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Fabbri C, Lewis CM, Serretti A. Polygenic risk scores for mood and related disorders and environmental factors: Interaction effects on wellbeing in the UK biobank. Prog Neuropsychopharmacol Biol Psychiatry 2024; 132:110972. [PMID: 38367896 DOI: 10.1016/j.pnpbp.2024.110972] [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: 08/30/2023] [Revised: 12/15/2023] [Accepted: 02/14/2024] [Indexed: 02/19/2024]
Abstract
Mood disorders have a genetic and environmental component and interactions (GxE) on the risk of psychiatric diseases have been investigated. The same GxE interactions may affect wellbeing measures, which go beyond categorical diagnoses and reflect the health-disease continuum. We evaluated GxE effects in the UK Biobank, considering as outcomes subjective wellbeing (feeling good and functioning well) and objective measures (education and income). We estimated the polygenic risk scores (PRSs) of major depressive disorder, bipolar disorder, schizophrenia, and attention deficit hyperactivity disorder. Stressful/traumatic events during adulthood or childhood were considered as E variables, as well as social support. The addition of the PRSxE interaction to PRS and E variables was tested in linear or multinomial regression models, adjusting for confounders. We included 33 k-380 k participants, depending on the variables considered. Most PRSs and E factors showed additive effects on outcomes, with effect sizes generally 3-5 times larger for E variables than PRSs. We found some interaction effects, particularly when considering recent stress, history of a long illness/disability/infirmity, and social support. Higher PRSs increased the negative effects of stress on wellbeing, but they also increased the positive effects of social support, with interaction effects particularly for the outcomes health satisfaction, loneliness, and income (p < Bonferroni corrected threshold of 1.92e-4). PRSxE terms usually added ∼0.01-0.02% variance explained to the corresponding additive model. PRSxE effects on wellbeing involve both positive and negative E factors. Despite small variance explained at the population level, preventive/therapeutic interventions that modify E factors could be beneficial at the individual level.
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Affiliation(s)
- Chiara Fabbri
- Department of Biomedical and NeuroMotor Sciences, University of Bologna, Bologna, Italy.
| | - Cathryn M Lewis
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Alessandro Serretti
- Department of Biomedical and NeuroMotor Sciences, University of Bologna, Bologna, Italy; Department of Medicine and Surgery, Kore University of Enna, Enna, Italy
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Chrouser KL, Zebib L, Webb BF, Bagian T, Arnold T. The Retrospective Stressor Analysis (RSA): a novel qualitative tool for identifying causes of burnout and mitigation strategies during residency. BMC MEDICAL EDUCATION 2024; 24:591. [PMID: 38811938 PMCID: PMC11138060 DOI: 10.1186/s12909-024-05571-3] [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: 02/09/2024] [Accepted: 05/17/2024] [Indexed: 05/31/2024]
Abstract
BACKGROUND Resident physicians are at an increased risk of burnout due to their high-pressure work environments and busy schedules which can lead to poor mental health outcomes and decreased performance quality. Given variability among training programs and institutions across the United States, stressors likely differ, and interventions must be tailored to the local context, but few tools exist to assist in this process. METHODS A tool commonly used in adverse event analysis was adapted into a "retrospective stressor analysis" (RSA) for burnout prevention. The RSA was tested in a group of chief residents studying quality improvement and patient safety in veteran's hospitals across the United States. The RSA prompted them to identify stressors experienced during their residencies across four domains (clinical practice, career development, personal life, and personal health), perceived causes of the stressors, and potential mitigation strategies. RESULTS Fifty-eight chief residents completed the RSA. Within the clinical domain, they describe the stress of striving for efficiency and clinical skills acquisition, all while struggling to provide quality care in high pressure environments. In the career domain, identifying mentors and opportunities for research engagement was stressful. Within their personal lives, a lack of time-constrained their ability to maintain hobbies, relationships, and attend meaningful social events while also reducing their engagement in healthy behaviors such as exercise, optimal nutrition, and attending medical appointments. Within each of these domains, they identified and described stress mitigation strategies at the individual, departmental, and national levels. CONCLUSION The RSA is a novel tool that can identify national trends in burnout drivers while simultaneously providing tailored prevention strategies for residents and their training sites.
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Affiliation(s)
| | - Laura Zebib
- Department of Urology, University of Michigan, Ann Arbor, MI, USA
| | - Blake F Webb
- VHA National Center for Patient Safety, Ann Arbor, MI, USA
| | - Tandi Bagian
- VHA National Center for Patient Safety, Ann Arbor, MI, USA
| | - Timothy Arnold
- Human Factors Engineering Division, Clinical Informatics and Data Management, Office of Health Informatics, Veterans Health Administration, Washington, DC, USA
- College of Pharmacy, University of Michigan, Ann Arbor, MI, USA
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Mohammed HE, Bady Z, Abdelhamid ZG, Elawfi B, AboElfarh HE, Elboraay T, Abdel-Salam DM. Factors influencing stress and resilience among Egyptian medical students: a multi-centric cross-sectional study. BMC Psychiatry 2024; 24:393. [PMID: 38783215 PMCID: PMC11112873 DOI: 10.1186/s12888-024-05820-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/15/2024] [Accepted: 05/07/2024] [Indexed: 05/25/2024] Open
Abstract
BACKGROUND Psychological stress is a common psychological comorbidity among medical students and worsens their quality of life. Psychological resilience is thought to have a protective role against stress. However, evidence regarding the prevalence of stress and resilience alongside their associated factors is scarce, especially in the Middle East. This is the first multicenter, cross-sectional study to investigate resilience and stress among Egyptian medical students. METHODS The current cross-sectional study was conducted on 2465 university students in seven public universities in Egypt. The universities were selected using the simple randomization method. The data was collected using a self-administered questionnaire consisting of four parts: demographic data, socioeconomic tool represented in the Family Affluence Scale (FAS), the Kessler Psychological Distress Scale (K10), and the Brief Resilience Scale (BRS). Data was analyzed in SPSS version 26 software. RESULTS The majority of the students were stressed (86.5%), most of whom had severe stress (48.9%). Most of the students had low resilience (49.9%), while only 3.2% had high resilience. In the logistic regression analysis, being a female, living alone, spending long hours on social media, and thinking of suicide or leaving medicine were associated with being stressed and having low resilience. Medical students with low resilience were significantly more liable to stress [Adjusted odds ratio (AOR) = 3.667, confidence interval (CI): 2.709-4.965, P = 0.000], and vice versa [AOR = 3.709, CI: 2.746-5.009, P = 0.000]. Interestingly, high socioeconomic status showed a significant association with high resilience (P = 0.004); nonetheless, it was not associated with stress (P = 0.993). Academic grades were not associated with both the level of stress and resilience. Aging, being in clinical or academic stages, smoking, having a chronic disease, and being financially-supported are neither associated with stress nor resilience. CONCLUSIONS The present study revealed that Egyptian medical students had low resilience and high stress, with a significant relationship between both of them. Further investigations via longitudinal study design to understand the resilience-stress relationship are recommended. Developing and implementing resilience-improving strategies in medical schools is highly recommended to decrease the prevalence of stress and its subsequent burdens.
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Affiliation(s)
| | - Zeyad Bady
- Faculty of Medicine, Assiut university, Assiut, Egypt
| | - Zeinab G Abdelhamid
- Department of Public Health and Community Medicine, Faculty of Medicine, Assiut University, Assiut, Egypt
| | - Bashaer Elawfi
- Faculty of Medicine, Sana'a University, Sana'a, Yemen
- Medical research group of Egypt (MRGE), Cairo, Egypt
| | - Hadeer Elsaeed AboElfarh
- Neurology Department, Faculty of Medicine, Mansoura University, Mansoura, Egypt
- Medical research group of Egypt (MRGE), Cairo, Egypt
| | - Toka Elboraay
- Faculty of Medicine, Zagazig University, Elsharqia, Egypt
- Medical research group of Egypt (MRGE), Cairo, Egypt
| | - Doaa Mazen Abdel-Salam
- Department of Public Health and Community Medicine, Faculty of Medicine, Assiut University, Assiut, Egypt.
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Robbins-Welty G, Nakatani M, Song YK, Riordan P, Pieper C, Price M, Scoggins C, Galanos A. Psychiatry Resident Physicians Experience Personal and Professional Grief, Burnout and Depression: Results From a National Survey. Am J Hosp Palliat Care 2024:10499091241256106. [PMID: 38769771 DOI: 10.1177/10499091241256106] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/22/2024] Open
Abstract
BACKGROUND Resident physicians experience personal and professional stressors throughout training. These experiences may increase levels of burnout, depression, and grief. Understanding how these stressors impact trainees is essential for improving wellbeing during residency. OBJECTIVE We examined the prevalence and associations between burnout, depression, and grief among a national sample of psychiatry resident physicians. METHODS A survey including validated scales for burnout (Modified Maslach Burnout Inventory-Health Services Survey [MBI]), depression (Patient Health Questionnaire-9 [PHQ-9]), and grief (Traumatic Grief Inventory Self Report [TGSIR]) was distributed to 296 psychiatry program directors in January 2023 for dispersal to their respective residents. RESULTS Fifty-seven participants completed the survey out of 245 participants who opened and started the survey (23.3%). All participants were current psychiatry residents. MBI scores averaged 21.2 (SD 6.5, range 11-40); 11 participants reported high levels of burnout (scores >27; 19.3%). PHQ-9 scores averaged 3.42 (SD 3.0, range 0-14), with 8 responses meeting the criteria for moderate depressive symptoms (scores >10-14; 14.0%). Suicidal ideation was reported by 5 of 57 participants (8.7%). TGISR scores averaged 12.2 (SD 11, range 0-43); no participants met the criteria for pathologic grief. TGISR scores were correlated with MBI (r = .30; P = .02) and PHQ-9 scores (r = .53; P < .0001). MBI scores were also correlated with PHQ-9 scores (r = .54; P < .0001). CONCLUSIONS Non-pathological grief was correlated with burnout and depression. 14% to 20% of psychiatry residents reported clinically significant levels of burnout and depression. Future studies should aim to further characterize burnout, depression, and grief in larger samples of trainees.
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Affiliation(s)
| | | | | | | | - Carl Pieper
- Duke University Medical Center, Durham, NC, USA
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Nohales L, Fort E, Pelloux S, Coste C, Leblanc P, De Ternay J, Wallon M, Rolland B, Fassier JB. Occupational, academic, and personal determinants of wellbeing and psychological distress in residents: results of a survey in Lyon, France. Front Psychol 2024; 15:1347513. [PMID: 38770261 PMCID: PMC11103015 DOI: 10.3389/fpsyg.2024.1347513] [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: 11/30/2023] [Accepted: 04/11/2024] [Indexed: 05/22/2024] Open
Abstract
Introduction The mental health of residents is a growing significant concern, particularly with respect to hospital and university training conditions. Our goal was to assess the professional, academic, and psychological determinants of the mental health status of all residents of the academy of Lyon, France. Materials and methods The Health Barometer of Lyon Subdivision Residents (BASIL) is an initiative which consists in proposing a recurrent online survey to all residents in medicine, pharmacy, and dentistry, belonging to the Lyon subdivision. The first of these surveys was conducted from May to July 2022. Participants should complete a series of validated questionnaires, including the Warwick-Edinburgh Mental Wellbeing Scale (WEMWBS), and the Kessler Psychological Distress Scale (K6), respectively, and ad-hoc questions assessing their global health and hospital and academic working conditions. A Directed Acyclic Graph (DAG) analysis was conducted prior to multivariable analyses, to explore the determinants associated with low wellbeing (WEMWBS <43) and high psychological distress (K6 ≥ 13). Results A total of 904 residents (response rate: 46.7%) participated in the survey. A low level of wellbeing was observed in 23% of participants, and was significantly associated to job strain (OR = 2.18; 95%CI = [1.32-3.60]), low social support (OR = 3.13; 95%CI = [2.05-4.78]) and the experience of very poor university teaching (OR = 2.51; 95%CI = [1.29-4.91]). A high level of psychological distress was identified for 13% of participants, and associated with low social support (OR = 2.41; 95%CI = [1.48-3.93]) and the experience of very poor university teaching (OR = 2.89, 95%CI = [1.16-7.21]). Conclusion Hospital working conditions, social support, and the perception of teaching quality, were three major determinants of wellbeing and psychological distress among health profession residents. Demographic determinants, personal life and lifestyle habits were also associated. This supports a multilevel action in prevention programs aiming to enhance wellbeing and reduce mental distress in this specific population and local organizational specificities.
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Affiliation(s)
- Ludivine Nohales
- Occupational Health and Medicine Department-CRPPE Hospices Civils de Lyon, Lyon, France
- Univ Lyon, University Lyon 1 Transport Work and Environmental Epidemiology Research and Surveillance Unit – UMRESTTE (UMR T9405), Lyon, France
| | - Emmanuel Fort
- Univ Lyon, University Lyon 1 Transport Work and Environmental Epidemiology Research and Surveillance Unit – UMRESTTE (UMR T9405), Lyon, France
| | - Sophie Pelloux
- Service de Santé Universitaire, University Claude Bernard Lyon, Lyon, France
| | - Clio Coste
- University Claude Bernard Lyon 1, Lyon, France
- Department of Radiotherapy, Léon Bérard Cancer Center, Lyon, France
| | - Pierre Leblanc
- Direction Qualité Usagers et Santé Populationnelle, Hospices Civils de Lyon, Lyon, France
- Research On Healthcare Performance (RESHAPE), Université Claude Bernard Lyon INSERM U1290, Lyon, France
| | - Julia De Ternay
- Research On Healthcare Performance (RESHAPE), Université Claude Bernard Lyon INSERM U1290, Lyon, France
- SUAL, Hospices Civils de Lyon, Bron, France
| | - Martine Wallon
- Institut des Agents Infectieux, Hospices Civils de Lyon, Lyon, France
- Waking Team, CRNL University Claude Bernard Lyon, Bron, France
| | - Benjamin Rolland
- SUAL Le Vinatier, Hospices Civils de Lyon, Bron, France
- Inserm U1028, CNRS UMR5292, University Claude Bernard Lyon 1, Bron, France
| | - Jean-Baptiste Fassier
- Occupational Health and Medicine Department-CRPPE Hospices Civils de Lyon, Lyon, France
- Univ Lyon, University Lyon 1 Transport Work and Environmental Epidemiology Research and Surveillance Unit – UMRESTTE (UMR T9405), Lyon, France
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Zhang M, Gulati A, Páez-Carpio A, Zaki-Metias KM, Cledera T. How to Succeed as a Radiology Fellow. Radiographics 2024; 44:e240003. [PMID: 38602865 DOI: 10.1148/rg.240003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/13/2024]
Affiliation(s)
- Meng Zhang
- From the Department of Radiology and Imaging Sciences, Emory University School of Medicine, 1365 Clifton Rd NE, Bldg C, Atlanta, GA 30322 (M.Z.); Department of Radiology, Thomas Jefferson University Hospital, Philadelphia, Pa (A.G.); Department of Radiology, CDI, Hospital Clínic Barcelona, Barcelona, Spain (A.P.C.); Department of Medical Imaging, University of Toronto, Toronto, Ontario, Canada (A.P.C.); Trinity Health Oakland Hospital/ Wayne State University School of Medicine, Pontiac, Mich (K.M.Z.M.); and Institute of Radiology, St. Luke's Medical Center Global City, Taguig, Philippines (T.C.)
| | - Aishwarya Gulati
- From the Department of Radiology and Imaging Sciences, Emory University School of Medicine, 1365 Clifton Rd NE, Bldg C, Atlanta, GA 30322 (M.Z.); Department of Radiology, Thomas Jefferson University Hospital, Philadelphia, Pa (A.G.); Department of Radiology, CDI, Hospital Clínic Barcelona, Barcelona, Spain (A.P.C.); Department of Medical Imaging, University of Toronto, Toronto, Ontario, Canada (A.P.C.); Trinity Health Oakland Hospital/ Wayne State University School of Medicine, Pontiac, Mich (K.M.Z.M.); and Institute of Radiology, St. Luke's Medical Center Global City, Taguig, Philippines (T.C.)
| | - Alfredo Páez-Carpio
- From the Department of Radiology and Imaging Sciences, Emory University School of Medicine, 1365 Clifton Rd NE, Bldg C, Atlanta, GA 30322 (M.Z.); Department of Radiology, Thomas Jefferson University Hospital, Philadelphia, Pa (A.G.); Department of Radiology, CDI, Hospital Clínic Barcelona, Barcelona, Spain (A.P.C.); Department of Medical Imaging, University of Toronto, Toronto, Ontario, Canada (A.P.C.); Trinity Health Oakland Hospital/ Wayne State University School of Medicine, Pontiac, Mich (K.M.Z.M.); and Institute of Radiology, St. Luke's Medical Center Global City, Taguig, Philippines (T.C.)
| | - Kaitlin M Zaki-Metias
- From the Department of Radiology and Imaging Sciences, Emory University School of Medicine, 1365 Clifton Rd NE, Bldg C, Atlanta, GA 30322 (M.Z.); Department of Radiology, Thomas Jefferson University Hospital, Philadelphia, Pa (A.G.); Department of Radiology, CDI, Hospital Clínic Barcelona, Barcelona, Spain (A.P.C.); Department of Medical Imaging, University of Toronto, Toronto, Ontario, Canada (A.P.C.); Trinity Health Oakland Hospital/ Wayne State University School of Medicine, Pontiac, Mich (K.M.Z.M.); and Institute of Radiology, St. Luke's Medical Center Global City, Taguig, Philippines (T.C.)
| | - Thurl Cledera
- From the Department of Radiology and Imaging Sciences, Emory University School of Medicine, 1365 Clifton Rd NE, Bldg C, Atlanta, GA 30322 (M.Z.); Department of Radiology, Thomas Jefferson University Hospital, Philadelphia, Pa (A.G.); Department of Radiology, CDI, Hospital Clínic Barcelona, Barcelona, Spain (A.P.C.); Department of Medical Imaging, University of Toronto, Toronto, Ontario, Canada (A.P.C.); Trinity Health Oakland Hospital/ Wayne State University School of Medicine, Pontiac, Mich (K.M.Z.M.); and Institute of Radiology, St. Luke's Medical Center Global City, Taguig, Philippines (T.C.)
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Ibraheim MK, Elsensohn A, Kraus C, Dao H, Luke J, Leigh R, Anderson N, Chow C. Satisfaction guaranteed? A need for evidence-based practices pertaining to patient reviews. Int J Dermatol 2024. [PMID: 38634623 DOI: 10.1111/ijd.17193] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/28/2024] [Accepted: 04/04/2024] [Indexed: 04/19/2024]
Affiliation(s)
| | - Ashley Elsensohn
- Department of Dermatology, Loma Linda University, Loma Linda, CA, USA
- Department of Pathology, Loma Linda University, Loma Linda, CA, USA
| | - Christina Kraus
- Department of Dermatology, University of California, Irvine, Irvine, CA, USA
| | - Harry Dao
- Department of Dermatology, Loma Linda University, Loma Linda, CA, USA
| | - Janiene Luke
- Department of Dermatology, Loma Linda University, Loma Linda, CA, USA
| | - Rebekah Leigh
- Loma Linda University School of Medicine, Loma Linda, CA, USA
| | - Nancy Anderson
- Department of Dermatology, Loma Linda University, Loma Linda, CA, USA
| | - Conroy Chow
- Department of Dermatology, Loma Linda University, Loma Linda, CA, USA
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Alwatban L, Alageel MS, Alshehri LA, Alfehaid NS, Albahlal RA, Almazrou NH, Almubarak R. The Stigma of Burnout Impeding Formal Help: A Qualitative Study Exploring Residents' Experiences During Training. ADVANCES IN MEDICAL EDUCATION AND PRACTICE 2024; 15:333-342. [PMID: 38646001 PMCID: PMC11032676 DOI: 10.2147/amep.s453564] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/06/2023] [Accepted: 04/02/2024] [Indexed: 04/23/2024]
Abstract
Purpose Burnout is an occupational stress syndrome that gives rise to emotional exhaustion (EE) depersonalization (DP) and reduced personal accomplishment (PA). Increasing rates of burnout among health care professionals has been reported globally. Saudi Arabia appears to be among the highest in prevalence with reports of higher than 70%. Medical residents in training are the highest group at risk. The literature has repeatedly linked burnout among residents with poor academic performance on training exams, impaired quality of life, career choice regret and intentions to abandon medicine. In this study, we explore the factors that contribute to resident burnout, their experiences with burnout and how they choose to mitigate it. Methods A qualitative design was used to conduct this study in the city of Riyadh, Saudi Arabia. A total of 14 residents from surgical and non-surgical programs were interviewed through in-depth interviews. Interpretive thematic analysis was used in coding and generated coding templates. Categories were repetitively reviewed and revised, expanding to include new data as it emerged and collapsing to remove redundant codes. Categories were organized into the final themes and sub-themes. Results All participants demonstrated a shared thread of shame in reaching the level of burnout. Three main interlinked themes were identified: Burnout stigma cycle, amalgamated causes of burnout and self-coping with burnout. One of the concerning findings in our study is the participants' pursuit of self-coping strategies and the avoidance of formal help, creating a cycle of suffering in silence. Conclusion The literature has repeatedly reported high levels of burnout among residents in training. This study has added another dimension to those findings through the exploration of residents actual accounts and appears to link burnout with suboptimal training and working conditions. We have highlighted the pivotal role stigma and shame play in completely preventing residents from seeking professional help.
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Affiliation(s)
- Lemmese Alwatban
- Department of Family and Community Medicine, College of Medicine, King Saud University, Riyadh, Saudi Arabia
- University Family Medicine Center, King Saud University Medical City, King Saud University, Riyadh, Saudi Arabia
| | - Mai S Alageel
- Department of Family Medicine, King Fahad Medical City, Riyadh, Saudi Arabia
| | - Lina A Alshehri
- Department of Neurosurgery, Prince Sultan Military Medical City, Riyadh, Saudi Arabia
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Oftung B, Tyssen R. Occupational stress among Norwegian physicians: A literature review of long-term prospective studies 2007-2019. Scand J Public Health 2024:14034948241243164. [PMID: 38600437 DOI: 10.1177/14034948241243164] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/12/2024]
Abstract
AIMS There are signs of increased stress at work among Norwegian physicians over the last decades, not least among general practitioners (GPs). In this review, we identify trends in both occupational stress and adverse work-related predictors of such stress and burnout in Norwegian physicians. METHODS We performed an extensive literature search using MEDLINE, Embase and PsycINFO. We included prospective and repeated cross-sectional studies of work stress among Norwegian physicians published in 2007-2019. RESULTS Nine studies with observation periods of 1-20 years were included. Occupational stress (global measure) among all doctors decreased gradually from medical school to 20 years later. The prevalence of an effort-reward imbalance increased fourfold among GPs during the period 2010-2019. Five studies reported higher levels of occupational stress among female physicians than among their male colleagues. Work-home conflict levels increased after graduation until 10 years after leaving medical school and plateaued thereafter. Physicians who graduated in a later cohort reported lower levels of work-home conflict and less workplace violence. Work-home conflict, low colleague support, number of work hours and workload/low autonomy were all independent predictors of occupational stress. CONCLUSIONS The reduction in occupational stress during the years after leaving medical school may result from increased competency in clinical work and decreased on-call work. The Co-ordination Act implemented in 2012 may explain the increase in occupational stress among GPs. These findings suggest that both reducing work-home conflict and increasing colleague support are important for doctors' well-being.
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Affiliation(s)
- Bendik Oftung
- Department of Behavioural Medicine, Institute of Basic Medical Sciences, Faculty of Medicine, University of Oslo, Norway
| | - Reidar Tyssen
- Department of Behavioural Medicine, Institute of Basic Medical Sciences, Faculty of Medicine, University of Oslo, Norway
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Almarzouki AF. Impact of on-call shifts on working memory and the role of burnout, sleep, and mental well-being in trainee physicians. Postgrad Med 2024; 136:312-317. [PMID: 38656827 DOI: 10.1080/00325481.2024.2347195] [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: 02/13/2024] [Accepted: 04/22/2024] [Indexed: 04/26/2024]
Abstract
BACKGROUND Optimal cognitive functions, including working memory (WM), are crucial to enable trainee physicians to perform and excel in their clinical practice. Several risk factors, including on-call shifts, poor mental health, burnout, and sleep problems, can impair clinical practice in trainee physicians, potentially through cognitive impairment; however, these associations have not been fully explored. OBJECTIVE This study investigated the effect of on-call shifts on WM among trainee physicians and its association with burnout, depression, anxiety, affect, and sleep. MATERIALS AND METHODS This cross-sectional study involved 83 trainee physicians (45% male). We measured demographic and training-related factors including on-call shifts and working hours. We also assessed depressive symptoms (PHQ-9), both state and trait anxiety (STAI total score), burnout (OLBI total score), positive and negative affect scores (PANAS), and sleep disturbances (PSQI total score). WM was evaluated using spatial working memory (SWM) strategy scores that reflected performance and total error counts. RESULTS Trainee physicians with more on-calls per month had significantly worse depressive symptoms, burnout scores, and sleep, as well as more negative affect. While controlling for covariates, being on-call more times per month was significantly associated with worse WM. Worse depressive symptoms and burnout scores were also significantly associated with impaired WM. CONCLUSION Working more on-call shifts is associated with compromised WM. Trainee physicians who experienced more depressive symptoms and burnout had worse WM.
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Affiliation(s)
- Abeer F Almarzouki
- Department of Clinical Physiology, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia
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Batheja A, Lalwani N. A National Survey Evaluating Burnout and Wellness During Radiology Residency. Acad Radiol 2024:S1076-6332(24)00137-5. [PMID: 38508933 DOI: 10.1016/j.acra.2024.02.046] [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: 12/23/2023] [Revised: 02/16/2024] [Accepted: 02/26/2024] [Indexed: 03/22/2024]
Abstract
RATIONALE AND OBJECTIVES Burnout is a serious problem during medical residency and can contribute to poorer resident and patient health. A thorough understanding of factors associated with burnout can provide insight into supporting resident well-being. The purpose of this study is to assess the prevalence of burnout and ascertain its associated factors among radiology residents in the U.S. MATERIALS AND METHODS This cross-sectional study involved sending an anonymous survey to radiology program directors, coordinators, and residents across the U.S. Data regarding demographics, burnout levels, and burnout-associated factors were collected in the month of August 2023. Multivariable linear regression models evaluated the association of demographic and burnout-associated variables with burnout scores in the dimensions of Emotional Exhaustion, Depersonalization, and Personal Accomplishment. Chi-square analyses with Bonferroni correction and Kruskal-Wallis analyses were used to assess associations between program types and burnout as well as between program type and program effectiveness in managing burnout. Resident suggestions on addressing burnout were qualitatively assessed. RESULTS 147 radiology residents responded to the survey. Emotional Exhaustion was positively associated with seeking social support (p = .03) and negatively associated with perceived program effectiveness in addressing burnout (p < .001). Respondents who identified as male experienced greater Depersonalization (p = .02). Increased frequency of physical activity was associated with higher Personal Accomplishment scores (p = .04). The most common resident suggestions related to Work Burden, Program Support, and Protected Wellness Time. CONCLUSION Radiology programs should consider designing interventions addressing burnout, such as enhancing avenues for feedback and tailoring resident training based on individual preferences for remote work. Understanding the unique challenges faced by radiology residents is essential to tackle burnout and improve wellness.
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Affiliation(s)
- Aashish Batheja
- Department of Radiology, Virginia Commonwealth University School of Medicine, 1200 East Broad Street, Box 980470, Richmond, Virginia 23298, USA
| | - Neeraj Lalwani
- Department of Radiology, Virginia Commonwealth University School of Medicine, 1200 East Broad Street, Box 980470, Richmond, Virginia 23298, USA.
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Böckelmann I, Zavgorodnii I, Litovchenko O, Kapustnyk V, Krasnoselskyi M, Thielmann B. Personal resources for addressing the work demands of Ukrainian oncologists in stressful crisis situations. BMC Public Health 2024; 24:792. [PMID: 38481162 PMCID: PMC10938727 DOI: 10.1186/s12889-024-18315-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2023] [Accepted: 03/08/2024] [Indexed: 03/17/2024] Open
Abstract
BACKGROUND Many work-related stresses are experienced by oncologists. Ukraine is currently undergoing numerous crises, including the SARS-CoV-2 pandemic and military conflicts, which represent stressful situations. The aim of this study was to explore the personal resources that Ukrainian oncologists use to cope with work demands in a situation featuring manifold crises. This study identified the ways in which people deal with stressful situations and the roles that they play in shaping the challenging situations that they encounter (work-related behavior) as well as how they cope with stress (stress management). METHODS Forty oncologists (18 men and 22 women) working in a clinic in Kharkiv (Ukraine) with an average age of 46.3 ± 13.37 years (ranging from 26 to 74 years) participated in this study. The occupational psychological survey consisted of the Work-Related Behavior and Experience Patterns (German: Arbeitsbezogenes Verhaltens- und Erlebensmuster, AVEM) questionnaire, which was developed by Schaarschmidt and Fischer, and the Differential Stress Inventory (DSI), which was developed by Léfevre and Kubinger. RESULTS 65% of oncologists exhibited AVEM risk pattern A or B. No gender differences were observed with regard to the distribution of AVEM patterns. Women obtained significantly higher scores than did men on only one dimension: experience of social support (4.86 vs. 3.44; p = 0.045). When the DSI categories were differentiated by gender, no significant differences were observed. Spearman's correlation analysis revealed a medium-sized correlation between perfection striving and palliative coping (ρ = 0.404). CONCLUSIONS Few gender-based differences in work-related behaviors, experiences, and stress management strategies are evident among oncologists. AVEM risk patterns are more prevalent among Ukrainian oncologists than among comparable occupational groups, and interventions in the context of health management are recommended.
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Affiliation(s)
- I Böckelmann
- Institute of Occupational Medicine, Faculty of Medicine, Otto von Guericke University Magdeburg, Leipziger Str. 44, 39120, Magdeburg, Germany
| | - I Zavgorodnii
- Department of Hygiene and Ecology № 2, Kharkiv National Medical University, Kharkiv, Ukraine
| | - O Litovchenko
- Department of Hygiene and Ecology № 2, Kharkiv National Medical University, Kharkiv, Ukraine
| | - V Kapustnyk
- Department of Internal and Occupational Diseases, Kharkiv National Medical University, Kharkiv, Ukraine
| | - M Krasnoselskyi
- Grigoryev Institute of Medical Radiology and Oncology, National Academy of Medical Sciences of Ukraine, Kharkiv, Ukraine
| | - Beatrice Thielmann
- Institute of Occupational Medicine, Faculty of Medicine, Otto von Guericke University Magdeburg, Leipziger Str. 44, 39120, Magdeburg, Germany.
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13
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Lin YK, Lin CD, Lin BYJ. Junior doctors' workplace well-being and the determinants based on ability-motivation-opportunity (AMO) theory: Educational and managerial implications from a three-year longitudinal observation after graduation. MEDICAL TEACHER 2024:1-16. [PMID: 38460181 DOI: 10.1080/0142159x.2024.2322719] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/18/2023] [Accepted: 02/20/2024] [Indexed: 03/11/2024]
Abstract
PURPOSE Junior doctors function as trainees from an educational perspective and as employees from a human resource management perspective. Employing the ability-motivation-opportunity (AMO) theory as a conceptual framework, this study longitudinally investigated the factors affecting the workplace well-being and career progression of junior doctors over a 3-year period following their graduation from medical schools. MATERIALS AND METHODS This 3-year prospective cohort study enrolled junior doctors who graduated from 2 medical schools in June 2019 in Taiwan. This study collected data by implementing web-based, self-administered structured questionnaires at 3-month intervals between September 2019 and July 2022. The collected data encompassed ability indicators (i.e. academic performance and perceived preparedness for clinical practice), motivation indicators (i.e. educational and clinical supervision), opportunity indicators (i.e. clinical unit cultures), and workplace well-being indicators (i.e. burnout, compassion satisfaction, and job performance). A total of 107 junior doctors participated, providing 926 total responses. The data were analysed using univariate analyses and structural equation modelling with path analysis. RESULTS Over the 3-year period following graduation, the junior doctors' confidence in their preparedness for clinical practice and the educational and clinical supervision had varying degrees of influence on the junior doctors' workplace well-being. The influence of clinical unit cultures, which can provide opportunities for junior doctors, became evident starting from the second year postgraduation; notably, unit cultures that emphasised flexibility and discretion played positive and critical roles in enhancing the junior doctors' workplace well-being lasted to the third year. CONCLUSIONS Our findings provide insights into the distinct critical factors that affect the socialisation of junior doctors within workplace environments over 3 consecutive years. These findings can provide guidance for medical educators and healthcare managers, helping them understand and support the progressive integration of junior doctors into their work environments.
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Affiliation(s)
- Yung Kai Lin
- Department of Surgery, Jen-Ai Hospital, Taichung, Taiwan, ROC
| | - Chia-Der Lin
- Department of Otorhinolaryngology Head & Neck Surgery, China Medical University Hospital, Taichung, Taiwan, ROC
- School of Medicine, China Medical University, Taichung, Taiwan, ROC
| | - Blossom Yen-Ju Lin
- Department of Medical Humanities and Social Sciences, School of Medicine, Chang Gung University, Taoyuan, Taiwan, ROC
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14
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Edmonds DM, Zayts-Spence O, Fortune Z, Chan A, Chou JSG. A scoping review to map the research on the mental health of students and graduates during their university-to-work transitions. BMJ Open 2024; 14:e076729. [PMID: 38443080 PMCID: PMC11146370 DOI: 10.1136/bmjopen-2023-076729] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/15/2023] [Accepted: 01/02/2024] [Indexed: 03/07/2024] Open
Abstract
OBJECTIVES This scoping review maps the extant literature on students' and graduates' mental health experiences throughout their university-to-work transitions. The current review investigates the methodological features of the studies, the main findings, and the theories that the studies draw on to conceptualise mental health and transitions. DESIGN This project used a scoping review methodology created and developed by Peters and colleagues and the Joanna Briggs Institute. The review searched academic databases and screened existing studies that met predetermined inclusion criteria. DATA SOURCES Seven academic databases and Google Scholar were searched with sets of search terms. ELIGIBILITY The included studies examined participants who were final-year university students or those who had graduated from university within a 3-year period. Studies published in English since 2000 and from any country were included. The review included studies examining the negative dimensions of mental health. The review excluded studies focusing on medical students and graduates. DATA EXTRACTION Basic information about the studies and their findings on mental health and university-to-work transitions was retrieved. The findings are presented in tables and in a qualitative thematic summary. RESULTS The scoping review included 12 studies. Mental health was often not explicitly defined and it's theoretical foundations were not clearly articulated. The review identified factors, including a lack of social support and economic precarity, as sources of adverse mental health. Other protective factors in these studies-variables that guard against mental health problems-were identified, such as career preparedness and having a good job. CONCLUSIONS Despite the methodological focus on the negative aspects of mental health, people's mental health experiences during university-to-work transitions are not uniformly negative. Clear conceptualisations of mental health in future studies will aid in developing resources to improve well-being. TRIAL REGISTRATION NUMBER This scoping review adhered to a protocol previously published in this journal and that is registered on the Open Science Framework website (https://osf.io/gw86x).
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Affiliation(s)
| | | | - Zoë Fortune
- School of English, The University of Hong Kong, Hong Kong, China
- School of Social Sciences, Heriot-Watt University Dubai, Dubai, UAE
| | - Angus Chan
- School of English, The University of Hong Kong, Hong Kong, China
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15
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Colin-Chevalier R, Dutheil F, Benson AC, Dewavrin S, Cornet T, Lambert C, Pereira B. Stress and job satisfaction over time, the influence of the managerial position: A bivariate longitudinal modelling of Wittyfit data. PLoS One 2024; 19:e0298126. [PMID: 38437204 PMCID: PMC10911592 DOI: 10.1371/journal.pone.0298126] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2023] [Accepted: 01/19/2024] [Indexed: 03/06/2024] Open
Abstract
BACKGROUND The managerial position affects stress and job satisfaction of workers, but these influences have always been studied separately. OBJECTIVE We aimed to assess bivariate influence of the managerial position on workers' stress and job satisfaction and the inter-relationship of these indicators over time. METHODS We have analyzed data from workers who use the Wittyfit software, collected annually between 2018 and 2021. Stress and job satisfaction were evaluated by self-report questionnaires. Job position (manager or employee) was provided by the software's client companies. RESULTS Data of 704 workers were included in the study. Cross-sectional and longitudinal multivariate analyses revealed that managerial position improves job satisfaction (p<0.001), but not stress (p = 0.4). Overall, while workers' job satisfaction has improved (p<0.001), stress has remained stable over time (p = 0.3). Three latent groups, with specific evolutionary multi-trajectory of stress and job satisfaction were identified in the sample (entropy = 0.80). Age and seniority, but not gender tended to influence managers' and employees' indicators. Over time, stress and job satisfaction have tended to negatively interconnect, in cross-section and in a cross-lagged manner (p<0.001). CONCLUSIONS The managerial position improves workers' job satisfaction but has no effect on stress. Sociodemographics including age and seniority, but not gender, can affect this relationship. Stress and job satisfaction can influence each other, both cross-sectionally and over time. To be more effective, organizations should implement holistic strategies targeting multiple indicators. TRIAL REGISTRATION Clinicaltrials.gov: NCT02596737.
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Affiliation(s)
- Rémi Colin-Chevalier
- Université Clermont Auvergne, CNRS, LaPSCo, CHU Clermont-Ferrand, Cegid, Clermont-Ferrand, France
| | - Frédéric Dutheil
- Université Clermont Auvergne, CNRS, LaPSCo, CHU Clermont-Ferrand, Cegid, Clermont-Ferrand, France
| | - Amanda Clare Benson
- Sport Innovation Research Group, Department of Health and Biostatistics, Swinburne University of Technology, Hawthorn, Victoria, Australia
| | | | | | - Céline Lambert
- Biostatistics Unit, DRCI, CHU Clermont-Ferrand, Clermont-Ferrand, France
| | - Bruno Pereira
- Biostatistics Unit, DRCI, CHU Clermont-Ferrand, Clermont-Ferrand, France
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Doe S, Coutinho A, Weidner A, Cheng Y, Sanders K, Bazemore AW, Phillips, Jr RL, Peterson LE. Prevalence and Predictors of Burnout Among Resident Family Physicians. Fam Med 2024; 56:148-155. [PMID: 38241747 PMCID: PMC11136626 DOI: 10.22454/fammed.2024.875388] [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] [Indexed: 01/21/2024]
Abstract
BACKGROUND AND OBJECTIVES Resident burnout may affect career choices and empathy. We examined predictors of burnout among family medicine residents. METHODS We used data from the 2019-2021 American Board of Family Medicine Initial Certification Questionnaire, which is required of graduating residents. Burnout was a binary variable defined as reporting callousness or emotional exhaustion once a week or more. We evaluated associations using bivariate and multilevel multivariable regression analyses. RESULTS Among 11,570 residents, 36.4% (n=4,211) reported burnout. This prevalence did not significantly vary from 2019 to 2021 and was not significantly attributable to the residency program (ICC=0.07). Residents identifying as female reported higher rates of burnout (39.0% vs 33.4%, AOR=1.29 [95% CI 1.19-1.40]). Residents reporting Asian race (30.5%, AOR=0.78 [95% CI 0.70-0.86]) and Black race (32.3%, AOR=0.71 [95% CI 0.60-0.86]) reported lower odds of burnout than residents reporting White race (39.2%). We observed lower rates among international medical graduates (26.7% vs 40.3%, AOR=0.54 [95% CI 0.48-0.60]), those planning to provide outpatient continuity care (36.0% vs 38.7%, AOR=0.77 [95% CI 0.68-0.86]), and those at smaller programs (31.7% for <6 residents per class vs 36.3% for 6-10 per class vs 40.2% for >10 per class). Educational debt greater than $250,000 was associated with higher odds of burnout than no debt (AOR=1.29 [95% CI 1.15-1.45]). CONCLUSIONS More than one-third of recent family medicine residents reported burnout. Odds of burnout varied significantly with resident and program characteristics.
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Affiliation(s)
- Sydney Doe
- Northwestern McGaw Family Medicine Residency Program at Humboldt ParkChicago, IL
| | | | - Amanda Weidner
- University of WashingtonSeattle, WA
- Association of Departments of Family MedicineLeawood, KS
| | - Yue Cheng
- Department of Pharmacy Practice and Science, College of Pharmacy, University of KentuckyLexington, KY
| | - Kaplan Sanders
- Department of Finance, Utah Tech UniversitySt George, UT
| | - Andrew W. Bazemore
- Center for Professionalism and Value in Health CareWashington, DC
- American Board of Family MedicineLexington, KY
| | - Robert L. Phillips, Jr
- Center for Professionalism and Value in Health CareWashington, DC
- American Board of Family MedicineLexington, KY
| | - Lars E. Peterson
- American Board of Family MedicineLexington, KY
- Department of Family and Community Medicine, University of KentuckyLexington, KY
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Gupta A. Commentary on "Hidden". ACADEMIC MEDICINE : JOURNAL OF THE ASSOCIATION OF AMERICAN MEDICAL COLLEGES 2024; 99:161. [PMID: 38294424 DOI: 10.1097/01.acm.0001006612.70402.96] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/01/2024]
Affiliation(s)
- Anjali Gupta
- A. Gupta is adjunct assistant professor, Department of Psychiatry, Georgetown University School of Medicine, Washington, DC; ; Twitter: @AnjaliMGupta14
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Benson J, Prentice S, Need P, Pitot M, Elliott T. 'A sense of self, empowerment and purposefulness': professional diversification and wellbeing in Australian general practitioners. Aust J Prim Health 2024; 30:NULL. [PMID: 37939485 DOI: 10.1071/py23090] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2023] [Accepted: 10/10/2023] [Indexed: 11/10/2023]
Abstract
BACKGROUND Burnout and workforce shortages comprise a vicious cycle in medicine, particularly for Australian general practitioners (GPs). Professional diversification, whereby individuals work multiple roles across their week, may help address this problem, but this strategy is under-studied. METHODS We surveyed 1157 Australian GPs using qualitative and quantitative questions examining professional diversification, values, autonomy, and wellbeing. Quantitative data were analysed using inferential statistics, whilst qualitative data were analysed using inductive thematic analysis. We triangulated the data by using the qualitative findings to inform further quantitative testing. RESULTS Approximately 40% of the sample had diversified. Although diversifying was not significantly associated with wellbeing, the qualitative data indicated that diversification supported GPs' wellbeing by enhancing career sustainability, accomplished through various pathways (e.g. value fulfilment, autonomy, variety). Subsequent quantitative analyses provided evidence that these pathways mediated the relationship between diversification and wellbeing. To diversify, GPs needed particular personal qualities, external supports, flexibility, and serendipity. Barriers to diversifying mirrored these factors, spanning individual (e.g. skillset) and situational levels (e.g. autonomy, location). CONCLUSIONS Diversification can support GPs' wellbeing if it meets their needs. Organisations should focus on publicising opportunities and accommodating requests to diversify.
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Affiliation(s)
- Jill Benson
- The University of Adelaide, Adelaide, SA, Australia; and The Royal Australian College of General Practitioners, East Melbourne, Vic., Australia
| | - Shaun Prentice
- The University of Adelaide, Adelaide, SA, Australia; and General Practice Training Research Department, Royal Australian College of General Practitioners, East Melbourne, Vic., Australia
| | - Penny Need
- The Royal Australian College of General Practitioners, East Melbourne, Vic., Australia
| | - Michelle Pitot
- The Royal Australian College of General Practitioners, East Melbourne, Vic., Australia
| | - Taryn Elliott
- The Royal Australian College of General Practitioners, East Melbourne, Vic., Australia
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Morgan T, Torkian P, Awan OA. Mandatory Wellness Lectures and Exercises: Helpful or Harmful? Acad Radiol 2024; 31:747-749. [PMID: 38401991 DOI: 10.1016/j.acra.2023.01.021] [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: 01/15/2023] [Accepted: 01/16/2023] [Indexed: 02/26/2024]
Affiliation(s)
- Tyler Morgan
- Texas Tech University, Health Sciences Center School of Medicine, Lubbock, Texas
| | - Pooya Torkian
- Vascular and Interventional Radiology, University of Minnesota, Minneapolis, Minnesota
| | - Omer A Awan
- University of Maryland School of Medicine, 655 W Baltimore Street, Baltimore, MD 21201.
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20
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Wan Z, Tang J, Bai X, Cao Y, Zhang D, Su T, Zhou Y, Qiao L, Shen K, Wang L, Tian X, Wang J. Burnout among radiology residents: a systematic review and meta-analysis. Eur Radiol 2024; 34:1399-1407. [PMID: 37589905 DOI: 10.1007/s00330-023-09986-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2023] [Revised: 04/24/2023] [Accepted: 05/30/2023] [Indexed: 08/18/2023]
Abstract
OBJECTIVE To analyze the prevalence of burnout among radiology residents. METHOD Five databases (PubMed, Web of Science, Embase, PsycINFO, and Scopus) were searched for studies reporting burnout in radiology residents for the period up to November 7, 2022. RESULTS A total of 423 studies were identified, and eventually, 16 studies were selected for the qualitative analysis, of which 11 studies were used in the meta-analysis. There was a total of 2164 radiology residents. Six studies reported the prevalence of burnout but the data could not be pooled due to their inconsistent definitions of burnout. The mean scores of three burnout subscales indicated a moderate to high degree of severity: emotional exhaustion = 25.2 (95% CI, 22.1-28.3; I2 = 94.4%), depersonalization = 10.2 (95% CI, 8.5-11.9; I2 = 93.0%), and low perception of personal accomplishment = 32.9 (95% CI, 30.5-35.4; I2 = 94.4%). The pooled prevalence of high-degree emotional exhaustion was 49.9% (95% CI, 43.6-56.1%; I2 = 55.7%), high-degree depersonalization was 45.1% (95% CI, 38.3-52.0%; I2 = 63.2%), and high-degree diminished personal accomplishment was 58.2% (95% CI, 36.0-77.6%; I2 = 84.9%). The impact of the COVID-19 pandemic on radiology residents was not investigated. In addition, there are inconsistent findings on the effects of female sex, seniority, and social support on burnout. CONCLUSIONS About half of the radiology residents showed at least one of the three burnout manifestations (emotional exhaustion, depersonalization, and personal accomplishment), with a moderate to high degree of severity. CLINICAL RELEVANCE STATEMENT Such a high prevalence and severity of burnout among radiology residents warrant the attention of residency program directors. KEY POINTS • Burnout, not uncommon among radiology residents, has not been effectively analyzed. • Nearly half of the radiology residents experience at least one of the three manifestations of burnout to a moderate to high degree. • The high prevalence and severe degree of burnout among radiology residents warrant the attention of residency program directors.
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Affiliation(s)
- Ziqi Wan
- Department of Internal Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
- Eight-year program, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China
| | - Jieying Tang
- Department of Surgery, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, Beijing, China
| | - Xiaoyin Bai
- Department of Internal Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Yihan Cao
- Department of Radiology, Mass General Brigham Salem Hospital, 81 Highland Avenue, Salem, MA, 01970, USA
| | - Dingding Zhang
- Medical Research Center, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Tong Su
- Department of Radiology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Yangzhong Zhou
- Department of Internal Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Lin Qiao
- Department of Internal Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Kaini Shen
- Department of Radiology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Luo Wang
- Department of Pulmonary and Critical Care Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China.
| | - Xinlun Tian
- Department of Pulmonary and Critical Care Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China.
| | - Jinglan Wang
- Department of Pulmonary and Critical Care Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
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21
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Belkić K, Rustagi N. Job stressors in relation to burnout and compromised sleep among academic physicians in India. Work 2024:WOR230383. [PMID: 38189728 DOI: 10.3233/wor-230383] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2024] Open
Abstract
BACKGROUND Burnout among physicians, especially in the academic setting, is an urgent concern, with adequate sleep one of the key focal points. OBJECTIVE To identify job stressors contributing to burnout and compromised sleep among academic physicians, using a comprehensive, theory-based instrument, the Occupational Stressor Index (OSI), whose specific form was created 'for physicians by physicians'. METHODS This parallel mixed-methods cross-sectional investigation was conducted among 109 physicians employed in a public teaching hospital, Jodhpur, India. Work conditions were evaluated by the physician-specific OSI (part I). The Copenhagen Burnout Index and Pittsburgh Sleep Quality Index (PSQI) were the outcome instruments (part II). Seventy-six physicians completed parts I and II. RESULTS The physicians were from wide-ranging specialties, and 82% of the cohort were residents. Mean total OSI scores were 87.4±8.1, with unit-change yielding adjusted odds-ratios (95% confidence-intervals) for personal (1.10 (1.02-1.18)) and work-related burnout (1.12 (1.04-1.22)), and PSQI (1.09 (1.01-1.17)). Significant multivariable associations with burnout and/or sleep indices included: working 7 days/week, lacking work-free vacation, insufficient rest breaks, interruptions, many patients in intensive-care, no separate time for non-clinical duties, pressure to publish, injury/suicide attempts of colleagues/staff, performing pointless tasks. The latter were described as administrative/clerical. Lacking genuine rest breaks was mainly patient-related, further compromised by emergency work and lacking separate time for non-clinical duties. Long workhours and exhausting schedule were cited as most difficult parts of work, while reducing workhours, improving work schedule, and hiring more staff most frequently recommended. CONCLUSION Specific working conditions potentially contributory to burnout and compromised sleep among physicians working in academic medicine are identified using a methodologically-rigorous, in-depth approach. These findings inform evidence-based interventions aimed at preserving physician mental health and work capacity.
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Affiliation(s)
- Karen Belkić
- Department of Oncology/Pathology, Karolinska Institute, Stockholm, Sweden
- Department of Medical Radiation Physics and Nuclear Medicine, Karolinska University Hospital, Stockholm, Sweden
- Claremont Graduate University, School of Community and Global Health, Claremont, CA, USA
- Institute for Health Promotion and Disease Prevention Research, University of Southern California School of Medicine, Los Angeles, CA, USA
| | - Neeti Rustagi
- Department of Community Medicine and Family Medicine, All India Institute of Medical Sciences, Jodhpur, India
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Ishizuka K, Shikino K, Kuriyama A, Nishimura Y, Tanaka E, Nonaka S, Sadohara M, Moriya M, Yamamoto N, Wada Y, Makiishi T. A proposal for coping strategies on burnout among Japanese resident physicians. J Gen Fam Med 2024; 25:83-84. [PMID: 38239993 PMCID: PMC10792311 DOI: 10.1002/jgf2.662] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2023] [Revised: 11/08/2023] [Accepted: 11/13/2023] [Indexed: 01/22/2024] Open
Affiliation(s)
- Kosuke Ishizuka
- Department of General MedicineYokohama City University School of MedicineYokohamaJapan
| | - Kiyoshi Shikino
- Department of Community‐oriented Medical EducationChiba University Graduate School of MedicineChibaJapan
- Department of General MedicineChiba University HospitalChibaJapan
| | - Akira Kuriyama
- Department of Primary Care & Emergency MedicineKyoto University HospitalKyotoJapan
| | - Yoshito Nishimura
- Department of Medicine, John A. Burns School of MedicineUniversity of Hawai'iHonoluluHawaiiUSA
| | - Emiri Tanaka
- The Jikei University School of MedicineMinato‐kuJapan
| | - Saori Nonaka
- Department of General MedicineTaito HospitalTaito‐kuJapan
| | - Michito Sadohara
- Department of Community, Family, and General MedicineKumamoto University HospitalKumamotoJapan
| | - Mitsuru Moriya
- Department of Psychosomatic Internal MedicineHealth Sciences University of HokkaidoIshikari‐gunJapan
| | | | - Yohnosuke Wada
- Department of Cardiovascular SurgeryJichi Medical University Saitama Medical CenterSaitamaJapan
| | - Tetsuya Makiishi
- Department of General MedicineShimane University HospitalIzumoJapan
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23
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Wilding HE, Sciscent BY, Hallan DR, Harbaugh T, Rizk EB. Letter to the Editor Regarding "Neurosurgery Applicant Perspective of Neurosurgery Residency Websites". World Neurosurg 2024; 181:189-190. [PMID: 38229279 DOI: 10.1016/j.wneu.2023.08.142] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2023] [Accepted: 08/31/2023] [Indexed: 01/18/2024]
Affiliation(s)
- Hannah E Wilding
- Department of Neurosurgery, Penn State Milton S. Hershey Medical Center, Hershey, Pennsylvania, USA.
| | - Bao Y Sciscent
- Department of Neurosurgery, Penn State Milton S. Hershey Medical Center, Hershey, Pennsylvania, USA
| | - David R Hallan
- Department of Neurosurgery, Penn State Milton S. Hershey Medical Center, Hershey, Pennsylvania, USA
| | - Thaddeus Harbaugh
- Department of Neurosurgery, Penn State Milton S. Hershey Medical Center, Hershey, Pennsylvania, USA
| | - Elias B Rizk
- Department of Neurosurgery, Penn State Milton S. Hershey Medical Center, Hershey, Pennsylvania, USA
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24
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Akaishi Y, Nawa N, Kashimada A, Itsui Y, Okada E, Yamawaki M. Association between Grit and depressive symptoms at the timing of job start among medical residents during the COVID-19 pandemic in Japan: a cross-sectional study. MEDICAL EDUCATION ONLINE 2023; 28:2225886. [PMID: 37343594 PMCID: PMC10286665 DOI: 10.1080/10872981.2023.2225886] [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: 04/27/2023] [Revised: 06/11/2023] [Accepted: 06/12/2023] [Indexed: 06/23/2023]
Abstract
INTRODUCTION The COVID-19 pandemic had an additional negative impact on the mental health of healthcare workers, including residents. Previous studies revealed that grit, which is an individual trait to achieve long-term goals unrelated to intelligence quotient, is not only positively associated with academic achievement and career success but also negatively correlated with depression. This study aimed to examine the association between grit and depressive symptoms among residents at the time of job start during the coronavirus disease 2019 (COVID-19) pandemic in Japan. MATERIALS AND METHODS This cross-sectional study used data from all post-graduate year 1 residents from March 2020 to April 2022 at Tokyo Medical and Dental University, Tokyo, Japan. Grit was measured by the Japanese version of Grit-S. The resident's depressive symptoms were assessed using the Center for Epidemiologic Studies Depression Scale. The association of interest was examined using logistic regression analysis. RESULTS Among 221 residents, 28 (12.7%) have depressive symptoms. One unit increase in Grit-S score after adjusting for age, sex, graduated university, and sleeping hours was associated with lower odds of having depressive symptoms by 63% (odds ratio [OR]: 0.37; 95% confidence interval [CI]: 0.19-0.74). Further, the perseverance of effort subscale score was associated with lower odds of having depressive symptoms after covariate adjustment (OR: 0.43; 95% CI: 0.22-0.84). CONCLUSIONS Higher grit scores were associated with lower odds of having depressive symptoms among residents at the timing of job start during the COVID-19 pandemic. Regular mental health assessment is particularly important for residents with low grit scores at entry.
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Affiliation(s)
- Yu Akaishi
- Department of Medical Education Research and Development, Tokyo Medical and Dental University, Tokyo, Japan
- Department of Professional Development, Tokyo Medical and Dental University, Tokyo, Japan
| | - Nobutoshi Nawa
- Department of Global Health Promotion, Tokyo Medical and Dental University, Tokyo, Japan
| | - Ayako Kashimada
- Department of Medical Education Research and Development, Tokyo Medical and Dental University, Tokyo, Japan
- Department of Professional Development, Tokyo Medical and Dental University, Tokyo, Japan
| | - Yasuhiro Itsui
- Department of Medical Education Research and Development, Tokyo Medical and Dental University, Tokyo, Japan
| | - Eriko Okada
- Department of Medical Education Research and Development, Tokyo Medical and Dental University, Tokyo, Japan
- Department of Professional Development, Tokyo Medical and Dental University, Tokyo, Japan
| | - Masanaga Yamawaki
- Department of Medical Education Research and Development, Tokyo Medical and Dental University, Tokyo, Japan
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Weigelt TM, Conrad I, Riedel-Heller SG, Hussenoeder FS. [Burnout in hospital-based surgeons. Approaches for prevention?]. CHIRURGIE (HEIDELBERG, GERMANY) 2023; 94:1009-1014. [PMID: 37749391 DOI: 10.1007/s00104-023-01966-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 07/30/2023] [Indexed: 09/27/2023]
Abstract
BACKGROUND Burnout among physicians is increasingly recognized as a public health issue including its scientific, political, and societal relevance. The effects of burnout go far beyond physician health as they affect the quality of care, patient safety, medical errors, and efficiency of health care. OBJECTIVE Assessment of the risk of burnout for hospital-based surgeons as well as associations between surgeon burnout and several work-related and person-related factors. METHODS From the representative Saxony physician survey from 2019, we utilized the subsample of 231 hospital-based surgeons. We conducted a regression analysis with workload, job satisfaction, work-life balance (WLB), resilience, inability to recover and health complaints as predictors of burnout (Maslach burnout inventory-General survey, MBI-GS). RESULTS Nearly half of the sample were female (49.4%), the average age was 42.0 years, 4.8% of participants exhibited burnout, 45.9% with some symptoms and 49.4% no burnout. Multivariate analysis showed significant positive associations between health complaints, inability to recover, a lack of job-based self-fulfillment and burnout. There were significant negative connections between WLB, the wish to remain in the job and burnout. CONCLUSION Burnout is a serious problem for surgeons. Preventive measures should focus on risk factors associated with the workplace and organization of work. Interventions targeted at the individual level should start at an early career stage.
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Affiliation(s)
- Tabea-Maria Weigelt
- Institut für Sozialmedizin, Arbeitsmedizin und Public Health, Universität Leipzig, P.-Rosenthal-Str. 55, 04103, Leipzig, Deutschland.
- Institut und Poliklinik für Arbeits- und Sozialmedizin, Technische Universität Dresden, Fetscherstr. 74, 01307, Dresden, Deutschland.
| | - Ines Conrad
- Institut für Sozialmedizin, Arbeitsmedizin und Public Health, Universität Leipzig, P.-Rosenthal-Str. 55, 04103, Leipzig, Deutschland
| | - Steffi G Riedel-Heller
- Institut für Sozialmedizin, Arbeitsmedizin und Public Health, Universität Leipzig, P.-Rosenthal-Str. 55, 04103, Leipzig, Deutschland
| | - Felix S Hussenoeder
- Institut für Sozialmedizin, Arbeitsmedizin und Public Health, Universität Leipzig, P.-Rosenthal-Str. 55, 04103, Leipzig, Deutschland
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Fu MZ, Islam R, DeMarzo J, Lichtbroun B, Tabakin AL, Park JH, Elsamra SE. The Boot Camp Model in Urology: Preparing PGY1 Urology Interns for Practice. Curr Urol Rep 2023; 24:553-559. [PMID: 37749358 DOI: 10.1007/s11934-023-01186-1] [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] [Accepted: 09/09/2023] [Indexed: 09/27/2023]
Abstract
PURPOSE OF REVIEW The purpose of this review is to highlight literature regarding resident boot camps published across surgical specialties with a focus on urology. Herein, we discuss different boot camp iterations, their results, and the integration of simulation into their curriculum. We review program elements such as curriculum, course length, and efficacy as well as areas for continued investigation. RECENT FINDINGS The field of urology has grown in both the breadth of knowledge and the complexity of procedures. With urology now being an integrated surgical subspecialty, interns often start on the urology service despite limited experience navigating this unique specialty. The boot camp model is one method by which interns and junior residents participate in consolidated training programs to best prepare them for a patient-facing role and the day-to-day demands of residency. Urology programs, both in the USA and abroad, have begun integrating boot camps into their training programs with positive results. Urology boot camps can be a valuable part of training programs for interns to quickly establish medical knowledge, skills, and efficiency. Boot camps should be easily accessible, have sufficient support from institutions, and provide effective training through various methods such as didactics and simulation.
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Affiliation(s)
- Melinda Z Fu
- Division of Urology, Department of Surgery, Rutgers Robert Wood Johnson Medical School, Clinical Academic Building, 125 Paterson Street, Suite 4100, New Brunswick, NJ, 08901, USA
| | - Raeesa Islam
- Division of Urology, Department of Surgery, Rutgers Robert Wood Johnson Medical School, Clinical Academic Building, 125 Paterson Street, Suite 4100, New Brunswick, NJ, 08901, USA
| | - Joseph DeMarzo
- Rutgers Robert Wood Johnson Medical School, Piscataway, NJ, USA
| | - Benjamin Lichtbroun
- Division of Urology, Department of Surgery, Rutgers Robert Wood Johnson Medical School, Clinical Academic Building, 125 Paterson Street, Suite 4100, New Brunswick, NJ, 08901, USA
| | - Alexandra L Tabakin
- Division of Female Pelvic Medicine and Reconstructive Surgery, Donald and Barbara Zucker School of Medicine and Hofstra/Northwell, Great Neck, NY, USA
| | - Ji Hae Park
- Division of Urology, Department of Surgery, Rutgers Robert Wood Johnson Medical School, Clinical Academic Building, 125 Paterson Street, Suite 4100, New Brunswick, NJ, 08901, USA
| | - Sammy E Elsamra
- Division of Urology, Department of Surgery, Rutgers Robert Wood Johnson Medical School, Clinical Academic Building, 125 Paterson Street, Suite 4100, New Brunswick, NJ, 08901, USA.
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Klein KC, Dittmar E, Vordenberg SE. Prevalence and Impact of Workplace Bullying among Pharmacy Practice Faculty in the United States. Innov Pharm 2023; 14:10.24926/iip.v14i3.5450. [PMID: 38487383 PMCID: PMC10936454 DOI: 10.24926/iip.v14i3.5450] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/17/2024] Open
Abstract
Objective: To identify the prevalence and impact of workplace bullying among pharmacy practice faculty in the United States. Methods: Members of the Pharmacy Practice section of the American Association of Colleges of Pharmacy were invited to complete an online survey about the frequency with which they experienced negative workplace behaviors in the communication, humiliation, manipulation, discrimination, and violence domains as well as workplace bullying in the previous 12 months. Independent t-tests and chi-squared tests were used to investigate associations between workplace bullying and pharmacy practice faculty demographic and employment characteristics. Results: Participants (n=256) reported a median of 6 negative behaviors in the workplace, most often in the communication and humiliation domains. A total of 50 (19.5%) reported experiencing workplace bullying. The most common impacts of workplace bullying included increasing their stress level (n=44/49, 89.8%), negative effects on their emotional health (n=42/49, 85.7%), and job dissatisfaction (n=40/49, 81.6%). Female participants more frequently reported workplace bullying (n=43/196, 21.9%) compared to male participants (n=4/56, 7.1%; p=0.012). Individuals who identified as white were less likely to report workplace bullying (n=40/233, 17.2%) compared to individuals of all other races (n=8/19, 42.1%; p=0.008). Conclusion: Most pharmacy practice faculty reported experiencing some degree of negative workplace behaviors during the past 12 months. Additional strategies are needed to create inclusive work environments with transparent, actionable policies when workplace bullying occurs.
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Aljuwaiser S, Brazzelli M, Arain I, Poobalan A. Common mental health problems in medical students and junior doctors - an overview of systematic reviews. J Ment Health 2023:1-37. [PMID: 37933550 DOI: 10.1080/09638237.2023.2278095] [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: 01/21/2023] [Accepted: 09/24/2023] [Indexed: 11/08/2023]
Abstract
BACKGROUND Common mental health problems (CMHP) are prevalent among junior doctors and medical students, and the COVID-19 pandemic has brought challenging situations with education disruptions, early graduations, and front-line work. CMHPs can have detrimental consequences on clinical safety and healthcare colleagues; thus, it is vital to assess the overall prevalence and available interventions to provide institutional-level support. AIMS This overview summarises the prevalence of CMHPs from existing published systematic reviews and informs public health prevention and early intervention practice. METHODS Four electronic databases were searched from 2012 to identify systematic reviews on the prevalence of CMHPs and/or interventions to tackle them. RESULTS Thirty-six reviews were included: 25 assessing prevalence and 11 assessing interventions. Across systematic reviews, the prevalence of anxiety ranged from 7.04 to 88.30%, burnout from 7.0 to 86.0%, depression from 11.0 to 66.5%, stress from 29.6 to 49.9%, suicidal ideation from 3.0 to 53.9% and one obsessive-compulsive disorder review reported a prevalence of 3.8%. Mindfulness-based interventions were included in all reviews, with mixed findings for each CMHP. CONCLUSIONS The prevalence of CMHPs is high among junior doctors and medical students, with anxiety remaining relatively stable and depression slightly increasing during the COVID-19 pandemic. Future research on mindfulness-based interventions is required for a resilient and healthy future workforce. PRISMA/PROSPERO the researchers have followed PRISMA guidance. This overview was not registered with PROSPERO as it was conducted as part of an MSc research project.
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Affiliation(s)
- Sameera Aljuwaiser
- School of Medicine, Medical Sciences and Nutrition, University of Aberdeen, Aberdeen, UK
| | - Miriam Brazzelli
- School of Medicine, Medical Sciences and Nutrition, University of Aberdeen, Aberdeen, UK
| | - Imran Arain
- School of Medicine, Medical Sciences and Nutrition, University of Aberdeen, Aberdeen, UK
| | - Amudha Poobalan
- School of Medicine, Medical Sciences and Nutrition, University of Aberdeen, Aberdeen, UK
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Watanabe S, Uemura T, Iwata Y, Yagasaki H, Itakura J, Suzuki T. Psychological distress among early medical residents: A 2-year longitudinal cohort study over seven years in Japan. Compr Psychiatry 2023; 127:152425. [PMID: 37774551 DOI: 10.1016/j.comppsych.2023.152425] [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: 06/26/2023] [Revised: 08/09/2023] [Accepted: 09/15/2023] [Indexed: 10/01/2023] Open
Abstract
BACKGROUND Early medical residents are expected to have a higher prevalence of burnout due to physical and psychological stressors. However psychological distress associated with burnout has not been adequately investigated in a longitudinal manner. We therefore examined the longitudinal trajectory of depression and its associated factors among early medical residents. METHODS In this cohort study, medical residents (n = 215) who started rotation at the University of Yamanashi Hospital during 2012 to 2018 were recruited and asked to complete the Brief Job Stress Questionnaire (BJSQ), Center for Epidemiologic Studies Depression Scale (CESD), Brief Scale for Coping Profile (BSCP) and Athens Insomnia Scale (AIS) at the time of exit from each clinical department for up to two years over seven years. Factors associated with the CES-D scores were statistically explored, with a cutoff score of 16 to denote depression. RESULTS The CES-D was completed by 205 residents. The average CES-D score was 10.3 ± 8.0 and the scores were lower in the 2nd versus 1st year of residency (11.3 ± 6.7 versus 9.2 ± 7.0). Multiple regression analysis of BJSQ/BSCP/AIS on CES-D revealed that insomnia had a significant impact on the CES-D scores. Apart from insomnia, avoidance and suppression and peer support had significant effects. Resilient residents, who showed the maximum CES-D score of under 16 consistently throughout the residency, was better in terms of changing a point of view, active solution and changing mood. Women were more likely to express emotions to others, while they reported more job control in the first year. CONCLUSIONS Our results have high clinical relevance to challenge psychological burnout among early medical residents, offering some possible clues for prevention such as reduced burden, more flexibility during the first year and strengthening coworker support. Insomnia exerted moderate to strong effects on depression and monitoring of sleep appears indispensable in this specific population.
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Affiliation(s)
- Shintaro Watanabe
- Department of Neuropsychiatry, University of Yamanashi Faculty of Medicine, Yamanashi, Japan
| | - Takuji Uemura
- Department of Neuropsychiatry, University of Yamanashi Faculty of Medicine, Yamanashi, Japan; Child Psychotherapy Center Uguisu-no-Mori, Yamanashi, Japan
| | - Yusuke Iwata
- Department of Neuropsychiatry, University of Yamanashi Faculty of Medicine, Yamanashi, Japan
| | - Hideaki Yagasaki
- Department of clinical education, University of Yamanashi Faculty of Medicine, Yamanashi, Japan
| | - Jun Itakura
- Department of clinical education, University of Yamanashi Faculty of Medicine, Yamanashi, Japan
| | - Takefumi Suzuki
- Department of Neuropsychiatry, University of Yamanashi Faculty of Medicine, Yamanashi, Japan; Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan.
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Pollard KJ, Gittelsohn J, Patel P, Lianov L, Freeman K, Staffier KL, Pauly KR, Karlsen MC. Lifestyle Medicine Practitioners Implementing a Greater Proportion of Lifestyle Medicine Experience Less Burnout. Am J Health Promot 2023; 37:1121-1132. [PMID: 37368959 PMCID: PMC10631282 DOI: 10.1177/08901171231182875] [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] [Indexed: 06/29/2023]
Abstract
PURPOSE To identify reasons for burnout, characterize the effect of lifestyle medicine (LM) practice on burnout, and assess the risk of burnout in relation to the proportion of LM practice. DESIGN Analysis of mixed methods data from a large, cross-sectional survey on LM practice. SETTING Web-based survey platform. PARTICIPANTS Members of an LM medical professional society at the time of survey administration. METHODS Practitioner members of a medical professional society were recruited to a cross-sectional, online survey. Data were collected on LM practice and experiences with burnout. Free-text data were thematically grouped and counted, and the association of burnout with the proportion of lifestyle-based medical practice was analyzed using logistic regression. RESULTS Of 482 respondents, 58% reported currently feeling burned out, 28% used to feel burned out but no longer do, and 90% reported LM had positively impacted their professional satisfaction. Among LM practitioners surveyed, practicing more LM was associated with a 43% decrease (0.569; 95% CI: 0.384, 0.845; P = 0.0051) in the odds of experiencing burnout. Top reasons for positive impact included professional satisfaction, sense of accomplishment, and meaningfulness (44%); improved patient outcomes and patient satisfaction (26%); enjoyment of teaching/coaching and engaging in relationships (22%); and helps me personally: quality of life and stress (22%). CONCLUSION Implementing LM as a greater proportion of medical practice was associated with lower likelihood of burnout among LM practitioners. Results suggest that increased feelings of accomplishment due to improved patient outcomes and reduced depersonalization contribute to reduced burnout.
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Affiliation(s)
| | - Joel Gittelsohn
- Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | | | - Liana Lianov
- Global Positive Health Institute, Sacramento, CA, USA
| | - Kelly Freeman
- American College of Lifestyle Medicine, Chesterfield, MO, USA
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Ahlness EA, Molloy-Paolillo BK, Brunner J, Cutrona SL, Kim B, Matteau E, Rinne ST, Walton E, Wong E, Sayre G. Impacts of an Electronic Health Record Transition on Veterans Health Administration Health Professions Trainee Experience. J Gen Intern Med 2023; 38:1031-1039. [PMID: 37798576 PMCID: PMC10593679 DOI: 10.1007/s11606-023-08283-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2022] [Accepted: 06/13/2023] [Indexed: 10/07/2023]
Abstract
BACKGROUND Adoption of electronic health care records (EHRs) has proliferated since 2000. While EHR transitions are widely understood to be disruptive, little attention has been paid to their effect on health professions trainees' (HPTs) ability to learn and conduct work. Veterans Health Administration's (VA) massive transition from its homegrown EHR (CPRS/Vista) to the commercial Oracle Cerner presents an unparalleled-in-scope opportunity to gain insight on trainee work functions and their ability to obtain requisite experience during transitions. OBJECTIVE To identify how an organizational EHR transition affected HPT work and learning at the third VA go-live site. DESIGN A formative mixed-method evaluation of HPT experiences with VHA's EHR transition including interviews with HPTs and supervisors at Chalmers P. Wylie VA Outpatient Clinic in Columbus, OH, before (~60 min), during (15-30 min), and after (~60 min) go-live (December 2021-July 2022). We also conducted pre- (March 2022-April 2022) and post-go live (May 2022-June 2022) HPT and employee surveys. PARTICIPANTS We conducted 24 interviews with HPTs (n=4), site leaders (n=2), and academic affiliates (n=2) using snowball sampling. We recruited HPTs in pre- (n=13) and post-go-live (n=10) surveys and employees in pre- (n=408) and post-go-live (n=458) surveys. APPROACH We conducted interviews using a semi-structured guide and grounded prompts. We coded interviews and survey free text data using a priori and emergent codes, subsequently conducting thematic analysis. We conducted descriptive statistical analysis of survey responses and merged interview and survey data streams. KEY RESULTS Our preliminary findings indicate that the EHR transition comprehensively affected HPT experiences, disrupting processes from onboarding and training to clinical care contributions and training-to-career retention. CONCLUSIONS Understanding HPTs' challenges during EHR transitions is critical to effective training. Mitigating the identified barriers to HPT training and providing patient care may lessen their dissatisfaction and ensure quality patient care during EHR transitions.
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Affiliation(s)
- Ellen A Ahlness
- Center of Innovation for Veteran-Centered and Value-Driven Care, Seattle. VA Medical Center, Seattle, WA, USA.
| | - Brianne K Molloy-Paolillo
- Center for Healthcare Organization and Implementation Research, Bedford VA Medical Center, Bedford, MA, USA
| | - Julian Brunner
- Center for the Study of Healthcare Innovation, Implementation & Policy, VA Greater Los Angeles Health Care, Los Angeles, CA, USA
| | - Sarah L Cutrona
- Center for Healthcare Organization and Implementation Research, Bedford VA Medical Center, Bedford, MA, USA
- Division of Health Informatics & Implementation Science, Department of Population and Quantitative Health Sciences, University of Massachusetts Chan Medical School, Worcester, MA, USA
| | - Bo Kim
- Center for Healthcare Organization and Implementation Research, VA Boston Health Care System, Boston, MA, USA
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA
| | - Erin Matteau
- VA Office of Academic Affiliations, Washington, DC, USA
| | - Seppo T Rinne
- Center for Healthcare Organization and Implementation Research, Bedford VA Medical Center, Bedford, MA, USA
- The Pulmonary Center, Department of Medicine, Boston University, Boston, MA, USA
| | - Edward Walton
- VA Office of Academic Affiliations, Washington, DC, USA
| | - Edwin Wong
- Center of Innovation for Veteran-Centered and Value-Driven Care, Seattle. VA Medical Center, Seattle, WA, USA
- University of Washington School of Public Health, Seattle, WA, USA
| | - George Sayre
- Center of Innovation for Veteran-Centered and Value-Driven Care, Seattle. VA Medical Center, Seattle, WA, USA
- University of Washington School of Public Health, Seattle, WA, USA
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SenthilKumar G, Mathieu NM, Freed JK, Sigmund CD, Gutterman DD. Addressing the decline in graduate students' mental well-being. Am J Physiol Heart Circ Physiol 2023; 325:H882-H887. [PMID: 37624099 DOI: 10.1152/ajpheart.00466.2023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2023] [Revised: 08/21/2023] [Accepted: 08/22/2023] [Indexed: 08/26/2023]
Abstract
At the American Physiology Summit 2023 session entitled, "Mental Health for Graduate Students," numerous students expressed struggling with poor mental well-being primarily because of negative experiences during their graduate training. In fact, studies show that up to 50% of graduate students report symptoms of depression, anxiety, or burnout during their training, and poor mental well-being is a major contributor to students' decision to leave academia. Most of the current solutions focus on treatment or wellness strategies; while these are important and necessary, the training environment or culture that often contributes to worsening well-being continues to persist. In this collaborative article between trainees and mentors across various career stages, we discuss how the pace of scientific advancements and the associated competition, lack of sufficient support for students from diverse backgrounds, and mentor-mentee relationships crucially influence graduate students' mental well-being. We then offer specific solutions at the individual, institutional, and national levels that can serve as a starting point for improving graduate students' mental health and overall training experience.
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Affiliation(s)
- Gopika SenthilKumar
- Department of Physiology, Medical College of Wisconsin, Milwaukee, Wisconsin, United States
- Department of Anesthesiology, Medical College of Wisconsin, Milwaukee, Wisconsin, United States
- Cardiovascular Center, Medical College of Wisconsin, Milwaukee, Wisconsin, United States
| | - Natalia M Mathieu
- Department of Physiology, Medical College of Wisconsin, Milwaukee, Wisconsin, United States
- Cardiovascular Center, Medical College of Wisconsin, Milwaukee, Wisconsin, United States
| | - Julie K Freed
- Department of Physiology, Medical College of Wisconsin, Milwaukee, Wisconsin, United States
- Department of Anesthesiology, Medical College of Wisconsin, Milwaukee, Wisconsin, United States
- Cardiovascular Center, Medical College of Wisconsin, Milwaukee, Wisconsin, United States
| | - Curt D Sigmund
- Department of Physiology, Medical College of Wisconsin, Milwaukee, Wisconsin, United States
- Cardiovascular Center, Medical College of Wisconsin, Milwaukee, Wisconsin, United States
| | - David D Gutterman
- Department of Physiology, Medical College of Wisconsin, Milwaukee, Wisconsin, United States
- Cardiovascular Center, Medical College of Wisconsin, Milwaukee, Wisconsin, United States
- Department of Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin, United States
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Țăranu SM, Ștefăniu R, Rotaru TȘ, Turcu AM, Pîslaru AI, Sandu IA, Herghelegiu AM, Prada GI, Alexa ID, Ilie AC. Factors Associated with Burnout in Medical Staff: A Look Back at the Role of the COVID-19 Pandemic. Healthcare (Basel) 2023; 11:2533. [PMID: 37761730 PMCID: PMC10530693 DOI: 10.3390/healthcare11182533] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2023] [Revised: 09/07/2023] [Accepted: 09/12/2023] [Indexed: 09/29/2023] Open
Abstract
Despite the significant consequences for medical practice and public health, burnout in healthcare workers remains underestimated. Pandemic periods have increased the reactivity to stress by favoring some changes whose influence are still felt. PURPOSE This study aims to identify opportune factors during pandemic periods that predispose medical personnel to burnout and the differences between medical staff which worked with COVID-19 patients and those who did not work with COVID-19 patients. MATERIAL AND METHODS This is a prospective study on 199 subjects, medical staff and auxiliary staff from national health units, COVID-19 and non-COVID-19, who answered questions using the Google Forms platform about the level of stress related to the workplace and the changes produced there. All statistical analyses were conducted using IBM SPSS Statistics (Version 28). RESULTS The limited equipment and disinfectant solutions from the lack of medical resources category, the fear of contracting or transmitting the infection from the fears in relation to the COVID-19 pandemic category and the lack of personal and system-level experience in combating the infection due to the lack of information on and experience with COVID-19 were the most predisposing factors for burnout. No significant differences were recorded between those on the front line and the other healthcare representatives. CONCLUSIONS The results of this study identify the stressors generated in the pandemic context with prognostic value in the development of burnout among medical personnel. At the same time, our data draw attention to the cynicism or false-optimism stage of burnout, which can mask a real decline.
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Affiliation(s)
- Sabinne-Marie Țăranu
- Department of Medical Specialties II, Faculty of Medicine, Grigore T. Popa University of Medicine and Pharmacy, 700115 Iași, Romania
| | - Ramona Ștefăniu
- Department of Medical Specialties II, Faculty of Medicine, Grigore T. Popa University of Medicine and Pharmacy, 700115 Iași, Romania
| | - Tudor-Ștefan Rotaru
- Department of Medical Specialties II, Faculty of Medicine, Grigore T. Popa University of Medicine and Pharmacy, 700115 Iași, Romania
| | - Ana-Maria Turcu
- Department of Medical Specialties II, Faculty of Medicine, Grigore T. Popa University of Medicine and Pharmacy, 700115 Iași, Romania
| | - Anca Iuliana Pîslaru
- Department of Medical Specialties II, Faculty of Medicine, Grigore T. Popa University of Medicine and Pharmacy, 700115 Iași, Romania
| | - Ioana Alexandra Sandu
- Department of Medical Specialties II, Faculty of Medicine, Grigore T. Popa University of Medicine and Pharmacy, 700115 Iași, Romania
| | - Anna Marie Herghelegiu
- Department of Geriatrics and Gerontology, Faculty of Medicine, Carol Davila University of Medicine and Pharmacy, 020956 București, Romania
| | - Gabriel Ioan Prada
- Department of Geriatrics and Gerontology, Faculty of Medicine, Carol Davila University of Medicine and Pharmacy, 020956 București, Romania
| | - Ioana Dana Alexa
- Department of Medical Specialties II, Faculty of Medicine, Grigore T. Popa University of Medicine and Pharmacy, 700115 Iași, Romania
| | - Adina Carmen Ilie
- Department of Medical Specialties II, Faculty of Medicine, Grigore T. Popa University of Medicine and Pharmacy, 700115 Iași, Romania
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Fresán A, Robles-García R, Yoldi-Negrete M, Guízar-Sánchez D, Tovilla-Zárate CA. To the bone: Prevalence and correlates of depression and anxiety among orthopedic residents in Mexico. Int J Psychiatry Med 2023:912174231199216. [PMID: 37653426 DOI: 10.1177/00912174231199216] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/02/2023]
Abstract
OBJECTIVE The present study examined among orthopedic residents the relationship between the presence of depressive or anxious symptoms and the degree of perfectionism, perceived work-related distress, and involvement in the care of patient(s) who died. METHOD A cross-sectional online survey based on self-reported measures was used to collect the data from October 2019 to April 2021. RESULTS The sample consisted of 642 orthopedic residents (50.6% response rate; 70.9% male; average age 29.8 years old). A total of 12.5 and 18.4% reported depressive or anxious symptoms, respectively. On a scale of 0-100, the mean score of perceived work-related distress was 51.9. A third (33.6%) reported being involved in the care of patient(s) who had died. Higher levels of perceived work-related distress and higher scores on the indecision of action/perfectionism dimension were associated with depressive and anxious symptoms. Being involved in the care of patient(s) who had died was associated with having anxious symptoms (OR = 1.79; 95%CI = 1.18-2.72). CONCLUSIONS These results highlight the need for the systematic monitoring of the mental health status of orthopedic residents in Mexico, particularly those who report a high level of work-related distress or perfectionism or who have recently experienced the death of a patient.
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Affiliation(s)
- Ana Fresán
- Subdirección de Investigaciones Clínicas, Instituto Nacional de Psiquiatría Ramón de la Fuente Muñiz, Mexico
| | - Rebeca Robles-García
- Centro de Investigación en Salud Mental Global, Instituto Nacional de Psiquiatría Ramón de la Fuente Muñiz, Mexico
| | - María Yoldi-Negrete
- Subdirección de Investigaciones Clínicas, Instituto Nacional de Psiquiatría Ramón de la Fuente Muñiz, Mexico
| | - Diana Guízar-Sánchez
- Departamento de Fisiología de la Facultad de Medicina, Universidad Nacional Autónoma de México, Mexico
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Moquin R, Dewey M, Weinhold A, Green O, Young AR. The Flipped Classroom Approach in a Pediatric Anesthesiology Fellowship Curriculum. Cureus 2023; 15:e43979. [PMID: 37746501 PMCID: PMC10516144 DOI: 10.7759/cureus.43979] [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] [Accepted: 08/23/2023] [Indexed: 09/26/2023] Open
Abstract
Background The flipped classroom approach is well documented to enhance medical education outcomes. Additionally, both the need for online learning materials and the increased demand for medical professionals during the COVID-19 pandemic has made this approach more relevant. The pediatric anesthesiology fellowship curriculum at one institution transitioned from a traditional classroom model to a flipped classroom approach to optimize the educational experience and support learner well-being. Approach Utilizing the American Board of Anesthesiology (ABA) and Accreditation Council for Graduate Medical Education (ACGME) content outlines, a novel, comprehensive curriculum was developed focusing on core clinical material and board review with the goal of providing structured learning while alleviating the burden of completing board review independently to improve work-life balance and reduce the potential for burnout. Evaluation Graduates of the program from 2017 to 2021 evaluated the flipped classroom structure and its perceived impact on their educational outcomes, wellness, and career development via a one-time, voluntary survey. Results indicated improved participation rates and educational benefits with the flipped classroom structure compared to the traditional structure. Fellows preferred the flipped classroom approach to the traditional lecture approach (72.2% vs. 27%), and they preferred custom-made prework material to traditional textbooks and articles. Fellows benefited from having more time for personal activities and other scholarly work, as evidenced by open-ended responses. Implications The flipped classroom structure was perceived as beneficial by pediatric anesthesiology fellows because of increased educational engagement, alleviation of academic burden, and improved wellness due to more time for non-academic activities. Further study is needed to optimize and correlate the new curriculum with objective educational outcomes.
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Affiliation(s)
- Rachel Moquin
- Department of Anesthesiology, Washington University School of Medicine, St. Louis, USA
| | - Megan Dewey
- Department of Anesthesiology, Washington University School of Medicine, St. Louis, USA
| | - Ashley Weinhold
- Department of Anesthesiology, Washington University School of Medicine, St. Louis, USA
| | - Ottavia Green
- Department of Anesthesiology, Washington University School of Medicine, St. Louis, USA
| | - Anna Rebecca Young
- Department of Anesthesiology, Washington University School of Medicine, St. Louis, USA
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Tell A, Westenhöfer J, Harth V, Mache S. Stressors, Resources, and Strain Associated with Digitization Processes of Medical Staff Working in Neurosurgical and Vascular Surgical Hospital Wards: A Multimethod Study. Healthcare (Basel) 2023; 11:1988. [PMID: 37510429 PMCID: PMC10379129 DOI: 10.3390/healthcare11141988] [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: 05/17/2023] [Revised: 07/02/2023] [Accepted: 07/03/2023] [Indexed: 07/30/2023] Open
Abstract
The digitization of German hospitals is proceeding continuously, leading to the implementation of new digital technologies, such as electronic health records (EHRs) or other technologies, used for the purpose of medical documentation tasks. Even though the replacement of paper documentation through digitized documentation in general promises to come along with plenty of benefits, the daily utilization of technologies might also lead to stresses and strains among the medical staff, eventually possibly leading to the development of different negative work and health-related outcomes. This study, therefore, aims at identifying persisting digitization-associated stressors and resources among medical hospital staff, examining their influences on different work and health-related outcomes, and finally, identifying potential needs for preventive measures. A quantitative study in the form of an online questionnaire survey was conducted among physicians working in the medical field of neuro- and vascular surgery in German hospitals. The study was carried out between June and October 2022 utilizing an online questionnaire based on several standardized scales, such as the technology acceptance model (TAM) and the technostress model, as well as on several scales from the Copenhagen Psychosocial Questionnaire (COPSOQ). The study found medium levels of technostress among the participating physicians (n = 114), as well as low to medium levels of persisting resources. The queried physicians, on average, reported low levels of burnout symptoms, generally described their health status as good, and were mostly satisfied with their job. Despite the prevalence of technostress and the low levels of resources among the surveyed physicians, there is little awareness of the problem of digital stress, and preventive measures have not been widely implemented yet in the clinics, indicating a needs gap and the necessity for the strategic and quality-guided implementation of measures to effectively prevent digital stress from developing.
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Affiliation(s)
- Anika Tell
- Institute for Occupational and Maritime Medicine (ZfAM), University Medical Center Hamburg-Eppendorf (UKE), Seewartenstraße 10, 20459 Hamburg, Germany
| | - Joachim Westenhöfer
- Department Health Sciences, Faculty of Life Sciences, University of Applied Sciences (HAW), Ulmenliet 20, 21033 Hamburg, Germany
| | - Volker Harth
- Institute for Occupational and Maritime Medicine (ZfAM), University Medical Center Hamburg-Eppendorf (UKE), Seewartenstraße 10, 20459 Hamburg, Germany
| | - Stefanie Mache
- Institute for Occupational and Maritime Medicine (ZfAM), University Medical Center Hamburg-Eppendorf (UKE), Seewartenstraße 10, 20459 Hamburg, Germany
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Wang CN, Cohen ZC, Fang R, Meeks W, Badalato GM, North A. Factors Related to Differential Treatment and Practice Limitations Amongst Urologists: A Report of American Urological Association 2021 Census Data. Urology 2023; 176:74-78. [PMID: 37003473 DOI: 10.1016/j.urology.2023.03.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2023] [Revised: 02/23/2023] [Accepted: 03/21/2023] [Indexed: 04/03/2023]
Abstract
OBJECTIVE To assess rates of urologist-reported differential treatment in practice and practice limitations based on characteristics of urologists... identity. MATERIALS AND METHODS The 2021 AUA Census samples were linked with the United States (US) practicing urologist population file and assigned proper sample weighting to adjust for non-response bias. Responses to 2 questions of the Census related to (1) (negative) differential treatment experienced in practice and (2) limitations in patients/diagnoses seen in practice due to different aspects of respondent...s identity were evaluated. Responses were stratified based on self-reported gender (female vs male) and race (White vs non-White); results were compared using a chi-squared test. RESULTS A total of 1742 urologists, representing 13,790 practicing US urologists through post-stratified weighting, responded to the Census. Overall, amongst those who answered the relevant questions, 16.3% reported having experienced differential treatment in practice due to their identity and 6.1% reported being limited in patients/diagnoses seen in practice due to their identity. Women were more likely than men to have experienced differential treatment (75.0% vs.ß10.2%, P.ß<.ß.001) and to be limited in patients/diagnoses seen in practice (27.0% vs.ß3.7%, P.ß<.ß.001). Similarly, non-White respondents were more likely than White urologists to both have experienced differential treatment (30.4% vs.ß14.1%, P.ß<.ß.001) and to be limited in patients/diagnoses seen in practice (12.8% vs.ß5.0%, P.ß<.ß.001). CONCLUSION Female and non-White urologists are more likely to experience differential treatment in their practice and limitations in the scope of their practice. Further studies are needed to characterize these experiences and explore the etiologies of these differences.
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Affiliation(s)
- Connie N Wang
- Columbia University Irving Medical Center, Department of Urology, New York, NY.
| | - Zo C Cohen
- Columbia University Irving Medical Center, Department of Urology, New York, NY.
| | - Raymond Fang
- Department of Data Management & Statistical Analysis, American Urological Association, Linthicum, MD.
| | - William Meeks
- Department of Data Management & Statistical Analysis, American Urological Association, Linthicum, MD.
| | - Gina M Badalato
- Columbia University Irving Medical Center, Department of Urology, New York, NY.
| | - Amanda North
- Montefiore Medical Center, Department of Urology, New York, NY.
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Medisauskaite A, Viney R, Rich A, Alexander K, Silkens M, Knight L, Harrison D, Crampton P, Griffin A. Financial difficulty in the medical profession. J R Soc Med 2023:1410768231172151. [PMID: 37217199 DOI: 10.1177/01410768231172151] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/24/2023] Open
Affiliation(s)
- Asta Medisauskaite
- UCL Medical School, University College London, Research Department of Medical Education, London, WC1E 6BT, UK
| | - Rowena Viney
- UCL Medical School, University College London, Research Department of Medical Education, London, WC1E 6BT, UK
| | - Antonia Rich
- UCL Medical School, University College London, Research Department of Medical Education, London, WC1E 6BT, UK
| | - Kirsty Alexander
- UCL Medical School, University College London, Research Department of Medical Education, London, WC1E 6BT, UK
| | - Milou Silkens
- UCL Medical School, University College London, Research Department of Medical Education, London, WC1E 6BT, UK
| | - Laura Knight
- UCL Medical School, University College London, Research Department of Medical Education, London, WC1E 6BT, UK
| | - David Harrison
- UCL Medical School, University College London, Research Department of Medical Education, London, WC1E 6BT, UK
| | - Paul Crampton
- Hull York Medical School, Health Professions Education Unit, York, YO10 5DD, UK
| | - Ann Griffin
- UCL Medical School, University College London, Research Department of Medical Education, London, WC1E 6BT, UK
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Loveless JP, Rosen JH, Yost JS. Implementing a workflow-integrated motivational interviewing training program for psychiatry trainees on an inpatient consultation-liaison rotation: lessons learned. Front Psychiatry 2023; 14:1184053. [PMID: 37275965 PMCID: PMC10232741 DOI: 10.3389/fpsyt.2023.1184053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/10/2023] [Accepted: 04/26/2023] [Indexed: 06/07/2023] Open
Abstract
Background Effective consultation-liaison psychiatry (CLP) is proactive, collaborative, and requires providers to have proficiency with therapeutic skills beyond nosology and medication management. Motivational interviewing (MI) is an evidenced-based intervention that should be considered essential for CLP trainees to learn. Given that the demands of training and patient care are already experienced as stressful for many psychiatry trainees, the authors endeavored to create a MI training program that was integrated into trainees' normal CLP workflow. Method Twenty-two trainees on an inpatient CLP rotation participated in a six-week MI training program that was incorporated into their regular workflow. The program included didactic sessions with role-playing, as well as on-demand between-session coaching via an expert in MI. Trainee participation and perceptions of MI were measured via a questionnaire that was administered prior to each training session. Results Trainee participation in the didactic sessions was inconsistent. Questionnaire data revealed positive baseline perceptions of motivational interviewing and its usefulness in inpatient medical settings. Additionally, as trainees participated in the program, perceived knowledge of motivational interviewing as well as awareness of motivational issues among their patients increased. Finally, participation in program was not perceived as disruptive to daily workflow for the participants. Discussion This the first documented attempt at implementing a MI training program for CLP trainees that was integrated into their regular workflow. Preliminary data identified some encouraging trends, but also unexpected challenges. These lessons could inform how these types of training programs are implemented moving forward.
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Affiliation(s)
- James P. Loveless
- Department of Psychology, Middle Tennessee State University, Murfreesboro, TN, United States
| | | | - Joanna S. Yost
- Department of Psychiatry and Neurobehavioral Sciences, University of Virginia, Charlottesville, VA, United States
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Fresán A, Guízar-Sánchez D, Yoldi-Negrete M, Robles-García R, Tovilla-Zárate CA, Saracco-Álvarez R. Gender Differences in Professional Adversities and Mental Health Among Surgical and Nonsurgical Medical Trainees: An Internet-Based Survey. JOURNAL OF SURGICAL EDUCATION 2023; 80:666-675. [PMID: 36801202 DOI: 10.1016/j.jsurg.2023.01.013] [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: 11/30/2022] [Revised: 01/05/2023] [Accepted: 01/27/2023] [Indexed: 06/18/2023]
Abstract
BACKGROUND Physicians in training face a variety of stressors throughout their professional development and according to their gender. Among them, surgical trainees appear to be especially at risk for mental health problems. OBJECTIVE The aim of the present study was to compare demographic features, professional activities and adversities, depression, anxiety, and distress among men and women trainees of surgical and nonsurgical medical specialties. DESIGN AND PARTICIPANTS A cross-sectional, retrospective, comparative study was conducted on a total of 12,424 trainees (68.7% nonsurgical and 31.3% surgical) from Mexico through an online survey. Demographic features, variables related to professional activities and adversities, depression, anxiety, and distress were evaluated through self-administered measures. Comparative analyses using the Cochran-Mantel-Haenszel test for categorical variables and multivariate analysis of variance including medical residency program and gender as fixed factors to test their interaction effect for continuous variables were used. RESULTS An important interaction between medical specialty and gender was found. Women trainees from surgical specialties report more frequent psychological and physical aggressions. Women from both specialties had higher distress, significant anxiety, and depression than men. Men from surgical specialties worked more hours per day. CONCLUSIONS Gender differences are evident in trainees for medical specialties, with a larger impact in surgical fields. Mistreatment of students is a pervasive behavior that affects society as a whole, and actions to improve learning and working environments in all medical specialties, but mostly in surgical fields, are urgently needed.
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Affiliation(s)
- Ana Fresán
- Subdirección de Investigaciones Clínicas, Instituto Nacional de Psiquiatría Ramón de la Fuente Muñiz, Mexico City, Mexico.
| | - Diana Guízar-Sánchez
- Departamento de Fisiología de la Facultad de Medicina, Universidad Nacional Autónoma de México, UNAM, Copilco Universidad, Mexico City, Mexico
| | - María Yoldi-Negrete
- Subdirección de Investigaciones Clínicas, Instituto Nacional de Psiquiatría Ramón de la Fuente Muñiz, Mexico City, Mexico
| | - Rebeca Robles-García
- Centro de Investigación en Salud Mental Global, Instituto Nacional de Psiquiatría Ramón de la Fuente Muñiz, Mexico City, Mexico
| | - Carlos-Alfonso Tovilla-Zárate
- División Académica Multidisciplinaria de Comalcalco, Universidad Juárez Autónoma de Tabasco, Ranchería Sur, Cuarta sección, Comalcalco, Tabasco, Mexico
| | - Ricardo Saracco-Álvarez
- Subdirección de Investigaciones Clínicas, Instituto Nacional de Psiquiatría Ramón de la Fuente Muñiz, Mexico City, Mexico
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Panagioti M, Hondkinson A. Adverse professional life experiences may affect mental health among cardiologists. Nat Rev Cardiol 2023; 20:287-288. [PMID: 36869095 DOI: 10.1038/s41569-023-00850-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/05/2023]
Affiliation(s)
- Maria Panagioti
- NIHR School for Primary Care Research, Division of Population Health, Health Services Research and Primary Care, School of Health Sciences, Faculty of Biology, Medicine and Health, Manchester Academic Health Science Centre, University of Manchester, Manchester, UK. .,NIHR Greater Manchester Patient Safety Translational Research Centre, Division of Population Health, Health Services Research and Primary Care, School of Health Sciences, Faculty of Biology, Medicine and Health, Manchester Academic Health Science Centre, University of Manchester, Manchester, UK.
| | - Alexander Hondkinson
- NIHR School for Primary Care Research, Division of Population Health, Health Services Research and Primary Care, School of Health Sciences, Faculty of Biology, Medicine and Health, Manchester Academic Health Science Centre, University of Manchester, Manchester, UK.,NIHR Greater Manchester Patient Safety Translational Research Centre, Division of Population Health, Health Services Research and Primary Care, School of Health Sciences, Faculty of Biology, Medicine and Health, Manchester Academic Health Science Centre, University of Manchester, Manchester, UK
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Prentice S, Elliott T, Dorstyn D, Benson J. Burnout, wellbeing and how they relate: A qualitative study in general practice trainees. MEDICAL EDUCATION 2023; 57:243-255. [PMID: 35997632 PMCID: PMC10086955 DOI: 10.1111/medu.14931] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/23/2022] [Revised: 08/15/2022] [Accepted: 08/19/2022] [Indexed: 06/15/2023]
Abstract
PURPOSE Although research has explored burnout risk factors among medical trainees, there has been little exploration of the personal experiences and perceptions of this phenomenon. Similarly, there has been little theoretical consideration of trainee wellbeing and how this relates to burnout. Our study aimed to conceptualise both constructs. METHOD We situated this study within a post-positivist epistemology using grounded theory to guide the research process. Participants were recruited from one Australian General Practice training organisation. Fourteen trainees completed interviews, while a further five focus groups explored the views of 33 supervisors, educators and training coordinators. Data collection and analysis occurred concurrently, drawing upon constant comparison and triangulation. Template analysis, using an iterative process of coding, was employed to generate conceptual models of the phenomena of interest. RESULTS Participants described burnout as an insidious syndrome lying on a spectrum, with descriptions coalescing under seven themes: altered emotion, compromised performance, disengagement, dissatisfaction, exhaustion, overexertion and feeling overwhelmed. Wellbeing was perceived to comprise personal and professional domains that interacted and were fuelled by an underlying 'reservoir'. Both constructs were linked by the degree of a trainee's value fulfilment, with burnout occurring when a trainee's wellbeing reservoir was depleted. CONCLUSIONS Participants in this study characterised burnout and wellbeing as multifaceted, connected constructs. Given the complexity of these constructs, preventive interventions should target both person and workplace-focused factors, with value fulfilment proposed as the basic change mechanism. A novel model that synthesises and advances previous research is offered based on these findings.
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Affiliation(s)
- Shaun Prentice
- School of Psychology, Faculty of Health and Medical SciencesUniversity of AdelaideAdelaideSouth AustraliaAustralia
- GPEx Ltd.AdelaideSouth AustraliaAustralia
| | | | - Diana Dorstyn
- School of Psychology, Faculty of Health and Medical SciencesUniversity of AdelaideAdelaideSouth AustraliaAustralia
| | - Jill Benson
- GPEx Ltd.AdelaideSouth AustraliaAustralia
- Health in Human Diversity Unit, School of Medicine, Faculty of Health and Medical SciencesUniversity of AdelaideAdelaideSouth AustraliaAustralia
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Marqueze EC, de Sá e Benevides EA, Russo AC, Fürst MSG, Roscani RC, Guimarães PCV, Salim CA. Organizational Risk Factors for Aircrew Health: A Systematic Review of Observational Studies. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:3401. [PMID: 36834104 PMCID: PMC9960399 DOI: 10.3390/ijerph20043401] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Revised: 01/12/2023] [Accepted: 02/08/2023] [Indexed: 06/18/2023]
Abstract
Addressing the field of health and safety at work, the primary objective of the present systematic review was to analyze the organizational risk factors for aircrew health according to professional category (flight attendants and pilots/co-pilots) and their consequences. The secondary objective was to identify the countries in which studies were carried out, focusing on the quality of content of the publications. The Medline/Pubmed, Cochrane, Web of Science, and Scopus databases were searched for eligible studies according to PRISMA statements. The risk of bias and the methodological quality of the studies were assessed using the Newcastle-Ottawa scale and Loney tools. Of the 3230 abstracts of articles screened, 36 studies met the inclusion criteria. Most of the research conducted on risk factors for the work organization of aircrew was carried out in the United States and the European Union and had moderate or low-quality methodology and evidence. However, the findings are homogeneous and allow the most prevalent organizational risk factors for the health of aircrew to be determined, namely, high work demand, long hours, and night work. Consequently, the most pervasive health problems were sleep disturbances, mental health disorders, musculoskeletal disorders, and fatigue. Thus, the regulation of the aircrew profession must prioritize measures that minimize these risk factors to promote better health and sleep for these professionals and, consequently, to provide excellent safety for workers and passengers.
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Affiliation(s)
- Elaine Cristina Marqueze
- Fundação Jorge Duprat Figueiredo de Segurança e Medicina do Trabalho—Fundacentro, São Paulo 30180-100, Brazil
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Akiyama N, Akiyama T, Sato H, Shiroiwa T, Kishi M. Comparison of physicians' and dentists' incident reports in open data from the Japan Council for Quality Health Care: a mixed-method study. BMC Oral Health 2023; 23:67. [PMID: 36732783 PMCID: PMC9896658 DOI: 10.1186/s12903-023-02749-x] [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: 09/16/2022] [Accepted: 01/16/2023] [Indexed: 02/04/2023] Open
Abstract
BACKGROUND Patient safety is associated with patient outcomes. However, there is insufficient evidence of patient safety in the dental field. This study aimed to compare incidents reported by dentists and physicians, compare the type of errors made by them, and identify how dentists prevent dental errors. METHODS A mixed-methods study was conducted using open data from the Japan Council for Quality Health Care database. A total of 6071 incident reports submitted for the period 2016-2020 were analyzed; the number of dentists' incident reports was 144, and the number of physicians' incident reports was 5927. RESULTS The percentage of dental intern reporters was higher than that of medical intern reporters (dentists: n = 12, 8.3%; physicians: n = 180, 3.0%; p = 0.002). The percentage of reports by dentists was greater than that by physicians: wrong part of body treated (dentists: n = 26, 18.1%; physicians: n = 120, 2.0%; p < 0.001), leaving foreign matter in the body (dentists: n = 15, 10.4%; physicians: n = 182, 3.1%; p < 0.001), and accidental ingestion (dentists: n = 8, 5.6%; physicians: n = 8, 0.1%; p < 0.001), and aspiration of foreign body (dentists: n = 5, 3.4%; physicians: n = 33, 0.6%; p = 0.002). The percentage of each type of prevention method utilized was as follows: software 27.8% (n = 292), hardware (e.g., developing a new system) 2.1% (n = 22), environment (e.g., coordinating the activities of staff) 4.2% (n = 44), liveware (e.g., reviewing procedure, double checking, evaluating judgement calls made) 51.6% (n = 542), and liveware-liveware (e.g., developing adequate treatment plans, conducting appropriate postoperative evaluations, selecting appropriate equipment and adequately trained medical staff) 14.3% (n = 150). CONCLUSION Hardware and software and environment components accounted for a small percentage of the errors made, while the components of liveware and liveware-liveware errors were larger. Human error cannot be prevented by individual efforts alone; thus, a systematic and holistic approach needs to be developed by the medical community.
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Affiliation(s)
- Naomi Akiyama
- School of Nursing, Gifu University of Health Science, 2-92 Higashi Uzura, Gifu City, Gifu Prefecture, 500-8281, Japan.
| | - Tomoya Akiyama
- grid.437848.40000 0004 0569 8970Center for Postgraduate Clinical Training and Career Development, Nagoya University Hospital, 65 Tsurumai, Syowaku, Nagoya City, Aichi Prefecture 466-8560 Japan
| | - Hideaki Sato
- grid.252427.40000 0000 8638 2724Department of Oral and Maxillofacial Surgery, Asahikawa Medical University, 2-1-1 Midorigaoka Higashi, Asahikawa City, Hokkaido 078-8510 Japan
| | - Takeru Shiroiwa
- grid.415776.60000 0001 2037 6433Center for Outcomes Research and Economic Evaluation for Health (C2H), National Institute of Public Health (NIPH), 2-3-6 Minami, Wako City, Saitama Prefecture 351-0197 Japan
| | - Mitsuo Kishi
- grid.411790.a0000 0000 9613 6383School of Dentistry, Iwate Medical University, 19-1 Uchimaru, Morioka City, Iwate Prefecture 020-8505 Japan
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Norvell J, Unruh G, Norvell T, Templeton KJ. Addressing Burnout Among Women Residents: Results from Focus Group Discussions. Kans J Med 2023; 16:83-87. [PMID: 37124099 PMCID: PMC10136605 DOI: 10.17161/kjm.vol16.18364] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Accepted: 03/03/2023] [Indexed: 05/02/2023] Open
Abstract
Introduction Physician burnout has been described as more common among women than men. Even if there are no gender-based differences in prevalence, risk factors, such as work/home integration/conflict and gendered biases, likely differ. Prior administrations of an annual resident wellness survey at a single urban academic institution confirmed that rates of burnout were higher among women, especially during the PGY-2 year. Methods A series of focus groups of PGY-3 women residents across specialties were organized in 2019 at a single urban academic medical center. Given the number of participants, demographics were not collected to maintain participant anonymity. The moderator for all groups used a discussion guide consisting of eight open-ended questions based on a review of the literature. Results Ten residents agreed to participate in one of four hour-long focus group discussions. While the residents identified some factors that were not gender-specific, they also discussed issues that they faced as women in medicine, including needing to work harder to prove themselves and unconscious gendered biases from faculty and patients. The residents thought that their well-being would be improved if their training programs better understood the experiences and needs of women residents and recommended a series of interventions, including improved mentoring and networking opportunities. Conclusions Interventions to improve well-being need to consider gender-based differences. While mentoring and networking can help all residents, these may be especially useful for women and should be considered as a component of an overarching plan to improve diversity, equity, inclusion, and belonging.
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Affiliation(s)
- Jeff Norvell
- Department of Emergency Medicine, University of Kansas Medical Center, Kansas City, KS
| | - Greg Unruh
- Department of Anesthesiology, University of Kansas Medical Center, Kansas City, KS
| | | | - Kimberly J Templeton
- Department of Orthopaedic Surgery, University of Kansas Medical Center, Kansas City, KS
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Rink LC, Oyesanya TO, Adair KC, Humphreys JC, Silva SG, Sexton JB. Stressors Among Healthcare Workers: A Summative Content Analysis. Glob Qual Nurs Res 2023; 10:23333936231161127. [PMID: 37020708 PMCID: PMC10068501 DOI: 10.1177/23333936231161127] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2022] [Revised: 02/09/2023] [Accepted: 02/15/2023] [Indexed: 04/03/2023] Open
Abstract
Healthcare workers are experiencing high stress and burnout, at rates up to 70%, hindering patient care. Studies often focus on stressors in a particular setting or within the context of the pandemic which limits understanding of a more comprehensive view of stressors experienced by healthcare workers. The purpose of this study was to assess healthcare workers’ self-reported major stressors. Between June 2018 and April 2019, U.S. healthcare workers ( N = 2,310) wrote answers to an open-ended question: “What are your biggest stressors as you look back over the last few weeks?” A summative content analysis was used to analyze the data. Healthcare workers described three types of stressors: work stressors (49% of total stressors), personal life stressors (32% of total stressors), and stressors that intersect work and personal life (19% of total stressors). Future research and clinical practice should consider the multi-faceted sources of stress.
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Affiliation(s)
- Lesley C. Rink
- Duke University, Durham, NC, USA
- Lesley Rink, Duke University, 307 Trent
Drive, Durham, NC 27710, USA.
| | | | - Kathryn C. Adair
- Duke University, Durham, NC, USA
- Duke University Health System, Durham,
NC, USA
| | | | | | - John Bryan Sexton
- Duke University, Durham, NC, USA
- Duke University Health System, Durham,
NC, USA
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Prevalence and determinants of Italian physicians' burnout in the "post-COVID-19" era. Int Arch Occup Environ Health 2023; 96:377-387. [PMID: 36335513 PMCID: PMC9638242 DOI: 10.1007/s00420-022-01929-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2022] [Accepted: 10/16/2022] [Indexed: 11/09/2022]
Abstract
PURPOSE Several studies investigated prevalence and determinants of physicians' burnout during the peak of the COVID-19 pandemic, but only a few during the chronic phase of the pandemic. This study thus aimed to examine this topic referring to the "post-COVID-19 era", defined as a chronic and likely-to-be endemic status quo. METHODS A cross-sectional, online survey (November 2021-January 2022) was addressed to physicians in Lombardia (Northern Italy). Besides socio-demographic and COVID-19-related data, measures of personal, work- and patient-related burnout (Copenhagen Burnout Inventory; CBI), depression (Patient Health Questionnaire-8), anxiety (General Anxiety Disorder-7), and self-efficacy (General Self-Efficacy Scale) were collected. Linear/generalized linear models were run to test associations/predictions of interest. RESULTS Among the 958 respondents, burnout symptoms were clinically significant in 18.5% of them. Predictive models showed that female sex (OR = 0.73, 95% CI 0.42-1.27), younger age (OR = 0.94, 95% CI 0.59-1.48), shorter job tenure (OR = 1.01, 95% CI 0.62-1.65), trainee status (OR = 1.41, 95% CI 1.16-7.10), higher PHQ-8 (OR = 1.260, 95% CI 1.16-1.37), and GAD-7 scores (OR = 1.19, 95% CI 1.10-1.30) increased the risk to suffer from clinical burnout. COVID-19-related variables were mostly not related/associated to burnout levels. CONCLUSION In Italy, physicians' burnout is moderately prevalent also in the chronic phase of the pandemic, with its determinants being more intrinsic than environmental. The development of effective interventions is needed to help physicians cope with the new challenges of their job.
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Zhou AY, Hann M, Panagioti M, Patel M, Agius R, Van Tongeren M, Esmail A, Bower P. Exploring Associations between Stressors and Burnout in Trainee Doctors During the COVID-19 Pandemic in the UK. ACADEMIC PSYCHIATRY : THE JOURNAL OF THE AMERICAN ASSOCIATION OF DIRECTORS OF PSYCHIATRIC RESIDENCY TRAINING AND THE ASSOCIATION FOR ACADEMIC PSYCHIATRY 2022; 46:723-728. [PMID: 35661339 PMCID: PMC9165924 DOI: 10.1007/s40596-022-01660-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/13/2021] [Accepted: 05/12/2022] [Indexed: 06/15/2023]
Abstract
OBJECTIVE The authors examined associations between stressors and burnout in trainee doctors during the COVID-19 pandemic. METHODS An anonymous online questionnaire including 42 questions on general and pandemic-specific stressors, and the Maslach Burnout Inventory-Health Services Survey (MBI-HSS), was sent to 1000 randomly selected trainee doctors in North-West England. Main outcomes were burnout scores that were stratified into Emotional Exhaustion (EE), Depersonalisation (DP), and reduced Personal Accomplishment (PA) and associations between stressors and burnout using stepwise regression analysis. RESULTS A total of 362 complete responses were received giving a response rate of 37%. Mean scores for EE, DP, and PA derived from the MBI-HSS were 27.7, 9.8, and 34.3 respectively. Twenty-three stressors were found to be associated with burnout dimensions. "Increase in workload and hours due to COVID-19," "Poor leadership and management in the National Health Service," and "Not feeling valued" were found to have strong associations with burnout dimensions. Only "Not confident in own abilities" was found to be associated with all burnout dimensions. CONCLUSIONS Associations with burnout were found to be identified in a range of work, pandemic, and non-work-related stressors, supporting the need for multi-level interventions to mitigate burnout.
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Affiliation(s)
| | - Mark Hann
- University of Manchester, Manchester, UK
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Garrett CC, Doonan RL, Pyle C, Azimov MB. Student loan debt and financial education: a qualitative analysis of resident perceptions and implications for resident well-being. MEDICAL EDUCATION ONLINE 2022; 27:2075303. [PMID: 35583298 PMCID: PMC9122352 DOI: 10.1080/10872981.2022.2075303] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Revised: 05/04/2022] [Accepted: 05/05/2022] [Indexed: 06/15/2023]
Abstract
High educational debt is prevalent among resident physicians and correlates with adverse well-being outcomes, including symptoms of stress and burnout. Residents also report low financial literacy levels, affecting financial well-being. Understanding resident viewpoints toward financial well-being initiatives is crucial to develop targeted resident financial well-being programs. This study aims to examine residents' experiences financing their medical education and how these experiences influence well-being and attitudes toward financial education in residency. We recruited residents from a Southern California health system with residency programs in Family Medicine, Internal Medicine, General Surgery, Orthopaedic Surgery, and Psychiatry. We contacted residents by email and text message to participate in semi-structured interviews. We conducted interviews from October 2020 to March 2021 and analyzed 59 resident interviews using reflexive thematic analysis. Among residents, 76% (45/59) had ≥ $200,000 in student loans. Residents perceived mounting medical education debt as unfairly burdensome for trainees engaged in socially beneficial work, leaving residents feeling undervalued - a feeling heightened by the stressors of the COVID-19 pandemic - and hampering well-being. Compartmentalizing debt attenuated financial stressors but often made financial education seem less pressing. A subset of residents described how financial planning restored some agency and enhanced well-being, noting that protected didactic time for financial education was crucial. Resident interviews provide practical guidance regarding designing financial education sessions. Desired education included managing debt, retirement planning, and the business of medicine. How residents framed educational debt and their degree of financial literacy impacted their well-being and sense of agency. Residents proposed that residency programs can aid in stress mitigation by providing residents with skills to help manage debt and plan for retirement. To reduce clinician indebtedness, this approach needs to occur in tandem with systemic changes to financing medical education.
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Affiliation(s)
- Cameryn C. Garrett
- Graduate Medical Education, Community Memorial Health System, Ventura, California, USA
| | - Ronda L. Doonan
- Graduate Medical Education, Community Memorial Health System, Ventura, California, USA
| | - Casey Pyle
- Orthopaedic Surgery Residency Program, Community Memorial Health System, Ventura, California, USA
| | - Michelle B. Azimov
- Graduate Medical Education, Community Memorial Health System, Ventura, California, USA
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Gohar AA, Knauert M, Kalot MA, Khan A, Sider D, Javed MA, Wooldridge D, Eck L, Buckhold F, Colaco B, Bhat A, Castillo DM, Newman R, Mustafa RA. Influence of medical trainee sleep pattern (chronotype) on burn-out and satisfaction with work schedules: a multicentre observational study. Postgrad Med J 2022; 98:936-941. [PMID: 37062998 PMCID: PMC10074556 DOI: 10.1136/postgradmedj-2021-140975] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2021] [Accepted: 10/25/2021] [Indexed: 01/25/2023]
Abstract
BACKGROUND Medical trainees' work schedule is designed to cover duties without consideration of differences in circadian rhythms during a 24-hour period (chronotype). OBJECTIVE To explore chronotype variation among medical trainees and understand its association with burn-out and schedule satisfaction. METHODS In a multicentre observational study, we conducted two surveys between 1 October 2018 and 1 April 2019. Trainees from nine centres across the USA participated. We measured burn-out using Maslach Burnout Inventory (MBI), and trainee chronotype using the Morningness-Eveningness Questionnaire (MEQ). RESULTS 324 (32%) out of 1012 responded to our survey. Participants were 51% female and had a mean age of 30.8 years. Most participants had an intermediate MEQ type (65%). A large proportion of participants had burn-out on at least one of three tested MBI scales (62%); 5% of participants had burn-out on all three MBI scales. More participants with evening MEQ type had burn-out (66%) compared with morning MEQ type (55%), however, the results were not statically significant (p=0.294). Overall satisfaction with work shifts was 6.5 (95% CI 6.3 to 6.7), with higher satisfaction with day shift 7.7 (95% CI 7.5 to 7.9) and lowest satisfaction with overnight 24-hour call 3.5 (95% CI 3.2 to 3.9). Satisfaction was lower in trainees with burn-out 6.0 (95% CI 5.7 to 6.4), (p<0.001). In the follow-up survey, burn-out was present in at least one scale in 64% compared with 60% of respondents in the initial survey. CONCLUSION Burn-out is prevalent among medical trainees. Improving alignment between trainee preferences may improve performance, reduce human errors and burn-out.
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Affiliation(s)
- Ashraf A Gohar
- Department of Medicine, University of Missouri, Kansas City, Missouri, USA
| | - Melissa Knauert
- Department of Medicine, Yale University School of Medicine, New Haven, Connecticut, USA
| | - Mohamad A Kalot
- Department of Medicine, State University of New York, Buffalo, New York, USA
| | - Akram Khan
- Department of Medicine, Oregon Health & Science University, Portland, Oregon, USA
| | - Darby Sider
- Department of Internal Medicine, Cleveland Clinic Florida, Weston, Florida, USA
| | - Muhammad Ali Javed
- Department of Critical Care Medicine, Mercy Hospital St Louis Area, Saint Louis, Missouri, USA
| | - David Wooldridge
- Department of Medicine, University of Missouri, Kansas City, Missouri, USA
| | - Leigh Eck
- Department of Medicine, University of Kansas Medical Center, Kansas City, Missouri, USA
| | - Fred Buckhold
- Department of Internal Medicine, Saint Louis University School of Medicine, Saint Louis, Missouri, USA
| | - Brendon Colaco
- Department of pulmonary, Mayo Clinic, Jacksonville, Florida, USA
| | - Abid Bhat
- Department of Medicine, University of Missouri, Kansas City, Missouri, USA
| | - Dubier Matos Castillo
- Division of Pulmonary Critical Care, Department of Medicine, Oregon Health & Science University, Portland, Oregon, USA
| | - Ross Newman
- Department of Pediatrics, Children's Mercy, Kansas City, Missouri, USA
| | - Reem A Mustafa
- Department of Internal Medicine, University of Kansas Medical Center, Kansas City, Kansas, USA
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