Identifying Key Factors for Burnout Among Orthopedic Surgeons Using the Analytic Hierarchy Process Method

Elevating Orthopaedic Excellence Through Professional Coaching

» Increased professional, personal, and emotional stress can have compounding negative effects on physicians, which can be detrimental to teamwork dynamics, workplace environment, productivity, and personal well-being. Orthopaedic surgery, in particular, is a medical specialty that demonstrates high workplace demands, elevated rates of burnout, and low workplace diversity.» Professional coaching can help combat these challenges and facilitate professional success by providing an outlet for discussion and planning toward one's career development and goals. Coaches, generally nonphysicians, are trained and certified to advise and guide physicians in their professional career paths.» There has been demonstrated success in the utilization of professional coaching in various medical specialties and groups, including anesthesiology, primary care, general surgery, and female surgeon organizations.» The purpose of this review is to evaluate existing models of professional coaching to inform its use within orthopaedic surgery as a means of promoting well-being, physician success, and workforce diversity.

Evaluation and improvement of nursing undergraduates' informatics competencies using a hybrid multi-criteria decision-making model

BACKGROUND

Nursing staff need to be constantly exposed to information systems at work and encounter patients who share medical data obtained from the internet; this was widely observed during the coronavirus disease 2019 (COVID-19) pandemic. Hence, nursing staff should have the necessary skills and education that can help them develop nursing students' informatics competencies. However, research on assessing and improving nursing students' informatics competencies remains scarce.

OBJECTIVE

This study aimed to provide nursing educators with a refined evaluation model and targeted improvement strategies tailored to enhance undergraduate students' informatics competencies.

DESIGN

A cross-sectional study.

METHODS

This study constructed a hybrid multiple-criteria decision-making model. The analytical hierarchical process was applied to obtain criteria weights; thereafter, the Visekriterijumska Optimizacija I Kompromisno Resenje with Aspiration-level (VIKOR-AS) method was used to assess undergraduate nursing students' informatics competencies of in the case hospital.

PARTICIPANTS

Data were obtained from 22 clinically experienced nurses with experience in supervising undergraduate nursing students at a secondary public hospital in Zhejiang Province, China.

RESULTS

According to the weighted results, "Skill (C2)" is an important dimension with the highest weight ranking. The corresponding highest-ranking criteria for each dimension are "Knowing how to explain the information management strategies to ensure patient safety (C12)," "Applying information technology tools to support patient safety management (wristband scanning to identify patients, patients' electronic orders, etc.) (C21)," and "Paying attention to the importance of information technology in clinical decision-making and preventing errors or facilitating patient care coordination (C32)." In the case of the undergraduate nursing students' performance assessment, Student E was the best overall performer from the perspective of overall utility value. The remaining students ranked as follows: Student C ≻ Student D ≻ Student F ≻ Student A ≻ Student B.

CONCLUSIONS

This study model remedies the shortcomings of previous studies on evaluating undergraduate students' informatics competency dimensions, provides a reference for nursing colleges to develop nursing informatics-related curriculum content, and helps train nursing instructors to assess and train specific students. The results indicate that information skills are an important factor in the development of nursing students' informatics competencies; hence, nursing educators should prioritize the development of nursing students' informatics competencies, followed by information knowledge and attitudes.

Surgeon Burnout-Time to Heal the Healers

Burnout could be understood by the Old Testament, in which Moses father-in-law rebukes, You will only wear yourselves out. The work is too heavy for you; you cannot handle it alone (Exodus 18:1718). Burnout syndrome was first introduced by Freudenberger in 1974 [1]. It is now a global concern, though it is very much under-reported and discussed in our country. Shanafelt et al. reported it in about 40% of physicians and a slightly higher rate of 53% among surgeons, by comparison [2]. On top of this ladder, orthopedic surgeons are just behind trauma surgeons in ranking [3]. Occupational burnout syndrome is a feeling of emotional exhaustion, depersonalization, and low sense of personal accomplishment secondary to chronic occupational stress [4]. In the high-stakes world of surgery, the demanding nature of the profession can take a toll on surgeons mental and physical well-being and disturb their healthy work–life balance. The etiology is multifactorial, including personal, working environment, and career ambitions, and surgeons often have a combination of these [5]. Long working hours, intense pressure during surgeries, and the emotional burden of dealing with life-and-death situations can lead to chronic stress [6]. Hierarchy in the workplace, over-demanding aggressive patients, and increasing medicolegal implications are additions to surgeon burnout. Due to the incorporation of new techniques and equipment, surgeons are compelled to be lifelong learners for their scientific and technical excellence in their practice. On top of these, the inclusion of administrative tasks takes away their time from patient care and contributes to stress. Limited emotional support, both within the workplace and personally, also contributes to feelings of isolation and burnout. All of these negatively impact personal well-being and threaten surgeons longevity and the safety of patients to whom they provide care. Therefore, burnout affects the well-being of surgeons and can have severe implications for the quality of patient care. Fatigued surgeons may experience reduced job performance and develop an emotional milieu that contributes to medical errors [7]. On the personal front, they suffer from poor physical quality of life, psychosomatic issues, stress, depression, insomnia, fatigue, relationship issues, substance abuse, and suicide. Recently, Jennings et al. reported that burnout-induced suicides are highest among orthopedic surgeons [8]. Therefore, recognizing burnout among surgeons is crucial for medical professionals well-being and the quality of patient care. Several tools have been devised to measure burnout, which include the Maslach Burnout Inventory, the Copenhagen Burnout Inventory, and the Mayo Clinic Physician Well-being Tool [2, 9, 10]. Addressing burnout needs social and institutional-level support. A few strategies are improving the workplace environment, promoting teamwork, and reducing the administrative workload. Darrell Cambell even suggested modifying the surgical curriculum to the extent of providing proper mentorship right from the trainees time [11]. He said, “In the classic training program, we have taught how to perform surgery but not how to live as a surgeon. Organizations can conduct regular surveys for feedback and support, flexible working hours when required, and medicolegal support in adverse outcomes or major complication cases. Regular and timely physical and mental health checkups and training programs focused on resilience, stress management, and coping strategies can enhance surgeons ability to navigate challenging situations [12]. At an individual level, one needs to chalk out a work–life balance. As rightly said, “If your compassion does not include yourself, it is incomplete. One needs to introspect, recognize one’s own limits, and not set unrealistic goals. We need to understand that burnout is a Choice that we make, and once we understand and deal with the choices that lead to burnout, we would understand that the choices are completely avoidable. Although our organizations and society would have us continuously work to our maximum capacity (as per their standards), we should define these work parameters for ourselves. Personal acceptance of burnout and insights into reasons for burnout with measures that will reduce these reasons are the main measures for dealing with burnout for professional reasons. In addition, inculcating some self-care practices such as exercise, yoga, meditation, sports, and music. would help too. Vacation and vocation should be an integral part of busy surgeons lives. Finally, one should be bold enough to communicate and seek help when required because burnout is real and not a sign of personal failure. We should all strive to be resilient health-care providers in a conducive professional environment.