The research team, led by Colleen P. Nofi, Ila Sethi, and Vihas Patel of Northwell Health and the Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, together with collaborators at Good Samaritan Regional Medical Center and Hackensack University Medical Center, designed an exploratory prospective observational cohort study spanning the 2022–2023 academic year. Their central question was deceptively simple: does a resident’s emotional intelligence, commonly abbreviated EI, predict the degree of agreement between how residents rate themselves and how their programs’ Clinical Competency Committees, the faculty panels formally charged with assessing trainee progress, rate them?

To measure emotional intelligence, the investigators used the 33-item Schutte Self-Report Emotional Intelligence Test, a validated instrument rooted in the Salovey and Mayer model of EI as the ability to monitor, discriminate among, and use emotional information. Self-assessment alignment was quantified using the Accreditation Council for Graduate Medical Education’s Milestones 2.0 framework, a competency-based evaluation system that grades residents across specialty-specific subcompetencies. Concordance between resident self-evaluations and Clinical Competency Committee evaluations was captured at two time points, mid-year and end-of-year, allowing the team to track not just whether residents were accurate, but whether their insight improved as the training year unfolded.

The dataset included performance evaluation data from 88 surgical residents whose concordance could be analyzed; of those, 36 also completed the emotional intelligence survey. The headline result was a trend rather than a definitive statistical verdict: residents with medium to high EI scores demonstrated greater concordance with their Clinical Competency Committee evaluations than residents with low EI scores, with a p-value of 0.059, just shy of the conventional threshold for statistical significance. In an exploratory study of this size, the researchers argue, such a near-significant association is meaningful evidence that self-awareness, a core component of emotional intelligence, underpins honest and accurate self-appraisal of surgical competence.

The temporal data added a second, arguably more hopeful, layer to the story. At mid-year, 43 percent of residents showed low concordance between self-assessment and faculty evaluation, while 57 percent showed high concordance. By the end of the academic year, low concordance had fallen to 38 percent and high concordance had climbed to 62 percent. In other words, residents as a group became more accurate judges of their own performance over time, a pattern the authors attribute plausibly to the accumulating effect of ongoing feedback, formal evaluations, and the reflective practice embedded in surgical training.

Perhaps the most unexpected finding concerned program size, a variable rarely scrutinized in competency research. Residents in medium-sized programs achieved strikingly higher concordance, at 86 percent, than those in small programs, at 58 percent, or large programs, at 52 percent, a difference that reached statistical significance with a p-value of 0.029. The authors offer no single explanation, but the pattern invites speculation about the social dynamics of feedback: in mid-sized programs, faculty may know each resident well enough to give calibrated, individualized evaluations, while the smallest programs may suffer from limited evaluator diversity and the largest from anonymity, with residents and faculty interacting too briefly for honest, granular assessment. Notably, neither postgraduate year level nor program type showed any significant association with concordance.

The significance of accurate self-assessment extends well beyond academic bookkeeping. Prior work has repeatedly documented that residents frequently overestimate their abilities relative to faculty judgment, and the milestone framework under which these evaluations occur directly shapes promotion, remediation, and ultimately board certification. A resident who cannot accurately perceive a competency gap may fail to seek the operative experience or study needed to close it, while a program that cannot rely on self-assessment must invest heavily in external surveillance. The new study suggests that emotional intelligence could serve as a screening variable, identifying trainees who need structured support in developing the self-awareness that honest self-evaluation demands.

The findings also sit within a growing body of literature linking emotional intelligence to surgical outcomes. Earlier studies have associated EI with resident well-being, lower burnout, higher job satisfaction, and even technical performance measures such as surgical quality. A 2020 pilot study by Nayar and colleagues reported that emotional intelligence predicted accurate self-assessment of surgical quality, and the present work extends that logic from the individual procedure to the full spectrum of clinical competencies codified by the ACGME. Educational researchers have begun designing interventions, from patient-centered experiences to formal EI coaching curricula, aimed at cultivating these skills deliberately rather than assuming they emerge from clinical exposure alone.

The authors are careful to frame their conclusions within the study’s limits. With only 36 residents completing the EI survey, the cohort was small and the near-significant p-value could shift in either direction with more data; the self-report nature of the Schutte test introduces the possibility that residents with genuinely high self-awareness also rate their EI differently; and the multi-institutional design, while a strength for generalizability, leaves residual confounding from institutional culture and evaluation practices unmeasured. Data privacy constraints prevent open sharing of the underlying dataset. Still, the study’s exploratory design was explicitly intended to generate hypotheses, and its results justify larger, powered trials of EI measurement and training in surgical education.

If confirmed, the implications for training programs are concrete. Programs might incorporate validated EI assessments at entry, use concordance between self- and faculty evaluations as a flag for residents lacking insight, and design feedback structures, particularly in small and large programs, that replicate the calibrated, personal evaluation environment apparently achieved in mid-sized ones. The steady improvement in self-assessment accuracy across the academic year reinforces a message educators have long promoted but rarely quantified: feedback, delivered consistently and received with genuine self-awareness, teaches residents not just how to operate, but how to see themselves as surgeons. In a profession where the cost of misjudging one’s own limits is measured in patient outcomes, cultivating that inner clarity may be one of the most consequential skills a training program can teach.

Subject of Research: The relationship between emotional intelligence and the accuracy of surgical residents' self-assessed clinical competency

Article Title: Emotional intelligence influences surgical resident’s self-perception of competency: an exploratory, multi-institutional study

Article References: Nofi, C. P., Sethi, I., Demyan, L., Koti, S., Hansen, L., Serfin, J., Surick, B., & Patel, V. (2026). Emotional intelligence influences surgical resident’s self-perception of competency: an exploratory, multi-institutional study. Global Surgical Education – Journal of the Association for Surgical Education, 5(1), Article 166. https://doi.org/10.1007/s44186-026-00568-6

Image Credits: AI Generated

DOI: 10.1007/s44186-026-00568-6

Keywords: emotional intelligence, surgical residents, self-assessment, Clinical Competency Committee, ACGME Milestones 2.0, surgical education, competency evaluation, Schutte Self-Report Emotional Intelligence Test, graduate medical education, feedback, self-awareness, Emotional

The review places music intervention within a biopsychosocial model of medicine, which recognizes that cancer affects biological systems as well as emotions, behavior, relationships and daily functioning. A diagnosis can trigger fear and uncertainty, while repeated procedures, treatment toxicity, financial pressure and concerns about recurrence can intensify psychological distress. These experiences can influence sleep, pain perception, treatment participation and recovery. The authors distinguish among music therapy delivered by trained professionals, medical music listening in which healthcare staff provide recorded music, and recreational musical activities led by musicians or clinical personnel. The distinctions matter because the interventions differ in intensity, personalization, therapeutic goals and the expertise required to deliver them.

Evidence summarized in the review suggests that the most consistent benefits occur when music is integrated with clinical assessment and patient preference rather than imposed as a generic soundtrack. During chemotherapy, for example, patients may listen to selected music for about an hour while receiving routine care. In studies of procedures such as peripherally inserted central catheter placement, sessions lasting about 30 minutes were associated with lower anxiety and changes in vital signs, including diastolic blood pressure and heart rate. A randomized study involving 304 people with lung cancer reported benefits when music accompanied routine care during catheter placement and afterward. Research involving children with leukemia similarly linked music therapy during catheter treatment with improved mood, less pain and reduced sedative use, although the review emphasizes that intervention designs and outcomes vary.

Music may also help patients manage the cognitive and emotional burden that accompanies cancer treatment. Chemotherapy-associated cognitive difficulties can involve memory, attention, learning and executive function, and these changes may compound the distress of diagnosis. The review cites a randomized study of 27 breast cancer survivors in which eight weeks of either meditation or classical music listening improved cognitive function, memory and verbal fluency. It also discusses postoperative brain-tumor research in which cognitive training combined with music intervention was associated with better cognitive function, sleep and psychological status. The proposed value of music in these settings is partly communicative: singing, listening, guided imagery or improvisation can give patients a manageable way to express emotions, focus attention and participate actively in their care.

Symptom control is the largest area covered by the review. Anxiety and fear can rise before imaging, surgery, chemotherapy or other procedures, particularly when patients must remain still in an enclosed or noisy environment. Music-guided relaxation before or during a procedure may reduce arousal and help patients complete care. In one study of 750 outpatient chemotherapy patients, participants who selected their own music experienced improvements in negative emotions and pain measures compared with routine care. A separate pilot trial combining face-to-face music listening with progressive muscle relaxation for three weeks reported lower anxiety, depression and stress at the end of treatment, with benefits still evident at follow-up. However, the evidence is not uniform: a meta-analysis of six randomized trials found improvements in anxiety and quality of life before chemotherapy but no substantial effect on depression.

Studies of chemotherapy-induced nausea and vomiting point to a similarly promising but qualified role. Antiemetic drugs remain central to prevention and treatment, yet nausea is influenced by anticipation, anxiety, sensory cues and a patient’s interpretation of symptoms. The review describes a meta-analysis of 10 studies that found music reduced the incidence and severity of anticipated nausea and vomiting, while noting continuing uncertainty about acute symptoms during or immediately after chemotherapy. Other analyses reported lower nausea and vomiting scores and a reduced likelihood of at least grade-one symptoms when individualized music was added to standard nursing care, particularly in gastrointestinal cancer. The findings suggest that timing, musical preference, therapeutic guidance and the patient’s prior experience may all shape the response, making repeated assessment important.

Pain, sleep and fatigue are additional targets. In palliative care, music selected according to patient preference and combined with medication was associated with lower pain and greater comfort in a randomized study of 60 people. After lung-cancer surgery, music therapy alongside intravenous sufentanil analgesia was linked to lower pain scores and reduced dose and administration frequency over the first postoperative day. Music does not act as a substitute for analgesics, but relaxation and attentional engagement may alter how pain is perceived and help patients use other treatments more effectively. Sleep studies have reported benefits after sessions of roughly 30 minutes; a meta-analysis of hospitalized patients found improved sleep quality, and studies in breast and lung cancer suggested additional gains when music was combined with exercise or psychological support.

The review also describes music as a possible bridge between symptom management and physical rehabilitation. After breast-cancer surgery, programs combining music-guided relaxation with limb exercises were associated with improved shoulder movement, reduced swelling and fewer discomfort symptoms. In lung rehabilitation, music can provide rhythm or structure for breathing exercises, relaxation and vocal activities. Evidence from pulmonary rehabilitation, cardiothoracic surgery and postoperative non-small-cell lung cancer care suggests potential improvements in respiratory muscle performance, lung expansion, functional indices and quality of life. These interventions require clinical judgment: therapists must consider cardiovascular and pulmonary function, pain during breathing, the prescribed inhalation-to-exhalation ratio, fatigue and the patient’s preferences. Severe respiratory or cardiovascular problems require coordination with the treating physician.

Combining music with other supportive approaches may produce broader effects than music alone. The review cites studies pairing it with mindfulness-based stress reduction, progressive muscle relaxation, aromatherapy, acupressure and aerobic exercise. In patients with osteosarcoma, music combined with mindfulness practices was associated with improvements in pain, anxiety and sleep. Among women undergoing breast-cancer treatment, aromatherapy plus music relaxation performed better for perioperative pain and anxiety than either intervention alone. Yet the authors caution that many studies are small, use different musical formats and measure short-term outcomes, making direct comparison difficult. Music intervention should therefore be viewed as patient-centered supportive care, not an anticancer treatment or a guaranteed method of changing survival. Larger, rigorously designed trials are needed to establish which patients benefit, which delivery methods work best, how often sessions should occur and whether gains persist. For now, the review argues that music offers a relatively simple, safe and adaptable addition to multidisciplinary oncology care when integrated with medical treatment and individualized assessment.

The clinical rationale for these interventions extends beyond distraction. Within the biopsychosocial framework described by the review, music can engage emotional, cognitive and social dimensions of illness at the same time. It may provide a familiar structure during periods in which diagnosis and treatment feel unpredictable, while also creating an avenue for communication when patients find direct discussion difficult. In a therapeutic setting, a patient’s responses to a song, rhythm or musical activity can help reveal distress, preferences and changing needs. This makes music potentially relevant not only to symptom relief but also to the human relationship at the center of supportive oncology.

Delivery should be matched to the purpose of care. Passive listening may be practical in an infusion unit, before a procedure or during rest, whereas music therapy involves a qualified practitioner who adapts the session and uses music within a defined treatment process. Active approaches, such as singing or other guided musical participation, may encourage agency and interaction, but they are not interchangeable with recorded music. The review’s comparison of studies found more consistently favorable findings for interventions provided by trained music therapists, while results for medical music listening were less uniform. This distinction is important when hospitals interpret evidence or plan services.

Patient choice is another clinically meaningful variable. Musical familiarity, cultural background, age, language, prior experiences and current mood can influence whether a session feels calming, irritating or emotionally overwhelming. The review therefore supports flexible strategies rather than a single preferred genre or universal protocol. Clinicians can ask what the patient normally listens to, whether music is welcome at that moment and whether listening should be uninterrupted or combined with conversation, breathing practice or rehabilitation. Patients should also be able to stop an intervention, particularly when music evokes unwanted memories or increases discomfort.

Implementation is best understood as part of coordinated supportive care rather than an isolated activity. Oncology nurses, physicians, rehabilitation professionals, palliative-care teams and music therapists may use different observations to determine whether a session is helping. Repeated assessment can include the patient’s reported anxiety, pain, nausea, sleep or fatigue, together with participation in treatment and functional recovery. Such monitoring can identify when music is useful and when another intervention is needed. It also helps separate immediate comfort from longer-term outcomes, a necessary distinction because the reviewed studies varied in intervention length, cancer type, setting and outcome measurement.

The review’s findings support continued clinical investigation, but they do not establish that music directly alters tumor biology or reliably extends survival. Most of the evidence concerns patient-reported symptoms, psychological states, physiological responses or rehabilitation measures. Future studies would benefit from clearer descriptions of therapist training, session content, timing, dose, patient selection and usual-care comparisons. Consistent outcome measures and longer follow-up could clarify whether short-term reductions in distress translate into sustained improvements in functioning, adherence or quality of life. Until then, music is most appropriately offered as an individualized, low-burden complement to evidence-based cancer treatment and palliative care.

Subject of Research: Clinical use of music interventions to support psychological, physical and rehabilitation outcomes in cancer patients

Article Title: The integrated application of music intervention in clinical practice for cancer patients

Article References: Zhang, F., Li, X., Wang, J., Ma, M., Xu, Y., & Hong, L. (2026). The integrated application of music intervention in clinical practice for cancer patients. Holistic Integrative Oncology, 5(1), Article 71. https://doi.org/10.1007/s44178-026-00271-y

Image Credits: AI Generated

DOI: 10.1007/s44178-026-00271-y

Keywords: music therapy, cancer care, integrative oncology, symptom management, anxiety, pain, sleep, chemotherapy, rehabilitation, quality of life, integrated, application