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Seyffert M, Wu C, Özkan-Seely GF. Insights into the Impact of Organizational Factors and Burnout on the Employees of a For-Profit Psychiatric Hospital during the Third Wave of the COVID-19 Pandemic. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2024; 21:484. [PMID: 38673395 PMCID: PMC11050685 DOI: 10.3390/ijerph21040484] [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: 01/11/2024] [Revised: 04/02/2024] [Accepted: 04/04/2024] [Indexed: 04/28/2024]
Abstract
In this paper, we provide insights into the interplay among the organizational, job, and attitudinal factors and employees' intentions to resign during the third wave of the COVID-19 pandemic at a mental health hospital. We point out shortcomings in the relationship dynamics between executive administration and operational staff and propose a pathway to develop more effective leadership frameworks to increase job satisfaction. We integrate qualitative data from case information and open-ended questions posed to employees at a mental health hospital and quantitative data from a small-scale survey (n = 19). We highlight that the ability to achieve objectives, work autonomy, burnout, affective commitment, distributive and procedural justice, and job satisfaction are critical in determining individuals' intentions to resign. Individuals identified disconnectedness and moral distress as critical aspects, while highlighting empathy, compassion, satisfaction, and confidence as pivotal elements. Mental healthcare settings could benefit from enhancing the staff's ability to achieve objectives, work autonomy, affective commitment, and both distributive and procedural justice. Addressing burnout and implementing measures to increase job satisfaction are equally vital. Efficiently restructuring dynamics between various leadership levels and staff can significantly improve employee retention.
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Affiliation(s)
- Michael Seyffert
- School of Business, University of Washington Bothell, Bothell, WA 98195, USA;
| | - Chunyi Wu
- Michigan Medicine, University of Michigan, Ann Arbor, MI 48109, USA;
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Phua GLG, Owyong JLJ, Leong ITY, Goh S, Somasundaram N, Poon EYL, Chowdhury AR, Ong SYK, Lim C, Murugam V, Ong EK, Mason S, Hill R, Krishna LKR. A systematic scoping review of group reflection in medical education. BMC MEDICAL EDUCATION 2024; 24:398. [PMID: 38600515 PMCID: PMC11007913 DOI: 10.1186/s12909-024-05203-w] [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: 01/20/2023] [Accepted: 02/20/2024] [Indexed: 04/12/2024]
Abstract
BACKGROUND Reviewing experiences and recognizing the impact of personal and professional views and emotions upon conduct shapes a physician's professional and personal development, molding their professional identity formation (PIF). Poor appreciation on the role of reflection, shortages in trained tutors and inadequate 'protected time' for reflections in packed medical curricula has hindered its integration into medical education. Group reflection could be a viable alternative to individual reflections; however, this nascent practice requires further study. METHODS A Systematic Evidence Based Approach guided Systematic Scoping Review (SSR in SEBA) was adopted to guide and structure a review of group reflections in medical education. Independent searches of articles published between 1st January 2000 and 30th June 2022 in bibliographic and grey literature databases were carried out. Included articles were analysed separately using thematic and content analysis, and combined into categories and themes. The themes/categories created were compared with the tabulated summaries of included articles to create domains that framed the synthesis of the discussion. RESULTS 1141 abstracts were reviewed, 193 full-text articles were appraised and 66 articles were included and the domains identified were theories; indications; types; structure; and benefits and challenges of group reflections. CONCLUSIONS Scaffolded by current approaches to individual reflections and theories and inculcated with nuanced adaptations from other medical practices, this SSR in SEBA suggests that structured group reflections may fill current gaps in training. However, design and assessment of the evidence-based structuring of group reflections proposed here must be the focus of future study.
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Affiliation(s)
- Gillian Li Gek Phua
- Yong Loo Lin School of Medicine, National University of Singapore, NUHS Tower Block, Level 11, Singapore, Singapore
- Division of Supportive and Palliative Care, National Cancer Centre Singapore, Singapore, Singapore
- Lien Centre for Palliative Care, Duke-NUS Medical School, National University of Singapore, Singapore, Singapore
- Division of Cancer Education, National Cancer Centre Singapore, Singapore, Singapore
- Duke-NUS Medical School, 8 College Road, Singapore, 169857, Singapore
| | - Jasmine Lerk Juan Owyong
- Division of Cancer Education, National Cancer Centre Singapore, Singapore, Singapore
- School of Humanities and Behavioural Sciences, Singapore University of Social Sciences, 463 Clementi Road, Singapore, Singapore
| | - Ian Tze Yong Leong
- Yong Loo Lin School of Medicine, National University of Singapore, NUHS Tower Block, Level 11, Singapore, Singapore
- Division of Supportive and Palliative Care, National Cancer Centre Singapore, Singapore, Singapore
| | - Suzanne Goh
- Duke-NUS Medical School, 8 College Road, Singapore, 169857, Singapore
- KK Women's and Children Hospital, 100 Bukit Timah Rd, Singapore, 169854, Singapore
| | - Nagavalli Somasundaram
- Division of Cancer Education, National Cancer Centre Singapore, Singapore, Singapore
- Duke-NUS Medical School, 8 College Road, Singapore, 169857, Singapore
- Division of Medical Oncology, National Cancer Centre Singapore, Singapore, Singapore
| | - Eileen Yi Ling Poon
- Division of Medical Oncology, National Cancer Centre Singapore, Singapore, Singapore
| | | | - Simon Yew Kuang Ong
- Division of Cancer Education, National Cancer Centre Singapore, Singapore, Singapore
- Duke-NUS Medical School, 8 College Road, Singapore, 169857, Singapore
- Division of Medical Oncology, National Cancer Centre Singapore, Singapore, Singapore
| | - Crystal Lim
- Duke-NUS Medical School, 8 College Road, Singapore, 169857, Singapore
- Medical Social Services, Singapore General Hospital, 16 College Road, Block 3 Level 1, Singapore, 169854, Singapore
| | - Vengadasalam Murugam
- Division of Supportive and Palliative Care, National Cancer Centre Singapore, Singapore, Singapore
- Duke-NUS Medical School, 8 College Road, Singapore, 169857, Singapore
| | - Eng Koon Ong
- Division of Supportive and Palliative Care, National Cancer Centre Singapore, Singapore, Singapore
- Division of Cancer Education, National Cancer Centre Singapore, Singapore, Singapore
- Duke-NUS Medical School, 8 College Road, Singapore, 169857, Singapore
- Assisi Hospice, 832 Thomson Rd, Singapore, Singapore
- Office of Medical Humanities, SingHealth Medicine Academic Clinical Programme, 31 Third Hospital Ave, Singapore, 168753, Singapore
| | - Stephen Mason
- Palliative Care Institute Liverpool, Academic Palliative & End of Life Care Centre, Cancer Research Centre, University of Liverpool, 200 London Rd, Liverpool, L3 9TA, UK
| | - Ruaridh Hill
- Health Data Science, University of Liverpool, Whelan Building, The Quadrangle, Brownlow Hill, Liverpool, UK
| | - Lalit Kumar Radha Krishna
- Yong Loo Lin School of Medicine, National University of Singapore, NUHS Tower Block, Level 11, Singapore, Singapore.
- Division of Supportive and Palliative Care, National Cancer Centre Singapore, Singapore, Singapore.
- Division of Cancer Education, National Cancer Centre Singapore, Singapore, Singapore.
- Duke-NUS Medical School, 8 College Road, Singapore, 169857, Singapore.
- Palliative Care Institute Liverpool, Academic Palliative & End of Life Care Centre, Cancer Research Centre, University of Liverpool, 200 London Rd, Liverpool, L3 9TA, UK.
- PalC, The Palliative Care Centre for Excellence in Research and Education, PalC c/o Dover Park Hospice, Singapore, Singapore.
- Centre for Biomedical Ethics, National University of Singapore, Singapore, Singapore.
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Lopina N. A Staged Defragmented Simultaneous Debriefing Model As Integrated Micro-debriefing Components Inside Online Simulation for Competencies Formation. Cureus 2024; 16:e56000. [PMID: 38606236 PMCID: PMC11007450 DOI: 10.7759/cureus.56000] [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: 03/09/2024] [Indexed: 04/13/2024] Open
Abstract
Background Currently, there are no separate debriefing models for online simulation training, and existing models simply imitate the traditional models used in on-site simulation training (the physical presence of individuals, such as students or trainees, in a simulation center). This involves hands-on, in-person training within a simulated environment to enhance practical skills and knowledge in a controlled setting. This scenario does not fully meet the requirements and capabilities of distance learning. Objective To develop a staged defragmented debriefing model as integrated micro-debriefing components inside an online simulation to support the development of clinical decision-making and competencies formation within medical education and offer recommendations to support the use of this debriefing model as a teaching strategy. Methods This descriptive study was conducted from August 2020 to September 2023. To build a staged defragmented debriefing model as integrated micro-debriefing components inside an online simulation for competencies formation the traditional debriefing model's components for on-site simulation training, simulation type, and structure, modern concepts of e-learning, and classification of the seriousness of medication errors were used. The main focus of this study was on providing a detailed account of the debriefing components for online simulation training, features, and implementation of this new teaching model. A total of 38 participants, healthcare professionals, were recruited for this study. The participants were randomly assigned to two groups: one experiencing the staged defragmented debriefing model (n = 20) and the other control group, which received traditional debriefing following simulation training (n = 18). Results The results allowed us to successfully develop a staged defragmented debriefing model inside the simulation that integrates micro-debriefing components located at different points of the simulation scenarios. This teaching approach was successfully implemented in online clinical case scenarios in the "ClinCaseQuest" Simulation Training Platform for continuous medical education. Additionally, an internal validation experiment comparing the effectiveness of the staged defragmented debriefing model with the traditional debriefing method demonstrated superior learning outcomes and participant satisfaction in the staged debriefing group. Conclusions The staged defragmented debriefing model, when integrated into online simulations, represents a promising strategy for advancing clinical decision-making skills and competencies formation in medical education. Implementation of this debriefing model as a teaching strategy holds promise for enhancing learning outcomes in medical education settings. Further research, validation, and implementation are recommended to maximize the model's potential impact on medical education and training.
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Berchtenbreiter K, Innes K, Watterson J, Nickson CP, Wong P. Intensive care unit nurses' perceptions of debriefing after critical incidents: A qualitative descriptive study. Aust Crit Care 2024; 37:288-294. [PMID: 37537123 DOI: 10.1016/j.aucc.2023.06.002] [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: 10/02/2022] [Revised: 05/22/2023] [Accepted: 06/03/2023] [Indexed: 08/05/2023] Open
Abstract
BACKGROUND Intensive care unit (ICU) nurses are exposed to critical incidents daily at their workplace, which may have long-term physical and psychological impacts. Despite the growing evidence supporting clinical debriefing in health care to prevent these impacts, a scarcity of literature exists to support its use in the adult intensive care setting. OBJECTIVES The objective of this study was to explore nurses' perceptions of clinical debriefing after critical incidents in an adult ICU. METHODS A qualitative descriptive design was utilised. Thematic analysis of data from individual semistructured interviews with six ICU nurses was undertaken. FINDINGS In this study, two themes were identified. Firstly, participants valued hot debriefing after critical incidents for the key reasons of having an opportunity to reflect on and learn from a critical incident and reduce normalisation of stressful situations. Secondly, when logistical factors such as communication, timing, and location were not considered, the attendance at debriefings was negatively influenced. Participants identified that ICU nurses commonly prioritised patient tasks over attending a debrief; therefore, teamwork and flexibility with logistics was crucial. CONCLUSIONS Hot debriefing, of a short duration and close to the time of the event, was valued and played an important role in staff wellbeing and self-care, contributing to preventing self-blame and normalisation of stressful situations. A clearer definition of the term along with greater recognition of types of events that could be considered critical incidents is required for staff support after critical incidents in the complex intensive care setting.
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Affiliation(s)
- Kristie Berchtenbreiter
- Alfred Health, 55 Commercial Road, Prahran, Victoria, 3004, Australia; Monash University, Monash Nursing and Midwifery, Wellington Road, Clayton, Victoria, 3800, Australia.
| | - Kelli Innes
- Monash University, Monash Nursing and Midwifery, Wellington Road, Clayton, Victoria, 3800, Australia.
| | - Jason Watterson
- Monash University, School of Public Health and Preventative Medicine, Wellington Road, Clayton, Victoria, 3800, Australia; Peninsula Health, 2 Hastings Rd, Frankston, VIC 3199 Australia.
| | - Christopher Peter Nickson
- Alfred Health, 55 Commercial Road, Prahran, Victoria, 3004, Australia; Monash University, School of Public Health and Preventative Medicine, Wellington Road, Clayton, Victoria, 3800, Australia.
| | - Pauline Wong
- Monash University, Monash Nursing and Midwifery, Wellington Road, Clayton, Victoria, 3800, Australia.
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