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Chen Y, He Y, Wang P, Jiang F, Du Y, Cheung MY, Liu H, Liu Y, Liu T, Tang YL, Zhu J. The association between the adverse event reporting system and burnout and job satisfaction of nurses: Workplace violence as a mediator. Int Nurs Rev 2024. [PMID: 38650586 DOI: 10.1111/inr.12962] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2023] [Accepted: 02/25/2024] [Indexed: 04/25/2024]
Abstract
AIMS This study aims to explore the association between the implementation of the adverse event reporting system (AERS), burnout, and job satisfaction among psychiatric nurses, with a focus on examining the mediating effect of workplace violence from patients. BACKGROUND Many organizational and personal factors contribute to burnout and job satisfaction experienced by nurses. AERS, serving as a key component of organizational-level quality improvement system, impacts the overall workplace wellness of nurses. METHODS A national sample of 9,744 psychiatric nurses from 41 psychiatric hospitals across 29 provinces in China participated. Burnout was measured by the Maslach Burnout Inventory. Job satisfaction was measured using the Minnesota Satisfaction Questionnaire. Workplace violence was assessed by nurses' experience of verbal and physical violence. Multilevel linear regression analyses were carried out to examine if AERS impacts burnout and job satisfaction and to identify the mediating role of workplace violence. RESULTS AERS was positively associated with job satisfaction, but negatively with burnout and workplace violence. Workplace violence exhibited a positive association with burnout and a negative association with job satisfaction. Mediation analyses indicated that the associations between AERS, burnout, and job satisfaction were mediated by workplace violence. CONCLUSIONS The application of AERS is associated with a reduction in workplace violence in hospitals, which contributes to the diminished burnout and heightened job satisfaction among psychiatric nurses. IMPLICATIONS FOR NURSING PRACTICE AND HEALTH POLICY The study highlights the importance of organizational efforts and mechanisms in promoting nurses' well-being. It is necessary for hospital management to create a safe workplace through the implementation of AERS.
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Affiliation(s)
- Yanhua Chen
- Vanke School of Public Health, Tsinghua University, Beijing, China
- School of Medicine, Tsinghua University, Beijing, China
| | - Yanrong He
- Vanke School of Public Health, Tsinghua University, Beijing, China
| | - Peicheng Wang
- Vanke School of Public Health, Tsinghua University, Beijing, China
- School of Medicine, Tsinghua University, Beijing, China
| | - Feng Jiang
- School of International and Public Affairs, Shanghai Jiao Tong University, Shanghai, China
- Institute of Healthy Yangtze River Delta, Shanghai Jiao Tong University, Shanghai, China
| | - Yanrong Du
- Vanke School of Public Health, Tsinghua University, Beijing, China
| | | | - Huanzhong Liu
- Department of Psychiatry, Chaohu Hospital of Anhui Medical University, Hefei, China
- Anhui Psychiatric Center, Anhui Medical University, Hefei, China
| | - Yuanli Liu
- School of Health Policy and Management, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Tingfang Liu
- Institute for Hospital Management, Tsinghua University, Beijing, China
| | - Yi-Lang Tang
- Mental Health Service Line, Atlanta VA Medical Center, Decatur, Georgia, USA
- Addiction Psychiatry Fellowship Program, Department of Psychiatry and Behavioral Sciences, Emory University, Atlanta, Georgia, USA
| | - Jiming Zhu
- Vanke School of Public Health, Tsinghua University, Beijing, China
- Institute for Healthy China, Tsinghua University, Beijing, China
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Sprague C. HIV Inequities, the Therapeutic Alliance, Moral Injury, and Burnout: A Call for Nurse Workforce Participation and Action. J Assoc Nurses AIDS Care 2024:00001782-990000000-00098. [PMID: 38563450 DOI: 10.1097/jnc.0000000000000459] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/04/2024]
Abstract
ABSTRACT Health inequities for those living with HIV have persisted for key populations in the United States and globally. To address these inequities, in accordance with Goals 2 and 3 of the National HIV/AIDS Strategy for the United States, the evidence indicates that the therapeutic alliance could be effective in addressing impediments that undermine HIV outcomes. Nonetheless, the therapeutic alliance relies on health care providers, particularly nurses, reporting burnout and moral injury, further exacerbated by COVID-19. Burnout and moral injury have forced the systemic undervaluing of nurses as a social-cultural norm to the fore-in part a legacy of the economic model that underpins the health care system. Given a looming health workforce shortage and negative effects for key populations with HIV already experiencing health inequities, historic opportunities now exist to advance national institutional reforms to support nurses and other health professionals. This opportunity calls for concerted attention, multisectoral dialogue, and action, with nurses participating in and leading policy and interventions.
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Affiliation(s)
- Courtenay Sprague
- Courtenay Sprague, PhD, MA, is an Associate Professor of Global Health, Department of Conflict Resolution, Human Security & Global Governance, and Department of Nursing, University of Massachusetts Boston, Boston, Massachusetts, USA
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O'Donnell S, Hayden J, Quigley E, Adamis D, Gavin B, McNicholas F. "We're seen as part of the supply chain of medicines rather than as the professionals that we are": The wellbeing of community pharmacists during the COVID response. Res Social Adm Pharm 2024; 20:389-400. [PMID: 38350789 DOI: 10.1016/j.sapharm.2023.12.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2023] [Revised: 12/10/2023] [Accepted: 12/13/2023] [Indexed: 02/15/2024]
Abstract
INTRODUCTION Challenges facing community pharmacists in delivering and adapting services during the COVID-19 response have been reported. However, few qualitative studies have examined the impact of these experiences on their wellbeing, and what supports the profession requires in the future. AIM(S) To examine the work-related experiences and psychosocial needs of community pharmacists situated in the Republic of Ireland arising from the COVID-19 response. METHOD 11 pharmacists and 1 representative were interviewed and data analysed through inductive thematic analysis. RESULTS Work experiences were characterised by increased workload linked to multiple roles pharmacists played during the pandemic. Remaining open, meeting the social and medical needs of patients unable to easily access other primary services exerted its toll on pharmacists while at the same time providing a sense of professional fulfilment. Participants felt contributions made to the community during COVID-19 went largely unrecognised by the wider healthcare structure. This added to a prior sense of professional disenchantment arising from long-standing under-resourcing, lack of clinical autonomy and high administrative burden eroding their sense of purpose and meaning. Informal, peer-support networks were preferred over formal psychological support initiatives. CONCLUSIONS The post-pandemic environment is an opportune time for policy makers to reconsider the role of community pharmacists. Greater clinical autonomy beyond dispensing of medicines, for example, for example, would also serve to enhance the sense of purpose and meaning of pharmacists as healthcare professionals. The longer-term well-being of community pharmacists is contingent on recognition of the value that community pharmacy bring both to the healthcare system and wider society as a whole.
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Affiliation(s)
- Shane O'Donnell
- Department of Child & Adolescent Psychiatry, School of Medicine and Medical Science, University College Dublin (UCD), Ireland.
| | - John Hayden
- RCSI School of Pharmacy and Biomolecular Sciences (PBS), Royal College of Surgeons in Ireland, Ireland
| | - Etain Quigley
- National University of Ireland, Maynooth (Maynooth University) - Department of Law, Ireland
| | | | - Blánaid Gavin
- Department of Child & Adolescent Psychiatry, School of Medicine and Medical Science, University College Dublin (UCD), Ireland
| | - Fiona McNicholas
- Department of Child & Adolescent Psychiatry, School of Medicine and Medical Science, University College Dublin (UCD), Ireland; Children Health Ireland, Crumlin, Dublin 12, Ireland; Lucena Clinic Rathgar, Dublin 6, Ireland
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Goldberg BJ, Ferrigno C, Schundler SF, Norrell ES, Fox L, Woods S, Wilson AB. Employment benefits across U.S. allopathic medical schools: National norms and relationships with institutional wealth. ANATOMICAL SCIENCES EDUCATION 2024; 17:529-538. [PMID: 38234047 DOI: 10.1002/ase.2379] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/11/2023] [Revised: 11/30/2023] [Accepted: 12/24/2023] [Indexed: 01/19/2024]
Abstract
This study summarizes employment benefits from across 155 U.S. allopathic medical schools, investigates differences in employment benefits according to institutional characteristics, and explores possible connections between employment benefits and institutional wealth. Employment benefits data were extracted from institutions' websites across four categories: time-off, time-away, retirement contributions, and Employee Assistance Programs (EAPs)/family benefits. This dataset was mixed with other publicly available datasets sourced through the Association of American Medical Colleges (AAMC), the American Council on Education (ACE), and the American Association of University Professors (AAUP) to conduct additional analyses. Nationally, medical schools offered an average of 31 vacation/sick days and 12 paid holidays. Schools typically offered 4 out of 8 time-away benefits. Employers' retirement contributions ranged from 3.0% to 15.5%, with a mean contribution of 8.5%. A total of 43.2% (67 of 155) of medical schools offered a pension. Collectively, private medical schools offered fewer time-away benefits and more EAP/family benefits compared to public schools. Universities with larger endowments per student were associated with a higher number of EAP/family benefits offerings (r = 0.543, p < 0.001). Institutional wealth did not influence other benefits offerings. The quantity/quality of most employment benefits offered at allopathic medical schools were wide-ranging, tended not to vary by region or school control, and were not a function of institutional wealth.
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Affiliation(s)
| | | | | | - Eric S Norrell
- Rush Medical College, Rush University, Chicago, Illinois, USA
| | - Leah Fox
- College of Arts and Sciences, Drake University, Des Moines, Iowa, USA
| | - Sabrina Woods
- Department of Anatomy, Cell Biology, & Physiology, Indiana University School of Medicine, Indianapolis, Indiana, USA
| | - Adam B Wilson
- Department of Anatomy and Cell Biology, Rush University, Chicago, Illinois, USA
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Eley DS, Slavin SJ. Medical student mental health - the intransigent global dilemma: Contributors and potential solutions. MEDICAL TEACHER 2024; 46:156-161. [PMID: 37976369 DOI: 10.1080/0142159x.2023.2279909] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/19/2023]
Affiliation(s)
- Diann S Eley
- Medical School, University of Queensland, Queensland, Australia
| | - Stuart J Slavin
- Accreditation Council for Graduate Medical Education, Chicago, IL, USA
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Simpson SL, Khan S, Schiferl LM, Boehl L, Horewitz D, Hausfeld J, Samuels P, Kreeger RN, White CM. Implementation of a Peer-to-Peer Support Program in a Quaternary Pediatric Medical Center. Acad Pediatr 2023; 23:1481-1488. [PMID: 37482296 DOI: 10.1016/j.acap.2023.07.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/16/2022] [Revised: 07/13/2023] [Accepted: 07/14/2023] [Indexed: 07/25/2023]
Abstract
Healthcare worker burnout is a growing epidemic associated with multiple negative outcomes. Compounding the routine stresses of clinical practice, involvement in adverse events can be emotionally devastating. Healthcare organizations have an obligation to mitigate burnout and promote engagement and resiliency. Many institutions have launched wellness initiatives, but the value of these programs is unclear. Here, we describe the implementation of a peer-to-peer support program at our quaternary pediatric medical center. This proactive program is unique in its referral process and scope and has demonstrated efficacy in mitigating the emotional impact of adverse effects. In total, our institution has trained 125 peer supporters. Since initiation, there have been a total of 2187 referrals made to the program. Data collected in 2022 from these referrals showed a 60.3% (n = 1220) response rate to the offer of support. A survey was sent to frontline clinicians from divisions with trained supporters. Of 963 respondents, 71.8% (n = 691) agreed that this program was a valuable resource, and 81.3% (n = 783) recommended peer support to be offered to those involved in adverse and stressful events. Our experience supports that the implementation of a proactive, peer-to-peer support program is both feasible and valuable.
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Affiliation(s)
- Samantha L Simpson
- Division of Neonatology and Pulmonary Biology (SL Simpson), Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio.
| | - Sarah Khan
- Division of Hospital Medicine (S Khan), Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
| | - Lindsey M Schiferl
- Data Management, Office of the Chief of Staff (LM Schiferl), Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
| | - Lindsay Boehl
- Program Management, Office of the Chief of Staff (L Boehl), Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
| | - Debbie Horewitz
- Project Management, Office of the Chief of Staff (D Horewitz), Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
| | - Jackie Hausfeld
- Division of Patient Services Administration (J Hausfeld), Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
| | - Paul Samuels
- Department of Anesthesiology (P Samuels and RN Kreeger), Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio; Department of Anesthesia (P Samuels and RN Kreeger), University of Cincinnati, Cincinnati, Ohio
| | - Renee N Kreeger
- Department of Anesthesiology (P Samuels and RN Kreeger), Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio; Department of Anesthesia (P Samuels and RN Kreeger), University of Cincinnati, Cincinnati, Ohio
| | - Christine M White
- Division of Hospital Medicine (CM White), University of Cincinnati, Cincinnati, Ohio; Department of Pediatrics (CM White), College of Medicine, University of Cincinnati, Cincinnati, Ohio
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McNicholas F, O'Donnell S, Hayden J, Quigley E, Adamis D, Gavin B. Comment on: "Psychological distress among outpatient physicians in private practice linked to COVID-19 and related mental health during the second lockdown". J Psychiatr Res 2023; 165:14-15. [PMID: 37451203 DOI: 10.1016/j.jpsychires.2023.07.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/03/2022] [Revised: 06/30/2023] [Accepted: 07/07/2023] [Indexed: 07/18/2023]
Affiliation(s)
- Fiona McNicholas
- University College Dublin, Child Psychiatry, Ireland; OLCHC Crumlin, Pediatric Psychiatry, Ireland
| | - Shane O'Donnell
- University College Dublin, School of Medicine and Medical Science (SMMS), Ireland.
| | - John Hayden
- Royal College of Surgeons in Ireland, School of Pharmacy and Biomolecular Sciences (PBS), Ireland
| | | | - Dimitrios Adamis
- Health Service Executive (HSE), Sligo Mental Health Services, Ireland
| | - Blanaid Gavin
- University College Dublin, Dept of Child & Adolescent Psychiatry School of Medicine and Medical Science (SMMS), Ireland
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8
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MacKinnon NJ. Work-life harmony and pharmacy: Get the balance right. Am J Health Syst Pharm 2023; 80:1096-1100. [PMID: 37254838 DOI: 10.1093/ajhp/zxad118] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2023] [Indexed: 06/01/2023] Open
Affiliation(s)
- Neil J MacKinnon
- Medical College of Georgia, Augusta University, Augusta, GA, USA
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Pestian T, Awtrey E, Kanov J, Winick N, Thienprayoon R. The impact of organizational compassion in health care on clinicians: A scoping review. Worldviews Evid Based Nurs 2023; 20:290-305. [PMID: 37340547 DOI: 10.1111/wvn.12664] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2022] [Revised: 05/19/2023] [Accepted: 05/27/2023] [Indexed: 06/22/2023]
Abstract
BACKGROUND The unprecedented exodus of workers from the healthcare system is a patient safety crisis. Organizational compassion in health care is the proactive, systematic, and continuous identification, alleviation, and prevention of all sources of suffering. AIMS This scoping review aimed to describe the evidence regarding the impact of organizational compassion on clinicians, identify gaps, and provide recommendations for future research. METHODS A comprehensive librarian-assisted database search was conducted. Databases searched were PubMed, SCOPUS, EMBASE, Web of Science, PsychInfo, and Business Source Complete. Combinations of search terms regarding health care, compassion, organizational compassion, and workplace suffering were used. The search strategy was limited to English language articles and those published between 2000 and 2021. RESULTS Database search yielded 781 articles. After removing duplicates, 468 were screened by title and abstract, and 313 were excluded. One-hundred and fifty-five underwent full-text screening, and 137 were removed, leaving 18 eligible articles, two of which were set in the United States. Ten articles evaluated barriers or facilitators to organizational compassion, four evaluated elements of compassionate leadership, and four evaluated the Schwartz Center Rounds intervention. Several described the need to create systems that are compassionate to clinicians. Lack of time, support staff, and resources impeded the delivery of such interventions. LINKING EVIDENCE TO ACTION Little research has been done to understand and evaluate the impact of compassion on US clinicians. Given the workforce crisis in American health care and the potential positive impact of increasing compassion for clinicians, there is an urgent need for researchers and healthcare administrators to fill this gap.
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Affiliation(s)
- Teresa Pestian
- College of Education, Criminal Justice and Human Services, University of Cincinnati, Cincinnati, Ohio, USA
- Department of Anesthesia, College of Medicine, University of Cincinnati, Cincinnati, Ohio, USA
| | - Eli Awtrey
- Lindner College of Business, University of Cincinnati, Cincinnati, Ohio, USA
| | - Jason Kanov
- College of Business and Economics, Western Washington University, Bellingham, Washington, USA
| | - Naomi Winick
- Department of Pediatrics, College of Medicine, University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Rachel Thienprayoon
- Department of Anesthesia, College of Medicine, University of Cincinnati, Cincinnati, Ohio, USA
- Department of Pediatrics, College of Medicine, University of Cincinnati, Cincinnati, Ohio, USA
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Buchbinder M, Browne A, Berlinger N, Jenkins T, Buchbinder L. Moral Stress and Moral Distress: Confronting Challenges in Healthcare Systems under Pressure. THE AMERICAN JOURNAL OF BIOETHICS : AJOB 2023:1-15. [PMID: 37347222 PMCID: PMC10758677 DOI: 10.1080/15265161.2023.2224270] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/23/2023]
Abstract
Stresses on healthcare systems and moral distress among clinicians are urgent, intertwined bioethical problems in contemporary healthcare. Yet conceptualizations of moral distress in bioethical inquiry often overlook a range of routine threats to professional integrity in healthcare work. Using examples from our research on frontline physicians working during the COVID-19 pandemic, this article clarifies conceptual distinctions between moral distress, moral injury, and moral stress and illustrates how these concepts operate together in healthcare work. Drawing from the philosophy of healthcare, we explain how moral stress results from the normal operations of overstressed systems; unlike moral distress and moral injury, it may not involve a sense of powerlessness concerning patient care. The analysis of moral stress directs attention beyond the individual, to stress-generating systemic factors. We conclude by reflecting on how and why this conceptual clarity matters for improving clinicians' professional wellbeing, and offer preliminary pathways for intervention.
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Affiliation(s)
| | | | | | | | - Liza Buchbinder
- Center for Social Medicine and Humanities and Semel Institute, UCLA
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Paromita P, Mundnich K, Nadarajan A, Booth BM, Narayanan SS, Chaspari T. Modeling inter-individual differences in ambulatory-based multimodal signals via metric learning: a case study of personalized well-being estimation of healthcare workers. Front Digit Health 2023; 5:1195795. [PMID: 37363272 PMCID: PMC10289192 DOI: 10.3389/fdgth.2023.1195795] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2023] [Accepted: 05/22/2023] [Indexed: 06/28/2023] Open
Abstract
Introduction Intelligent ambulatory tracking can assist in the automatic detection of psychological and emotional states relevant to the mental health changes of professionals with high-stakes job responsibilities, such as healthcare workers. However, well-known differences in the variability of ambulatory data across individuals challenge many existing automated approaches seeking to learn a generalizable means of well-being estimation. This paper proposes a novel metric learning technique that improves the accuracy and generalizability of automated well-being estimation by reducing inter-individual variability while preserving the variability pertaining to the behavioral construct. Methods The metric learning technique implemented in this paper entails learning a transformed multimodal feature space from pairwise similarity information between (dis)similar samples per participant via a Siamese neural network. Improved accuracy via personalization is further achieved by considering the trait characteristics of each individual as additional input to the metric learning models, as well as individual trait base cluster criteria to group participants followed by training a metric learning model for each group. Results The outcomes of the proposed models demonstrate significant improvement over the other inter-individual variability reduction and deep neural baseline methods for stress, anxiety, positive affect, and negative affect. Discussion This study lays the foundation for accurate estimation of psychological and emotional states in realistic and ambulatory environments leading to early diagnosis of mental health changes and enabling just-in-time adaptive interventions.
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Affiliation(s)
- Projna Paromita
- HUman Bio-Behavioral Signals Lab, Texas A & M University, College Station, TX, United States
| | - Karel Mundnich
- Signal Analysis and Interpretation Laboratory, University of Southern California, Los Angeles, CA, United States
| | - Amrutha Nadarajan
- Signal Analysis and Interpretation Laboratory, University of Southern California, Los Angeles, CA, United States
| | - Brandon M. Booth
- Signal Analysis and Interpretation Laboratory, University of Southern California, Los Angeles, CA, United States
| | - Shrikanth S. Narayanan
- Signal Analysis and Interpretation Laboratory, University of Southern California, Los Angeles, CA, United States
| | - Theodora Chaspari
- HUman Bio-Behavioral Signals Lab, Texas A & M University, College Station, TX, United States
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Thienprayoon R. Beyond burnout: Collective suffering and organizational compassion. J Hosp Med 2022. [PMID: 36576037 DOI: 10.1002/jhm.13033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/05/2022] [Revised: 12/09/2022] [Accepted: 12/12/2022] [Indexed: 12/29/2022]
Affiliation(s)
- Rachel Thienprayoon
- Anesthesia and Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA
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13
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Eley DS, Leung J, Cloninger KM. A longitudinal cohort study observed increasing perfectionism and declining resilience, ambiguity tolerance and calling during medical school which is not explained by student personality. BMC MEDICAL EDUCATION 2022; 22:784. [PMID: 36371205 PMCID: PMC9655808 DOI: 10.1186/s12909-022-03850-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/05/2022] [Accepted: 10/31/2022] [Indexed: 05/19/2023]
Abstract
BACKGROUND The medical degree is a long and challenging program, not just academically, but regarding the expectations engrained in the culture of medical education. The recent proliferation of literature on the poor mental well-being among students suggests a dilemma that often lays the onus on students to improve their health. The link between personality and vulnerability to psychological distress is acknowledged. This longitudinal study looked at personality in 1st-year and changes in levels of certain psychological traits, as proxy indicators of well-being, in 4th-year. We aimed to determine to what extent changes in psychological traits over time may be attributed to personality. METHODS Medical students completed surveys at the start (1st-year: baseline) and finish (4th-year: follow-up) of their medical degree (N = 154). Temperament and character personality, Perfectionism-Concern over mistakes (CoM), Ambiguity Tolerance, Resilience, Calling to medicine, and demographic variables were measured. Paired t-tests compared changes in psychological traits from baseline to follow-up. Linear regression examined whether personality at baseline would predict levels of psychological traits at follow-up. RESULTS The temperament and character profile of the sample was as expected, and congruent with previous studies, which describe a mature personality. Over four years, levels of Perfectionism-CoM significantly increased, while Resilience, Ambiguity Tolerance and Calling to medicine decreased. Harm Avoidance, Persistence, Self-Directedness and Cooperativeness at baseline significantly predicted levels of these traits at follow-up, but effect sizes were weak. Correlations were in the expected direction and weak. CONCLUSIONS Most commencing medical students, including this cohort, have mature personalities with an industrious temperament and an adaptable character. Yet over four years of medicine, Ambiguity Tolerance, Resilience and Calling declined while Perfectionism-CoM, already elevated at baseline, continued to increase to the final year. Of concern is the increased perfectionism that is strongly associated with poor mental health and psychological distress. The findings suggest a closer look at the entirety of the education environment and how its culture, including secondary school and the medical school admissions processes may influence these trends in students. As medical educators we should question why the pathway to medicine places such unhealthy pressure on students who aspire to be doctors.
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Affiliation(s)
- Diann S. Eley
- Academy of Medical Education, Medical School, The University of Queensland, 288 Herston Road, Brisbane, QLD 4006 Australia
| | - Janni Leung
- National Centre for Youth Substance Use Research (NCYSUR), The University of Queensland, 17 Upland Road, St Lucia, QLD 4072 Australia
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Frenk J, Chen LC, Chandran L, Groff EOH, King R, Meleis A, Fineberg HV. Challenges and opportunities for educating health professionals after the COVID-19 pandemic. Lancet 2022; 400:1539-1556. [PMID: 36522209 PMCID: PMC9612849 DOI: 10.1016/s0140-6736(22)02092-x] [Citation(s) in RCA: 55] [Impact Index Per Article: 27.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/16/2022] [Revised: 08/17/2022] [Accepted: 10/14/2022] [Indexed: 11/06/2022]
Abstract
The education of health professionals substantially changed before, during, and after the COVID-19 pandemic. A 2010 Lancet Commission examined the 100-year history of health-professional education, beginning with the 1910 Flexner report. Since the publication of the Lancet Commission, several transformative developments have happened, including in competency-based education, interprofessional education, and the large-scale application of information technology to education. Although the COVID-19 pandemic did not initiate these developments, it increased their implementation, and they are likely to have a long-term effect on health-professional education. They converge with other societal changes, such as globalisation of health care and increasing concerns of health disparities across the world, that were exacerbated by the pandemic. In this Health Policy, we list institutional and instructional reforms to assess what has happened to health-professional education since the publication of the Lancet Commission and how the COVID-19 pandemic altered the education process.
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Affiliation(s)
- Julio Frenk
- Office of the President, University of Miami, Coral Gables, FL, USA
| | | | - Latha Chandran
- Department of Medical Education and Department of Pediatrics, Miller School of Medicine, University of Miami, Miami, FL, USA.
| | - Elizabeth O H Groff
- Department of Public Health Sciences, University of Miami, Coral Gables, FL, USA
| | - Roderick King
- Department of Pediatrics and Department of Health Policy and Management, University of Maryland Medical System, Baltimore, MD, USA
| | - Afaf Meleis
- School of Nursing, University of Pennsylvania, Philadelphia, PA, USA
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