2014, 36: S30–S35
Correlates of emotional intelligence: Results from a multi-institutional study among undergraduate medical students NAGHMA NAEEM1, CEES VAN DER VLEUTEN2, ARNO M. M. MUIJTJENS2, CLAUDIO VIOLATO3, SYED MOIN ALI4, EIAD ABDELMOHSEN AL-FARIS5, RON HOOGENBOOM2 & NADIA NAEEM5 1
Batterjee Medical College, Saudi Arabia, 2University of Maastricht, Netherlands, 3University of Calgary, Canada, University of Taif, Saudi Arabia, and 5King Saud University, Saudi Arabia
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Abstract Background: Emotional Intelligence (EI) is the ability to deal with your own and others emotions. Medical students are inducted into medical schools on the basis of their academic achievement. Professionally, however, their success rate is variable and may depend on their interpersonal relationships. EI is thought to be significant in achieving good interpersonal relationships and success in life and career. Therefore, it is important to measure EI and understand its correlates in an undergraduate medical student population. Aim: The objective of study was to investigate the relationship between the EI of medical students and their academic achievement (based on cumulative grade point average [CGPA]), age, gender and year of study. Methods: A cross-sectional survey design was used. The SSREIS and demographic survey were administered in the three medical schools in Saudi Arabia from April to May 2012. Results: The response rate was 30%. For the Optimism subscale, the mean score was M ¼ 3.79, SD 0.54 (a ¼ 0.82), for Awareness-of-emotion subscale M ¼ 3.94, SD 0.57 (a ¼ 0.72) and for Use-of-emotion subscale M ¼ 3.92, SD 0.54 (a ¼ 0.63). Multiple regression showed a significant positive correlation between CGPA and the EI of medical students (r ¼ 0.246, p ¼ 0.000) on the Optimism subscale. No correlation was seen between CGPA and Awareness of Emotions and Use of Emotions subscales. No relationship was seen for the other independent variables. Conclusion: The current study demonstrates that CGPA is the only significant predictor, indicating that Optimism tends to be higher for students with a higher CPGA. None of the other independent variables (age, year of study, gender) showed a significant relationship.
Introduction
Practice points
The need for improving interpersonal skills, increasing empathy, managing high stress situations and enhancing well-being are increasingly being recognized as essential to the functioning of doctors. These considerations have led to calls for incorporating Emotional Intelligence (EI) and empathy training as part of medical education (Shapiro et al. 2004). Taylor et al. (2011) have even suggested teaching EI as part of teaching professionalism to physicians-in-training. They stated that the abilities that constitute EI can help define specific curricula, which can then be taught, learned and measured. Carrothers et al. (2000) have suggested using EI as part of the selection process for medical students as EI is considered as a non-cognitive attribute, which is desirable in future physicians but not measured by current tools for selection. As mentioned by Leddy et al. (2011), the lack of substantial relationships between EI scores and traditional medical school admission measures suggests that EI evaluates a construct very different from the traits captured by the admission tests. Few studies have examined the relationship of EI to clinical outcomes.
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This multi-institutional study provides baseline data about emotional intelligence (EI) in undergraduate medical students. It demonstrates positive correlation between Cumulative Grade Point Average and Optimism Subscale of EI. It recommends that EI measurement and development should be included in formal medical curriculum to improve interpersonal relationship, team work and healthcare outcomes. It highlights areas for future research in this field.
Individuals with low levels of EI may lack the ability to relate empathetically with patients as they are unable to recognize feelings, distress, and mood (Stratton et al. 2005), which leads to a negative impact on the doctor–patient relationship (McQueen 2004). However, a study by Stratton et al. (2005) investigating the relationship between EI, empathy and
Correspondence: Dr. Naghma Naeem, MBBS, MMEd, PhD, Department of Medical Education, Batterjee Medical College, North Abhur District, P. O. Box 6231, Jeddah 21442, Saudi Arabia. Tel: +966530012464; E-mail: [email protected]
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ISSN 0142-159X print/ISSN 1466-187X online/14/S10030–6 ß 2014 Informa UK Ltd. DOI: 10.3109/0142159X.2014.886008
Correlates of emotional intelligence
students’ clinical skills assessed by standardized patients in an objective structured clinical examination (OSCE) found only a modest correlation. In a review of the literature regarding role of EI in medicine Arora et al. (2010) noted that higher EI played a role in maintaining good physician–patient relationships, improved teamwork and communication skills, better stress management, and superior commitment and leadership. Stoller et al. (2013) recommended that a spiral curriculum should be used to develop EI skills of physicians. Despite rising interest among health professionals and continuing research little is known about EI in the medical student population. Austin et al. (2005) measured EI in first year medical students in United Kingdom and reported a significant gender effect. Females scored significantly higher on overall EI, empathy and the utilization of emotions subscales. A study from the Peninsula Medical School which focused on students’ perceptions of the utility of EI, reported that the majority of the students liked to learn about the psychology of EI and valued identifying their emotional competencies and areas for development (Lewis et al. 2004). Another study by Stratton et al. (2005) found empathic concern to be a significant predictor of medical students’ physical examination skills. A study from Ohio (Carrothers et al. 2000) reported higher EI for female medical students and those graduating from a university where social sciences and humanities were valued. A number of instruments have been used to measure EI. Most of these (self-reports and ability based) measures have demonstrated adequate internal consistency reliability (Conte 2005). Cherniss and Goleman (2001) in their emotional process model, suggest that both an individual’s response to an event and the subsequent response selection are influenced by culture. Anthropologists also suggest that cultures have conventions and norms that influence the management of emotions in individuals (Ekman 1980). These cultural values create commonality and predictability among individuals in their interpretation and response to emotional stimuli. Past research has shown that Whites score lower on EI tests than Hispanics and Blacks (Roberts et al. 2001). Therefore, it is important to study EI in different cultures and ethnic populations to gain insights into their emotional processes. This information will allow researchers to make meaningful comparisons across ethnicity. The aim of the current study is to investigate the relationship between the EI of medical students and their academic achievement based on cumulative grade point average (CGPA), age, gender and year of study.
Method Design, sample and procedure A cross-sectional survey design was used in multiple institutions. Ethical approval was obtained from Institutional Review Boards of College of Medicine of the King Saud University and Taif University. Students were informed about the purposes and methods of the study, the risks and benefits, voluntary nature of participation, anonymity and confidentiality of data.
The survey instruments were administered in the three medical schools during April and May 2012. A total population convenience sample was used (1560 medical students). Two instruments were administered to students who agreed to participate in the study.
Demographic questionnaire This questionnaire comprised of four questions relating to age, sex, year of study and academic achievement as measured by the student’s self-reported CGPA over their college experience to date.
SSREI scale SSREI Scale was developed by Schutte et al. in 1998. This scale assesses Trait EI through 33 self-referencing items that assess EI level of the individual. Subjects rate the extent they agree or disagree with each statement on a 5-point Likert scale ranging from 1 (Strongly Disagree) to 5 (Strongly Agree). Of the 33 items, 3 items (5, 28, 33) are reverse scored. SSREI Scale was selected for this study as it is based on Salovey and Mayer’s theoretical model of EI. Schutte et al. (1998) reported that the scale has high internal consistency with Cronbach’s alpha (a) ranging from 0.87 to 0.90 and two-week test–retest reliability co-efficient of 0.78. There is evidence for convergent and divergent validity of the instrument. The scale correlates well with theoretically related constructs such as alexithymia, mood repair, optimism, and impulse control (Schutte et al. 1998). SSREI scale has been used with a variety of respondents including adults, adolescents and secondary school students, and the scale is easy to understand and score.
Development of the bilingual version of the scale Previous research has demonstrated that individuals who are less familiar with English language tend to score lower on written measures of EI. Medical students in Saudi Arabia have varying proficiency in English language; hence language barriers could potentially influence performance of individuals on the SSREI Scale. To remove this potential source of error in measurement, bilingual English–Arabic version of SSREI Scale was developed. The goal of translation was to obtain an instrument with conceptual equivalence in a different cultural group. The SSREI Scale was translated into Arabic language by a bilingual native Arabic speaker and blindly back-translated by another bilingual native Arabic speaker and a native English speaker. Through these rigorous cycles of translation and back translation it was ensured that original meaning of the SSREI Scale was retained. The bilingual instrument was then pilot tested with undergraduate medical students to ensure equivalence, clarity and comprehension.
Data analysis The SSREI questionnaire was validated for Saudi data using Exploratory Factor Analysis (EFA), Confirmatory Factor Analysis (CFA), reliability analysis, and content analysis. This resulted in three interpretable subscales Optimism, Awareness-
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of-Emotions and Use-of-Emotions consisting of 9, 2, and 5 items, respectively, constituting a new instrument of 16 items. Items of the original questionnaire that were not included in the new instrument have been removed in the validation process because they were not consistent with the developed scales. After validation of subscales of the new EI instrument, these were used in subsequent descriptive analysis. The scores used here are mean scores instead of sum scores. This makes comparison of scores between scales easier as they are all mean scores with equal scale 1–5 {Sum score ¼ mean score multiplied by the number of items in the scale(s)}. For investigating relationship with other variables, multiple regression analysis was performed with each of the three EI subscale scores as dependent variable and CGPA, age, gender and year of study as independent variables. Major indicators of the contribution of an independent variable are the regression coefficient b, the standard regression coefficient beta, and p, the p-value of the t-test for coefficient b. Data analysis was conducted using SPSS version 16 (SPSS for Windows, Version 16.0, SPSS Inc., Chicago).
Table 1. Demographic characteristics of study population.
Variables Ethnicity Gender Age Year of study
CGPA
N (%) Arabs Male Female 17–22 years 23–28 years 1st year 2nd year 3rd year 4th year 5th year 53 3.0 to 3.5 3.6 to 4.0 4.1 to 4.5 4.6 to 5.0
467 334 133 332 135 140 150 75 37 65 107 93 61 79 117
(100%) (71.5%) (28.5%) (71%) (29%) (30%) (32%) (16%) (8%) (14%) (23%) (20%) (13%) (17%) (25%)
Table 2. Mean scores, standard deviations and reliabilities of EI subscales.
Results
Schutte self-report emotional intelligence (SSREI) subscales
Of the total 1560 medical students, n ¼ 467 completed both the questionnaires. The overall response rate was 30%.
Optimism (9 items) Awareness of emotions (2 items) Use of emotions (5 items)
Mean Standard Cronbach’s (M) deviation (SD) alpha (a) 3.79 3.94 3.92
0.53 0.57 0.53
0.82 0.72 0.63
Demographics The demographic characteristics of the study participants are described below in Table 1. Fewer students from the third, fourth and final year participated in the study as they were not available on campus due to being deputed to their clinical rotations.
Mean EI scores The mean score on EI subscales, standard deviation and reliabilities are reported in Table 2. The mean scores for Saudi undergraduate medical students (expressed as average for the items comprising the scale out of maximum of 5) was highest on the awareness-of-emotion subscale, followed by use-of-emotion subscale and then optimism subscale.
Correlation between CGPA and EI A significant positive correlation was only found between CGPA and the EI of medical students (r ¼ 0.246, p ¼ 0.000) on the optimism subscale. No correlation was seen between CGPA and Awareness of Emotions and Use of Emotions subscale (Table 3).
Multiple regression analysis For each subscale the relationship of EI with gender, age, year and CPGA was investigated in a multiple regression analysis according to the model:
EI subscale score ¼ Intercept þ b1 Gender þ b2 Age þ b3 Year þ b4 CPGA þ Error S32
Table 3. Correlation of CGPA with EI subscales.
CGPA Pearson correlation Sig. (two-tailed) N
Optimism
Awareness of emotions
Use of emotions
0.246** 0.000 456
0.119* 0.011 456
0.058 0.213 456
**Correlation is significant at the 0.01 level (two-tailed). *Correlation is significant at the 0.05 level (two-tailed).
Results for the EI Optimism subscale showed that CPGA was the only significant predictor (b ¼ 0.084, beta ¼ 0.23, p ¼ 0.0005, R2 ¼ 0.069), indicating that Optimism tends to be higher for students with a higher CPGA. Using beta as an indicator of effect size, and applying Cohen’s (1969) classification (0.1 ¼ small effect; 0.3 ¼ medium effect; 0.5 ¼ large effect), the effect of CPGA on Optimism is found to be small to medium. For the two other subscales, none of the independent variables had a significant contribution.
Discussion The current study demonstrates that Saudi medical students are emotionally intelligent. The subscales scores are reported in the study as the structure of the data is three-dimensional; therefore, use of a sum score would not be meaningful. Reference to scores of the original instrument is also not indicated as the validation process resulted in a new instrument with reduced items. A recent study among Japanese students (Fukuda 2011) also reported that the means of the
Correlates of emotional intelligence
items ranged from 2.92 to 4.34 with standard deviations ranging from 1.52 to 1.71. An important finding of the study is a significant association between academic achievement as measured by CGPA and EI. Similar findings have been reported by several other researchers (Parker et al. 2004; Pau et al. 2004). In two studies of full time university students and high school students, it was reported that academic success was strongly associated with several dimensions of EI (Parker et al. 2004, 2005). Petrides et al. (2004) investigated the relationships between trait EI and academic performance and found that trait EI moderated the relationship between academic performance and cognitive ability. One of the possible explanations is that students with high EI may be more reflective and possess better organizational and time management skills, whereas students with low EI may engage in damaging behaviours (Pau et al. 2004) and poor management skills. In the innovative student centered curricula currently in vogue worldwide, most of the academic work is self-directed, requiring high levels of self-management (Rode et al. 2006). Mathur et al. (2003) reported that students with high EI are more responsible, more confident and better adjusted, hence, they perform better. Research by Mayer and Salovey (1997) highlights that individuals with a high level of EI are able to direct positive emotions to sustain increased levels of energy required for high performance over long periods of time and to redirect negative emotions into productive behaviors. Individuals possessing high EI may also be able to maintain the social relationships required for effective group work (Lopes et al. 2003). The ability to network and maintain social relationships may be important not only for gaining high grades on team based and group assessments, but also for sustaining social support and well-being in the school environment (Parker et al. 2004; Linnenbrink-Garcia et al. 2011). A recent study in Nigeria also reported a significant correlation between EI and psychological well-being (Ugoani & Ewuzie 2013). High CGPA in emotionally intelligent students can result from interplay of several factors mentioned above, which may be agenda for further future research. Mayer et al. (1999) suggests that EI is not set at birth but can be developed through education and training. Boyatzis and Saatcioglu (2008) also report that EI competencies can be developed in students. Furthermore, when a student’s emotional and social skills are addressed, academic achievement of the student increases and interpersonal relationships improve (Goleman 1996). Positive, caring environments enhance emotional skills (McMullen 2003; Sala 2007; Nelis et al. 2009). Therefore, medical colleges should consider instituting training programs and workshops both face to face and web based (Bar-On 2002) to increase EI among medical students. Multiple strategies such as small group discussions, lectures, role-play, and assigned readings (Nelis et al. 2009) can be utilized for this purpose. In the current study, age was not associated with EI as no significant difference was observed among medical students belonging to the younger or older age group. This finding is similar to that of Jacques (2009), Day and Carroll (2004) and Palmer et al. (2005) who found no or non-significant correlation between EI and age but contrary to the findings of Van
Rooy et al. (2005) who found significant increase in EI with age. According to the ability model of EI, it is expected that EI should increase with age, because it is an adaptive function that develops with the cognitive and social skills (Mayer 1999). The finding in the current study that age is not related to EI may be explained on the basis of Piaget theory which states that at adolescence, the individual’s brain is fully developed (Wadsworth 1996). This study included young adults between the ages of 17 to 28 years. Some differences might have been observed, had a longitudinal study been conducted, where study participants were followed over a longer period of time. No significant association was seen between EI of students belonging to different years of the medical school in the current study. Hence it might be concluded that EI remains stable during the years at the medical college. In the current study girls scored slightly higher on the useof-emotions subscale but the overall scores EI were comparable for the two genders. Similar results were reported by Bastian et al. (2005) and Tyagi (2004), who found no gender difference in EI. However, several studies have reported that women are emotionally more intelligent than their male counterparts (Ciarrochi 2001; Palmer et al. 2003; Day & Carroll 2004; Carr 2009). Caution should be exercised when comparing the findings of the current study with those of previous ones, as the present study used subscale scores rather than overall EI scores. Another study, which used global as well as subscale scores also found no gender differences (Whitman et al. 2009). An explanation may be that male and female undergraduates are exposed to the same social and academic environment; hence they may be equally emotionally intelligent.
Limitations Cross-sectional survey design cannot establish causation between variables, however, it is a relatively feasible method to determine association in an initial, exploratory study such as the current one (Streiner & Norman 1998). SSREI being a self-report measure has limitations such as concerns about accuracy, validity, reliance upon the insight of the respondent and susceptibility to socially desirable responding. A response rate of 30% is generally considered low for quantitative studies; however, a meta-analysis comprising of 231 studies (Cycyota & Harrison 2006) on EI in management executives during the period 1992–2003 appearing in management journals, reported an overall response rate of 32%, which is similar to the current study. This study did not examine cultural impact on the EI construct, further studies are necessary to examine whether there are some EI attributes and skills unique to the Arab culture, which require the development of a more culturally sensitive scale.
Conclusions and recommendations This multi-institutional study provides preliminary data about EI in undergraduate medical students in Saudi Arabia.
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It demonstrates positive correlation between CGPA and Optimism subscale of EI. Although there was insufficient evidence to support the inclusion of EI as a criteria for selection, the trainability of EI and its positive effect on student achievement merits further investigation. EI skills inclusion and training in the formal medical curriculum of medical schools can enable future doctors to deal better with their own emotions and those of their patients and colleagues, improving interpersonal relationships and becoming more productive members of the health care team.
Notes on contributors NAGHMA NAEEM, MBBS, MMED, PhD, is an Associate Professor and Head of Department, Medical Education, Batterjee Medical College, Jeddah, Kingdom of Saudi Arabia. She was previously affiliated with King Saud University Chair for Medical Education Research and Development, Riyadh, Kingdom of Saudi Arabia. E-mail: [email protected] CEES VAN DER VLEUTEN, PhD, is a Visiting Professor, King Saud University Chair for Medical Education Research and Development, Riyadh, Kingdom of Saudi Arabia & Chair Department of Educational Development, Maastricht University. E-mail: c.vandervleuten@ maastrichtuniversity.nl ARNO MUIJTJENS, PhD, is a Statistician and Associate Professor at the School of Health Professions Education, Department for Educational Development & Research, Maastricht University. E-mail: [email protected] CLAUDIO VIOLATO, BSc, MA, PhD, is a Professor at Department of Community Health Sciences & Director, Medical Education and Research Unit, Faculty of Medicine. University of Calgary. E-mail: [email protected] SYED MOYN ALI, MBBS, MHPE, is the Chair, Department of Medical Education, College of Medicine, University of Taif, Jeddah, Kingdom of Saudi Arabia. E-mail: [email protected] EIAD ABDELMOHSEN ALFARIS, MRCGP, MMED, is a Professor of Family Medicine and Supervisor, King Saud University Chair for Medical Education Research and Development, Riyadh, Kingdom of Saudi Arabia. E-mail: [email protected] RON HOOGENBOOM, MSc, is a Research Assistant, School of Health Professions Education, Department for Educational Development & Research, Maastricht University. E-mail: [email protected] NADIA NAEEM, BBA, is a Marketing Executive, Department of Medical Education, College of Medicine, King Saud University, Riyadh, Kingdom of Saudi Arabia. E-mail: [email protected]
Acknowledgements The authors wish to thank Ms. Dalal AlSaleh and Mr Abdullah for their help in data collection. We also wish to thank all students who participated in this study. Name of Institution(s) at which research was conducted: (1) King Saud University Chair for Medical Education Research & Development, King Saud University, Riyadh, Kingdom of Saudi Arabia. (2) Department for Medical Education, College of Medicine, University of Taif, Taif, Kingdom of Saudi Arabia. The publication of this supplement has been made possible with the generous financial support of the Dr Hamza Alkholi Chair for Developing Medical Education in KSA. S34
Declaration of interest: This research was supported by the College of Medicine Research Centre, Deanship of Scientific Research, King Saud University, Riyadh, Kingdom of Saudi Arabia. The authors report no declarations of interest.
References Arora S, Ashrafian H, Davis R, Athanasiou T, Darzi A, Sevdalis N. 2010. Emotional intelligence in medicine: A systematic review through the context of the ACGME competencies. Med Educ 44(8):749–764. Austin EJ, Evans P, Goldwater R, Potter V. 2005. A preliminary study of emotional intelligence, empathy and exam performance in first year students. Person Indiv Diff 39:1395–1405. Bar-On R. 2002. BarOn emotional quotient inventory: Short (BarOn EQ-i:S) development edition. Toronto: Multi-Health Systems Inc. Bastian VA, Burns NR, Nettelbeck T. 2005. Emotional intelligence predicts life skills, but not as well as personality and cognitive abilities. Person Indiv Diff 39:1135–1145. Boyatzis RE, Saatcioglu A. 2008. A 20-year view of trying to develop emotional, social and cognitive intelligence competencies in graduate management education. J Manage Dev 27:92–108. Carr SE. 2009. Emotional intelligence in medical students: Does it correlate with selection measures? Med Educ 43:1069–1077. Carrothers R, Gregory S, Gallagher T. 2000. Measuring emotional intelligence of medical school applicants. Acad Med 75:456–463. Cherniss C, Goleman D. 2001. The emotionally intelligent workplace. How to select for, measure and improve emotional intelligence in individuals, groups and organisations. San Francisco: Jossey-Bass. Ciarrochi J, Chan AYC, Bajgar J. 2001. Measuring emotional intelligence in adolescents. Person Indiv Diff 31:1105–1119. Cohen J. 1969. Statistical power analysis for the behavioral Sciences. New York: Academic Press. Conte JM. 2005. A review and critique of emotional intelligence measures. J Organiz Behav 26:433–440. Cycyota CS, Harrison DA. 2006. What (not) to expect when surveying executives a meta-analysis of top manager response rates and techniques over time. Organ Res Meth 9:133–160. Day AL, Carroll SA. 2004. Using an ability-based measure of emotional intelligence to predict individual performance, group performance, and group citizenship behaviours. Person Indiv Diff 36:1443–1458. Ekman P. 1980. The face of man: Expressions of universal emotions in a new Guinea village. New York: Garland STPM Press. Fukuda E, Saklofske DH, Tamaoka K, Fung TS, Mavaoka Y, Kiyama S. 2011. Factor structure of Japanese versions of two emotional intelligence scales. Int J Test 11:71–92. Goleman D. 1996. Emotional intelligence: Why it can matter more than IQ. New York: Bantam Books. Jacques ET. 2009. The relationships between emotional intelligence and the academic performance and selection of a major of college students. DAI Section A: Humanities and Social Sciences 70, 1193. Leddy JJ, Moineau G, Puddester D, Wood TJ, Humphrey-Murto S. 2011. Does an emotional intelligence test correlate with traditional measures used to determine medical school admission? Acad Med 86: S39–S41. Lewis NJ, Rees CE, Hudson N. 2004. Helping medical students identify their emotional intelligence. Med Educ 38:563. Linnenbrink-Garcia L, Rogat TK, Koskey KLK. 2011. Affect and engagement during small group instruction. Contemp Educ Psychol 36:13–24. Lopes PN, Salovey P, Straus R. 2003. Emotional intelligence, personality, and the perceived quality of social relationships. Person Indiv Diff 35: 641–658. Mathur M, Dube S, Malhotra B. 2003. Emotional intelligence: Interrelationships of attribution, taking responsibility and scholastic performance in adolescents. Indian Psychol Rev 60:175–180. Mayer J. 1999. Emotional intelligence: Popular or scientific psychology? APA Monitor 30:50.
Correlates of emotional intelligence
Mayer JD, Caruso DR, Salovey P. 1999. Emotional intelligence meets traditional standards for an intelligence. Intelligence 27:267–298. Mayer JD, Salovey P. 1997. What is emotional intelligence? In: Salovey P, Sluyter DJ, editors. Emotional development and emotional intelligence. New York: Basic Books. McMullen B. 2003. Emotional intelligence. Br Med J 326:19–19. McQueen ACH. 2004. Emotional intelligence in nursing work. J Adv Nurs 47(1):101–108. Nelis J, Quoidbach M, Mikolajczak M, Hansenne M. 2009. Increasing emotional intelligence: (How) is it possible? Person Indiv Diff 47: 36–41. Palmer BR, Gignac G, Manocha R, Stough C. 2005. A psychometric evaluation of the Mayer–Salovey–Caruso emotional intelligence test version 2.0. Intelligence 33:285–305. Palmer BR, Manocha R, Gignac G, Stough C. 2003. Examining the factor structure of the Bar-On Emotional Quotient Inventory with an Australian general population sample. Person Indiv Diff 35:1191–1210. Parker JDA, Saklofske DH, Wood LM, Eastabrook JM, Taylor RN. 2005. Stability and change in emotional intelligence: Exploring the transition to young adulthood. J Indiv Diff 26:100. Parker JDA, Summerfeldt LJ, Hogan MJ, Majeski SA. 2004. Emotional intelligence and academic success: Examining the transition from high school to university. Person Indiv Diff 36:163–172. Pau A, Croucher R, Sohanpal R, Muirhead V, Seymour K. 2004. Emotional intelligence and stress coping in dental undergraduates—A qualitative study. Br Dental J 197:205–209. Petrides K, Frederickson N, Furnham A. 2004. The role of trait emotional intelligence in academic performance and deviant behavior at school. Person Indiv Diff 36:277–293. Roberts R, Zeidner M, Matthews GM. 2001. Does emotional intelligence meet traditional standards for an intelligence? Some new data and conclusions. Emotions 1:196–231. Rode JC, Mooney CH, Arthaud-Day ML, Near JP, Baldwin TT, Rubin RS, Bommer WH. 2006. Emotional intelligence and individual performance: Evidence of direct and moderated effects. J Org Behav 28:399–421.
Sala F. 2007. Do programs designed to increase emotional intelligence at work-work? Issues and recent developments in emotional intelligence 2007. [Accessed 28 September 2012.] Available from http:// www.eiconsortium.org. Schutte NS, Malouff JM, Hall LE, Haggerty DJ, Cooper JT, Golden CJ, Dornhelm L. 1998. Development and validation of a measure of emotional intelligence. Person Indiv Diff 25:167–177. Shapiro J, Morrison EH, Boker JR. 2004. Teaching empathy to first year medical students: Evaluation of an elective literature and medicine course. Educ Health 17:73–84. Stratton TD, Elam CL, Murphy-Spencer AE, Quinlivan SL. 2005. Emotional intelligence and clinical skills: Preliminary results from a comprehensive clinical performance examination. Acad Med 80(10):S34–S35. Streiner DL, Norman GR. 1998. PDQ epidemiology, 2nd ed. Hamilton: B.C. Decker. Stoller JK, Taylor CA, Farver CF. 2013. Emotional intelligence competencies provide a developmental curriculum for medical training. Med Teach 35(3):243–7. Taylor C, Farver C, Stoller JK. 2001. Perspective: Can emotional intelligence training serve as an alternative approach to teaching professionalism to residents? Acad Med 86(12):1551–1554. Tyagi S. 2004. Emotional intelligence of secondary teachers in relation to gender and age. J Educ Res Exten 41:39–45. Ugoani JNN, Ewuzie MA. 2013. Imperatives of emotional intelligence on psychological wellbeing among adolescents. Am J Appl Psychol 1(3):44–48. Van Rooy DL, Alonso A, Viswesvaran C. 2005. Group differences in emotional intelligence scores: Theoretical and practical implications. Pers Individ Diff 38:689–700. Wadsworth BJ. 1996. Piaget’s theory of cognitive and affective development: Foundations of constructivism, 5th ed. White Plains, NY: Longman Publishing. Whitman DS, Van Rooy DL, Viswesvaran C, Kraus E. 2009. Testing the second-order factor structure and measurement equivalence of the Wong and Law emotional intelligence scale across gender and ethnicity. Educ Psychol Measure 69(6):1059–1074.
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Correlates of emotional intelligence: Results from a multi-institutional study among undergraduate medical students NAGHMA NAEEM1, CEES VAN DER VLEUTEN2, ARNO M. M. MUIJTJENS2, CLAUDIO VIOLATO3, SYED MOIN ALI4, EIAD ABDELMOHSEN AL-FARIS5, RON HOOGENBOOM2 & NADIA NAEEM5 1
Batterjee Medical College, Saudi Arabia, 2University of Maastricht, Netherlands, 3University of Calgary, Canada, University of Taif, Saudi Arabia, and 5King Saud University, Saudi Arabia
4
Abstract Background: Emotional Intelligence (EI) is the ability to deal with your own and others emotions. Medical students are inducted into medical schools on the basis of their academic achievement. Professionally, however, their success rate is variable and may depend on their interpersonal relationships. EI is thought to be significant in achieving good interpersonal relationships and success in life and career. Therefore, it is important to measure EI and understand its correlates in an undergraduate medical student population. Aim: The objective of study was to investigate the relationship between the EI of medical students and their academic achievement (based on cumulative grade point average [CGPA]), age, gender and year of study. Methods: A cross-sectional survey design was used. The SSREIS and demographic survey were administered in the three medical schools in Saudi Arabia from April to May 2012. Results: The response rate was 30%. For the Optimism subscale, the mean score was M ¼ 3.79, SD 0.54 (a ¼ 0.82), for Awareness-of-emotion subscale M ¼ 3.94, SD 0.57 (a ¼ 0.72) and for Use-of-emotion subscale M ¼ 3.92, SD 0.54 (a ¼ 0.63). Multiple regression showed a significant positive correlation between CGPA and the EI of medical students (r ¼ 0.246, p ¼ 0.000) on the Optimism subscale. No correlation was seen between CGPA and Awareness of Emotions and Use of Emotions subscales. No relationship was seen for the other independent variables. Conclusion: The current study demonstrates that CGPA is the only significant predictor, indicating that Optimism tends to be higher for students with a higher CPGA. None of the other independent variables (age, year of study, gender) showed a significant relationship.
Introduction
Practice points
The need for improving interpersonal skills, increasing empathy, managing high stress situations and enhancing well-being are increasingly being recognized as essential to the functioning of doctors. These considerations have led to calls for incorporating Emotional Intelligence (EI) and empathy training as part of medical education (Shapiro et al. 2004). Taylor et al. (2011) have even suggested teaching EI as part of teaching professionalism to physicians-in-training. They stated that the abilities that constitute EI can help define specific curricula, which can then be taught, learned and measured. Carrothers et al. (2000) have suggested using EI as part of the selection process for medical students as EI is considered as a non-cognitive attribute, which is desirable in future physicians but not measured by current tools for selection. As mentioned by Leddy et al. (2011), the lack of substantial relationships between EI scores and traditional medical school admission measures suggests that EI evaluates a construct very different from the traits captured by the admission tests. Few studies have examined the relationship of EI to clinical outcomes.
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This multi-institutional study provides baseline data about emotional intelligence (EI) in undergraduate medical students. It demonstrates positive correlation between Cumulative Grade Point Average and Optimism Subscale of EI. It recommends that EI measurement and development should be included in formal medical curriculum to improve interpersonal relationship, team work and healthcare outcomes. It highlights areas for future research in this field.
Individuals with low levels of EI may lack the ability to relate empathetically with patients as they are unable to recognize feelings, distress, and mood (Stratton et al. 2005), which leads to a negative impact on the doctor–patient relationship (McQueen 2004). However, a study by Stratton et al. (2005) investigating the relationship between EI, empathy and
Correspondence: Dr. Naghma Naeem, MBBS, MMEd, PhD, Department of Medical Education, Batterjee Medical College, North Abhur District, P. O. Box 6231, Jeddah 21442, Saudi Arabia. Tel: +966530012464; E-mail: [email protected]
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ISSN 0142-159X print/ISSN 1466-187X online/14/S10030–6 ß 2014 Informa UK Ltd. DOI: 10.3109/0142159X.2014.886008
Correlates of emotional intelligence
students’ clinical skills assessed by standardized patients in an objective structured clinical examination (OSCE) found only a modest correlation. In a review of the literature regarding role of EI in medicine Arora et al. (2010) noted that higher EI played a role in maintaining good physician–patient relationships, improved teamwork and communication skills, better stress management, and superior commitment and leadership. Stoller et al. (2013) recommended that a spiral curriculum should be used to develop EI skills of physicians. Despite rising interest among health professionals and continuing research little is known about EI in the medical student population. Austin et al. (2005) measured EI in first year medical students in United Kingdom and reported a significant gender effect. Females scored significantly higher on overall EI, empathy and the utilization of emotions subscales. A study from the Peninsula Medical School which focused on students’ perceptions of the utility of EI, reported that the majority of the students liked to learn about the psychology of EI and valued identifying their emotional competencies and areas for development (Lewis et al. 2004). Another study by Stratton et al. (2005) found empathic concern to be a significant predictor of medical students’ physical examination skills. A study from Ohio (Carrothers et al. 2000) reported higher EI for female medical students and those graduating from a university where social sciences and humanities were valued. A number of instruments have been used to measure EI. Most of these (self-reports and ability based) measures have demonstrated adequate internal consistency reliability (Conte 2005). Cherniss and Goleman (2001) in their emotional process model, suggest that both an individual’s response to an event and the subsequent response selection are influenced by culture. Anthropologists also suggest that cultures have conventions and norms that influence the management of emotions in individuals (Ekman 1980). These cultural values create commonality and predictability among individuals in their interpretation and response to emotional stimuli. Past research has shown that Whites score lower on EI tests than Hispanics and Blacks (Roberts et al. 2001). Therefore, it is important to study EI in different cultures and ethnic populations to gain insights into their emotional processes. This information will allow researchers to make meaningful comparisons across ethnicity. The aim of the current study is to investigate the relationship between the EI of medical students and their academic achievement based on cumulative grade point average (CGPA), age, gender and year of study.
Method Design, sample and procedure A cross-sectional survey design was used in multiple institutions. Ethical approval was obtained from Institutional Review Boards of College of Medicine of the King Saud University and Taif University. Students were informed about the purposes and methods of the study, the risks and benefits, voluntary nature of participation, anonymity and confidentiality of data.
The survey instruments were administered in the three medical schools during April and May 2012. A total population convenience sample was used (1560 medical students). Two instruments were administered to students who agreed to participate in the study.
Demographic questionnaire This questionnaire comprised of four questions relating to age, sex, year of study and academic achievement as measured by the student’s self-reported CGPA over their college experience to date.
SSREI scale SSREI Scale was developed by Schutte et al. in 1998. This scale assesses Trait EI through 33 self-referencing items that assess EI level of the individual. Subjects rate the extent they agree or disagree with each statement on a 5-point Likert scale ranging from 1 (Strongly Disagree) to 5 (Strongly Agree). Of the 33 items, 3 items (5, 28, 33) are reverse scored. SSREI Scale was selected for this study as it is based on Salovey and Mayer’s theoretical model of EI. Schutte et al. (1998) reported that the scale has high internal consistency with Cronbach’s alpha (a) ranging from 0.87 to 0.90 and two-week test–retest reliability co-efficient of 0.78. There is evidence for convergent and divergent validity of the instrument. The scale correlates well with theoretically related constructs such as alexithymia, mood repair, optimism, and impulse control (Schutte et al. 1998). SSREI scale has been used with a variety of respondents including adults, adolescents and secondary school students, and the scale is easy to understand and score.
Development of the bilingual version of the scale Previous research has demonstrated that individuals who are less familiar with English language tend to score lower on written measures of EI. Medical students in Saudi Arabia have varying proficiency in English language; hence language barriers could potentially influence performance of individuals on the SSREI Scale. To remove this potential source of error in measurement, bilingual English–Arabic version of SSREI Scale was developed. The goal of translation was to obtain an instrument with conceptual equivalence in a different cultural group. The SSREI Scale was translated into Arabic language by a bilingual native Arabic speaker and blindly back-translated by another bilingual native Arabic speaker and a native English speaker. Through these rigorous cycles of translation and back translation it was ensured that original meaning of the SSREI Scale was retained. The bilingual instrument was then pilot tested with undergraduate medical students to ensure equivalence, clarity and comprehension.
Data analysis The SSREI questionnaire was validated for Saudi data using Exploratory Factor Analysis (EFA), Confirmatory Factor Analysis (CFA), reliability analysis, and content analysis. This resulted in three interpretable subscales Optimism, Awareness-
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of-Emotions and Use-of-Emotions consisting of 9, 2, and 5 items, respectively, constituting a new instrument of 16 items. Items of the original questionnaire that were not included in the new instrument have been removed in the validation process because they were not consistent with the developed scales. After validation of subscales of the new EI instrument, these were used in subsequent descriptive analysis. The scores used here are mean scores instead of sum scores. This makes comparison of scores between scales easier as they are all mean scores with equal scale 1–5 {Sum score ¼ mean score multiplied by the number of items in the scale(s)}. For investigating relationship with other variables, multiple regression analysis was performed with each of the three EI subscale scores as dependent variable and CGPA, age, gender and year of study as independent variables. Major indicators of the contribution of an independent variable are the regression coefficient b, the standard regression coefficient beta, and p, the p-value of the t-test for coefficient b. Data analysis was conducted using SPSS version 16 (SPSS for Windows, Version 16.0, SPSS Inc., Chicago).
Table 1. Demographic characteristics of study population.
Variables Ethnicity Gender Age Year of study
CGPA
N (%) Arabs Male Female 17–22 years 23–28 years 1st year 2nd year 3rd year 4th year 5th year 53 3.0 to 3.5 3.6 to 4.0 4.1 to 4.5 4.6 to 5.0
467 334 133 332 135 140 150 75 37 65 107 93 61 79 117
(100%) (71.5%) (28.5%) (71%) (29%) (30%) (32%) (16%) (8%) (14%) (23%) (20%) (13%) (17%) (25%)
Table 2. Mean scores, standard deviations and reliabilities of EI subscales.
Results
Schutte self-report emotional intelligence (SSREI) subscales
Of the total 1560 medical students, n ¼ 467 completed both the questionnaires. The overall response rate was 30%.
Optimism (9 items) Awareness of emotions (2 items) Use of emotions (5 items)
Mean Standard Cronbach’s (M) deviation (SD) alpha (a) 3.79 3.94 3.92
0.53 0.57 0.53
0.82 0.72 0.63
Demographics The demographic characteristics of the study participants are described below in Table 1. Fewer students from the third, fourth and final year participated in the study as they were not available on campus due to being deputed to their clinical rotations.
Mean EI scores The mean score on EI subscales, standard deviation and reliabilities are reported in Table 2. The mean scores for Saudi undergraduate medical students (expressed as average for the items comprising the scale out of maximum of 5) was highest on the awareness-of-emotion subscale, followed by use-of-emotion subscale and then optimism subscale.
Correlation between CGPA and EI A significant positive correlation was only found between CGPA and the EI of medical students (r ¼ 0.246, p ¼ 0.000) on the optimism subscale. No correlation was seen between CGPA and Awareness of Emotions and Use of Emotions subscale (Table 3).
Multiple regression analysis For each subscale the relationship of EI with gender, age, year and CPGA was investigated in a multiple regression analysis according to the model:
EI subscale score ¼ Intercept þ b1 Gender þ b2 Age þ b3 Year þ b4 CPGA þ Error S32
Table 3. Correlation of CGPA with EI subscales.
CGPA Pearson correlation Sig. (two-tailed) N
Optimism
Awareness of emotions
Use of emotions
0.246** 0.000 456
0.119* 0.011 456
0.058 0.213 456
**Correlation is significant at the 0.01 level (two-tailed). *Correlation is significant at the 0.05 level (two-tailed).
Results for the EI Optimism subscale showed that CPGA was the only significant predictor (b ¼ 0.084, beta ¼ 0.23, p ¼ 0.0005, R2 ¼ 0.069), indicating that Optimism tends to be higher for students with a higher CPGA. Using beta as an indicator of effect size, and applying Cohen’s (1969) classification (0.1 ¼ small effect; 0.3 ¼ medium effect; 0.5 ¼ large effect), the effect of CPGA on Optimism is found to be small to medium. For the two other subscales, none of the independent variables had a significant contribution.
Discussion The current study demonstrates that Saudi medical students are emotionally intelligent. The subscales scores are reported in the study as the structure of the data is three-dimensional; therefore, use of a sum score would not be meaningful. Reference to scores of the original instrument is also not indicated as the validation process resulted in a new instrument with reduced items. A recent study among Japanese students (Fukuda 2011) also reported that the means of the
Correlates of emotional intelligence
items ranged from 2.92 to 4.34 with standard deviations ranging from 1.52 to 1.71. An important finding of the study is a significant association between academic achievement as measured by CGPA and EI. Similar findings have been reported by several other researchers (Parker et al. 2004; Pau et al. 2004). In two studies of full time university students and high school students, it was reported that academic success was strongly associated with several dimensions of EI (Parker et al. 2004, 2005). Petrides et al. (2004) investigated the relationships between trait EI and academic performance and found that trait EI moderated the relationship between academic performance and cognitive ability. One of the possible explanations is that students with high EI may be more reflective and possess better organizational and time management skills, whereas students with low EI may engage in damaging behaviours (Pau et al. 2004) and poor management skills. In the innovative student centered curricula currently in vogue worldwide, most of the academic work is self-directed, requiring high levels of self-management (Rode et al. 2006). Mathur et al. (2003) reported that students with high EI are more responsible, more confident and better adjusted, hence, they perform better. Research by Mayer and Salovey (1997) highlights that individuals with a high level of EI are able to direct positive emotions to sustain increased levels of energy required for high performance over long periods of time and to redirect negative emotions into productive behaviors. Individuals possessing high EI may also be able to maintain the social relationships required for effective group work (Lopes et al. 2003). The ability to network and maintain social relationships may be important not only for gaining high grades on team based and group assessments, but also for sustaining social support and well-being in the school environment (Parker et al. 2004; Linnenbrink-Garcia et al. 2011). A recent study in Nigeria also reported a significant correlation between EI and psychological well-being (Ugoani & Ewuzie 2013). High CGPA in emotionally intelligent students can result from interplay of several factors mentioned above, which may be agenda for further future research. Mayer et al. (1999) suggests that EI is not set at birth but can be developed through education and training. Boyatzis and Saatcioglu (2008) also report that EI competencies can be developed in students. Furthermore, when a student’s emotional and social skills are addressed, academic achievement of the student increases and interpersonal relationships improve (Goleman 1996). Positive, caring environments enhance emotional skills (McMullen 2003; Sala 2007; Nelis et al. 2009). Therefore, medical colleges should consider instituting training programs and workshops both face to face and web based (Bar-On 2002) to increase EI among medical students. Multiple strategies such as small group discussions, lectures, role-play, and assigned readings (Nelis et al. 2009) can be utilized for this purpose. In the current study, age was not associated with EI as no significant difference was observed among medical students belonging to the younger or older age group. This finding is similar to that of Jacques (2009), Day and Carroll (2004) and Palmer et al. (2005) who found no or non-significant correlation between EI and age but contrary to the findings of Van
Rooy et al. (2005) who found significant increase in EI with age. According to the ability model of EI, it is expected that EI should increase with age, because it is an adaptive function that develops with the cognitive and social skills (Mayer 1999). The finding in the current study that age is not related to EI may be explained on the basis of Piaget theory which states that at adolescence, the individual’s brain is fully developed (Wadsworth 1996). This study included young adults between the ages of 17 to 28 years. Some differences might have been observed, had a longitudinal study been conducted, where study participants were followed over a longer period of time. No significant association was seen between EI of students belonging to different years of the medical school in the current study. Hence it might be concluded that EI remains stable during the years at the medical college. In the current study girls scored slightly higher on the useof-emotions subscale but the overall scores EI were comparable for the two genders. Similar results were reported by Bastian et al. (2005) and Tyagi (2004), who found no gender difference in EI. However, several studies have reported that women are emotionally more intelligent than their male counterparts (Ciarrochi 2001; Palmer et al. 2003; Day & Carroll 2004; Carr 2009). Caution should be exercised when comparing the findings of the current study with those of previous ones, as the present study used subscale scores rather than overall EI scores. Another study, which used global as well as subscale scores also found no gender differences (Whitman et al. 2009). An explanation may be that male and female undergraduates are exposed to the same social and academic environment; hence they may be equally emotionally intelligent.
Limitations Cross-sectional survey design cannot establish causation between variables, however, it is a relatively feasible method to determine association in an initial, exploratory study such as the current one (Streiner & Norman 1998). SSREI being a self-report measure has limitations such as concerns about accuracy, validity, reliance upon the insight of the respondent and susceptibility to socially desirable responding. A response rate of 30% is generally considered low for quantitative studies; however, a meta-analysis comprising of 231 studies (Cycyota & Harrison 2006) on EI in management executives during the period 1992–2003 appearing in management journals, reported an overall response rate of 32%, which is similar to the current study. This study did not examine cultural impact on the EI construct, further studies are necessary to examine whether there are some EI attributes and skills unique to the Arab culture, which require the development of a more culturally sensitive scale.
Conclusions and recommendations This multi-institutional study provides preliminary data about EI in undergraduate medical students in Saudi Arabia.
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It demonstrates positive correlation between CGPA and Optimism subscale of EI. Although there was insufficient evidence to support the inclusion of EI as a criteria for selection, the trainability of EI and its positive effect on student achievement merits further investigation. EI skills inclusion and training in the formal medical curriculum of medical schools can enable future doctors to deal better with their own emotions and those of their patients and colleagues, improving interpersonal relationships and becoming more productive members of the health care team.
Notes on contributors NAGHMA NAEEM, MBBS, MMED, PhD, is an Associate Professor and Head of Department, Medical Education, Batterjee Medical College, Jeddah, Kingdom of Saudi Arabia. She was previously affiliated with King Saud University Chair for Medical Education Research and Development, Riyadh, Kingdom of Saudi Arabia. E-mail: [email protected] CEES VAN DER VLEUTEN, PhD, is a Visiting Professor, King Saud University Chair for Medical Education Research and Development, Riyadh, Kingdom of Saudi Arabia & Chair Department of Educational Development, Maastricht University. E-mail: c.vandervleuten@ maastrichtuniversity.nl ARNO MUIJTJENS, PhD, is a Statistician and Associate Professor at the School of Health Professions Education, Department for Educational Development & Research, Maastricht University. E-mail: [email protected] CLAUDIO VIOLATO, BSc, MA, PhD, is a Professor at Department of Community Health Sciences & Director, Medical Education and Research Unit, Faculty of Medicine. University of Calgary. E-mail: [email protected] SYED MOYN ALI, MBBS, MHPE, is the Chair, Department of Medical Education, College of Medicine, University of Taif, Jeddah, Kingdom of Saudi Arabia. E-mail: [email protected] EIAD ABDELMOHSEN ALFARIS, MRCGP, MMED, is a Professor of Family Medicine and Supervisor, King Saud University Chair for Medical Education Research and Development, Riyadh, Kingdom of Saudi Arabia. E-mail: [email protected] RON HOOGENBOOM, MSc, is a Research Assistant, School of Health Professions Education, Department for Educational Development & Research, Maastricht University. E-mail: [email protected] NADIA NAEEM, BBA, is a Marketing Executive, Department of Medical Education, College of Medicine, King Saud University, Riyadh, Kingdom of Saudi Arabia. E-mail: [email protected]
Acknowledgements The authors wish to thank Ms. Dalal AlSaleh and Mr Abdullah for their help in data collection. We also wish to thank all students who participated in this study. Name of Institution(s) at which research was conducted: (1) King Saud University Chair for Medical Education Research & Development, King Saud University, Riyadh, Kingdom of Saudi Arabia. (2) Department for Medical Education, College of Medicine, University of Taif, Taif, Kingdom of Saudi Arabia. The publication of this supplement has been made possible with the generous financial support of the Dr Hamza Alkholi Chair for Developing Medical Education in KSA. S34
Declaration of interest: This research was supported by the College of Medicine Research Centre, Deanship of Scientific Research, King Saud University, Riyadh, Kingdom of Saudi Arabia. The authors report no declarations of interest.
References Arora S, Ashrafian H, Davis R, Athanasiou T, Darzi A, Sevdalis N. 2010. Emotional intelligence in medicine: A systematic review through the context of the ACGME competencies. Med Educ 44(8):749–764. Austin EJ, Evans P, Goldwater R, Potter V. 2005. A preliminary study of emotional intelligence, empathy and exam performance in first year students. Person Indiv Diff 39:1395–1405. Bar-On R. 2002. BarOn emotional quotient inventory: Short (BarOn EQ-i:S) development edition. Toronto: Multi-Health Systems Inc. Bastian VA, Burns NR, Nettelbeck T. 2005. Emotional intelligence predicts life skills, but not as well as personality and cognitive abilities. Person Indiv Diff 39:1135–1145. Boyatzis RE, Saatcioglu A. 2008. A 20-year view of trying to develop emotional, social and cognitive intelligence competencies in graduate management education. J Manage Dev 27:92–108. Carr SE. 2009. Emotional intelligence in medical students: Does it correlate with selection measures? Med Educ 43:1069–1077. Carrothers R, Gregory S, Gallagher T. 2000. Measuring emotional intelligence of medical school applicants. Acad Med 75:456–463. Cherniss C, Goleman D. 2001. The emotionally intelligent workplace. How to select for, measure and improve emotional intelligence in individuals, groups and organisations. San Francisco: Jossey-Bass. Ciarrochi J, Chan AYC, Bajgar J. 2001. Measuring emotional intelligence in adolescents. Person Indiv Diff 31:1105–1119. Cohen J. 1969. Statistical power analysis for the behavioral Sciences. New York: Academic Press. Conte JM. 2005. A review and critique of emotional intelligence measures. J Organiz Behav 26:433–440. Cycyota CS, Harrison DA. 2006. What (not) to expect when surveying executives a meta-analysis of top manager response rates and techniques over time. Organ Res Meth 9:133–160. Day AL, Carroll SA. 2004. Using an ability-based measure of emotional intelligence to predict individual performance, group performance, and group citizenship behaviours. Person Indiv Diff 36:1443–1458. Ekman P. 1980. The face of man: Expressions of universal emotions in a new Guinea village. New York: Garland STPM Press. Fukuda E, Saklofske DH, Tamaoka K, Fung TS, Mavaoka Y, Kiyama S. 2011. Factor structure of Japanese versions of two emotional intelligence scales. Int J Test 11:71–92. Goleman D. 1996. Emotional intelligence: Why it can matter more than IQ. New York: Bantam Books. Jacques ET. 2009. The relationships between emotional intelligence and the academic performance and selection of a major of college students. DAI Section A: Humanities and Social Sciences 70, 1193. Leddy JJ, Moineau G, Puddester D, Wood TJ, Humphrey-Murto S. 2011. Does an emotional intelligence test correlate with traditional measures used to determine medical school admission? Acad Med 86: S39–S41. Lewis NJ, Rees CE, Hudson N. 2004. Helping medical students identify their emotional intelligence. Med Educ 38:563. Linnenbrink-Garcia L, Rogat TK, Koskey KLK. 2011. Affect and engagement during small group instruction. Contemp Educ Psychol 36:13–24. Lopes PN, Salovey P, Straus R. 2003. Emotional intelligence, personality, and the perceived quality of social relationships. Person Indiv Diff 35: 641–658. Mathur M, Dube S, Malhotra B. 2003. Emotional intelligence: Interrelationships of attribution, taking responsibility and scholastic performance in adolescents. Indian Psychol Rev 60:175–180. Mayer J. 1999. Emotional intelligence: Popular or scientific psychology? APA Monitor 30:50.
Correlates of emotional intelligence
Mayer JD, Caruso DR, Salovey P. 1999. Emotional intelligence meets traditional standards for an intelligence. Intelligence 27:267–298. Mayer JD, Salovey P. 1997. What is emotional intelligence? In: Salovey P, Sluyter DJ, editors. Emotional development and emotional intelligence. New York: Basic Books. McMullen B. 2003. Emotional intelligence. Br Med J 326:19–19. McQueen ACH. 2004. Emotional intelligence in nursing work. J Adv Nurs 47(1):101–108. Nelis J, Quoidbach M, Mikolajczak M, Hansenne M. 2009. Increasing emotional intelligence: (How) is it possible? Person Indiv Diff 47: 36–41. Palmer BR, Gignac G, Manocha R, Stough C. 2005. A psychometric evaluation of the Mayer–Salovey–Caruso emotional intelligence test version 2.0. Intelligence 33:285–305. Palmer BR, Manocha R, Gignac G, Stough C. 2003. Examining the factor structure of the Bar-On Emotional Quotient Inventory with an Australian general population sample. Person Indiv Diff 35:1191–1210. Parker JDA, Saklofske DH, Wood LM, Eastabrook JM, Taylor RN. 2005. Stability and change in emotional intelligence: Exploring the transition to young adulthood. J Indiv Diff 26:100. Parker JDA, Summerfeldt LJ, Hogan MJ, Majeski SA. 2004. Emotional intelligence and academic success: Examining the transition from high school to university. Person Indiv Diff 36:163–172. Pau A, Croucher R, Sohanpal R, Muirhead V, Seymour K. 2004. Emotional intelligence and stress coping in dental undergraduates—A qualitative study. Br Dental J 197:205–209. Petrides K, Frederickson N, Furnham A. 2004. The role of trait emotional intelligence in academic performance and deviant behavior at school. Person Indiv Diff 36:277–293. Roberts R, Zeidner M, Matthews GM. 2001. Does emotional intelligence meet traditional standards for an intelligence? Some new data and conclusions. Emotions 1:196–231. Rode JC, Mooney CH, Arthaud-Day ML, Near JP, Baldwin TT, Rubin RS, Bommer WH. 2006. Emotional intelligence and individual performance: Evidence of direct and moderated effects. J Org Behav 28:399–421.
Sala F. 2007. Do programs designed to increase emotional intelligence at work-work? Issues and recent developments in emotional intelligence 2007. [Accessed 28 September 2012.] Available from http:// www.eiconsortium.org. Schutte NS, Malouff JM, Hall LE, Haggerty DJ, Cooper JT, Golden CJ, Dornhelm L. 1998. Development and validation of a measure of emotional intelligence. Person Indiv Diff 25:167–177. Shapiro J, Morrison EH, Boker JR. 2004. Teaching empathy to first year medical students: Evaluation of an elective literature and medicine course. Educ Health 17:73–84. Stratton TD, Elam CL, Murphy-Spencer AE, Quinlivan SL. 2005. Emotional intelligence and clinical skills: Preliminary results from a comprehensive clinical performance examination. Acad Med 80(10):S34–S35. Streiner DL, Norman GR. 1998. PDQ epidemiology, 2nd ed. Hamilton: B.C. Decker. Stoller JK, Taylor CA, Farver CF. 2013. Emotional intelligence competencies provide a developmental curriculum for medical training. Med Teach 35(3):243–7. Taylor C, Farver C, Stoller JK. 2001. Perspective: Can emotional intelligence training serve as an alternative approach to teaching professionalism to residents? Acad Med 86(12):1551–1554. Tyagi S. 2004. Emotional intelligence of secondary teachers in relation to gender and age. J Educ Res Exten 41:39–45. Ugoani JNN, Ewuzie MA. 2013. Imperatives of emotional intelligence on psychological wellbeing among adolescents. Am J Appl Psychol 1(3):44–48. Van Rooy DL, Alonso A, Viswesvaran C. 2005. Group differences in emotional intelligence scores: Theoretical and practical implications. Pers Individ Diff 38:689–700. Wadsworth BJ. 1996. Piaget’s theory of cognitive and affective development: Foundations of constructivism, 5th ed. White Plains, NY: Longman Publishing. Whitman DS, Van Rooy DL, Viswesvaran C, Kraus E. 2009. Testing the second-order factor structure and measurement equivalence of the Wong and Law emotional intelligence scale across gender and ethnicity. Educ Psychol Measure 69(6):1059–1074.
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