The Flipped Classroom Approach in a Pediatric Anesthesiology Fellowship Curriculum

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.

Healthcare Workers' Well-Being: A Systematic Review of Positive Psychology Interventions

Given persistent occupational stressors and multiple challenges in the delivery of healthcare, there is an increased focus on the well-being of healthcare workers. Responding to these challenges will require a multipronged approach, focusing on system level, organization, and individual actions. Positive psychology interventions (PPIs) represent a promising area for individual action. This systematic review indicates that PPI, delivered via many methods, holds promise for improving the well-being of healthcare workers, although there is a clear need for additional randomized controlled trials utilizing defined and standardized outcome measures. In this review, the most commonly evaluated PPIs were mindfulness-based or gratitude-based interventions. These were delivered via different methods, with many administered in the workplace and commonly in the form of courses ranging from two days to eight weeks. Researchers documented measurable improvements in multiple studied outcomes, noting reductions in symptoms of depression, anxiety, burnout, and stress. Some interventions increased well-being, job and life satisfaction, self-compassion, relaxation, and resilience. Most studies emphasized that these are simple, accessible, low-cost interventions. Limitations included some nonrandomized or quasi-experimental designs, alongside generally small sample sizes and varying methods of intervention delivery. Another concern is the lack of standardized outcome assessments and long-term follow-up data. As almost all studies included were performed before the pandemic, further research will be required post-pandemic. Overall, however, PPI shows promise as one arm of a multipronged approach to improving the well-being of healthcare workers.

An Ontological, Anthropological, and Psychoanalytic Perspective on Physician Burnout

Post-industrialization, societies have evolved with profound changes in ways of life. However, it was not until just recently that the overall impact of its deleterious and pernicious effects has been widely recognized, studied, and accepted. In the last few years, increased rates of stress and burnout (BO) not only affect clinicians, personally, but health care systems across the nation. The understanding of BO in the realm of current nosological limitations lacks context and is often unrecognized given the stigma associated with mental illness. However, the emerging data regarding this syndrome is highly concerning. Its impact on professionals and leaders across various disciplines is puzzling and underscores the nature and extent of the problem. A search of PubMed, PsycINFO, Cochrane Library, and Google Scholar was conducted from the date of inception until June 2022 using the keywords Burnout", "Mental Health"," Physicians", "Addiction", "Health Care Workers", "Anthropology", "Psychopathology", Philosophy", "Wellness". The search resulted in the identification of 135 articles; 56 articles met the inclusion criteria for the review. Post-pandemic BO has reached distressing levels. BO remains poorly understood highly complex and has multifactorial etiology which is now included in the 11th Revision of the International Classification of Diseases (ICD-11) as an occupational phenomenon. Besides being linked with known factors such as long work hours, administrative burdens, and a lack of control over one's work environment there are many confounders. It is a serious issue that can have negative consequences for both the physician and the patient, and therefore mitigation strategies are needed. The awareness of these unmanifested conflicts, mindfulness training, limiting addictive habits, and efforts toward wellness may provide some alternative solutions. Lastly, developing a coherent philosophy may be useful for distress tolerance, dealing with ambiguity related to the profession, and paving the way to a more meaningful life.