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Desai V, Lee DJ, Lin RJ, Alvinia M, MacNeill H, Chan Y. Assessing Educator Burnout in Online Synchronous Teaching in Surgical Disciplines. JOURNAL OF SURGICAL EDUCATION 2024; 81:1409-1417. [PMID: 38997834 DOI: 10.1016/j.jsurg.2024.06.017] [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: 12/06/2023] [Revised: 04/19/2024] [Accepted: 06/16/2024] [Indexed: 07/14/2024]
Abstract
BACKGROUND COVID-19 had a tremendous impact on surgical residency education and training. With little experience or training in using online learning in pedagogically informed ways, some surgical educators and learners experienced the disadvantages of online learning which may have contributed to a greater sense of burnout in the pandemic. The purpose of this study is to survey the level of burnout in surgical educators and assess educators' perspectives on factors that increased or decreased burnout in synchronous online teaching during the pandemic. METHODS A cross-sectional study consisting of 4 sections was sent to surgical educators at the University of Toronto. Demographic data, validated surveys on burnout and videoconferencing fatigue (the Maslach Burnout Inventory-Educators Survey (MBI-ES) and the Zoom Exhaustion and Fatigue (ZEF) scale respectively), and quantitative questions about teaching factors in synchronous online environments were collected and analyzed. RESULTS The MBI-ES demonstrated a high degree of emotional exhaustion, and depersonalization and a moderate degree of personal accomplishment in surgeon educators. The ZEF scale noted moderate fatigue across all domains. Although educators noted online learning to be a moderate factor contributing to burnout during the pandemic, there was no correlation between the number of hours or percentage of time teaching online to burnout or zoom fatigue scores. The largest reported contributing factor to online learning leading to burnout was lack of connection to learners, whereas the largest mitigating factor was decreased travel time. INTERPRETATIONS The study found a moderate degree of exhaustion and burnout among surgical educators in Canada during COVID-19 and examined how aspects of online synchronous learning may have contributed to or helped mitigate these experiences. Based on this, we present approaches and educational theories to improve the online learning experience for surgical educators going forward.
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Affiliation(s)
- Veeral Desai
- Department of Otolaryngology-Head and Neck Surgery, University of Ottawa, Ontario, Canada
| | - Daniel J Lee
- Department of Otolaryngology-Head and Neck Surgery, St. Micheal's Hospital, Unity Health, Ontario, Canada
| | - Rui Jun Lin
- Department of Otolaryngology-Head and Neck Surgery, St. Micheal's Hospital, Unity Health, Ontario, Canada; Department of Otolaryngology-Head and Neck Surgery, University of Toronto, Ontario, Canada
| | | | - Heather MacNeill
- The KITE Research Institute, Toronto Rehabilitation Institute, University Health Network, Toronto, Ontario, Canada
| | - Yvonne Chan
- Department of Otolaryngology-Head and Neck Surgery, St. Micheal's Hospital, Unity Health, Ontario, Canada; Department of Otolaryngology-Head and Neck Surgery, University of Toronto, Ontario, Canada.
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Geiger JT, Lehane DJ, Nithipalan V, Kedwai BJ, Stoner MC, Ellis JL, Glocker RJ, Newhall KA, Doyle AJ. Implementation of a vascular acute care surgery service model is associated with decreased surgeon burnout. J Vasc Surg 2024; 80:894-901.e1. [PMID: 38796030 DOI: 10.1016/j.jvs.2024.05.040] [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: 04/11/2024] [Revised: 05/17/2024] [Accepted: 05/17/2024] [Indexed: 05/28/2024]
Abstract
OBJECTIVE Vascular surgeons have one of the highest rates of burnout among surgical specialties, often attributed to high patient acuity and clinical workload. Acute Care Surgery models are a potential solution used among general and trauma surgeons. METHODS This is a retrospective analysis of prospectively collected Accreditation Council for Graduate Medical Education survey results from faculty and residents before and after implementation of a vascular Acute Care Surgery (VACS) model. The VACS model assigns a weekly rotation of an attending surgeon with no elective cases or clinic responsibilities and a monthly rotating resident team. Residents and attendings are in-house to cover all urgent and emergent vascular daytime consultations and procedures, whereas nights and weekend coverage remain a typical rotating schedule. Survey question results were binned into domains consistent with the Maslach Burnout Inventory. RESULTS Both residents and faculty reported an increase in median scores in Maslach Burnout Inventory domains of emotional exhaustion (Faculty: 2.9 vs 3.4; P < .001; Residents: 3.1 vs 3.6; P < .001) and faculty reported higher personal accomplishment scores (Faculty: 3.3 vs 3.8; P = .005) after the VACS model implementation. CONCLUSIONS A VACS model is a tangible practice change that can address a major problem for current vascular surgeons, as it is associated with decreased burnout for faculty and residents through improvement in both emotional exhaustion and personal accomplishment. Improved longitudinal assessment of resident and faculty burnout is needed and future work should identify specific practice patterns related to decreased burnout.
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Affiliation(s)
- Joshua T Geiger
- University of Rochester Medical Center, Department of Surgery, Division of Vascular Surgery, Rochester, NY
| | - Daniel J Lehane
- University of Rochester Medical Center, Department of Surgery, Division of Vascular Surgery, Rochester, NY
| | - Vivek Nithipalan
- University of Rochester Medical Center, Department of Surgery, Division of Vascular Surgery, Rochester, NY
| | - Baqir J Kedwai
- University of Rochester Medical Center, Department of Surgery, Division of Vascular Surgery, Rochester, NY
| | - Michael C Stoner
- University of Rochester Medical Center, Department of Surgery, Division of Vascular Surgery, Rochester, NY
| | - Jennifer L Ellis
- University of Rochester Medical Center, Department of Surgery, Division of Vascular Surgery, Rochester, NY
| | - Roan J Glocker
- University of Rochester Medical Center, Department of Surgery, Division of Vascular Surgery, Rochester, NY
| | - Karina A Newhall
- University of Rochester Medical Center, Department of Surgery, Division of Vascular Surgery, Rochester, NY
| | - Adam J Doyle
- University of Rochester Medical Center, Department of Surgery, Division of Vascular Surgery, Rochester, NY.
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Barter CA, Humes D, Lund J. The Impact of the Covid-19 Pandemic on Annual Review of Competency Progression Outcomes Issued to General Surgical Trainees. JOURNAL OF SURGICAL EDUCATION 2024; 81:1119-1132. [PMID: 38825562 DOI: 10.1016/j.jsurg.2024.05.003] [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: 02/08/2024] [Revised: 04/29/2024] [Accepted: 05/07/2024] [Indexed: 06/04/2024]
Abstract
BACKGROUND The Covid-19 pandemic had a profound impact on surgical training. In this longitudinal cohort study, we quantify the effects of the pandemic on United Kingdom (UK) surgeons in higher specialty training by analyzing the Annual Review of Competency Progression (ARCP) Outcomes issued to them prior to, and during, the pandemic. METHODS Anonymized records were provided from the UK training management system- the Intercollegiate Surgical Curriculum Programme (ISCP)- on the ARCP Outcomes of higher specialty trainees in General Surgery over the period between January 2017 and December 2022. Demographic data including sex and age group on starting higher specialty training were considered, as were working pattern, phase of training during the height of the pandemic (2020 and 2021), and training region. The proportion of nonstandard outcomes, and the use of specific Covid-19 outcomes, were analyzed to assess the impact of these variables on ARCP outcome using univariate and multivariate logistic regression. Prepandemic outcomes in 2017 were used as a comparator. RESULTS A total of 7414 ARCP outcomes issued to 1874 General Surgery higher speciality trainees were analysed. The Adjusted Odds Ratio (AOR) for receiving a nonstandard outcome in 2020 (compared to 2017) was 3.07 (95% CI: 2.47-3.81, p < 0.001) not recovering to prepandemic levels by the end of 2022 (AOR 2.11 (95% CI: 1.69-2.64, p < 0.001)). Female sex (AOR 1.27 (95% CI: 1.13-1.43, p < 0.001) and being older on starting higher surgical training (AOR = 1.51 (95% CI: 1.34-1.70, p < 0.001) were both significantly associated with a higher chance of nonstandard outcome. Working pattern was linked to ARCP outcome on univariate analysis, but this relationship disappeared once corrected for other demographic factors (1.05, 95% CI: 0.88-1.24, p = 0.582). Being at a later stage of training during the pandemic was not linked to an increase in AOR of receiving a nonstandard outcome (1.09, 95% CI: 0.97-1.22, p = 0.134), but trainees receiving a nonstandard outcome in this group were more likely to have extra training time advised (15.49%, vs 4.27% in 2021). The highest AOR of receiving a Covid-19 outcome was in the Wessex Deanery at 2.85 (95% CI: 1.83-4.46, p < 0.001), whilst the lowest AOR were seen in Yorkshire and the Humber (0.32, 95% CI: 0.17-0.62, p < 0.001). Removing Covid-19 specific outcomes from the analysis shows a continued rise in the use of nonstandard outcomes in all years except 2020. CONCLUSIONS The Covid-19 Pandemic had a significant impact on the trajectory of training in General Surgery in the UK. Training extensions were more likely to be recommended later in training. There was considerable variation in the use of Covid-19 ARCP outcomes across the UK. There is ongoing evidence of differential attainment at ARCP in General Surgery, with female trainees and older graduates having greater chances of nonstandard outcomes. The underlying reasons for these associations need to be explored. Efforts to urgently address deficits in training post Covid-19 with an awareness of the intersectional nature of differential attainment are needed.
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Affiliation(s)
- Charlotte A Barter
- Division of Medical Sciences and Graduate Entry Medicine, University of Nottingham, Royal Derby Hospital, Derby, United Kingdom.
| | - David Humes
- National Institute for Health Research Nottingham Digestive Diseases Biomedical Research Unit, QMC Campus, Nottingham University Hospitals NHS Trust, Nottingham, United Kingdom; Division of Epidemiology and Public Health, School of Medicine, University of Nottingham, Nottingham, United Kingdom; Nottingham Digestive Diseases Centre, School of Medicine, University of Nottingham, Nottingham, United Kingdom
| | - Jonathan Lund
- Division of Medical Sciences and Graduate Entry Medicine, University of Nottingham, Royal Derby Hospital, Derby, United Kingdom
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Ojute F, Gonzales PA, Berler M, Puente N, Johnston B, Singh D, Edwards A, Lin J, Lebares C. Identifying Novel Inhibitors of Workplace Support and the Importance of Value Congruence and Feeling Valued in General Surgery Residency Training. JOURNAL OF SURGICAL EDUCATION 2024; 81:804-815. [PMID: 38658309 DOI: 10.1016/j.jsurg.2024.02.008] [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: 08/23/2023] [Revised: 02/13/2024] [Accepted: 02/19/2024] [Indexed: 04/26/2024]
Abstract
OBJECTIVE To explore residents' perceptions of workplace support inhibitors and their relationship to resident wellbeing. We aim to provide evidence-based targets to inform future work operationalizing support in surgical training. DESIGN This is a 2-part mixed-methods cross-sectional study. Part 1 analyzed qualitative data from focus groups (April 2021-May 2022). Part 2 comprised an online survey (informed by findings in Part 1, May 2022) to assess the association between perceived workplace support (e.g. feeling valued and value congruence) and poor individual global wellbeing (e.g. languishing). SETTING National multi-center study including 16 ACGME-accredited academic programs. PARTICIPANTS General surgery residents at all training levels, both clinical and research years. RESULTS 28 residents participated in the focus groups which revealed three major themes around perceived inhibitors of workplace support: lack of trust in residency program (e.g. ulterior motives), poor communication from leadership (e.g. lack of transparency, ineffective dialogue), and unfair systems in residency training (e.g. exploitation of residents, paternal leave policies). These themes emphasized the importance of feeling valued and value congruence, with the latter reflected in the form of trust and communication with leadership, a key element of worker-workplace alignment. 251 residents responded to the survey (response rate 31%, 50.6% women) which revealed that a lower sense of feeling valued and lower perceived value congruence were significantly associated with languishing. CONCLUSIONS Our findings suggest feeling valued and value congruence (specifically, having trust and communication with leadership) are important targets for increasing workplace support in surgical training, offering evidence-based targets for future work to operationalize support in surgical training.
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Affiliation(s)
- Feyisayo Ojute
- UCSF Center of Mindfulness in Surgery, Department of Surgery, University of California San Francisco, San Francisco, California
| | - Paul Adam Gonzales
- UCSF Center of Mindfulness in Surgery, Department of Surgery, University of California San Francisco, San Francisco, California
| | - Michael Berler
- UCSF Center of Mindfulness in Surgery, Department of Surgery, University of California San Francisco, San Francisco, California
| | - Nicole Puente
- UCSF Center of Mindfulness in Surgery, Department of Surgery, University of California San Francisco, San Francisco, California
| | - Brianna Johnston
- UCSF Center of Mindfulness in Surgery, Department of Surgery, University of California San Francisco, San Francisco, California
| | - Damin Singh
- UCSF Center of Mindfulness in Surgery, Department of Surgery, University of California San Francisco, San Francisco, California
| | - Anya Edwards
- UCSF Center of Mindfulness in Surgery, Department of Surgery, University of California San Francisco, San Francisco, California
| | - Joseph Lin
- UCSF Center of Mindfulness in Surgery, Department of Surgery, University of California San Francisco, San Francisco, California
| | - Carter Lebares
- UCSF Center of Mindfulness in Surgery, Department of Surgery, University of California San Francisco, San Francisco, California.
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Johnson BA, Callaway KJ, Vegiraju M, Ramakrishnan S, Ogola GO, Mohr DC, Waddimba AC. Study protocol of a systematic review and metaanalysis of stress and burnout among general surgery residents. Proc AMIA Symp 2024; 37:640-645. [PMID: 38910816 PMCID: PMC11188834 DOI: 10.1080/08998280.2024.2346398] [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: 07/08/2023] [Accepted: 04/05/2024] [Indexed: 06/25/2024] Open
Abstract
Introduction Chronic workplace stress and burnout are impediments to physicians' professional fulfillment, healthcare organizations' efficiency, and patient care quality/safety. General surgery residents are especially at risk due to the complexity of their training. We report the protocol of a metaanalysis of chronic stress and burnout among Accreditation Council for Graduate Medical Education (ACGME)-affiliated general surgery residents in the era after duty-hour reforms, plus downstream effects on their health and clinical performance. Methods The proposed systematic review and metaanalysis (PROSPERO registration CRD42021277626) will synthesize/pool data from studies of chronic stress and burnout among general surgery residents at ACGME-affiliated programs. The timeframe under review is subdivided into three intervals: (a) after the 2003 duty-hour restrictions but before 2011 reforms, (b) after the 2011 reforms but before the coronavirus pandemic, and (c) the first 3 years after the pandemic's outbreak. Only studies reporting outcomes based on validated instruments will be included. Qualitative studies, commentaries/editorials, narrative reviews, and studies not published in English will be excluded. Multivariable analyses will adjust for sample characteristics and the methodological quality of included studies. Conclusions The metaanalysis will yield evidence reflecting experiences of North American-based general surgery residents in the years after ACGME-mandated duty-hour restructuring.
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Affiliation(s)
- Brett A. Johnson
- Department of Surgery, General Medical Education, Baylor University Medical Center, Dallas, Texas, USA
| | - Kayla J. Callaway
- College of Medicine, Texas A&M University Health Sciences Center, Dallas, Texas, USA
- Houston Methodist Hospital, Texas Medical Center, Houston, Texas, USA
| | - Monica Vegiraju
- College of Medicine, Texas A&M University Health Sciences Center, Dallas, Texas, USA
| | - Sudha Ramakrishnan
- Baylor Health Sciences Library, Baylor Scott and White, Dallas, Texas, USA
| | - Gerald O. Ogola
- Department of Surgery, Division of Surgical Research, Baylor University Medical Center, Dallas, Texas, USA
- Baylor Scott and White Research Institute, Dallas, Texas, USA
| | - David C. Mohr
- Veterans Health Administration, National Center for Organizational Development, Cincinnati, Ohio, USA
- Department of Health Law, Policy and Management, Boston University School of Public Health, Boston, Massachusetts, USA
| | - Anthony C. Waddimba
- College of Medicine, Texas A&M University Health Sciences Center, Dallas, Texas, USA
- Department of Surgery, Division of Surgical Research, Baylor University Medical Center, Dallas, Texas, USA
- Baylor Scott and White Research Institute, Dallas, Texas, USA
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Lie JJ, Huynh C, Li J, Mak N, Wiseman SM. Psychological Impact of the COVID-19 Pandemic on Canadian Surgical Residents: A Province-Wide Study. JOURNAL OF SURGICAL EDUCATION 2024; 81:486-494. [PMID: 38388311 DOI: 10.1016/j.jsurg.2023.12.013] [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: 04/05/2023] [Revised: 09/22/2023] [Accepted: 12/22/2023] [Indexed: 02/24/2024]
Abstract
OBJECTIVES The objective of this study was to evaluate the psychological impact of the COVID-19 pandemic on surgical residents. DESIGN An online survey was distributed evaluating multiple domains: demographics, health and socioeconomic factors, clinical experience, educational experience, and psychological outcomes. The Mayo Clinic Resident Well-Being Index (RWBI) was used as a validated measure of resident mental health. SETTING AND PARTICIPANTS Surgical residents from University of British Columbia's surgical residency programs. RESULTS A total of 31/86 surgical residents responded to the survey. Of which, 57% and 46% reported feeling burned out or depressed, respectively. Residents who were concerned about personal protective equipment supply and who lived with family members with comorbidities had a higher risk of depression (p = 0.03, p = 0.04). The median Mayo Clinic Resident Well-Being Index was 2.5, higher than the median of 2 observed in the United States national survey of residents. CONCLUSIONS The pandemic had a considerable negative impact on the psychological well-being of surgical residents.
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Affiliation(s)
- Jessica J Lie
- Department of Surgery, St. Paul's Hospital & University of British Columbia, Vancouver, British Columbia, Canada
| | - Caroline Huynh
- Department of Surgery, St. Paul's Hospital & University of British Columbia, Vancouver, British Columbia, Canada
| | - Jennifer Li
- Department of Surgery, St. Paul's Hospital & University of British Columbia, Vancouver, British Columbia, Canada
| | - Nicole Mak
- Department of Surgery, St. Paul's Hospital & University of British Columbia, Vancouver, British Columbia, Canada
| | - Sam M Wiseman
- Department of Surgery, St. Paul's Hospital & University of British Columbia, Vancouver, British Columbia, Canada.
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Ojute F, Gonzales PA, Berler M, Puente N, Johnston B, Singh D, Edwards A, Lin J, Lebares C. Investigating Workplace Support and the Importance of Psychological Safety in General Surgery Residency Training. JOURNAL OF SURGICAL EDUCATION 2024; 81:514-524. [PMID: 38388307 DOI: 10.1016/j.jsurg.2023.12.010] [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: 08/23/2023] [Revised: 11/27/2023] [Accepted: 12/17/2023] [Indexed: 02/24/2024]
Abstract
OBJECTIVE Workplace interventions that increase support can mitigate burnout, improve workplace satisfaction, and increase well-being. Our aim is to provide evidence-based targets to inform future work for operationalizing support in general surgery residency. DESIGN This is a 2-part mixed-methods cross-sectional study. Part 1 analyzed qualitative data from focus groups (April 2021-May 2022). Part 2 comprised an online survey (informed by findings in Part 1) in May 2022 to assess the association between perceived psychological safety (PS) and flourishing, as well as PS and languishing. SETTING National multi-center study including 16 ACGME-accredited academic programs. PARTICIPANTS General surgery residents at various training levels, in both clinical and research. RESULTS A total of 28 residents participated in the focus groups which revealed both enhancers and inhibitors of support pertaining to PS in the workplace. Enhancers of support included those currently implemented (i.e., allyship of mentors) and those proposed by residents (i.e., nonpunitive analysis of mistakes). Inhibitors of support included both systems (i.e., wellness initiatives as a 'band-aid' for systems issues) and culture (i.e., indefatigability, stoicism). About 251 residents (31%) responded to the survey which revealed higher perception of PS was significantly associated with flourishing at the level of residency program and departmental leadership. Lower perception of PS was significantly associated with languishing at the level of residency program leadership only. CONCLUSION Our findings highlight the promotion of PS, such as expansion of mentorship to include advocacy (advocating on a resident's behalf, recognition when mistreated) and affirmation (i.e., soliciting opinions on controversial social matters/events, recognizing different life experiences), cultural acceptance of asking for help (without being perceived as weak), formal help navigating interpersonal dynamics (i.e., guidance from senior residents), and leadership presentations and modeling to destigmatize asking for help, as a means of operationalizing workplace support to increase flourishing and decrease languishing.
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Affiliation(s)
- Feyisayo Ojute
- UCSF Center of Mindfulness in Surgery, Department of Surgery, University of California San Francisco, San Francisco, California
| | - Paul Adam Gonzales
- UCSF Center of Mindfulness in Surgery, Department of Surgery, University of California San Francisco, San Francisco, California
| | - Michael Berler
- UCSF Center of Mindfulness in Surgery, Department of Surgery, University of California San Francisco, San Francisco, California
| | - Nicole Puente
- UCSF Center of Mindfulness in Surgery, Department of Surgery, University of California San Francisco, San Francisco, California
| | - Brianna Johnston
- UCSF Center of Mindfulness in Surgery, Department of Surgery, University of California San Francisco, San Francisco, California
| | - Damin Singh
- UCSF Center of Mindfulness in Surgery, Department of Surgery, University of California San Francisco, San Francisco, California
| | - Anya Edwards
- UCSF Center of Mindfulness in Surgery, Department of Surgery, University of California San Francisco, San Francisco, California
| | - Joseph Lin
- UCSF Center of Mindfulness in Surgery, Department of Surgery, University of California San Francisco, San Francisco, California
| | - Carter Lebares
- UCSF Center of Mindfulness in Surgery, Department of Surgery, University of California San Francisco, San Francisco, California.
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Chung SH, Rasic G, Romatoski KS, Kenzik K, Tseng JF, Sachs TE. Disparate impact of the COVID-19 pandemic on delays in colorectal cancer treatment: A National Cancer Database study. Surgery 2024; 175:1013-1020. [PMID: 38245445 DOI: 10.1016/j.surg.2023.12.016] [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: 07/04/2023] [Revised: 11/29/2023] [Accepted: 12/15/2023] [Indexed: 01/22/2024]
Abstract
BACKGROUND Timely treatment for patients with colorectal cancer may have been disrupted by the COVID-19 pandemic. We evaluated the impact of the pandemic on delays to treatment with surgery or systemic therapy for patients with colorectal cancer and delineated factors predictive of delayed treatment. METHODS Using the National Cancer Database, patients diagnosed with colorectal cancer were categorized by year of diagnosis as COVID-19 era (2020) versus pre-COVID-19 (2018-2019). Categorical variables were compared by χ2 analysis. Multivariate logistic regression was used to assess odds ratios for delayed time to surgery or chemoimmunotherapy, defined as >60 days. RESULTS In total, 50,689 patients colorectal cancer were diagnosed patients who were pre-COVID-19 vs 21,331 within the COVID-19-era. Patients diagnosed with COVID-19 had a higher stage at diagnosis. There were no differences in the proportion of delayed time to surgery for patients diagnosed in 2020, but patients who were tested for COVID-19 had increased proportions of delayed time to surgery (P < .0001). In multivariate analysis, Black race (P = .0026) and uninsured/underinsured status (P = .0017) were associated with delayed time to surgery. Diagnosis during COVID-19 did not increase delayed time to chemoimmunotherapy, regardless of COVID-19 testing or positivity; however, delays were seen for Black (P < .0001), Hispanic (P < .0001), and uninsured/underinsured patients (P < .0001). CONCLUSION Although the pandemic did not delay treatment for colorectal cancer overall, vulnerable and underserved populations were disproportionately affected by delays to all forms of therapy. The difference in colorectal cancer outcomes in the coming years as a result of delays in treatment may be significant for these patients.
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Affiliation(s)
- Sophie H Chung
- Department of Surgery, Boston Medical Center, Boston University Chobanian and Avedisian School of Medicine, MA. https://twitter.com/SophieChung91
| | - Gordana Rasic
- Department of Surgery, Boston Medical Center, Boston University Chobanian and Avedisian School of Medicine, MA. https://twitter.com/GordanaRasic
| | - Kelsey S Romatoski
- Department of Surgery, Boston Medical Center, Boston University Chobanian and Avedisian School of Medicine, MA. https://twitter.com/KelseyRomatoski
| | - Kelly Kenzik
- Department of Surgery, Boston Medical Center, Boston University Chobanian and Avedisian School of Medicine, MA
| | - Jennifer F Tseng
- Department of Surgery, Boston Medical Center, Boston University Chobanian and Avedisian School of Medicine, MA. https://twitter.com/TsengJennifer
| | - Teviah E Sachs
- Department of Surgery, Boston Medical Center, Boston University Chobanian and Avedisian School of Medicine, MA.
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Thielmann B, Meyer F, Böckelmann I. [Against the mental stress-Resilient work in surgery]. CHIRURGIE (HEIDELBERG, GERMANY) 2024; 95:135-147. [PMID: 37987763 PMCID: PMC10834595 DOI: 10.1007/s00104-023-01977-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 10/05/2023] [Indexed: 11/22/2023]
Abstract
BACKGROUND Surgery represents a challenging medical discipline. AIM This article focuses on psychological stress in surgery and explains resilience as a protective factor against the consequences of psychological stress, based on selected literature references and own relevant clinical experiences. In this context, the sense of coherence, social support and self-efficacy expectation are discussed in more detail as resilience factors. METHOD Narrative review. RESULTS (CORNER POINTS) Surgery is classified as a challenging medical subspecialty with a high reputation but associated with diverse and varied physical and psychological stress factors. Stress factors differ individually in terms of requirements (can be overdemanding or underdemanding but also stimulating, relevant to learning and meaningful, thus positively or negatively stressful) and resources (potentially beneficial working conditions, experience, or behavior, e.g., social support, scope for action). Fluctuations within surgical specialties and a high dropout rate during residency training are well known and the causes include high psychological stress. In the case of persistent and at the same time insufficient compensation of work stress caused by a lack of or insufficient resources, these can be associated with mental illnesses. Nonetheless, many physicians spend their entire lives working in hospital or private surgical settings and remain healthy, a strong sense of resilience to mental illness may be fundamental to this. Resilience can be present as a personal characteristic or it can be learnt through a process or adapted through positive or negative influences, thus strengthening the personal characteristics. Overall, data on surgeon resilience or interventional studies in resilience research in the surgical setting are limited and provide another research gap. Resilience training (directed at a sense of coherence, social support, strengthening knowledge of coping skills, positive emotions, optimism, hope, self-efficacy expectations, control beliefs or robustness), also clearly indicated in the "robust" medical specialty of surgery, is always individual and should not be generalized. If the surgeon cannot retrieve sufficient resources due to the stressful situation, stress management with its methods is helpful to reduce the psychological stress and to be able to maintain the performance and health of this person. CONCLUSION The consolidation of resilience as a notable aspect of employee management. In collegial interactions, resilience must be based on workplace-based approaches to strengthen coping mechanisms in the face of work stress. Workplace-related stress should also be perceived, addressed and counteracted within the organization, certainly also as an elementary management task.
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Affiliation(s)
- Beatrice Thielmann
- Bereich Arbeitsmedizin, Medizinische Fakultät, Otto-von-Guericke-Universität Magdeburg, Magdeburg, Deutschland
| | - Frank Meyer
- Universitätsklinik für Allgemein-, Viszeral-, Gefäß- und Transplantationschirurgie, Otto-von-Guericke-Universität Magdeburg mit Universitätsklinikum Magdeburg A. ö. R., Magdeburg, Deutschland.
| | - Irina Böckelmann
- Bereich Arbeitsmedizin, Medizinische Fakultät, Otto-von-Guericke-Universität Magdeburg, Magdeburg, Deutschland
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Al‐Ghunaim T, Johnson J, Biyani CS, Coleman R, Simms‐Ellis R, O'Connor DB. Evaluation of the reboot coaching workshops among urology trainees: A mixed method approach. BJUI COMPASS 2023; 4:533-542. [PMID: 37636204 PMCID: PMC10447217 DOI: 10.1002/bco2.249] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2023] [Revised: 03/16/2023] [Accepted: 04/05/2023] [Indexed: 08/29/2023] Open
Abstract
Background Urology trainees experience high burnout, and there is an urgent need for acceptable and effective interventions. The current study evaluated Reboot coaching workshops (Reboot-C), a tailored intervention based on cognitive-behavioural principles, with urology trainees. Objective Our primary objective was to evaluate the acceptability of Reboot-C among urology trainees. In addition, this study aimed to investigate whether there were changes in confidence, resilience, depression and burnout levels. Materials and method A single-arm design was used, including pre- and post-online questionnaires and semi-structured interviews. Result Twenty-one urology trainees replied to the survey, attended both Reboot-C workshops and responded to the post-intervention questionnaire. Thirteen of 21 (61%) urology trainees participated in the interview. Participating in Reboot-C was associated with significant improvements in resilience and confidence and a significant reduction in burnout. However, there was no significant reduction in depression. Qualitative data indicated that Reboot was acceptable and helped participants develop useful skills. Conclusion These findings pave the way for more conclusive studies on the efficacy of Reboot-C for surgeons.
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Affiliation(s)
| | - Judith Johnson
- School of PsychologyUniversity of LeedsLeedsUK
- Bradford Institute for Health ResearchBradford Royal InfirmaryBradfordUK
- School of Public Health and Community MedicineUniversity of New South WalesSydneyAustralia
| | | | | | - Ruth Simms‐Ellis
- School of PsychologyUniversity of LeedsLeedsUK
- Bradford Institute for Health ResearchBradford Royal InfirmaryBradfordUK
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11
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Cheng K, Wu C, Gu S, Lu Y, Wu H, Li C. WHO declares the end of the COVID-19 global health emergency: lessons and recommendations from the perspective of ChatGPT/GPT-4. Int J Surg 2023; 109:2859-2862. [PMID: 37246993 PMCID: PMC10498859 DOI: 10.1097/js9.0000000000000521] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2023] [Accepted: 05/16/2023] [Indexed: 05/30/2023]
Affiliation(s)
- Kunming Cheng
- Department of Intensive Care Unit, The Second Affiliated Hospital of Zhengzhou University, Zhengzhou
| | - Chunchun Wu
- Department of Emergency, Taikang People's Hospital, Zhoukou, Henan
| | - Shuqin Gu
- Duke Human Vaccine Institute, Duke University Medical Center
| | - Yanqiu Lu
- Department of Intensive Care Unit, The Second Affiliated Hospital of Zhengzhou University, Zhengzhou
| | - Haiyang Wu
- Clinical College of Neurology, Neurosurgery and Neurorehabilitation
- Department of Graduate School, Tianjin Medical University, Tianjin, People's Republic of China
- Duke Molecular Physiology Institute, Duke University School of Medicine, Durham, North Carolina, USA
| | - Cheng Li
- Department of Orthopaedic Surgery, Beijing Jishuitan Hospital, Fourth Clinical College of Peking University
- State Key Laboratory of Toxicology and Medical Countermeasures, Beijing Institute of Pharmacology and Toxicology, Beijing
- Center for Musculoskeletal Surgery (CMSC), Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt University of Berlin, and Berlin Institute of Health, Berlin, Germany
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12
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Tsagkaris C, Trygonis N, Spyrou V, Koulouris A. Telemedicine in Care of Sarcoma Patients beyond the COVID-19 Pandemic: Challenges and Opportunities. Cancers (Basel) 2023; 15:3700. [PMID: 37509361 PMCID: PMC10378403 DOI: 10.3390/cancers15143700] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2023] [Revised: 07/15/2023] [Accepted: 07/17/2023] [Indexed: 07/30/2023] Open
Abstract
BACKGROUND The COVID-19 pandemic has created a challenging environment for sarcoma patients. Most oncology societies published guidelines or recommendations prioritizing sarcoma patients and established telehealth as an efficient method of approaching them. The aim of this review is the assessment of current evidence regarding the utilization of telemedicine in diagnosis, treatment modalities, telerehabilitation and satisfaction among sarcoma patients and healthcare providers (HP). METHODS This systematic review was carried out using the databases PubMed and Ovid MEDLINE according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). RESULTS The application of telemedicine to the management of sarcoma has yielded improved clinical and psychological outcomes. Specifically, significant progress has been demonstrated in the areas of tele-oncology and telerehabilitation during the last decade, and the COVID-19 outbreak has accelerated this transition toward them. Telehealth has been proven efficient in a wide spectrum of applications from consultations on physical therapy and psychological support to virtual care symptom management. Both HP and patients reported satisfaction with telehealth services at levels comparable to in-person visits. CONCLUSIONS Telehealth has already unveiled many opportunities in tailoring individualized care, and its role in the management of sarcoma patients has been established in the post-COVID-19 era, as well.
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Affiliation(s)
- Christos Tsagkaris
- European Student Think Tank, Public Health and Policy Working Group, 1058 DE Amsterdam, The Netherlands
| | - Nikolaos Trygonis
- Department of Orthopaedics, University Hospital of Heraklion, 70013 Heraklion, Greece
| | - Vasiliki Spyrou
- Post Covid Department, Theme Female Health, Karolinska University Hospital, 14157 Stockholm, Sweden
| | - Andreas Koulouris
- Department of Oncology-Pathology, Karolinska Institute, 17176 Stockholm, Sweden
- Thoracic Oncology Center, Theme Cancer, Karolinska University Hospital, 17177 Stockholm, Sweden
- Faculty of Medicine, University of Crete, 70013 Heraklion, Greece
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13
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Benjamin T, Gulati A, Zebolsky AL, Seth R, Knott PD, Okuyemi O, Park AM. Assessing the Prevalence of Burnout Among Female Microvascular Head and Neck Surgeons. Facial Plast Surg Aesthet Med 2023; 25:298-303. [PMID: 37162749 DOI: 10.1089/fpsam.2022.0312] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/11/2023] Open
Abstract
Background: Research has not explicitly explored differences between male and female microvascular head and neck (MHN) surgeon burnout, which should be identified and addressed to ensure career satisfaction and longevity. Objective: To measure and compare the prevalence of burnout among male versus female MHN surgeons. Methods: A prospective questionnaire based on the Maslach Burnout Inventory (MBI) was distributed through a web-based survey to the American Association of Facial Plastic and Reconstructive Surgeons and American Head and Neck Society in 2021 and 2022. Additional variables collected included demographics, relationship and parental status, academic rank, annual salary, and COVID-19-related questions. Results: One hundred thirteen surveys were collected. Twenty-nine (25.7%) were women and all completed MHN surgery fellowships. Women trended toward more emotional exhaustion than men (2.8 mean MBI vs. 2.3 mean MBI) but reported similar personal achievement (4.8 mean MBI vs. 4.9 mean MBI). Men experienced less workplace sexual harassment (p < 0.001). Women experienced more burnout (69% vs. 39%, p = 0.006) during the COVID-19 pandemic. Conclusion: Female MHN surgeons reported in this survey to experience more workplace sexual harassment and higher COVID-19-related burnout than their male counterparts.
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Affiliation(s)
- Tania Benjamin
- Department of Otolaryngology-Head and Neck Surgery, University of California, San Francisco, San Francisco, California, USA
| | - Arushi Gulati
- Department of Otolaryngology-Head and Neck Surgery, University of California, San Francisco, San Francisco, California, USA
| | - Aaron L Zebolsky
- Homer Stryker M.D. School of Medicine, Western Michigan University, Kalamazoo, Michigan, USA
| | - Rahul Seth
- Department of Otolaryngology-Head and Neck Surgery, University of California, San Francisco, San Francisco, California, USA
| | - P Daniel Knott
- Department of Otolaryngology-Head and Neck Surgery, University of California, San Francisco, San Francisco, California, USA
| | - Oluwafunmilola Okuyemi
- Department of Otolaryngology-Head and Neck Surgery, University of Nevada Las Vegas, Las Vegas, Nevada, USA
| | - Andrea M Park
- Department of Otolaryngology-Head and Neck Surgery, University of California, San Francisco, San Francisco, California, USA
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14
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Shin P, Desai V, Hobbs J, Conte AH, Qiu C. Time Out: The Impact of Physician Burnout on Patient Care Quality and Safety in Perioperative Medicine. Perm J 2023; 27:160-168. [PMID: 37278062 PMCID: PMC10266854 DOI: 10.7812/tpp/23.015] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Perioperative care delivery is a patient-centered, multidisciplinary process. It relies heavily on synchronized teamwork from a well-coordinated team. Perioperative physicians-surgeons and anesthesiologists-face enormous challenges in surgical care delivery due to changing work environments, post-COVID consequences, shift work disorder, value conflict, escalating demands, regulatory complexity, and financial uncertainties. Physician burnout in this working environment has become increasingly prevalent. It is not only harmful to physicians' health and well-being, but it also affects the quality and safety of patient care. Additionally, the economic costs associated with physician burnout are untenable due to the high turnover rate, high recruitment expenses, and potential early permanent exit from medical practice. In this deteriorating environment of unbalanced physician supply/demand, recognizing, managing, and preventing physician burnout may help preserve the system's most valuable asset and contribute to higher quality and safety of patient care. Leaders in government agencies, health care systems, and organizations must work together to re-engineer the health care system for better physicians and patient care.
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Affiliation(s)
- Philip Shin
- Department of Anesthesiology, Southern California Permanente Medical Group, Pasadena, CA, USA
| | - Vimal Desai
- Department of Anesthesiology, Southern California Permanente Medical Group, Pasadena, CA, USA
| | - Janet Hobbs
- Department of Anesthesiology, Southern California Permanente Medical Group, Pasadena, CA, USA
| | - Antonio Hernandez Conte
- Department of Anesthesiology, Southern California Permanente Medical Group, Pasadena, CA, USA
| | - Chunyuan Qiu
- Department of Anesthesiology, Southern California Permanente Medical Group, Pasadena, CA, USA
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15
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Tao R, Hsu M, Min K, Mo D, Geng F, Xia L, Liu T, Liu Y, Jiang F, Liu H, Tang YL. Alcohol misuse, health-related behaviors, and burnout among clinical therapists in China during the early Covid-19 pandemic: A Nationwide survey. Front Public Health 2023; 11:1084259. [PMID: 37089496 PMCID: PMC10118037 DOI: 10.3389/fpubh.2023.1084259] [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] [Received: 10/30/2022] [Accepted: 03/20/2023] [Indexed: 04/25/2023] Open
Abstract
Objectives This study aimed to assess the extent of alcohol use and misuse among clinical therapists working in psychiatric hospitals in China during the early COVID-19 Pandemic, and to identify associated factors. Methods An anonymous nationwide survey was conducted in 41 tertiary psychiatric hospitals. We collected demographic data as well as alcohol use using the Alcohol Use Disorders Identification Test-Consumption (AUDIT-C) and burnout using the Maslach Burnout Inventory Human Services Survey. Results In total, 396 clinical therapists completed the survey, representing 89.0% of all potential participants we targeted. The mean age of participants was 33.8 years old, and more than three-quarters (77.5%) were female. Nearly two-fifths (39.1%) self-reported as current alcohol users. The overall prevalence of alcohol misuse was 6.6%. Nearly one-fifth (19.9%) reported symptoms of burnout with high emotional exhaustion in 46 (11.6%), and high depersonalization in 61 (15.4%). Multiple logistic regression showed alcohol use was associated with male gender (OR = 4.392; 95% CI =2.443-7.894), single marital status (OR = 1.652; 95% CI =0.970-2.814), smoking habit (OR = 3.847; 95%CI =1.160-12.758) and regular exercise (OR = 2.719; 95%CI =1.490-4.963). Alcohol misuse was associated with male gender (OR = 3.367; 95% CI =1.174-9.655), a lower education level (OR = 3.788; 95%CI =1.009-14.224), smoking habit (OR = 4.626; 95%CI =1.277-16.754) and high burnout (depersonalization, OR = 4.848; 95%CI =1.433-16.406). Conclusion During the COVID-19 pandemic, clinical therapists' alcohol consumption did not increase significantly. Male gender, cigarette smoking, and burnout are associated with an increased risk of alcohol misuse among clinical therapists. Targeted intervention is needed when developing strategies to reduce alcohol misuse and improve clinical therapists' wellness and mental health.
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Affiliation(s)
- Rui Tao
- Department of Substance-Related Disorders, Affiliated Psychological Hospital of Anhui Medical University, Hefei, China
- Department of Psychiatry, Chao hu Hospital of Anhui Medical University, Hefei, China
- Department of Psychiatry, School of Mental Health and Psychological Sciences, Anhui Medical University, Hefei, China
- Department of Substance-Related Disorders, Hefei Fourth People’s Hospital, Hefei, China
| | - Michael Hsu
- Addiction Psychiatry Fellowship Program, Department of Psychiatry and Behavioral Sciences, Emory University, Atlanta, GA, United States
| | - Kaiyuan Min
- State Key Laboratory of Medical Molecular Biology, Institute of Basic Medical Sciences, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Daming Mo
- Department of Substance-Related Disorders, Affiliated Psychological Hospital of Anhui Medical University, Hefei, China
- Department of Psychiatry, Chao hu Hospital of Anhui Medical University, Hefei, China
- Department of Psychiatry, School of Mental Health and Psychological Sciences, Anhui Medical University, Hefei, China
- Department of Substance-Related Disorders, Hefei Fourth People’s Hospital, Hefei, China
| | - Feng Geng
- Department of Psychiatry, Second Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Lei Xia
- Department of Psychiatry, Chao hu Hospital of Anhui Medical University, Hefei, China
- Department of Psychiatry, School of Mental Health and Psychological Sciences, Anhui Medical University, Hefei, China
| | - Tingfang Liu
- Research Department, School of Health Policy and Management, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Yuanli Liu
- Research Department, School of Health Policy and Management, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Feng Jiang
- Research Department, School of International and Public Affairs, Shanghai Jiao Tong University, Shanghai, China
- Research Department, Institute of Healthy Yangtze River Delta, Shanghai Jiao Tong University, Shanghai, China
| | - Huanzhong Liu
- Department of Psychiatry, Chao hu Hospital of Anhui Medical University, Hefei, China
- Department of Psychiatry, School of Mental Health and Psychological Sciences, Anhui Medical University, Hefei, China
- Department of Psychiatry, Anhui Psychiatric Center, Hefei, China
| | - Yi-lang Tang
- Addiction Psychiatry Fellowship Program, Department of Psychiatry and Behavioral Sciences, Emory University, Atlanta, GA, United States
- Mental Health Service Line, Atlanta Veterans Affairs Medical Center, Decatur, GA, United States
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16
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Al-Ghunaim T, Johnson J, Biyani CS, Yiasemidou M, O'Connor DB. Burnout and patient safety perceptions among surgeons in the United Kingdom during the early phases of the coronavirus disease 2019 pandemic: A two-wave survey. Scott Med J 2023; 68:41-48. [PMID: 36946068 PMCID: PMC10067362 DOI: 10.1177/00369330231163378] [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: 03/23/2023]
Abstract
BACKGROUND Surgeons in the UK report high burnout levels. Burnout has been found to be associated with adverse patient outcomes but there are few studies that have examined this association in surgeons and even fewer which have examined this relationship over time. PURPOSE The main aim was to examine the relationships between surgeon burnout and surgeons' perceptions of patient safety cross-sectionally and longitudinally. The secondary aim was to test whether surgeons' burnout levels varied over the first six months of the coronavirus disease 2019 pandemic. METHODS This paper reports data from a two-wave survey (first wave from 5 May and 30 June 2020, the second wave 5 January to 30 February 2021). The dataset was divided into a longitudinal group (for surgeons who responded at both the time points) and two cross-sectional groups (for surgeons who responded at a one-time point, but not the other). RESULTS The first key finding was that burnout was associated with patient safety outcomes measured at the same time point (Group 1 = 108, r = 0.309, p < 0.05 and Group 2 = 84, r = 0.238, p < 0.05). Second, burnout predicted poor patients' safety perceptions over time, and poor patient safety predicted burnout over time (Group 3 = 39, p < 0.05). Third, burnout increased between the first and second surveys (t = -4.034, p < 0.05). CONCLUSION Burnout in surgeons may have serious implications for patient safety. Interventions to support surgeons should be prioritised, and healthcare organisations, surgeons and psychological specialists should collaborate on their development.
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Affiliation(s)
| | - Judith Johnson
- School of Psychology University of Leeds, Leeds, UK
- Bradford Institute for Health Research, Bradford Royal Infirmary, Bradford, UK
- School of Public Health and Community Medicine, University of New South Wales, Sydney, Australia
| | - Chandra S Biyani
- Department of Urology, St James's University Hospital, Beckett Street, Leeds, West Yorkshire, UK
| | - Marina Yiasemidou
- NIHR Academic Clinical Lecturer General Surgery, University of Hull, Hull, UK
- ST8 Colorectal Surgery, Bradford Teaching Hospitals, Bradford, UK
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Alkhamees AA, Aljohani MS, Kalani S, Ali AM, Almatham F, Alwabili A, Alsughier NA, Rutledge T. Physician's Burnout during the COVID-19 Pandemic: A Systematic Review and Meta-Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:ijerph20054598. [PMID: 36901612 PMCID: PMC10001574 DOI: 10.3390/ijerph20054598] [Citation(s) in RCA: 11] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/21/2022] [Revised: 12/04/2022] [Accepted: 12/09/2022] [Indexed: 05/09/2023]
Abstract
The burnout rate among physicians is expected to be higher during COVID-19 period due to the additional sources of physical and emotional stressors. Throughout the current COVID-19 pandemic, numerous studies have evaluated the impacts of COVID-19 on physicians' burnout, but the reported results have been inconsistent. This current systematic review and meta-analysis aims to assess and estimate the epidemiology of burnout and the associated risk factors during the COVID-19 pandemic among physicians. A systematic search for studies targeting physicians' burnout was conducted using PubMed, Scopus, ProQuest, Cochrane COVID-19 registry, and pre-print services (PsyArXiv and medRχiv) for English language studies published within the time period of 1 January 2020 to 1 September 2021. Search strategies resulted in 446 possible eligible studies. The titles and abstracts of these studies were screened, which resulted in 34 probable studies for inclusion, while 412 studies were excluded based on the predetermined inclusion criteria. These 34 studies went through a full-text screening for eligibility, which resulted in 30 studies being included in the final reviews and subsequent analyses. Among them, the prevalence of physicians' burnout rate ranged from 6.0-99.8%. This wide variation could be due to the heterogeneity among burnout definitions, different applied assessment tools, and even cultural factors. Further studies may consider other factors when assessing burnout (e.g., the presence of a psychiatric disorders, other work-related and cultural factors). In conclusion, a consistent diagnostic indices for the assessment of burnout is required to enable consistent methods of scoring and interpretation.
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Affiliation(s)
- Abdulmajeed A. Alkhamees
- Department of Medicine, Unayzah College of Medicine and Medical Sciences, Qassim University, Unayzah 52571, Saudi Arabia
- Correspondence:
| | - Moath S. Aljohani
- Department of Family and Community Medicine, Unayzah College of Medicine and Medical Sciences, Qassim University, Unayzah 52571, Saudi Arabia
| | - Simindokht Kalani
- Department of Psychology, Faculty of Education and Psychology, University of Isfahan, Isfahan 8174673441, Iran
| | - Amira Mohammed Ali
- Department of Psychiatric Nursing and Mental Health, Faculty of Nursing, Alexandria University, Alexandria 5424041, Egypt
| | - Fahad Almatham
- Department of Medicine, Unayzah College of Medicine and Medical Sciences, Qassim University, Unayzah 52571, Saudi Arabia
| | - Afnan Alwabili
- Department of Medicine, Unayzah College of Medicine and Medical Sciences, Qassim University, Unayzah 52571, Saudi Arabia
| | - Naif Abdullah Alsughier
- Department of Medicine, Unayzah College of Medicine and Medical Sciences, Qassim University, Unayzah 52571, Saudi Arabia
| | - Thomas Rutledge
- VA San Diego Healthcare System, Department of Psychiatry, Psychology Service, University of California San Diego, San Diego, CA 92093, USA
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Ju TR, Mikrut EE, Spinelli A, Romain AM, Brondolo E, Sundaram V, Pan CX. Factors Associated with Burnout among Resident Physicians Responding to the COVID-19 Pandemic: A 2-Month Longitudinal Observation Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:9714. [PMID: 35955071 PMCID: PMC9367700 DOI: 10.3390/ijerph19159714] [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: 07/21/2022] [Revised: 07/31/2022] [Accepted: 08/04/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND Burnout during residency may be a function of intense professional demands and poor work/life balance. With the onset of the COVID-19 pandemic, NYC hospital systems were quickly overwhelmed, and trainees were required to perform beyond the usual clinical duties with less supervision and limited education. OBJECTIVE The present longitudinal study examined the effects of COVID-19 caseload over time on burnout experienced by resident physicians and explored the effects of demographic characteristics and organizational and personal factors as predictors of burnout severity. METHODS This study employed a prospective design with repeated measurements from April 2020 to June 2020. Participants were surveyed about their well-being every 5 days. Predictors included caseload, sociodemographic variables, self-efficacy, hospital support, perceived professional development, meaning in work, and postgraduate training level. RESULTS In total, 54 resident physicians were recruited, of whom 50% reported burnout on initial assessment. Periods of higher caseload were associated with higher burnout. PGY-3 residents reported more burnout initially but appeared to recover faster compared to PGY-1 residents. Examined individually, higher self-efficacy, professional development, meaningful work, and hospital support were associated with lower burnout. When all four predictors were entered simultaneously, only self-efficacy was associated with burnout. However, professional development, meaningful work, and hospital support were associated with self-efficacy. CONCLUSION Burnout among residency is prevalent and may have implications for burnout during later stages of a physician's career. Self-efficacy is associated with lower burnout and interventions to increase self-efficacy and the interpersonal factors that promote self-efficacy may improve physician physical and emotional well-being.
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Affiliation(s)
- Teressa R. Ju
- Department of Medicine, NewYork-Presbyterian Queens, 56-45 Main Street, Flushing, NY 11354, USA
| | - Emilia E. Mikrut
- Department of Psychology, St. John’s University, 152-11 Union Turnpike, Jamaica, NY 11367, USA
| | - Alexandra Spinelli
- Department of Psychology, St. John’s University, 152-11 Union Turnpike, Jamaica, NY 11367, USA
| | - Anne-Marie Romain
- Department of Psychology, St. John’s University, 152-11 Union Turnpike, Jamaica, NY 11367, USA
| | - Elizabeth Brondolo
- Department of Psychology, St. John’s University, 152-11 Union Turnpike, Jamaica, NY 11367, USA
| | - Varuna Sundaram
- Department of Surgery, Division of Vascular and Endovascular Surgery, Weill Cornell Medical College, 1300 York Avenue, New York, NY 10065, USA
- Department of Surgery, NewYork-Presbyterian Queens, 56-45 Main Street, Flushing, NY 11354, USA
| | - Cynthia X. Pan
- Department of Medicine, NewYork-Presbyterian Queens, 56-45 Main Street, Flushing, NY 11354, USA
- Department of Medicine, Weill Cornell Medical College, 1300 York Avenue, New York, NY 10065, USA
- Division of Geriatrics and Palliative Care, NewYork-Presbyterian Queens, 56-45 Main Street, Flushing, NY 11354, USA
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