Mindful Communication to Address Burnout, Empathy, and Attitudes

To the Editor: We have 2 concerns about the outcome measures and the statistical methods used in the study of the association of mindful communication with burnout, empathy, and attitudes among primary care physicians by Dr Krasner and colleagues.¹ First, the outcome measures may have been influenced by social desirability responding, the tendency for participants to present a favorable image of themselves. Participants completed 5 sets of Likert surveys covering socially sensitive topics, which might have been contaminated by social desirability responding. This may happen, for example, if persons with higher levels of social desirability responding substitute a socially desirable response for the true response; in that case, any variation in responses would reflect variations in understanding the social norms rather than variations in personality. Social desirability responding can suppress, obscure, or produce artificial relationships among variables, resulting in confounding.² The study design does not appear to have controlled for or distinguished social desirability responding. It may be possible to explore the relationship between 2 variables of interest while statistically controlling for social desirability responding using partial correlations.³