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Prentice S, Mullner H, Benson J, Kay M. Family medicine and general practitioner supervisor wellbeing: a literature review. BJGP Open 2024:BJGPO.2023.0230. [PMID: 38479758 DOI: 10.3399/bjgpo.2023.0230] [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: 11/20/2023] [Revised: 12/14/2023] [Accepted: 12/14/2023] [Indexed: 07/11/2024] Open
Abstract
BACKGROUND Research examining general practice supervisor wellbeing has often been conducted within the context of trainee wellbeing and educational outcomes. AIM To consolidate the current literature regarding the wellbeing of GP supervisors through a 'supervisor-wellbeing' lens. DESIGN & SETTING Literature review of original research studies on Embase, Ovid MEDLINE, and Ovid PsycINFO from inception to December 2022. METHOD The Embase, Ovid MEDLINE, and Ovid PsycINFO databases were systematically searched from inception to December 2022. Original research studies were eligible if they explored any aspect of wellbeing or burnout (that is, construct conceptualisations, risk and protective factors, implications, or interventions) among GPs involved in educating GP trainees. Reporting quality of included studies was assessed using the QualSyst tool. Results from included studies were narratively synthesised. RESULTS Data from 26 independent samples were reviewed. Burnout was generally conceptualised using the Leiter and Maslach model. Wellbeing was poorly defined in the literature, largely being conceptualised in personal psychological terms and, to a lesser extent, professional satisfaction. Risk and protective factors were identified and grouped as individual (for example, satisfaction with capacity to teach) and external (for example, autonomy, collegial relationships, resource availability) factors. GP supervisors' wellbeing appeared to affect their job performance and retention. This review identified only two studies evaluating interventions to support GP supervisors' wellbeing. CONCLUSION The present review highlights a lack of conceptual clarity and research examining interventions for GP supervisor wellbeing. It provides guidance for future research designed to maximise the wellbeing of GP supervisors and support the wellbeing of trainees.
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Affiliation(s)
- Shaun Prentice
- School of Psychology, The University of Adelaide, Adelaide, South Australia
- General Practice Training Research Department, Royal Australian College of General Practitioners, Adelaide, South Australia
| | - Helen Mullner
- General Practice Training, Royal Australian College of General Practitioners, Adelaide, South Australia
| | - Jill Benson
- General Practice Training, Royal Australian College of General Practitioners, Adelaide, South Australia
- School of Medicine, The University of Adelaide, Adelaide, Australia
| | - Margaret Kay
- General Practice Clinical Unit, Faculty of Medicine, The University of Queensland, Brisbane, Queensland
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Nevin SM, Le Marne FA, Beavis E, Macintosh R, Palmer EE, Sachdev R, Nunn K, Bye A. Psychosocial experiences of clinicians providing care for children with severe neurological impairment. Dev Med Child Neurol 2024. [PMID: 38837791 DOI: 10.1111/dmcn.15987] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/17/2023] [Revised: 04/22/2024] [Accepted: 05/06/2024] [Indexed: 06/07/2024]
Abstract
AIM To investigate clinicians' psychosocial experiences navigating interdisciplinary care for children with severe neurological impairment (SNI), for example children with a developmental epileptic encephalopathy; secondarily, to identify preferences for future interventions to support clinicians caring for children with SNI. METHOD We conducted a qualitative descriptive study with interdisciplinary clinicians by using a purposeful sampling recruitment strategy. Twenty-four participants with expertise caring for children with SNI completed in-depth, semi-structured interviews. We transcribed the interviews, de-identified them, and performed inductive thematic analysis. RESULTS Thematic analysis elicited interrelated themes. Clinicians experienced immense professional barriers providing patient-centred care across fragmented healthcare contexts. Physical, emotional, and psychological impacts were attributed to inadequate reflective practice training and a paucity of integrated resources to support clinicians over time. Multipronged strategies were prioritized by clinicians, incorporating psychoeducation, interdisciplinary peer mentorship, and psychological resources to build reflective practice skills for clinicians providing complex care in an advancing era of medicine. INTERPRETATION This study provides novel and in-depth insight into clinicians' experiences navigating care for children with SNI. The results will be used to inform future integrated and multipronged co-developed resources tailored for clinicians, on the basis of their recommendations.
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Affiliation(s)
- Suzanne M Nevin
- School of Clinical Medicine, UNSW Medicine & Health, Randwick Clinical Campus, Sydney, NSW, Australia
- Behavioral Sciences Unit, Kids Cancer Centre, Sydney Children's Hospital Network, Randwick, NSW, Australia
| | - Fleur A Le Marne
- School of Clinical Medicine, UNSW Medicine & Health, Randwick Clinical Campus, Sydney, NSW, Australia
- Department of Neurology, Sydney Children's Hospital Network, Randwick, NSW, Australia
| | - Erin Beavis
- Department of Neurology, Sydney Children's Hospital Network, Randwick, NSW, Australia
| | - Rebecca Macintosh
- Centre for Clinical Genetics, Sydney Children's Hospital Network, Randwick, NSW, Australia
| | - Elizabeth E Palmer
- School of Clinical Medicine, UNSW Medicine & Health, Randwick Clinical Campus, Sydney, NSW, Australia
- Centre for Clinical Genetics, Sydney Children's Hospital Network, Randwick, NSW, Australia
| | - Rani Sachdev
- School of Clinical Medicine, UNSW Medicine & Health, Randwick Clinical Campus, Sydney, NSW, Australia
- Centre for Clinical Genetics, Sydney Children's Hospital Network, Randwick, NSW, Australia
| | - Kenneth Nunn
- Department of Psychological Medicine Sydney, Children's Hospital Network, Sydney, NSW, Australia
| | - Ann Bye
- School of Clinical Medicine, UNSW Medicine & Health, Randwick Clinical Campus, Sydney, NSW, Australia
- Department of Neurology, Sydney Children's Hospital Network, Randwick, NSW, Australia
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Brulin E, Henriksson K, Landstad BJ. An impaired learning environment: Resident physicians' experience of the transition to pandemic care during the first wave of the COVID-19 pandemic in Sweden. Front Psychol 2023; 13:1090515. [PMID: 36687854 PMCID: PMC9853888 DOI: 10.3389/fpsyg.2022.1090515] [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: 11/05/2022] [Accepted: 12/19/2022] [Indexed: 01/07/2023] Open
Abstract
Introduction Extensive studies regarding the COVID-19 pandemic have shown negative effects on physicians-in-training. Besides a high workload, their learning environment has been affected. A quality learning environment is vital for residents' physician's clinical development and also their health. Nevertheless, few studies have explored this. The aim of this study was to explore resident physicians' experiences of transition to pandemic care during the first wave of the COVID-19 pandemic in Sweden. Method In this qualitative study, 12 Swedish resident physicians were interviewed using a semi-structured interview guide. They were interviewed between June and October of 2020 and asked to reflect on the pandemic and, more specifically, the first wave. The empirical material was analysed using qualitative content analysis. The analysis resulted in one theme and four categories. Results The theme identified was An impaired learning environment which signifies the disruptions the resident physicians experienced during the first wave of the pandemic. The four categories, Professional role insecurity, High expectations but little influence, Stagnant clinical development, and Professional growth through experience, describe in what way the learning environment was impacted.
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Affiliation(s)
- Emma Brulin
- The Department of Occupational Medicine, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | | | - Bodil J. Landstad
- The Department of Health Sciences, Mid Sweden University, Östersund, Sweden,The Unit of Research, Education and Development, Östersund Hospital, Östersund, Sweden,*Correspondence: Bodil J. Landstad, ✉
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Akhavan AR, Strout TD, Germann CA, Nelson SW, Jauregui J, Lu DW. "Going through the motions": A qualitative exploration of the impact of emergency medicine resident burnout on patient care. AEM EDUCATION AND TRAINING 2022; 6:e10809. [PMID: 36189447 PMCID: PMC9513530 DOI: 10.1002/aet2.10809] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/27/2022] [Revised: 08/30/2022] [Accepted: 09/06/2022] [Indexed: 06/16/2023]
Abstract
Objectives Burnout occurs frequently in emergency medicine (EM) residents and has been shown to have a negative impact on patient care. The specific effects of burnout on patient care are less well understood. This study qualitatively explores how burnout may change the way EM residents provide patient care. Methods Qualitative data were obtained from a sample of 29 EM residents in four semistructured focus groups across four institutions in the United States in early 2019. Transcripts were coded and organized into major patient care themes. Results Residents described many ways in which feelings of burnout negatively impacted patient care. These detrimental effects most often fit into one of four main themes: reduced motivation to care for patients, poor communication with patients, difficult interactions with health care colleagues, and impaired decision making. Conclusions According to EM residents, burnout negatively impacts several important aspects of patient care. Resident engagement with clinical care, communication with patients and colleagues, and clinical care may suffer as a result of burnout.
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Affiliation(s)
| | | | | | | | | | - Dave W. Lu
- Department of Emergency MedicineUniversity of WashingtonSeattleWashingtonUSA
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Silistraru I, Olariu O, Ciubara A, Roșca Ș, Roșca RO, Stanciu S, Condratovici AP, Ciureanu IA. Burnout and Online Medical Education: Romanian Students in Lockdown and Their Residency Choices. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19095449. [PMID: 35564841 PMCID: PMC9102410 DOI: 10.3390/ijerph19095449] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/20/2022] [Revised: 04/27/2022] [Accepted: 04/28/2022] [Indexed: 12/10/2022]
Abstract
The primary aim of the study was to investigate the prevalence of burnout in Romanian medical students during the COVID-19 pandemic using the Maslach Burnout Inventory-General Survey for Students (MBI-GS(S)). The presence of burnout was assessed based on Exhaustion (EX), Cynicism (CY) and Professional Efficacy (PE) subscales. The secondary aim of the study was to identify the presence of intentional shift in medical specialty compared to their initial pursued choice within the population investigated. Data was collected online at the end of 2020 and beginning of 2021 through a licensed, customized MBI-GS(S) questionnaire from a sample of 126 Romanian medical students at the two leading medical schools in the country, Iasi (N = 56) and Cluj Napoca (N = 70). Descriptive statistics and bivariate correlations were also applied to describe the data set (age and gender of participants) and the relationship between variables (EX, CY, PE). Subsequently, the MBI-GS(S) group report revealed that 36.5% of the medical students in the sample (46) experienced burnout, with problematic results both in Exhaustion and Cynicism. Exhaustion and Cynicism, which contribute to burnout, showed high scores compared to the average scale (EX = 3.5/2.4; CY = 2.8/1.8), while the Professional Efficacy score was relatively high (PE = 3.8/4.4), showing a protective effect and burnout reduction. One of the main conclusions is that the consequences of burnout in medical students plays a significant role in shaping the future healthcare practitioners’ perception of the medical profession and of patients’ wellbeing. Exhaustion and Cynicism are mainly associated with depersonalization and disconnection from the patient. Another conclusion of the study is that about one third of the respondents (30% Cluj students and 37.5% Iasi students) considered changing residency options. The pandemic has also revealed the limitations of and challenges facing current medical education, and that further research is required to assess the trends in prevalence of burnout in medical students.
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Affiliation(s)
- Ioana Silistraru
- Faculty of Social Sciences and Humanities, Lucian Blaga University of Sibiu, 550024 Sibiu, Romania;
| | - Oana Olariu
- Faculty of Medicine and Pharmacy, Dunarea de Jos University of Galati, 800008 Galati, Romania; (O.O.); (A.C.); (A.P.C.)
| | - Anamaria Ciubara
- Faculty of Medicine and Pharmacy, Dunarea de Jos University of Galati, 800008 Galati, Romania; (O.O.); (A.C.); (A.P.C.)
| | - Ștefan Roșca
- Faculty of Medicine and Pharmacy, Dunarea de Jos University of Galati, 800008 Galati, Romania; (O.O.); (A.C.); (A.P.C.)
- Correspondence:
| | - Ramona Oana Roșca
- Department of Chemistry, Physics and Environment, Faculty of Sciences and Environment, Dunarea de Jos University of Galati, 800008 Galati, Romania;
| | - Silviu Stanciu
- SAIABA Department-BIOALIMENT Research Center, Faculty of Food Science and Engineering, Dunarea de Jos University of Galati, 800008 Galati, Romania;
| | - Alina Plesea Condratovici
- Faculty of Medicine and Pharmacy, Dunarea de Jos University of Galati, 800008 Galati, Romania; (O.O.); (A.C.); (A.P.C.)
| | - Ioan-Adrian Ciureanu
- Medical Informatics and Biostatistics Department, Faculty of Medicine, Grigore T. Popa University of Medicine and Pharmacy, 700115 Iași, Romania;
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Lu DW, Germann CA, Nelson SW, Jauregui J, Strout TD. "Pulling the Parachute": A Qualitative Study of Burnout's Influence on Emergency Medicine Resident Career Choices. AEM EDUCATION AND TRAINING 2021; 5:e10535. [PMID: 34099988 PMCID: PMC8166306 DOI: 10.1002/aet2.10535] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/15/2020] [Revised: 08/30/2020] [Accepted: 09/11/2020] [Indexed: 06/12/2023]
Abstract
OBJECTIVES About half of all resident physicians report symptoms of burnout. Burnout negatively influences multiple aspects of their education and training. How burnout may impact residents' career choices remains unclear. The authors explored the role burnout played in residents' career decisions. METHODS This was a qualitative study among a sample of 29 emergency medicine residents from four institutions. Qualitative data were generated through four semistructured focus groups. The authors employed a constructivist approach to thematic analysis. Transcripts were coded and organized into major themes. RESULTS Five major themes connecting burnout with residents' career choices emerged: 1) residents' current burnout and the prevention of future burnout figured prominently in their career considerations, 2) residents aimed to mitigate sources of burnout through their career choices, 3) residents' view of clinical work as a burden and a burnout contributor spurred the pursuit of other interests, 4) faculty advice and role modeling in relation to burnout shaped residents' career perspectives, and 5) residents weighed long-term burnout concerns with short-term financial needs. CONCLUSION Burnout played an important role in multiple aspects of residents' career considerations. Educators, program directors, and organization leaders can focus on identified target areas to address burnout's influence on residents' career decisions.
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Affiliation(s)
- Dave W. Lu
- From theDepartment of Emergency MedicineUniversity of Washington School of MedicineSeattleWAUSA
- and theDepartment of Emergency MedicineTufts University School of Medicine–Maine Medical CenterPortlandMEUSA
| | - Carl A. Germann
- and theDepartment of Emergency MedicineTufts University School of Medicine–Maine Medical CenterPortlandMEUSA
| | - Sara W. Nelson
- and theDepartment of Emergency MedicineTufts University School of Medicine–Maine Medical CenterPortlandMEUSA
| | - Joshua Jauregui
- From theDepartment of Emergency MedicineUniversity of Washington School of MedicineSeattleWAUSA
| | - Tania D. Strout
- and theDepartment of Emergency MedicineTufts University School of Medicine–Maine Medical CenterPortlandMEUSA
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