentation and skin yellowness is associated with increased fruit and vegetable intake, but whether other aspects of human health benefit skin color is unknown. Carotenoids, as antioxidants, help maintain oxidative balance but are expended in this role. Therefore, any health factor affecting oxidative balance could alter the quantity of carotenoids available to color skin. Exercise increases endogenous antioxidant capacity and consequently may decrease expenditure of carotenoids. Fitness could also raise skin carotenoids by lowering body fat (a source of oxidative stress). Here we investigate the relationship between skin color (measured spectrophotometrically), aerobic fitness (measured by estimating the maximum volume of oxygen that a person can use per unit of time, VO₂ max), and body fat. In a cross-sectional design, we find that both higher aerobic fitness and lower body fat are predictors of skin yellowness, independent of each other and dietary fruit and vegetable intake. In a longitudinal design over 8 weeks, we found that increase in fitness and decrease in body fat were independently associated with an increase in skin yellowness. Change in self-reported stress and sleep were further predictors of skin yellowness indicating a more general relation between health and skin tone. Simulations of the skin color associated with higher fitness were found to appear healthier. Hence, our results suggest that increasing cardiovascular fitness and decreasing fat levels produce a healthier skin color. Such findings have repercussions for public health because improved attractiveness can provide an incentive for a healthier lifestyle, including exercise and weight regulation.

Objectives The aim of this scoping review was to identify pre-existing interventions to support the well-being of healthcare workers during a pandemic or other crisis and to assess the quality of these interventions. Design Arksey and O’Malley’s five-stage scoping review framework was used to identify the types of evidence available in the field of well-being interventions for healthcare workers during a pandemic. PubMed, PsycINFO, Embase, Scopus, Web of Science, CINAHL and ERIC databases were searched to find interventions for the well-being of doctors during pandemics. Owing to a lack of results, this search was expanded to all healthcare workers and to include any crisis. Databases were searched in June 2020 and again in October 2020. Inclusion/exclusion criteria Articles were included that studied healthcare workers, reported an intervention design and were specifically designed for use during a pandemic or other crisis. Well-being was defined broadly and could include psychological, physical, social or educational interventions. Results Searching produced 10 529 total academic references of which 2062 were duplicates. This left 8467 references. Of these, 16 met our inclusion criteria and were included in data extraction. During data extraction, three more papers were excluded. This left 13 papers to summarise and report. Of these 13 papers, 6 were prospective studies and 7 were purely descriptive. None of the interventions were theoretically informed in their development and the quality of the evidence was generally deemed poor. Conclusions There are no high-quality, theory-based interventions for the well-being of healthcare workers during a pandemic or other crisis. Given that previous pandemics have been shown to have a negative effect on healthcare workers well-being, it is imperative this shortcoming is addressed. This scoping review highlights the need for high-quality, theory-based and evidence-based interventions for the well-being of healthcare workers during a pandemic.

Introduction: Supporting doctors' wellbeing is crucial for medical education to help minimise negative long‐term impacts on medical workforce retention and ultimately patient care. There is limited study of how doctors' transitions experiences impact wellbeing, particularly socially and culturally. Multiple Multidimensional Transitions (MMT) theory views transitions as dynamic, incorporating multiple contexts and multiple domains. Using MMT as our lens, we report a qualitative analysis of how transitions experienced by doctors during the pandemic impacted on social and cultural aspects of wellbeing. Methods: Longitudinal narrative inquiry was employed, using interviews and audio‐diaries. Data were collected over 6 months in three phases: (i) interviews with doctors from across the career spectrum ( n = 98); (ii) longitudinal audio‐diaries for 2–4 months ( n = 71); (iii) second interviews ( n = 83). Data were analysed abductively, narrowing focus to factors important to social and cultural wellbeing. Results: Doctors described experiencing multiple interacting transitions triggered by the pandemic in multiple contexts (workplace, role, homelife and education). Patterns identifiable across the dataset allowed us to explore social and cultural wellbeing crosscutting beyond individual experience. Three critical factors contributed to social and cultural wellbeing both positively and negatively: being heard (e.g., by colleagues asking how they are); being valued (e.g., removal of rest spaces by organisations showing lack of value) ; and being supported (e.g., through regular briefing by education bodies). Conclusions: This study is the first to longitudinally explore the multiple‐multidimensional transitions experienced by doctors during the COVID‐19 pandemic. Our data analysis helped us move beyond existing perceptions around wellbeing and articulate multiple factors that contribute to social and cultural wellbeing. It is vital that medical educators consider the learning from these experiences to help pinpoint what aspects of support might be beneficial to trainee doctors and their trainers. This study forms the basis for developing evidenced‐based interventions that ensure doctors are heard, valued and supported.

Background: Insomnia is a prevalent condition with significant health, societal, and economic impacts. Cognitive behavioral therapy for insomnia (CBTI) is recommended as the first-line treatment. With limited accessibility to in-person–delivered CBTI (ipCBTI), electronically delivered eHealth CBTI (eCBTI), ranging from telephone- and videoconference-delivered interventions to fully automated web-based programs and mobile apps, has emerged as an alternative. However, the relative efficacy of eCBTI compared to ipCBTI has not been conclusively determined. Objective: This study aims to test the comparability of eCBTI and ipCBTI through a systematic review and meta-analysis of equivalence based on randomized controlled trials directly comparing the 2 delivery formats. Methods: A comprehensive search across multiple databases was conducted, leading to the identification and analysis of 15 unique randomized head-to-head comparisons of ipCBTI and eCBTI. Data on sleep and nonsleep outcomes were extracted and subjected to both conventional meta-analytical methods and equivalence testing based on predetermined equivalence margins derived from previously suggested minimal important differences. Supplementary Bayesian analyses were conducted to determine the strength of the available evidence. Results: The meta-analysis included 15 studies with a total of 1083 participants. Conventional comparisons generally favored ipCBTI. However, the effect sizes were small, and the 2 delivery formats were statistically significantly equivalent (P<.05) for most sleep and nonsleep outcomes. Additional within-group analyses showed that both formats led to statistically significant improvements (P<.05) in insomnia severity; sleep quality; and secondary outcomes such as fatigue, anxiety, and depression. Heterogeneity analyses highlighted the role of treatment duration and dropout rates as potential moderators of the differences in treatment efficacy. Conclusions: eCBTI and ipCBTI were found to be statistically significantly equivalent for treating insomnia for most examined outcomes, indicating eCBTI as a clinically relevant alternative to ipCBTI. This supports the expansion of eCBTI as a viable option to increase accessibility to effective insomnia treatment. Nonetheless, further research is needed to address the limitations noted, including the high risk of bias in some studies and the potential impact of treatment duration and dropout rates on efficacy. Trial Registration: PROSPERO CRD42023390811; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=390811