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07/12/26

When emergency physicians meet patients displaying irritable behaviours: a randomised vignette-based experiment investigating physicians' emotions and clinical reasoning.

Isbell, Linda M; Huff, Nathan R; Liu, Guanyu; Bessen, Howard; Kan, Vincent; Levesque, Isabella; Bird, Matthew; Smulowitz, Peter. BMJ Qual Saf.

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Summary

Emergency department sessions with "challenging" patients are common and can heighten physicians' negative emotions. In this study of 134 experienced emergency physicians with computer simulated vignettes, "irritable" (versus "calm") patient behavior increased anger, anxiety, and fatigue while reducing empathy, happiness, and engagement. The results find that these emotional reactions to unsettled patients did not compromise diagnostic accuracy, decision-making, or other measures of care quality.
Read the paper
Isbell LM, Huff NR, Liu G, et al. When emergency physicians meet patients displaying irritable behaviours: a randomised vignette-based experiment investigating physicians’ emotions and clinical reasoning. BMJ Qual Saf. Epub 2026 Jul 12.