Theory of Pain Laboratory, Department of Psychology, Faculty of Psychology and Educational Sciences (FPSE), University of Geneva, Geneva, Switzerland.
Geneva Neuroscience Center, University of Geneva, Geneva, Switzerland.
Elife. 2021 Apr 27;10:e63272. doi: 10.7554/eLife.63272.
Healthcare providers often underestimate patients' pain, sometimes even when aware of their reports. This could be the effect of experience reducing sensitivity to others pain, or distrust toward patients' self-evaluations. Across multiple experiments (375 participants), we tested whether senior medical students differed from younger colleagues and lay controls in the way they assess people's pain and take into consideration their feedback. We found that medical training affected the sensitivity to pain faces, an effect shown by the lower ratings and highlighted by a decrease in neural response of the insula and cingulate cortex. Instead, distrust toward the expressions' authenticity affected the processing of feedbacks, by decreasing activity in the ventral striatum whenever patients' self-reports matched participants' evaluations, and by promoting strong reliance on the opinion of other doctors. Overall, our study underscores the multiple processes which might influence the evaluation of others' pain at the early stages of medical career.
医疗服务提供者常常低估患者的疼痛，即使他们已经了解了患者的报告。这种情况可能是因为经验降低了对他人疼痛的敏感度，或者对患者自我评估的不信任。在多项实验（375 名参与者）中，我们测试了老年医学生与年轻同事和非医学专业人士在评估他人疼痛和考虑其反馈时的差异。我们发现，医学培训会影响对疼痛面孔的敏感度，这种影响体现在评分较低，并且大脑岛和扣带回皮层的神经反应减少。相反，对表情真实性的不信任会影响反馈的处理，当患者的自我报告与参与者的评估一致时，腹侧纹状体的活动减少，并且会强烈依赖其他医生的意见。总的来说，我们的研究强调了在医疗职业生涯早期可能影响他人疼痛评估的多个过程。
