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Hanson MN, Hughes D, Alseidi A, Bittner JG, Romanelli J, Vassiliou M, Feldman LS, Asbun H. The joy of surgery: how gender influences surgeons' experiences. Surg Endosc 2024:10.1007/s00464-024-10976-8. [PMID: 38902408 DOI: 10.1007/s00464-024-10976-8] [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: 04/29/2024] [Accepted: 05/30/2024] [Indexed: 06/22/2024]
Abstract
INTRODUCTION Burnout in medicine is an epidemic, and surgeons are not immune. Studies often focus on negative factors leading to burnout, with less emphasis on optimizing joy. The purpose of this study, conducted by the SAGES Reimagining the Practice of Surgery Task Force, was to explore how gender may influence surgeon well-being to better inform organizational change. METHODS The study team developed a survey with the domains: facilitators of joy, support for best work, time for work tasks, barriers to joy, and what they would do with more time. The survey was emailed to 5777 addresses on the SAGES distribution list. Results were analyzed by calculating summary statistics. RESULTS 223 surgeons completed the survey; 62.3% identified as men, 32.3% as women, and 5.4% did not indicate gender. Female compared to male respondents were younger (41.6 vs 52.5 years) and had practiced for fewer years (8.4 vs 19.4 years). The three greatest differences in facilitators of joy were being a leader in the field, leading clinical teams, and teaching, with a > 10 percentage point difference between men/women rating these highly (score of ≥ 8). Women generally perceived less support from their institutions than men. The greatest gender difference was in support for teaching, with 52.8% of men rating this highly compared to 30.2% of women. Only 52% of women felt respected by coworkers most of the time compared to 68.3% of men. Most (96.0%) respondents (men 95.7% and women 98.6%) reported wanting more time with family and friends. CONCLUSION This study demonstrates the complexity of the personal and professional factors that influence joy in surgery, highlight gender differences that impact joy and suggests opportunities for improved gender-based support. These results can inform potential organization-level changes and further research to better understand emerging differences in joy across gender identities.
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Affiliation(s)
- Melissa N Hanson
- Department of Surgery, Guelph General Hospital, Guelph, ON, Canada.
| | - Dorothy Hughes
- Departments of Population Health and Surgery, University of Kansas School of Medicine- Salina, Salina, KS, USA
| | - Adnan Alseidi
- Department of Surgery, University of California San Francisco, San Francisco, CA, USA
| | - James G Bittner
- Department of Surgery, Sentara Obici Hospital, Suffolk, VA, USA
| | - John Romanelli
- Department of Surgery, University of Massachusetts Chan Medical School - Baystate Medical Center, Springfield, MA, USA
| | | | - Liane S Feldman
- Department of Surgery, McGill University, Montreal, QC, Canada
| | - Horacio Asbun
- Department of Hepato-Pancreato-Biliary Surgery, Miami Cancer Institute, Miami, FL, USA
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Anderson LN, Anaya YB, Gilchrist V. Supporting Our Women Colleagues. Fam Med 2024; 56:219-221. [PMID: 38748630 PMCID: PMC11189125 DOI: 10.22454/fammed.2024.754708] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/22/2024]
Abstract
Burnout is a challenge for all of us. Many of us experience burnout and know the toll it can take on our health and well-being. This editorial focuses on the experiences of women physicians and learners by highlighting the lived experience of one woman physician, briefly examining the extensive research into women physicians' practice, and identifying solutions that all genders can leverage to support women physicians and learners.
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Affiliation(s)
- LaKesha N Anderson
- Center for Health Professions Education, Uniformed Services University of the Health Sciences, Bethesda, MD
| | - Yohualli B Anaya
- Department of Family Medicine and Community Health, School of Medicine and Public Health, University of Wisconsin, Madison, WI
| | - Valerie Gilchrist
- Department of Family Medicine and Community Health, School of Medicine and Public Health, University of Wisconsin, Madison, WI
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Chiou PZ, Herring RP, Oh J, Medina E. Health impacts in pathology workforce during mergers and acquisitions (M&A). J Clin Pathol 2024; 77:98-104. [PMID: 37914381 DOI: 10.1136/jcp-2023-209124] [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] [Received: 08/08/2023] [Accepted: 09/22/2023] [Indexed: 11/03/2023]
Abstract
AIMS To compare burn-out in laboratory professionals (LPs) with exposure to consolidation to those without, and to investigate the role of social support as a moderator in the exposure to mergers and acquisitions (M&A). METHODS Surveys were sent to the clinical LPs, including 732 with exposure to M&A and 819 without. The dependent variable was burn-out, and the independent variable was exposure to M&A. In investigating the role of social support in exposure group, a logistic regression was used with education, time since M&A, gender, merger types, practice setting, lab hierarchy and race as covariates. RESULTS Exposure to M&A was associated with higher levels of burn-out (p<0.05). In logistic regression of the workforce exposed to M&A, the odds for LP developing a high level of burn-out are lowered by 7.1% for every unit of increase in social support (OR 0.93; 95% CI 0.88 to 0.98; p=0.004). CONCLUSION LPs exposed to M&A are more likely to experience higher levels of burn-out but having social support can protect against burn-out, which has policy implications for leadership managing laboratories in times of M&A.
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Affiliation(s)
- Paul Zone Chiou
- Clinical Laboratory Science, Rutgers Biomedical and Health Sciences, Newark, New Jersey, USA
- Loma Linda University School of Public Health, Loma Linda, California, USA
| | - R Patti Herring
- Loma Linda University School of Public Health, Loma Linda, California, USA
| | - Jisoo Oh
- Loma Linda University School of Public Health, Loma Linda, California, USA
| | - Ernest Medina
- Loma Linda University School of Public Health, Loma Linda, California, USA
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Rometsch C. The Role of Female Physicians in Psychosomatic Medicine: Opportunities and Challenges. WOMEN'S HEALTH REPORTS (NEW ROCHELLE, N.Y.) 2024; 5:8-12. [PMID: 38249938 PMCID: PMC10797173 DOI: 10.1089/whr.2023.0070] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 10/25/2023] [Indexed: 01/23/2024]
Abstract
Background Female physicians are in some cases preferred by patients due to their sex-related characteristics such as softness and empathy. Psychosomatic medicine presents a compelling working environment due to its holistic approach. Methods This brief review synthesizes the challenges encountered by female physicians in psychosomatic medicine and outlines potential strategies for overcoming these barriers. Results The presence of female role models may constitute a crucial advancement in this process. There exists a pressing demand for specialized clinical and scientific programs in psychosomatic medicine at both national and international levels. Such programs, offered by universities and ministries, as well as comprehensive training initiatives, are indispensable in fostering the next generation of females in psychosomatics. Leading journals can lend their support by publishing special issues dedicated to female physicians. Conclusion Strengthening female physicians throughout all positions in psychosomatic medicine can contribute ultimately to the improvement of patient care.
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Affiliation(s)
- Caroline Rometsch
- Department of Experimental and Clinical Medicine, University of Florence, Firenze, Italy
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Al Wahaibi N, Al Kindi R, Al Hinai M. Quality of Life Among Postgraduate Medical Residents in Oman: A Cross-sectional Survey. Oman Med J 2023; 38:e568. [PMID: 38264518 PMCID: PMC10803895 DOI: 10.5001/omj.2023.115] [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: 02/26/2023] [Accepted: 05/23/2023] [Indexed: 01/25/2024] Open
Abstract
Objectives To assess the quality of life (QoL) of medical residents enrolled in the various postgraduate programs of the Oman Medical Specialty Board (OMSB). Methods The data for this cross-sectional study was collected from January to June 2022. All postgraduate residents who were enrolled in all 19 OMSB training programs were targeted. An online English version of the validated 36-Item Short Form Health Survey (SF-36) was used to assess the participants' self-reported QoL. Results The participants were 425 OMSB residents (mean age = 29.6±2.2 years), of whom 289 (68.0%) were female, 259 (60.9%) were married, and 295 (69.4%) were enrolled in medical specialties. Overall, female residents reported significantly poorer QoL than male residents in all subscales of SF-36 (p =0.001). Married residents reported lower bodily pain scores than unmarried residents (p =0.005), although the latter endorsed better physical functioning, general health, and mental health. Residents in laboratory specialties had higher scores than those in medical and surgical specialties in most QoL dimensions including physical health, role functioning, energy/fatigue, emotional well-being, bodily pain, and general health (p ≤ 0.003). Psychiatry residents reported the lowest overall QoL. Conclusions Postgraduate medical residents in Oman reported significant variations in QoL based on specialization, gender, and marital status. These findings underscore the need for targeted interventions to tackle health inequalities and improve the QoL of this population.
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Affiliation(s)
- Noor Al Wahaibi
- Family Medicine Residency Training Program, Oman Medical Specialty Board, Muscat, Oman
| | - Rahma Al Kindi
- Department of Family Medicine and Public Health, Sultan Qaboos University Hospital, Muscat, Oman
| | - Mustafa Al Hinai
- Department of Family Medicine and Public Health, Sultan Qaboos University Hospital, Muscat, Oman
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McGoldrick J, Molina-Ochoa D, Schwab P, Edwards ST, Barton JL. An Evaluation of Burnout Among US Rheumatology Fellows: A National Survey. J Rheumatol 2023; 50:1185-1190. [PMID: 36921966 DOI: 10.3899/jrheum.221114] [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] [Accepted: 03/02/2023] [Indexed: 03/17/2023]
Abstract
OBJECTIVE To evaluate levels of burnout and correlates of burnout among US rheumatology fellows. METHODS US rheumatology fellows were invited to complete an electronic survey in 2019. Burnout was assessed using the Maslach Burnout Inventory. Measures of depression, fatigue, quality of life, and training year were also collected. Open-ended questions about perceived factors to promote resiliency and factors leading to increased burnout were included. Bivariate and multivariate regression analyses were used to examine correlates of burnout. Open-ended responses were analyzed using thematic analysis. RESULTS The response rate was 18% (105/582 pediatric and adult rheumatology fellows). Over one-third (38.5%) of postgraduate year (PGY) 4 and 16.7% of PGY5/6 fellows reported at least 1 symptom of burnout. Of PGY4 fellows, 12.8% met criteria for depression compared with 2.4% of PGY5/6 fellows. PGY4 fellows reported worse fatigue and poorer quality of life compared with PGY5/6. In multivariable models controlling for training year and gender, older age (> 31 years) was associated with lower odds of burnout. Thematic analysis of open-ended responses identified factors that help reduce burnout: exercise, family/friends, sleep, support at work, and hobbies. Factors contributing to burnout: pager, documentation, long hours, demands of patient care, and presentations and expectations. CONCLUSION This national survey of US rheumatology fellows reveals that early trainee level and younger age are associated with worse levels of fatigue, quality of life, and burnout. Although awareness of and strategies to reduce burnout are needed for all fellows, targeted interventions for younger fellows and those in their first year of training may be of highest yield.
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Affiliation(s)
| | - Diego Molina-Ochoa
- D. Molina-Ochoa, BS, University of Maryland School of Medicine, Baltimore, Maryland
| | - Pascale Schwab
- P. Schwab, MD, S.T. Edwards, MD, MPH, J.L. Barton, MD, MCR, Oregon Health & Science University, and VA Portland Health Care System, Portland, Oregon, USA
| | - Samuel T Edwards
- P. Schwab, MD, S.T. Edwards, MD, MPH, J.L. Barton, MD, MCR, Oregon Health & Science University, and VA Portland Health Care System, Portland, Oregon, USA
| | - Jennifer L Barton
- P. Schwab, MD, S.T. Edwards, MD, MPH, J.L. Barton, MD, MCR, Oregon Health & Science University, and VA Portland Health Care System, Portland, Oregon, USA
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Peterson K, Mundo W, McGladrey L, Aagaard LM, Stalder S, Cook PF. Stress Impact and Care for COVID-19: Pilot Education and Support Course Decreases Burnout Among Nursing Students. J Am Psychiatr Nurses Assoc 2023; 29:363-374. [PMID: 37534666 DOI: 10.1177/10783903231186997] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 08/04/2023]
Abstract
BACKGROUND Nurses and nursing students have been at the forefront of the fight against COVID-19, often working in conditions that produce stress injuries and burnout. Early recognition and mitigation of stress and emotional trauma help prevent burnout. AIMS To evaluate the effectiveness of an online 8-hour stress awareness course and associated 1-hour support group in reducing stress and burnout among nursing students. METHODS We conducted a program evaluation for an online stress awareness pilot course offered to nursing students. The course, and associated support groups led by trained psychiatric mental health nurse practitioner students, included a common language for talking about stress, screening tools for recognizing stress injuries, and strategies for improving self-care. Students completed pre- and post-course surveys. Outcome measures included changes on course learning objectives, level of burnout, health-related locus of control, and experiences of stress and coping. RESULTS Nursing students (n = 360) enrolled in the course, and 224 (62%) completed pre- and post-course surveys. Sixty percent rated the course excellent or very good. Depression Anxiety and Stress Scales and Impact of Event Scale Revised scores were within established normal ranges. There was a significant increase in all nine course learning objectives (p < .001) and decreased signs of stress (p < .001). Students' level of burnout decreased by odds ratio = 0.58 (95% CI: [0.4, 0.9], p < .006). CONCLUSIONS Nursing leaders can use psychoeducational strategies to mitigate the impact of stress, build confidence, and support nursing students entering the workforce during these unprecedented times.
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Affiliation(s)
- Kerry Peterson
- Kerry Peterson, PhD, DNP, PMHCNS-BC, PMHNP-BC, FAANP, University of Colorado, Aurora, CO, USA
| | - William Mundo
- William Mundo, MD, MPH, Denver Health Medical Center, Denver, CO, USA
| | - Laura McGladrey
- Laura McGladrey, PMHNP, FNP, FAWM, University of Colorado, Aurora, CO, USA
| | - Laurra M Aagaard
- Laurra M. Aagaard, MA, MS, University of Colorado, Aurora, CO, USA
| | - Sarah Stalder
- Sarah Stalder, MSN, PMHNP-BC, University of Colorado, Aurora, CO, USA
| | - Paul F Cook
- Paul F. Cook, PhD, University of Colorado, Aurora, CO, USA
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Lee AI, Masselink LE, De Castro LM, Marshall AL, Connell NT, Dent GA, Fritz J, Homer M, Lucas TL, Naik RP, Nelson M, O’Connell CL, Rajasekhar A, Reynolds RJ, Sharma D, Smith M, Weeks LD, Erikson CE. Burnout in US hematologists and oncologists: impact of compensation models and advanced practice provider support. Blood Adv 2023; 7:3058-3068. [PMID: 35476017 PMCID: PMC10331414 DOI: 10.1182/bloodadvances.2021006140] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2021] [Revised: 04/08/2022] [Accepted: 04/08/2022] [Indexed: 11/20/2022] Open
Abstract
Burnout is prevalent throughout medicine. Few large-scale studies have examined the impact of physician compensation or clinical support staff on burnout among hematologists and oncologists. In 2019, the American Society of Hematology conducted a practice survey of hematologists and oncologists in the AMA (American Medical Association) Masterfile; burnout was measured using a validated, single-item burnout instrument from the Physician Work-Life Study, while satisfaction was assessed in several domains using a 5-point Likert scale. The overall survey response rate was 25.2% (n = 631). Of 411 respondents with complete responses in the final analysis, 36.7% (n = 151) were from academic practices and 63.3% (n = 260) from community practices; 29.0% (n = 119) were female. Over one-third (36.5%; n = 150) reported burnout, while 12.0% (n = 50) had a high level of burnout. In weighted multivariate logistic regression models incorporating numerous variables, compensation plans based entirely on relative value unit (RVU) generation were significantly associated with high burnout among academic and community physicians, while the combination of RVU + salary compensation showed no significant association. Female gender was associated with high burnout among academic physicians. High advanced practice provider utilization was inversely associated with high burnout among community physicians. Distinct patterns of career dissatisfaction were observed between academic and community physicians. We propose that the implementation of compensation models not based entirely on clinical productivity increased support for women in academic medicine, and expansion of advanced practice provider support in community practices may address burnout among hematologists and oncologists.
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Affiliation(s)
- Alfred Ian Lee
- Section of Hematology, Yale School of Medicine, New Haven, CT
| | - Leah E. Masselink
- Department of Health Policy and Management, Milken Institute School of Public Health, The George Washington University, Washington, DC
| | - Laura M. De Castro
- Division of Hematology/Oncology, Hillman Cancer Center, University of Pittsburgh Medical Center, Pittsburgh, PA
| | | | - Nathan T. Connell
- Hematology Division, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA
| | - Georgette A. Dent
- Department of Pathology & Laboratory Medicine, University of North Carolina School of Medicine, Chapel Hill, NC
| | - Josel Fritz
- American Society of Hematology, Washington, DC
| | | | | | - Rakhi P. Naik
- Division of Hematology, Department of Medicine, Johns Hopkins University, Baltimore, MD
| | - Marquita Nelson
- Division of Hematology/Oncology, University of Tennessee Health Science Center, Memphis, TN
| | - Casey L. O’Connell
- Jane Anne Nohl Division of Hematology, Keck School of Medicine, University of Southern California, Los Angeles, CA
| | - Anita Rajasekhar
- Division of Hematology/Oncology, Department of Medicine, University of Florida, Gainesville, FL
| | | | - Deva Sharma
- Department of Pathology, Microbiology, and Immunology, Vanderbilt University Medical Center, Nashville, TN
| | - Melody Smith
- Division of Blood & Marrow Transplantation and Cellular Therapy, Stanford University, Stanford, CA
| | | | - Clese E. Erikson
- Fitzhugh Mullan Institute for Health Workforce Equity, The George Washington University, Washington, DC
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Song HI, Yun JA, Ahn YS, Choi KS. Validating a Korean Version of the Single-Item Burnout Measure for Evaluating Burnout Among Doctors. Psychiatry Investig 2023; 20:681-688. [PMID: 37525618 PMCID: PMC10397769 DOI: 10.30773/pi.2022.0339] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/28/2022] [Revised: 03/23/2023] [Accepted: 05/24/2023] [Indexed: 08/02/2023] Open
Abstract
OBJECTIVE It is essential to measure the effect of burnout on doctors because burnout can affect doctors' mental health as well as the functioning of medical practice. This study aims to validate a Korean version of the single-item burnout measure (SIBM), which was developed to quickly measure the level of burnout among doctors. METHODS Through an online survey, a self-report questionnaire was administered to 324 public health doctors in Korea. The Korean version of the SIBM was validated against the Maslach Burnout Inventory-General Survey (MBI-GS), the Patient Health Questionnaire-9 (PHQ-9), the Generalized Anxiety Disorder-7 (GAD-7) screening tool, the Perceived Stress Scale (PSS), and the Vaccination Attitudes Examination (VAX) scale. Pearson correlation coefficients and analysis of variance (ANOVA) were used to determine the association between the SIBM and other scales. ANOVA was additionally used to determine the associations between the subscales of the MBI-GS and those of the SIBM. RESULTS The correlation coefficient between the SIBM and the MBI-GS, PHQ-9, GAD-7, and PSS was positive (p<0.01), and the correlation coefficient between the SIBM and the VAX scale was not significant. Therefore, convergent and discriminant validity was verified. Exhaustion and cynicism, which were correlated with the SIBM, with r2=0.43 (p<0.01) and 0.48 (p<0.01), yielded R2 scores of 0.27 (p<0.01) and 0.20 (p<0.01) in ANOVA. CONCLUSION The Korean version of the SIBM is an appropriate screening tool for burnout. It can be evaluated in a short time, thereby enhancing continuous follow-up observations and response rates to burnout.
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Affiliation(s)
- Hye-in Song
- Department of Neuropsychiatry, Eulji University School of Medicine, Daejeon, Republic of Korea
- Department of Psychiatry, Pusan National University Hospital, Busan, Republic of Korea
| | - Ji-Ae Yun
- Department of Neuropsychiatry, Eulji University School of Medicine, Daejeon, Republic of Korea
- Department of Neuropsychiatry, Daejeon Eulji Medical Center, Eulji University, Daejeon, Republic of Korea
| | - Yeon-Soon Ahn
- Department of Preventive Medicine, Yonsei University Wonju College of Medicine, Wonju, Republic of Korea
| | - Kyeong-Sook Choi
- Department of Neuropsychiatry, Eulji University School of Medicine, Daejeon, Republic of Korea
- Department of Neuropsychiatry, Daejeon Eulji Medical Center, Eulji University, Daejeon, Republic of Korea
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Alzahrani MA, Almhmd A, Khan MA, Badriq F, Salman B, Aljaziri ZY, Alotaibi N, Alkhamees M, Almutairi S, Ahmad MS, Alkhateeb S. Women as Urologists in Saudi Arabia: Career Choice and Practice Challenges: A Comparative Cross-Sectional Study. Res Rep Urol 2023; 15:273-289. [PMID: 37396016 PMCID: PMC10314780 DOI: 10.2147/rru.s412713] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2023] [Accepted: 06/14/2023] [Indexed: 07/04/2023] Open
Abstract
Background There is limited research on whether women choose urology as a future career. Therefore, we aimed in this study to assess the influencing and challenging factors among female physicians in Saudi Arabia. Methods We approached 552 female physicians, including 29 (5.2%) urologists and 523 (94.7%) non-urologists. A cross-sectional survey was carried out, which included five sections and 46 items to assess and compare the perspectives of (urologists and non-urologists regarding influencing factors to choose urology, challenges toward applying to urology, and challenges during and after urology residency. Statistical analysis was conducted using SPSS software. Responses were presented as frequencies and percentages, while associations were studied using the Chi-squared test/Fisher's exact test. A p-value of ≤ 0.05 was considered significant. Results Out of 552 female physicians, 466 completed the survey. The survey items compared urologists and non-urologists among female physicians. Among both cohorts, the most influencing factors in choosing urology were the diversity of practice and urological procedures (p =0.002, p<0.001). There were no social barriers or challenges when applying for urology residency (p<0.001). Overall, the majority of female urologists reported a high level of agreement that they have more time to work at the clinic (55.2%), they are satisfied as they are currently being urologists (75.8%), satisfied with their current lifestyle (72.6%). They would choose urology again as a future career (58.6%). Non-urologist female physicians 326 (74.6%) think they are more likely to have experienced gender discrimination than urologists 15 (51.7%) (p<0.001). Female urologists were less likely to face social barriers when applying for urology residency than non-urologists (p<0.001). Conclusion As urologists, we must understand women's struggles, such as gender discrimination, a lack of academic advancement, and a lack of mentorship. To foster women's careers in urology, we must understand their unique needs, provide adequate mentorship, exterminate gender discrimination bias, and improve mentorship.
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Affiliation(s)
- Meshari A Alzahrani
- Department of Urology, College of Medicine, Majmaah University, Al-Majmaah, Saudi Arabia
| | - Abdalah Almhmd
- College of Medicine, Majmaah University, Al-Majmaah, Saudi Arabia
| | - Muhammad A Khan
- College of Medicine, King Saud bin Abdulaziz University for Health Sciences (KSAU-HS), Jeddah, Saudi Arabia
- King Abdullah International Medical Research Centre (KAIMRC), Jeddah, Saudi Arabia
| | - Feras Badriq
- Division of Urology, Department of Surgery, East Jeddah General Hospital, Ministry of Health, Jeddah, Saudi Arabia
| | - Budoor Salman
- Department of Urology, King Abdulaziz Medical City, Ministry of National Guard - Health Affairs, Jeddah, Saudi Arabia
| | - Zainab Y Aljaziri
- Department of Family Medicine, Al Ahsa Health Cluster, Ministry of Health, Al Ahsa, Saudi Arabia
| | - Naif Alotaibi
- King Salman Bin Abdulaziz Hospital, Ministry of Health, Riyadh, Saudi Arabia
| | - Mohammad Alkhamees
- Department of Urology, College of Medicine, Majmaah University, Al-Majmaah, Saudi Arabia
| | - Sulaiman Almutairi
- Department of Urology, College of Medicine, Majmaah University, Al-Majmaah, Saudi Arabia
| | - Mohammad Shakil Ahmad
- Department of Family & Community Medicine, College of Medicine, Majmaah University, Al Majmaah, Saudi Arabia
| | - Sultan Alkhateeb
- Department of Urology, King Faisal Specialist Hospital & Research Center, Riyadh, Saudi Arabia
- College of Medicine, Alfaisal University, Riyadh, Saudi Arabia
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O’Ferrell Beacham A, Westfall King A, Nash BF. Psychologists' Role in Addressing Healthcare Provider Burnout and Well-Being. JOURNAL OF HEALTH SERVICE PSYCHOLOGY 2023; 49:1-13. [PMID: 37360220 PMCID: PMC10251314 DOI: 10.1007/s42843-023-00083-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/28/2023]
Abstract
Burnout in health care has received considerable attention; widespread efforts to implement burnout reduction initiatives are underway. Healthcare providers with marginalized identities may be especially at risk. Health service psychologists are often key members of interprofessional teams and may be asked to intervene with colleagues exhibiting signs of burnout. Consequently, psychologists in these settings can then find themselves in professional quandaries. In the absence of clear guidelines, psychologists are learning to enhance their scope of practice and navigate ethical guidelines while supporting colleagues and simultaneously satisfying organizational priorities. In this paper we (a) provide an overview of burnout and its scope, (b) discuss ethical challenges health service psychologists face in addressing provider burnout, and (c) present three models to employ in healthcare provider burnout and well-being.
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Hu TY, Surampudy A, Divatia H, Friedland AR. A Quality Improvement Initiative to Reduce Pediatrician Burnout Led by the American Academy of Pediatrics Section on Internal Medicine and Pediatrics (Med-Peds). Cureus 2023; 15:e41205. [PMID: 37534306 PMCID: PMC10392022 DOI: 10.7759/cureus.41205] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2022] [Accepted: 06/28/2023] [Indexed: 08/04/2023] Open
Abstract
Physician burnout impacts care (of self and patient), productivity, longevity of career, and overall cost to the system. While burnout rates for pediatricians are lower than average, they have not improved significantly over time. While strategies at the system level have been more successful than those at the individual level, both aspects are vital. This quality improvement study explores physician wellness and burnout trends of a sample population of pediatricians at the 2018 and 2019 AAP National Conference and Exhibition (NCE), using the Physician Health and Wellness Booth (PHWB). A rapid cycle approach with the Plan-Do-Check-Act (PDCA) framework was utilized. The aim was to observe if reported burnout decreased by 20% over six months. Of the pediatricians who interacted with the PHWB, 56 were randomly selected to participate. This included men and women and those in various practice settings, ranging from resident physicians to providers in practice for over 20 years. Baseline surveys included elements from a modified Maslach Burnout Inventory and the Stanford Physician Wellness Survey, focusing on burnout components (emotional exhaustion, depersonalization, and fulfillment) and wellness activities. Individual-based interventions were provided at the PHWB, including adult preventative health guidelines, resources on sleep, stress mitigation, and complementary medicine. Participants received a movie ticket and Starbucks gift card. Follow-up included six monthly newsletters with strategies from seven wellness domains. Post-intervention surveys at six months assessed all baseline questions plus the effectiveness of monthly newsletters. A second PDCA cycle was conducted from the 2019 NCE. All individual-based interventions continued with an added aromatherapy oil station. Additional system-based resources included sample institutional wellness initiatives and burnout cost analyses, all focusing on advocating for cultural change at their respective home organizations. Interactive monthly wellness calendars addressing seven wellness domains were emailed for six months follow-up. Results from 10 post-intervention surveys (10/56=18% of respondents) from the initial cohort reported an average of 25% decrease in burnout (p=0.09). This was measured on a scale of 1-10 (from "never" burned out to "very often") and improved from 6.68 ("sometimes" to "often" burned out) to 5.0 ("rarely" to "sometimes" burned out). Results from Cohort 2 reflected a decrease in burnout from 4.94 ("rarely" to "sometimes" burned out) to 2.85 ("never" to "rarely" burned out) in return from 20 post-intervention surveys (20/48=42% of respondents, p=0.003). Participants noted a lack of control over work schedules and a disconnect with organizational values as drivers of burnout. Both the PHWB and monthly newsletters were rated as valuable as reminders about wellness practices. Limitations included low response rate, which was notable, and inability to prove causation of improvement from our intervention. Future steps include utilizing subject identification numbers to allow for anonymity in a prospective cohort study with a third PDCA cycle. This would allow anonymous but matched same-subject comparison of pre- and post-survey results despite the small sample size. Follow-up incentives could be beneficial. Lastly, data from both cohorts revealed the highest level of burnout in early career physicians within 10 years of training, paving an opportunity for future study.
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Affiliation(s)
- Tina Y Hu
- Internal Medicine-Pediatrics, ChristianaCare/Nemours Children's Hospital, Delaware, Newark, USA
| | - Abhishek Surampudy
- Internal Medicine-Pediatrics, ChristianaCare/Nemours Children's Hospital, Delaware, Newark, USA
| | - Himani Divatia
- Internal Medicine-Pediatrics, ChristianaCare, Newark, USA
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Naggie S, Milstone A, Castro M, Collins SP, Lakshmi S, Anderson DJ, Cahuayme-Zuniga L, Turner KB, Cohen LW, Currier J, Fraulo E, Friedland A, Garg J, George A, Mulder H, Olson RE, O'Brien EC, Rothman RL, Shenkman E, Shostak J, Woods CW, Anstrom KJ, Hernandez AF. Hydroxychloroquine for pre-exposure prophylaxis of COVID-19 in health care workers: a randomized, multicenter, placebo-controlled trial Healthcare Worker Exposure Response and Outcomes of Hydroxychloroquine (HERO-HCQ). Int J Infect Dis 2023; 129:40-48. [PMID: 36682681 PMCID: PMC9851717 DOI: 10.1016/j.ijid.2023.01.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2022] [Revised: 01/06/2023] [Accepted: 01/12/2023] [Indexed: 01/21/2023] Open
Abstract
OBJECTIVES To determine whether hydroxychloroquine (HCQ) is safe and effective at preventing COVID-19 infections among health care workers (HCWs). METHODS In a 1: 1 randomized, placebo-controlled, double-blind, parallel-group, superiority trial at 34 US clinical centers, 1360 HCWs at risk for COVID-19 infection were enrolled between April and November 2020. Participants were randomized to HCQ or matched placebo. The HCQ dosing included a loading dose of HCQ 600 mg twice on day 1, followed by 400 mg daily for 29 days. The primary outcome was a composite of confirmed or suspected COVID-19 clinical infection by day 30, defined as new-onset fever, cough, or dyspnea and either a positive SARS-CoV-2 polymerase chain reaction test (confirmed) or a lack of confirmatory testing due to local restrictions (suspected). RESULTS Study enrollment closed before full accrual due to recruitment challenges. The primary end point occurred in 41 (6.0%) participants receiving HCQ and 53 (7.8%) participants receiving placebo. No difference in the proportion of participants experiencing clinical infection (estimated difference of -1.8%, 95% confidence interval -4.6-0.9%, P = 0.20) was identified nor any significant safety issues. CONCLUSION Oral HCQ taken as prescribed appeared safe among HCWs. No significant clinical benefits were observed. The study was not powered to detect a small but potentially important reduction in infection. TRIAL REGISTRATION NCT04334148.
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Affiliation(s)
- Susanna Naggie
- Duke Clinical Research Institute, Duke University, Durham, North Carolina, USA.
| | | | - Mario Castro
- University of Kansas Medical Center, Kansas City, Kansas, USA
| | - Sean P Collins
- Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | | | | | | | | | - Lauren W Cohen
- Duke Clinical Research Institute, Duke University, Durham, North Carolina, USA
| | - Judith Currier
- University of California Los Angeles, Los Angeles, California, USA
| | - Elizabeth Fraulo
- Duke Clinical Research Institute, Duke University, Durham, North Carolina, USA
| | - Anne Friedland
- Duke Clinical Research Institute, Duke University, Durham, North Carolina, USA
| | - Jyotsna Garg
- Duke Clinical Research Institute, Duke University, Durham, North Carolina, USA
| | - Anoop George
- Temple University, Philadelphia, Pennsylvania, USA
| | - Hillary Mulder
- Duke Clinical Research Institute, Duke University, Durham, North Carolina, USA
| | - Rachel E Olson
- Duke Clinical Research Institute, Duke University, Durham, North Carolina, USA
| | - Emily C O'Brien
- Duke Clinical Research Institute, Duke University, Durham, North Carolina, USA
| | | | | | - Jack Shostak
- Duke Clinical Research Institute, Duke University, Durham, North Carolina, USA
| | - Christopher W Woods
- Duke Clinical Research Institute, Duke University, Durham, North Carolina, USA
| | - Kevin J Anstrom
- University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Adrian F Hernandez
- Duke Clinical Research Institute, Duke University, Durham, North Carolina, USA
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14
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Edmonds VS, Chatterjee K, Girardo ME, Butterfield RJ, Stonnington CM. Evaluation of a Novel Wellness Curriculum on Medical Student Wellbeing and Engagement Demonstrates a Need for Student-Driven Wellness Programming. TEACHING AND LEARNING IN MEDICINE 2023; 35:52-64. [PMID: 35107397 DOI: 10.1080/10401334.2021.2004415] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/13/2021] [Accepted: 09/15/2021] [Indexed: 06/14/2023]
Abstract
PROBLEM Medical training is stressful and has well-established implications for student wellbeing. Despite widespread efforts to reduce student burnout through wellness programming in medical schools, there is a paucity of literature examining students' perception of wellness and engagement with these programs. As such, we sought to evaluate: 1) medical students' level of engagement with a multifaceted wellness curriculum, 2) factors students perceived as important to wellbeing, and 3) associations with longitudinal measures of wellbeing and perceived stress. Intervention: A multipronged wellness curriculum was instituted at Mayo Clinic Alix School of Medicine-AZ (MCASOM-AZ) in 2017. This includes mental health services, curriculum-embedded seminars, wellness committee (composed of students, faculty, and administration) driven programming, and student proposed wellness activities that are reviewed and funded by the committee. The authors invited students at our institution to complete questionnaires at three timepoints during the 2018-2019 academic year. Questionnaires asked participants to rank eight factors from least to most important to their overall wellbeing. Participants self-reported their participation in each prong of the wellness curriculum and ranked the impact of each on their overall wellbeing. Their wellbeing and perceived stress were measured at each timepoint using validated psychological instruments. Context: As MCASOM-AZ opened in 2017, the student body at the time of study consisted of first- and second-year medical students. All students had the opportunity to engage with all aspects of the wellness curriculum and participate in this study, however participation was elective and all responses were anonymous. Of the MCASOM-AZ student body comprised of 100 students, 58 consented to participate in the study, 41.4% of which were Year 1 and 58.6% of which were Year 2 students. Participant age and gender were collected and were representative of the larger student body. Impact: Students engaged most with student-initiated wellness. They perceived unscheduled time as most impactful to their overall wellbeing with student-initiated activities as second-most impactful. Students with higher perceived stress were more likely than others to use mental health resources, which otherwise ranked lower in importance. Ranking academic performance as important to wellbeing was associated with higher wellbeing. There was no difference in wellbeing between students who participated in the wellness curriculum and those who did not. However, overall student wellbeing increased over the course of the year while perceived stress decreased. Lessons Learned: Medical school programs may benefit from allowing students to direct or contribute to the design of their own wellness curriculum. Additionally, medical education should work toward creating a more supportive learning environment with improved flexibility in order to better meet students' individual needs without compromising their education. Despite having low utilization rates overall, mental health resources remain an important aspect of student support services as they are used by students under greater amounts of perceived stress than their peers. UNLABELLED Supplemental data for this article is available online at https://doi.org/10.1080/10401334.2021.2004415 .
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Affiliation(s)
- Victoria S Edmonds
- Mayo Clinic Alix School of Medicine, Mayo Clinic, Scottsdale, Arizona, USA
| | | | - Marlene E Girardo
- Department of Quantitative Health Sciences, Mayo Clinic, Scottsdale, Arizona, USA
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15
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Prevalence and determinants of Italian physicians' burnout in the "post-COVID-19" era. Int Arch Occup Environ Health 2023; 96:377-387. [PMID: 36335513 PMCID: PMC9638242 DOI: 10.1007/s00420-022-01929-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2022] [Accepted: 10/16/2022] [Indexed: 11/09/2022]
Abstract
PURPOSE Several studies investigated prevalence and determinants of physicians' burnout during the peak of the COVID-19 pandemic, but only a few during the chronic phase of the pandemic. This study thus aimed to examine this topic referring to the "post-COVID-19 era", defined as a chronic and likely-to-be endemic status quo. METHODS A cross-sectional, online survey (November 2021-January 2022) was addressed to physicians in Lombardia (Northern Italy). Besides socio-demographic and COVID-19-related data, measures of personal, work- and patient-related burnout (Copenhagen Burnout Inventory; CBI), depression (Patient Health Questionnaire-8), anxiety (General Anxiety Disorder-7), and self-efficacy (General Self-Efficacy Scale) were collected. Linear/generalized linear models were run to test associations/predictions of interest. RESULTS Among the 958 respondents, burnout symptoms were clinically significant in 18.5% of them. Predictive models showed that female sex (OR = 0.73, 95% CI 0.42-1.27), younger age (OR = 0.94, 95% CI 0.59-1.48), shorter job tenure (OR = 1.01, 95% CI 0.62-1.65), trainee status (OR = 1.41, 95% CI 1.16-7.10), higher PHQ-8 (OR = 1.260, 95% CI 1.16-1.37), and GAD-7 scores (OR = 1.19, 95% CI 1.10-1.30) increased the risk to suffer from clinical burnout. COVID-19-related variables were mostly not related/associated to burnout levels. CONCLUSION In Italy, physicians' burnout is moderately prevalent also in the chronic phase of the pandemic, with its determinants being more intrinsic than environmental. The development of effective interventions is needed to help physicians cope with the new challenges of their job.
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Chandrabhatla T, Asgedom H, Gaudiano ZP, de Avila L, Roach KL, Venkatesan C, Weinstein AA, Younossi ZM. Second victim experiences and moral injury as predictors of hospitalist burnout before and during the COVID-19 pandemic. PLoS One 2022; 17:e0275494. [PMID: 36194588 PMCID: PMC9531782 DOI: 10.1371/journal.pone.0275494] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2021] [Accepted: 09/19/2022] [Indexed: 11/07/2022] Open
Abstract
Background The increasing number of physicians leaving practice, especially hospitalists, has been well-documented. The most commonly examined factor associated with this exodus has been burnout. The COVID-19 pandemic has put a unique and unprecedented stress on hospitalists who have been at the front lines of patient care. Therefore, the investigation of burnout and its related factors in hospitalists is essential to preventing future physician shortages. Objective This study examined the relationship between burnout, second victim, and moral injury experiences before and during the COVID-19 pandemic among hospitalists. Methods Two anonymous cross-sectional surveys of hospitalists from a community hospital in the metropolitan Washington, DC area were conducted. One was conducted pre-COVID-19 (September-November 2019) and one was conducted during COVID-19 (July-August 2020). The surveys were sent to all full-time hospitalists via an online survey platform. A variety of areas were assessed including demographic (e.g., age, gender), work information (e.g., hours per week, years of experience), burnout, second victim experiences, well-being, and moral injury. Results Burnout rates among providers during these two time periods were similar. Second victim experiences remained prevalent in those who experienced burnout both pre and during COVID-19, but interestingly the prevalence increased in those without burnout during COVID-19. Moral injury was predictive of burnout during COVID-19. Conclusion While there were some factors that predicted burnout that were similar both pre- and during-pandemic, moral injury was unique to predicting burnout during COVID-19. With burnout as a contributing factor to future physician shortages, it is imperative that predictive factors in a variety of different environments are well understood to prevent future shortages. Hospitalists may be an excellent barometer of these factors given their presence on the front line during the pandemic, and their experiences need to be further explored so that targeted interventions aimed at addressing those factors may be created.
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Affiliation(s)
- Tejasri Chandrabhatla
- Department of Medicine, Inova Fairfax Hospital, Fairfax, VA, United States of America
| | - Henok Asgedom
- Department of Global and Community Health, College of Health and Human Services, George Mason University, Fairfax, VA, United States of America
| | - Zehra P. Gaudiano
- Department of Medicine, Inova Fairfax Hospital, Fairfax, VA, United States of America
| | - Leyla de Avila
- Betty and Guy Beatty Center for Integrated Research, Inova Health System, Falls Church, VA, United States of America
| | - Kenneth L. Roach
- Department of Medicine, Inova Fairfax Hospital, Fairfax, VA, United States of America
| | - Chapy Venkatesan
- Department of Medicine, Inova Fairfax Hospital, Fairfax, VA, United States of America
| | - Ali A. Weinstein
- Department of Global and Community Health, College of Health and Human Services, George Mason University, Fairfax, VA, United States of America
- Betty and Guy Beatty Center for Integrated Research, Inova Health System, Falls Church, VA, United States of America
- Center for the Advancement of Well-Being, George Mason University, Fairfax, VA, United States of America
- * E-mail:
| | - Zobair M. Younossi
- Department of Medicine, Inova Fairfax Hospital, Fairfax, VA, United States of America
- Center for the Advancement of Well-Being, George Mason University, Fairfax, VA, United States of America
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17
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Dweik A, Dweik H, Mian H, Mohan M, Schinke C, Al Hadidi S. Gender disparities in multiple myeloma publications. EJHAEM 2022; 3:966-969. [PMID: 36051049 PMCID: PMC9422002 DOI: 10.1002/jha2.470] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 03/07/2022] [Accepted: 04/26/2022] [Indexed: 06/15/2023]
Abstract
Gender disparities exist in academia and are disproportionately affecting females. We conducted a cross-sectional study to analyze gender disparities in multiple myeloma (MM) publications. A total of 679 publications with 8898 authorships were analyzed. The mean number of authors for females vs. males, per publication, was 4.4 and 8.7, respectively. Females constituted a third of the total authors. Female first authors, corresponding authors, and last/senior authors were 34%, 21%, and 18%, respectively. Note that, 17% of authors of clinical trial publications were females. Gender disparities in MM publications exist and are more obvious in the last/corresponding authorship. Efforts should be made to identify factors that contribute to these disparities and work to resolve them.
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Affiliation(s)
- Aala Dweik
- Department of Medicine, Faculty of MedicineUniversity of JordanAmmanJordan
| | - Hadeel Dweik
- Department of Medicine, Faculty of MedicineUniversity of JordanAmmanJordan
| | - Hira Mian
- Department of OncologyMcMaster UniversityHamiltonCanada
| | - Meera Mohan
- Department of Internal MedicineDivision of Hematology and OncologyMedical College of WisconsinMilwaukeeWisconsinUSA
| | - Carolina Schinke
- Department of Hematology and Oncology, Myeloma CenterWinthrop P. Rockefeller Cancer InstituteUniversity of Arkansas for Medical SciencesLittle RockArkansasUSA
| | - Samer Al Hadidi
- Department of Hematology and Oncology, Myeloma CenterWinthrop P. Rockefeller Cancer InstituteUniversity of Arkansas for Medical SciencesLittle RockArkansasUSA
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18
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He B, Tanya SM, Costello F, Kherani F, Shamie N, Zhu D. Navigating Personal and Professional Development Through Social Media in Ophthalmology. Clin Ophthalmol 2022; 16:2263-2274. [PMID: 35859671 PMCID: PMC9289453 DOI: 10.2147/opth.s368674] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Accepted: 07/07/2022] [Indexed: 12/02/2022] Open
Abstract
Background Although social media use among physicians skyrocketed during the COVID-19 pandemic, its role for networking, mentorship, and support among ophthalmologists remains unknown. The objective of this study was to elucidate how ophthalmologists use social media for navigating challenges related to personal and professional development. Methods This was a cross-sectional survey study conducted during the height of the COVID-19 pandemic. A 40-item questionnaire investigating the usage of social media was developed and distributed to active social media users in ophthalmology including trainees and practitioners from November 2020 to December 2020 via social media channels. Quantitative responses were analyzed using descriptive and basic statistics, while a thematic analysis was conducted to examine the qualitative responses. Results One hundred and forty-nine respondents (67% women) completed the survey, with 56% of participants between the ages of 25–35 years old. Women were more likely to report experiencing workplace discrimination (p < 0.005) and work-life imbalance (p < 0.05) compared to men, and social media was found to be useful in addressing those challenges in addition to parenting and mentorship (p < 0.005 and p < 0.001, respectively). Compared to their older counterparts, younger ophthalmologists (<45 years old) cited more challenges with practice management (p < 0.005) and turned to social media for corresponding guidance (p < 0.05). Compared to late career ophthalmologists, trainees were more likely to report difficulties with career development (p < 0.05), practice management (p < 0.0001), and financial planning (p < 0.05), and found social media beneficial for learning financial literacy (p < 0.05). A qualitative analysis of the free-response texts found both positive and negative viewpoints of social media use in ophthalmology. Conclusion Social media is an invaluable tool for enhancing professional and personal growth for ophthalmologists, particularly for women, trainees, and younger surgeons through education and community-building. Future directions include exploring how social media can be used to improve mentorship, outreach, and training in ophthalmology.
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Affiliation(s)
- Bonnie He
- Department of Ophthalmology and Visual Sciences, Dalhousie University, Halifax, Nova Scotia, Canada
- Correspondence: Bonnie He, Dalhousie University Department of Ophthalmology & Visual Sciences, Halifax, Nova Scotia, Canada, Email
| | - Stuti M Tanya
- Department of Medicine, Memorial University of Newfoundland, St. John’s, Newfoundland and Labrador, Canada
| | - Fiona Costello
- Departments of Clinical Neurosciences and Surgery, University of Calgary, Calgary, Alberta, Canada
| | - Femida Kherani
- Department of Surgery, Division of Ophthalmology, University of Calgary, Calgary, Alberta, Canada
- Maloney-Shamie Vision Institute, Los Angeles, CA, USA
| | - Neda Shamie
- Maloney-Shamie Vision Institute, Los Angeles, CA, USA
| | - Dagny Zhu
- NVISION Eye Centers, Rowland Heights, Los Angeles County, California, USA
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Zhuang C, Hu X, Dill MJ. Do physicians with academic affiliation have lower burnout and higher career-related satisfaction? BMC MEDICAL EDUCATION 2022; 22:316. [PMID: 35473565 PMCID: PMC9039267 DOI: 10.1186/s12909-022-03327-5] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/15/2021] [Accepted: 03/28/2022] [Indexed: 06/14/2023]
Abstract
BACKGROUND Physicians report increasing burnout and declining career-related satisfaction, negatively impacting physician well-being and patient care quality. For physicians with academic affiliations, these issues can directly affect future generations of physicians. Previous research on burnout and satisfaction has focused on factors like work hours, gender, race, specialty, and work setting. We seek to contribute to the literature by examining these associations while controlling for demographic, family, and work-related characteristics. Furthermore, we aim to determine any differential effects of faculty rank. METHODS We analyzed data on practicing physicians in the U.S. from the Association of American Medical College's (AAMC) 2019 National Sample Survey of Physicians (NSSP,) which includes variables adapted from the Maslach Burnout Inventory. We used ordinal logistic regressions to explore associations between academic affiliation and burnout. We conducted a factor analysis to consolidate satisfaction measures, then examined their relationship with academic affiliation using multivariate linear regressions. All regression analyses controlled for physicians' individual, family, and work characteristics. RESULTS Among respondents (n = 6,000), 40% were affiliated with academic institutions. Physicians with academic affiliations had lower odds than their non-affiliated peers for feeling emotional exhaustion every day (Odds Ratio [OR] 0.87; 95% CI: 0.79-0.96; P < .001) and reported greater career-related satisfaction (0.10-0.14, SE, 0.03, 0.02; P < .001). The odds of feeling burnt out every day were higher for associate professors, (OR 1.57; 95% CI: 1.22-2.04; P < .001) assistant professors, (OR 1.64; 95% CI: 1.28-2.11; P < .001), and instructors (OR 1.72; 95% CI, 1.29-2.29; P < .001), relative to full professors. CONCLUSIONS Our findings contribute to the literature on burnout and career satisfaction by exploring their association with academic affiliation and examining how they vary among different faculty ranks. An academic affiliation may be an essential factor in keeping physicians' burnout levels lower and career satisfaction higher. It also suggests that policies addressing physician well-being are not "one size fits all" and should consider factors such as academic affiliation, faculty rank and career stage, gender identity, the diversity of available professional opportunities, and institutional and social supports. For instance, department chairs and administrators in medical institutions could protect physicians' time for academic activities like teaching to help keep burnout lower and career satisfaction higher.
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Affiliation(s)
- Chu Zhuang
- Department of Health Policy and Management, University of Maryland, College Park, School of Public Health, Maryland, 20742, USA.
| | - Xiaochu Hu
- Association of American Medical Colleges, 655 K St. NW Suite 100, Washington DC, USA
| | - Michael J Dill
- Association of American Medical Colleges, 655 K St. NW Suite 100, Washington DC, USA
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Abusanad A, Bensalem A, Shash E, Mula-Hussain L, Benbrahim Z, Khatib S, Abdelhafiz N, Ansari J, Jradi H, Alkattan K, Jazieh AR. Prevalence and Risk Factors of Burnout Among Female Oncologists From the Middle East and North Africa. Front Psychol 2022; 13:845024. [PMID: 35391953 PMCID: PMC8980775 DOI: 10.3389/fpsyg.2022.845024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2021] [Accepted: 02/25/2022] [Indexed: 11/13/2022] Open
Abstract
Background Burnout (BO) is a recognized challenge among the oncology workforce. It affects both genders with a higher frequency among women. This study examined the factors contributing to the development of burnout among female oncologists from the Middle East and North Africa (MENA). Methods An online cross-sectional survey was distributed to oncology professionals from different countries in the MENA region. The validated Maslach Burnout Inventory (MBI) of emotional exhaustion (EE), Depersonalization (DE), and Personal Achievement (PA) plus questions about demography/work-related factors and attitudes toward oncology were included. Data were analyzed to measure BO prevalence and related factors. Results Between 10 February and 15 March 2020, 545 responses were submitted by female oncologists. The responses pre-dated the COVID-19 pandemic emergence in the region. BO prevalence was 71% among female professionals. Women aged <44 years represented 85% of the cohort. Sixty-two percent were married, 52% with children and one-third practiced a hobby. Two-thirds worked in medical oncology, worked for <10 years and 35% worked in academia. The majority (73%) spent >25% on administrative work daily. Nearly half of the respondents (49%) expressed a recurring thought of quitting oncology and 70% had no burnout support or education. Inability to deliver optimal care was reported as distressing for career development in 82%. Factors significantly influencing the BO risk were identified. Marital status, having children, academia and years in practice did not impact the risk of BO among female oncologists from MENA. Conclusion Female oncologists from the Middle East and North Africa (MENA) were found to have a high prevalence of BO. In this cohort, the majority of women oncology workers were young and in their early to mid-career stages. Burnout was linked to being younger, practicing in North African nations, having a heavy administrative load, and having persistent thoughts of quitting. Practicing a hobby and engaging in oncology communication, on the other hand, reduced the chance of BO. Burnout support and education, specifically for oncology women, is required.
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Affiliation(s)
- Atlal Abusanad
- Faculty of Medicine, Medical Oncology, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Assia Bensalem
- Oncology Department, CHU Dr Benbadis, Constantine, Algeria
| | - Emad Shash
- Medical Oncology, National Cancer Institute - Cairo University, Cairo, Egypt
| | - Layth Mula-Hussain
- Department of Radiation Oncology, Sultan Qaboos Comprehensive Cancer and Research Center, Muscat, Oman
| | - Zineb Benbrahim
- Medical Oncology, CHU - University Hospital of Hassan II, Fez, Morocco
| | - Sami Khatib
- Oncology Department, Private Sector, Amman, Jordan
| | - Nafisa Abdelhafiz
- Department of Oncology, King Abdulaziz Medical City, Riyadh, Saudi Arabia
| | - Jawaher Ansari
- Medical Oncology, Tawam Hospital, Al Ain, United Arab Emirates
| | - Hoda Jradi
- Public Health Faculty, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
| | - Khaled Alkattan
- Head of Thoracic Surgery at King Faisal Specialist Hospital and Research Center (KFSH-RC), Alfaisal University, Riyadh, Saudi Arabia
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Laraja K, Mansfield L, de Ferranti S, Elia E, Gudanowski B, Gurvitz M, Gauthier N. Disproportionate Negative Career Impact of the COVID-19 Pandemic on Female Pediatric Cardiologists in the Northeast United States. Pediatr Cardiol 2022; 43:1913-1921. [PMID: 35648196 PMCID: PMC9158305 DOI: 10.1007/s00246-022-02934-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/07/2022] [Accepted: 05/13/2022] [Indexed: 11/30/2022]
Abstract
The COVID-19 pandemic has had a dramatic impact on practicing physicians, with effects in clinical practice, academic pursuits, research endeavors, and personal lives. Women in medicine have been uniquely impacted. We examined the impact of the pandemic on the careers of pediatric cardiologists in the Northeast with an anonymous online survey. Participants reported demographic data, information on work hours, administrative burden, career satisfaction, academic productivity, and burnout. We approached 490 cardiologists and received 127 completed surveys (response rate 26%; 49% female). Among all respondents, 72% reported increased burnout, 43% reported decreased career satisfaction, and 57% reported decreased academic productivity. In multivariable ordinal regression analysis, when compared to male physicians, females were 2.4 times more likely to report decreased overall career satisfaction (p = 0.027), 2.6 times more likely to report decreased academic productivity (p = 0.028), and 2.6 times more likely to report increased feelings of burnout "to a large degree" (p = 0.022). Among all respondents, decreased career satisfaction was independently associated with increased household responsibility (OR = 4.4, p = 0.001). Increased administrative burden was independently associated with decreased academic productivity (OR = 2.6, p = 0.038). Open-ended responses highlighted loss of community due to remote work and blurring of the boundaries between work and home. Conversely, respondents appreciated flexibility to work remotely. In conclusion, the majority of pediatric cardiologists in the Northeast experienced negative career impacts due to the COVID-19 pandemic. Important gender differences emerged, with female physicians disproportionately reporting increased burnout, decreased career satisfaction, and decreased academic productivity.
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Affiliation(s)
- Kristin Laraja
- Division of Pediatric Cardiology, Department of Pediatrics, University of Massachusetts Medical School, Worcester, MA USA
| | - Laura Mansfield
- Department of Cardiology, Department of Pediatrics, Harvard Medical School, Boston Children's Hospital, 300 Longwood Ave Boston, Boston, MA, 02115, USA.
| | - Sarah de Ferranti
- Department of Cardiology, Department of Pediatrics, Harvard Medical School, Boston Children’s Hospital, 300 Longwood Ave Boston, Boston, MA 02115 USA
| | - Eleni Elia
- Department of Cardiology, Department of Pediatrics, Harvard Medical School, Boston Children’s Hospital, 300 Longwood Ave Boston, Boston, MA 02115 USA ,School of Engineering, Computing and Mathematics, Oxford Brookes University, Oxford, UK
| | - Brittany Gudanowski
- Department of Cardiology, Department of Pediatrics, Harvard Medical School, Boston Children’s Hospital, 300 Longwood Ave Boston, Boston, MA 02115 USA
| | - Michelle Gurvitz
- Department of Cardiology, Department of Pediatrics, Harvard Medical School, Boston Children’s Hospital, 300 Longwood Ave Boston, Boston, MA 02115 USA
| | - Naomi Gauthier
- Department of Cardiology, Department of Pediatrics, Harvard Medical School, Boston Children’s Hospital, 300 Longwood Ave Boston, Boston, MA 02115 USA
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22
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Bochatay N, Bajwa NM, Ju M, Appelbaum NP, van Schaik SM. Towards equitable learning environments for medical education: Bias and the intersection of social identities. MEDICAL EDUCATION 2022; 56:82-90. [PMID: 34309905 DOI: 10.1111/medu.14602] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/12/2021] [Revised: 07/12/2021] [Accepted: 07/19/2021] [Indexed: 06/13/2023]
Abstract
CONTEXT Medical educators are increasingly paying attention to how bias creates inequities that affect learners across the medical education continuum. Such bias arises from learners' social identities. However, studies examining bias and social identities in medical education tend to focus on one identity at a time, even though multiple identities often interact to shape individuals' experiences. METHODS This article examines prior studies on bias and social identity in medical education, focusing on three social identities that commonly elicit bias: race, gender and profession. By applying the lens of intersectionality, we aimed to generate new insights into intergroup relations and identify strategies that may be employed to mitigate bias and inequities across all social identities. RESULTS Although different social identities can be more or less salient at different stages of medical training, they intersect and impact learners' experiences. Bias towards racial and gender identities affect learners' ability to reach different stages of medical education and influence the specialties they train in. Bias also makes it difficult for learners to develop their professional identities as they are not perceived as legitimate members of their professional groups, which influences interprofessional relations. To mitigate bias across all identities, three main sets of strategies can be adopted. These strategies include equipping individuals with skills to reflect upon their own and others' social identities; fostering in-group cohesion in ways that recognise intersecting social identities and challenges stereotypes through mentorship; and addressing intergroup boundaries through promotion of allyship, team reflexivity and conflict management. CONCLUSIONS Examining how different social identities intersect and lead to bias and inequities in medical education provides insights into ways to address these problems. This article proposes a vision for how existing strategies to mitigate bias towards different social identities may be combined to embrace intersectionality and develop equitable learning environments for all.
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Affiliation(s)
- Naike Bochatay
- Department of Pediatrics, University of California San Francisco, San Francisco, California, USA
| | - Nadia M Bajwa
- Unit of Development and Research in Medical Education, Faculty of Medicine, University of Geneva, Geneva, Switzerland
- Department of General Pediatrics, Children's Hospital, Geneva University Hospitals, Geneva, Switzerland
| | - Mindy Ju
- Department of Pediatrics, University of California San Francisco, San Francisco, California, USA
| | - Nital P Appelbaum
- Department of Education, Innovation and Technology, Baylor College of Medicine, Houston, Texas, USA
| | - Sandrijn M van Schaik
- Department of Pediatrics, University of California San Francisco, San Francisco, California, USA
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23
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Sanford J, Agrawal A, Miotto K. Psychological Distress Among Women Healthcare Workers: A Health System's Experience Developing Emotional Support Services During the COVID-19 Pandemic. Front Glob Womens Health 2021; 2:614723. [PMID: 34816185 PMCID: PMC8593987 DOI: 10.3389/fgwh.2021.614723] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2020] [Accepted: 01/18/2021] [Indexed: 11/18/2022] Open
Abstract
Ensuring the mental health and well-being of the healthcare workforce globally, especially women healthcare workers (HCWs), is an ongoing challenge that has been accentuated by the novel coronavirus (COVID-19) pandemic. Already at high risk of experiencing symptoms of stress, burnout, and depression, women HCWs are now also facing the psychosocial impacts of the COVID-19 pandemic. Although different types of mental health interventions have been introduced to support HCW well-being, the current needs of women HCWs have not been emphasized and replicable processes for developing and implementing specific emotional support services for women HCWs have not yet been well-described in the literature. Therefore, in this perspective, we discuss the approach our institution (University of California, Los Angeles) took for developing emotional support services for women HCWs that incorporate aspects of disaster behavioral health models and address various barriers to support and treatment. In addition, we describe and illustrate the process that we utilized to develop individual-level and institutional-level emotional support services. Finally, based on our institution's experience, we share recommendations for developing emotional support services for women HCWs during the COVID-19 pandemic and other future crises.
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Affiliation(s)
- Jesse Sanford
- Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, Los Angeles, CA, United States
| | - Alpna Agrawal
- Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, Los Angeles, CA, United States.,Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, Los Angeles, CA, United States.,VA Greater Los Angeles Healthcare System, Los Angeles, CA, United States
| | - Karen Miotto
- Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, Los Angeles, CA, United States
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24
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Chaukos D, Zebrowski JP, Benson NM, Celik A, Chad-Friedman E, Teitelbaum A, Bernstein C, Cook R, Genfi A, Denninger JW. "One size does not fit all" - lessons learned from a multiple-methods study of a resident wellness curriculum across sites and specialties. BMC MEDICAL EDUCATION 2021; 21:576. [PMID: 34774057 PMCID: PMC8590124 DOI: 10.1186/s12909-021-02995-z] [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] [Received: 08/29/2021] [Accepted: 10/22/2021] [Indexed: 06/13/2023]
Abstract
BACKGROUND There is growing recognition that wellness interventions should occur in context and acknowledge complex contributors to wellbeing, including individual needs, institutional and cultural barriers to wellbeing, as well as systems issues which propagate distress. The authors conducted a multiple-methods study exploring contributors to wellbeing for junior residents in diverse medical environments who participated in a brief resilience and stress-reduction curriculum, the Stress Management and Resiliency Training Program for Residents (SMART-R). METHODS Using a waitlist-controlled design, the curriculum was implemented for post-graduate year (PGY)-1 or PGY-2 residents in seven residency programs across three sites. Every three months, residents completed surveys, including the Perceived Stress Scale-10, General Self-Efficacy Questionnaire, a mindfulness scale (CAMSR), and a depression screen (PHQ-2). Residents also answered free-text reflection questions about psychological wellbeing and health behaviors. RESULTS The SMART-R intervention was not significantly associated with decreased perceived stress. Linear regression modeling showed that depression was positively correlated with reported stress levels, while male sex and self-efficacy were negatively correlated with stress. Qualitative analysis elucidated differences in these groups: Residents with lower self-efficacy, those with a positive depression screen, and/or female residents were more likely to describe experiencing lack of control over work. Residents with higher self-efficacy described more positive health behaviors. Residents with a positive depression screen were more self-critical, and more likely to describe negative personal life events. CONCLUSIONS This curriculum did not significantly modify junior residents' stress. Certain subpopulations experienced greater stress than others (female residents, those with lower self-efficacy, and those with a positive depression screen). Qualitative findings from this study highlight universal stressful experiences early in residency, as well as important differences in experience of the learning environment among subgroups. Tailored wellness interventions that aim to support diverse resident sub-groups may be higher yield than a "one size fits all" approach. TRIAL REGISTRATION NCT02621801 , Registration date: December 4, 2015 - Retrospectively registered.
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Affiliation(s)
- Deanna Chaukos
- Mount Sinai Hospital/ University of Toronto Temerty Faculty of Medicine, 600 University Avenue, Toronto, Ontario, M5G1X5, Canada.
| | | | | | | | | | | | - Carol Bernstein
- Montefiore Medical Center/Albert Einstein College of Medicine, New York, NY, USA
| | - Rebecca Cook
- Dell Medical School/University of Texas-Austin, Austin, TX, USA
| | | | - John W Denninger
- Massachusetts General Hospital/ Harvard Medical School, Boston, MA, USA
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25
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Rehder K, Adair KC, Sexton JB. The Science of Health Care Worker Burnout: Assessing and Improving Health Care Worker Well-Being. Arch Pathol Lab Med 2021; 145:1095-1109. [PMID: 34459858 DOI: 10.5858/arpa.2020-0557-ra] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/07/2021] [Indexed: 11/06/2022]
Abstract
CONTEXT.— Problems with health care worker (HCW) well-being have become a leading concern in medicine given their severity and robust links to outcomes like medical error, mortality, and turnover. OBJECTIVE.— To describe the state of the science regarding HCW well-being, including how it is measured, what outcomes it predicts, and what institutional and individual interventions appear to reduce it. DATA SOURCES.— Peer review articles as well as multiple large data sets collected within our own research team are used to describe the nature of burnout, associations with institutional resources, and individual tools to improve well-being. CONCLUSIONS.— Rates of HCW burnout are alarmingly high, placing the health and safety of patients and HCWs at risk. To help address the urgent need to help HCWs, we summarize some of the most promising early interventions, and point toward future research that uses standardized metrics to evaluate interventions (with a focus on low-cost institutional and personal interventions).
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Affiliation(s)
- Kyle Rehder
- From the Duke Center for Healthcare Safety and Quality, Duke University Health System, Durham, North Carolina
| | - Kathryn C Adair
- From the Duke Center for Healthcare Safety and Quality, Duke University Health System, Durham, North Carolina
| | - J Bryan Sexton
- From the Duke Center for Healthcare Safety and Quality, Duke University Health System, Durham, North Carolina
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26
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Affiliation(s)
- Ozgul Ekmekcioglu
- Sisli Hamidiye Etfal Education and Research Hospital, Nuclear Medicine Department, University of Health Sciences, Istanbul, Turkey.
| | - Laura Evangelista
- Department of Medicine - DIMED, Nuclear Medicine Unit, University of Padova, Padova, Italy
| | - Jolanta Kunikowska
- Nuclear Medicine Department, Medical University of Warsaw, Warsaw, Poland
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27
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Shahriar AA, Prasad K, Casty K, Rahman ZI, Westerhaus M, Satin DJ. Race and Gender Differences in Medical Student Perspectives on Social Determinants of Health Education: A Single-Institution Survey Study. ADVANCES IN MEDICAL EDUCATION AND PRACTICE 2021; 12:587-595. [PMID: 34104037 PMCID: PMC8179748 DOI: 10.2147/amep.s300447] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/12/2021] [Accepted: 05/02/2021] [Indexed: 06/12/2023]
Abstract
PURPOSE The field of medicine is becoming increasingly aware of the role that social determinants of health (SDH) play in shaping health and health outcomes. Organized medicine - including prominent physician groups and accreditation bodies - has endorsed SDH education as an integral component of medical school curricula. This study sought to describe medical student perspectives on the current state of SDH in preclinical curricula. METHODS The authors developed a 9-item survey to assess time being spent on SDH and attitudes toward the current level of SDH content in preclinical curricula. All medical students at both campuses of a large public medical school were invited to participate between December 2019 and February 2020. RESULTS Of 1010 medical students invited to participate, 515 (51.0%) responded. Of the 515 respondents, 480 (93.2%) reported spending at least 40 hours per week on medical school, and of those, 405 (84.4%) said they spend 0-2 hours on SDH. The majority of all respondents (62.1%; 320/515) felt the current level of focus on SDH is "not enough", while only eleven students (2.1%; 11/515) felt it is "too much". In a multiple logistic model, Black students were over four times as likely as white students (aOR 4.19; 95% CI 1.37-18.38) to feel the current level of focus on SDH is "not enough". Likewise, women were 2.3-times (aOR 2.30; 95% CI 1.52-3.49) as likely as men to feel the level of focus on SDH is "not enough". CONCLUSION In practice, medical students are spending considerably less time learning SDH than is advised by consensus of expert educators and administrators. Over sixty percent of medical students do not feel the current level of focus on SDH is sufficient. Further study is needed to determine why women and racial minority students are significantly more likely to feel this way.
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Affiliation(s)
| | - Kriti Prasad
- University of Minnesota Medical School, Minneapolis, MN, USA
| | - Katherine Casty
- University of Minnesota Medical School, Minneapolis, MN, USA
| | - Zarin I Rahman
- University of Minnesota Medical School, Minneapolis, MN, USA
| | - Michael Westerhaus
- University of Minnesota, Global Medicine, Minneapolis, MN, USA
- Center for International Health, St. Paul, MN, USA
| | - David J Satin
- University of Minnesota Medical School, Minneapolis, MN, USA
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28
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Wright GC. The Evolving Workforce in Rheumatology: The Effect of Gender. J Rheumatol 2021; 48:967-968. [PMID: 33795329 DOI: 10.3899/jrheum.210082] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Population shifts in the workforce have been noted for the past few decades. In the United States, the number of people aged 65 and older is expected to double, reaching almost a quarter of the population.1 By 2045, the US is expected to experience a demographic shift, with an increase in the percentage of minority populations to greater than 50%.
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Affiliation(s)
- Grace C Wright
- Association of Women in Rheumatology, New York, New York, USA.
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29
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Jyothindran R, d’Etienne JP, Marcum K, Ho AF, Robinson RD, Tijerina A, Graca C, Knowles HC, Zenarosa NR, Wang H. Association between burnout and wellness culture among emergency medicine providers. Clin Exp Emerg Med 2021; 8:55-64. [PMID: 33845524 PMCID: PMC8041580 DOI: 10.15441/ceem.20.074] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2020] [Revised: 07/11/2020] [Accepted: 07/20/2020] [Indexed: 11/29/2022] Open
Abstract
OBJECTIVE Burnout is a common occurrence among healthcare providers and has been associated with provider wellness culture. However, this association has not been extensively studied among emergency medicine (EM) providers. We aim to determine the association between EM provider burnout and their culture of wellness, and to elicit the independent wellness culture domains most predictive of burnout prevention. METHODS This was a multi-center observational study. We enrolled EM physicians and advanced practice providers from sixteen different emergency departments (EDs). Provider wellness culture and burnout surveys were performed. The wellness culture domains included in this study are personal/organizational value alignment, provider appreciation, leadership quality, self-controlled scheduling, peer support, and family support. Correlations between each wellness culture domain and burnout were analyzed by Pearson correlation co-efficiency, and their associations were measured by multivariate logistic regression with adjustments of other confounders. RESULTS A total of 242 ED provider surveys were entered for final analysis. The overall burnout rate was 54% (130/242). Moderate correlations were found between burnout and two wellness culture domains (value alignment: r=-0.43, P<0.001 and provider appreciation: r=-0.49, P<0.001). The adjusted odds ratio of provider appreciation associated with burnout was 0.44 (95% confidence interval, 0.25-0.77; P=0.004), adjusted odds ratio of family support was 0.67 (95% confidence interval, 0.48-0.95; P=0.025). CONCLUSION ED providers have a relatively high burnout rate. Provider burnout might have certain associations with wellness culture domains. Provider appreciation and family support seem to play important roles in burnout protection.
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Affiliation(s)
- Revathi Jyothindran
- Integrative Emergency Services, John Peter Smith Health Network, Dallas, TX, USA
| | - James P d’Etienne
- Integrative Emergency Services, John Peter Smith Health Network, Dallas, TX, USA
| | - Kevin Marcum
- Integrative Emergency Services, John Peter Smith Health Network, Dallas, TX, USA
| | - Amy F Ho
- Integrative Emergency Services, John Peter Smith Health Network, Dallas, TX, USA
| | - Richard D Robinson
- Integrative Emergency Services, John Peter Smith Health Network, Dallas, TX, USA
| | - Aubre Tijerina
- Integrative Emergency Services, John Peter Smith Health Network, Dallas, TX, USA
| | - Clare Graca
- Integrative Emergency Services, John Peter Smith Health Network, Dallas, TX, USA
| | - Heidi C Knowles
- Integrative Emergency Services, John Peter Smith Health Network, Dallas, TX, USA
| | - Nestor R Zenarosa
- Integrative Emergency Services, John Peter Smith Health Network, Dallas, TX, USA
| | - Hao Wang
- Integrative Emergency Services, John Peter Smith Health Network, Dallas, TX, USA
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30
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Norvell JG, Baker AM, Carlberg DJ, Diller D, Dziedzic JM, Finnell JT, Greenberger S, Kessler C, Lo BM, Moungey BM, Schiller E, Walter LA. Does academic practice protect emergency physicians against burnout? J Am Coll Emerg Physicians Open 2021; 2:e12329. [PMID: 33521781 PMCID: PMC7819260 DOI: 10.1002/emp2.12329] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2020] [Revised: 11/12/2020] [Accepted: 11/20/2020] [Indexed: 11/19/2022] Open
Abstract
Burnout is a complex syndrome thought to result from long-term exposure to career-related stressors. Physicians are at higher risk for burnout than the general United States (US) working population, and emergency medicine has some of the highest burnout rates of any medical specialty. Burnout impacts physicians' quality of life, but it can also increase medical errors and negatively affect patient safety. Several studies have reported lower burnout rates and higher job satisfaction in academic medicine as compared with private practice. However, researchers have only begun to explore the factors that underlie this protective effect. This paper aims to review existing literature to identify specific aspects of academic practice in emergency medicine that may be associated with lower physician burnout rates and greater career satisfaction. Broadly, it appears that spending time in the area of emergency medicine one finds most meaningful has been associated with reduced physician burnout. Certain non-clinical academic work, including involvement in research, leadership, teaching, and mentorship, have been identified as specific activities that may protect against burnout and contribute to higher job satisfaction. Given the epidemic of physician burnout, hospitals and practice groups have a responsibility to address burnout, both by prevention and by early recognition and support. We discuss methods by which organizations can actively foster physician well-being and provide examples of 2 leading academic institutions that have developed comprehensive programs to promote physician wellness and prevent burnout.
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Affiliation(s)
- Jeffrey G. Norvell
- Department of Emergency MedicineUniversity of Kansas Medical CenterKansas CityKansasUSA
| | - Annalee M. Baker
- Department of Emergency MedicineAventura Hospital and Medical CenterFIU Herbert Wertheim College of MedicineAventuraFloridaUSA
| | - David J. Carlberg
- Department of Emergency MedicineGeorgetown University Hospital/Georgetown University School of MedicineWashington, DCUSA
| | - David Diller
- Department of Emergency MedicineLAC+USC Medical CenterKeck School of Medicine of the University of Southern CaliforniaLos AngelesCaliforniaUSA
| | - Jacqueline M. Dziedzic
- Department of Emergency MedicineLoyola University Chicago‐Stritch School of MedicineChicagoIllinoisUSA
| | - John T. Finnell
- Department of Emergency MedicineIndiana University School of MedicineIndianapolisIndianaUSA
| | - Sarah Greenberger
- Department of Emergency MedicineDepartment of Emergency MedicineUniversity of Arkansas for Medical Sciences College of MedicineLittle RockArkansasUSA
| | - Chad Kessler
- Durham VA Medical CenterDepartment of Emergency MedicineDuke UniversityDurhamNorth CarolinaUSA
| | - Bruce M. Lo
- Department of Emergency MedicineSentara Norfolk General Hospital/Eastern Virginia Medical SchoolNorfolkVirginiaUSA
| | - Brooke M. Moungey
- The Ohio State University Department of Emergency MedicineColumbusOhioUSA
| | - Elizabeth Schiller
- Department of Emergency MedicineSaint Francis Hospital and Medical Center/University of Connecticut SOMHartfordConnecticutUSA
| | - Lauren A. Walter
- Department of Emergency MedicineThe University of Alabama at Birmingham School of MedicineBirminghamAlabamaUSA
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31
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Obregon M, Luo J, Shelton J, Blevins T, MacDowell M. Assessment of burnout in medical students using the Maslach Burnout Inventory-Student Survey: a cross-sectional data analysis. BMC MEDICAL EDUCATION 2020; 20:376. [PMID: 33087080 PMCID: PMC7579892 DOI: 10.1186/s12909-020-02274-3] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/27/2020] [Accepted: 10/01/2020] [Indexed: 05/16/2023]
Abstract
BACKGROUND Medical student burnout can cause emotional and physical exhaustion and detachment. The objectives of this study were to evaluate burnout using the Maslach Burnout Inventory-Student Survey (MBI-SS), identify factors that may predict burnout, and assess wellness initiatives effectiveness at reducing burnout. METHODS The MBI-SS was administered to all medical students (Classes 2019 to 2022) at the University of Illinois College of Medicine (UICOM) from February to May 2019. Factor analysis and internal consistency of the MBI-SS were assessed. Mean MSBI-SS subscale scores for burnout were calculated for cynicism (CY), emotional exhaustion (EE), and academic efficacy (AE). Multiple regression analysis was used to identify student factors that may predict burnout. RESULTS A total of 273 (21.6%) UICOM students completed the survey and 110 (40.3%) respondents reported self-perceived burnout. MBI-SS subscale scores were significantly higher for CY and EE, and significantly lower for AE in students who reported suffering from burnout versus students who did not report burnout. Mean ± SD subscale scores for CY, EE, and AE in burnout students were 14.44 ± 5.59, 23.23 ± 4.74, and 24.81 ± 5.35, respectively. In comparison, mean ± SD subscale scores for CY, EE, and AE in non-burnout students were 7.59 ± 5.16, 14.96 ± 5.71, and 28.74 ± 3.21, respectively. Regression analysis denoted significant associations between burnout and being out-of-phase in the curriculum, the effectiveness of wellness initiatives, and strength of motivation for medical school (SMMS) in both the two- and three-dimensional MBI-SS models. Gender was significantly associated with burnout in only the two-dimensional model. CONCLUSIONS Self-reported burnout in medical students at UICOM was validated using the MBI-SS. Being out-of-phase in the curriculum, being female, rating wellness initiatives as less effective, and demonstrating lower motivation for continued medical school education may be used as predictors of medical student burnout. This investigation may act as a guide for measuring burnout in medical student populations and how the implementation of wellness initiatives may ameliorate burnout.
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Affiliation(s)
- Michael Obregon
- University of Illinois College of Medicine at Rockford, 1601 Parkview Ave, Rockford, IL, 61107, USA
| | - Jessica Luo
- University of Illinois College of Medicine at Rockford, 1601 Parkview Ave, Rockford, IL, 61107, USA
| | - Jarod Shelton
- University of Illinois College of Medicine at Rockford, 1601 Parkview Ave, Rockford, IL, 61107, USA.
| | - Terri Blevins
- Research Assistant Professor and Assistant Dean for Student Affairs and Academic Progress, University of Illinois College of Medicine at Rockford, Rockford, IL, USA
| | - Martin MacDowell
- Research Professor and Associate Director Health Professions Education, Department of Family Medicine, National Center for Rural Health Professions, University of Illinois College of Medicine at Rockford, Rockford, IL, USA
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Winkel AF. A National Curriculum to Address Professional Fulfillment and Burnout in OB-GYN Residents. J Grad Med Educ 2020; 12:461-468. [PMID: 32879687 PMCID: PMC7450736 DOI: 10.4300/jgme-d-19-00728.1] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/18/2019] [Revised: 01/17/2020] [Accepted: 04/22/2020] [Indexed: 11/06/2022] Open
Abstract
BACKGROUND Physician well-being is a priority in graduate medical education as residents suffer high rates of burnout. With complex stressors affecting the clinical environment, conflicting evidence exists as to whether a formal curriculum improves resident well-being. OBJECTIVE We assessed the feasibility and impact of a national pilot of a yearlong wellness curriculum for obstetrics and gynecology (OB-GYN) residents. METHODS The Council on Resident Education in Obstetrics and Gynecology Wellness Task Force developed a national multicenter pilot group of 25 OB-GYN programs to participate in a prospective cohort study. The curriculum included 6 interactive wellness workshops using uniform teaching materials delivered during didactic time. Prior to and following their participation in the curriculum, residents completed a survey containing demographic information and the Professional Fulfillment Index. RESULTS Among 592 eligible participants, 429 (72%) responded to the pretest and 387 (65%) to the posttest. Average age of respondents was 29.1 years (range = 24-52 years) and included 350 (82%) women and 79 (18%) men. At baseline, 254 of 540 (47%) respondents met criteria for burnout, and 101 (23%) met criteria for robust professional fulfillment. Residents participated in an average of 3.9 workshops. While aggregate posttest scores did not differ from baseline, residents attending 4 to 6 workshops had improved rates of burnout (40% vs 50%, P = .017) and robust professional fulfillment (28% vs 20%, P < .001) compared with those with lower attendance. CONCLUSIONS A wellness curriculum was a feasible addition to OB-GYN residency program curricula in programs across the country. Residents with higher attendance experienced improved professional fulfillment and less burnout.
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Ramani D, Konopasky A, Artino A, Durning S, Mikita J. An Exploratory Assessment of Sleep Patterns, Burnout and Perceived Stress of a Cohort of Active Duty Military Physicians. MEDEDPUBLISH 2020; 9:145. [PMID: 38073802 PMCID: PMC10702675 DOI: 10.15694/mep.2020.000145.1] [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: 12/22/2023] Open
Abstract
This article was migrated. The article was marked as recommended. Introduction: Physician well-being is crucial and has the potential to impact patient safety. Many physicians across different stages of their careers experience stress, burnout, and/or decreased sleep. These factors can negatively affect physician well-being and performance and contribute to medical errors. The purpose of this study is to further understand physician well-being by examining a single cohort for patterns of sleep, burnout, and perceived stress across gender, training level, and specialty. Materials and methods: A cohort of 32 practicing military physicians ranging from first-year residents to experienced attendings continuously wore an actigraphy watch for a duration of at least 5 days to capture baseline sleep patterns. On the last day of data collection, participants completed a self-reported assessment of their daytime sleepiness using the Epworth Sleepiness Scale (ESS), a two-item burnout scale adapted from the Maslach Burnout Inventory, and a 10-item perceived stress questionnaire. Data for the entire cohort were descriptively analyzed. Results: The cohort had a mean sleep duration of 6.69 hours across the 5 days, with a maximum mean sleep duration of 7.90 hours, and a minimum mean sleep duration of 5.69 hours per day. Analysis stratified by gender and level of training revealed an average sleep duration of at least 6 hours across these groups. Overall, the cohort reported low perceived stress levels, low daytime sleepiness, and low burnout. Conclusion: The cohort of physicians examined in the present study did not show signs of significant sleep deprivation, feelings of perceived stress, or burnout. This may be due to military culture and the structure of military training facilities that emphasize duty hour regulations. In addition, these findings may be related to the fact that military health professionals are salaried, as opposed to being on a fee-for-service schedule, and military facilities offer well-being programs.
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Affiliation(s)
- Divya Ramani
- Uniformed Services University of the Health Sciences
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Agrawal V, Plantinga L, Abdel-Kader K, Pivert K, Provenzano A, Soman S, Choi MJ, Jaar BG. Burnout and Emotional Well-Being among Nephrology Fellows: A National Online Survey. J Am Soc Nephrol 2020; 31:675-685. [PMID: 32123052 DOI: 10.1681/asn.2019070715] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
BACKGROUND Physician burnout and emotional distress are associated with work dissatisfaction and provision of suboptimal patient care. Little is known about burnout among nephrology fellows. METHODS Validated items on burnout, depressive symptoms, and well being were included in the American Society of Nephrology annual survey emailed to US nephrology fellows in May to June 2018. Burnout was defined as an affirmative response to two single-item questions of experiencing emotional exhaustion or depersonalization. RESULTS Responses from 347 of 808 eligible first- and second-year adult nephrology fellows were examined (response rate=42.9%). Most fellows were aged 30-34 years (56.8%), male (62.0%), married or partnered (72.6%), international medical graduates (62.5%), and pursuing a clinical nephrology fellowship (87.0%). Emotional exhaustion and depersonalization were reported by 28.0% and 14.4% of the fellows, respectively, with an overall burnout prevalence of 30.0%. Most fellows indicated having strong program leadership (75.2%), positive work-life balance (69.2%), presence of social support (89.3%), and career satisfaction (73.2%); 44.7% reported a disruptive work environment and 35.4% reported depressive symptoms. Multivariable logistic regression revealed a statistically significant association between female gender (odds ratio [OR], 1.90; 95% confidence interval [95% CI], 1.09 to 3.32), poor work-life balance (OR, 3.97; 95% CI, 2.22 to 7.07), or a disruptive work environment (OR, 2.63; 95% CI, 1.48 to 4.66) and burnout. CONCLUSIONS About one third of US nephrology fellows surveyed reported experiencing burnout and depressive symptoms. Further exploration of burnout-especially that reported by female physicians, as well as burnout associated with poor work-life balance or a disruptive work environment-is warranted to develop targeted efforts that may enhance the educational experience and emotional well being of nephrology fellows.
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Affiliation(s)
- Varun Agrawal
- Division of Nephrology and Hypertension, University of Vermont, Burlington, Vermont;
| | | | - Khaled Abdel-Kader
- Division of Nephrology, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Kurtis Pivert
- Workforce, Training, and Career Advancement Department, American Society of Nephrology, Washington, DC
| | | | - Sandeep Soman
- Division of Nephrology and Hypertension, Henry Ford Hospital, Detroit, Michigan
| | - Michael J Choi
- Division of Nephrology and Hypertension, Medstar Georgetown University Hospital, Washington, DC
| | - Bernard G Jaar
- Department of Medicine, Division of Nephrology, Johns Hopkins University, Baltimore, Maryland.,Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health Welch Center for Prevention, Epidemiology, and Clinical Research, Baltimore, Maryland; and.,Nephrology Center of Maryland, Baltimore, Maryland
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Prasad K, Poplau S, Brown R, Yale S, Grossman E, Varkey AB, Williams E, Neprash H, Linzer M. Time Pressure During Primary Care Office Visits: a Prospective Evaluation of Data from the Healthy Work Place Study. J Gen Intern Med 2020; 35:465-472. [PMID: 31797160 PMCID: PMC7018911 DOI: 10.1007/s11606-019-05343-6] [Citation(s) in RCA: 37] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2018] [Revised: 07/10/2019] [Accepted: 08/28/2019] [Indexed: 01/13/2023]
Abstract
BACKGROUND The relationship between worklife factors, clinician outcomes, and time pressure during office visits is unclear. OBJECTIVE To quantify associations between time pressure, workplace characteristics ,and clinician outcomes. DESIGN Prospective analysis of data from the Healthy Work Place randomized trial. PARTICIPANTS 168 physicians and advanced practice clinicians in 34 primary care practices in Upper Midwest and East Coast. MAIN MEASURES AND METHODS Time pressure was present when clinicians needed more time than allotted to provide quality care. Other metrics included work control, work pace (calm to chaotic), organizational culture and clinician satisfaction, stress, burnout, and intent to leave the practice. Hierarchical analysis assessed relationships between time pressure, organizational characteristics, and clinician outcomes. Adjusted differences between clinicians with and without time pressure were expressed as effect sizes (ESs). KEY RESULTS Sixty-seven percent of clinicians needed more time for new patients and 53% needed additional time for follow-up appointments. Time pressure in new patient visits was more prevalent in general internists than in family physicians (74% vs 55%, p < 0.05), women versus men (78% vs 55%, p < 0.01), and clinicians with larger numbers of complex psychosocial (81% vs 59%, p < 0.01) and Limited English Proficiency patients (95% vs 57%, p < 0.001). Time pressure in new patient visits was associated with lack of control, clinician stress, and intent to leave (ESs small to moderate, p < 0.05). Time pressure in follow-up visits was associated with chaotic workplaces and burnout (small to moderate ESs, p's < 0.05). Time pressure improved over time in workplaces with values alignment and an emphasis on quality. CONCLUSIONS Time pressure, more common in women and general internists, was related to chaos, control and culture, and stress, burnout, and intent to leave. Future studies should evaluate these findings in larger and more geographically diverse samples.
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Affiliation(s)
- Kriti Prasad
- Division of General Internal Medicine, Hennepin Healthcare, Minneapolis, MN, USA.,Office of Professional Worklife, Hennepin Healthcare, Minneapolis, MN, USA.,Hennepin Healthcare Research Institute, Hennepin Healthcare, Minneapolis, MN, USA
| | - Sara Poplau
- Division of General Internal Medicine, Hennepin Healthcare, Minneapolis, MN, USA.,Office of Professional Worklife, Hennepin Healthcare, Minneapolis, MN, USA.,Hennepin Healthcare Research Institute, Hennepin Healthcare, Minneapolis, MN, USA
| | - Roger Brown
- School of Nursing, UW-Madison, Madison, WI, USA
| | - Steven Yale
- University of Central Florida College of Medicine, Lake Nona, Orlando, FL, USA
| | | | - Anita B Varkey
- Loyola University Stritch School of Medicine, Maywood, IL, USA
| | | | - Hannah Neprash
- University of Minnesota School of Public Health, Minneapolis, MN, USA
| | - Mark Linzer
- Division of General Internal Medicine, Hennepin Healthcare, Minneapolis, MN, USA. .,Office of Professional Worklife, Hennepin Healthcare, Minneapolis, MN, USA. .,Hennepin Healthcare Research Institute, Hennepin Healthcare, Minneapolis, MN, USA. .,Department of Medicine, Hennepin Healthcare, 701 Park Ave (G5), Minneapolis, MN, 55415, USA.
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Kirby E, Broom A, Karikios D, Harrup R, Lwin Z. Exploring the impact and experience of fractional work in medicine: a qualitative study of medical oncologists in Australia. BMJ Open 2019; 9:e032585. [PMID: 31826894 PMCID: PMC6924865 DOI: 10.1136/bmjopen-2019-032585] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
OBJECTIVES Fractional (part-time) appointments are becoming more commonplace in many professions, including medicine. With respect to the contemporary oncological landscape, this highlights a critical moment in the optimisation of employment conditions to enable high-quality service provision given growing patient numbers and treatment volume intensification. Data are drawn from a broader study which aimed to better understand the workforce experiences of medical oncologists in Australia. This paper specifically aims to examine a group of clinicians' views on the consequences of fractional work in oncology. DESIGN Qualitative, one-on-one semistructured interviews. Interview transcripts were digitally audio recorded and transcribed verbatim. Data were subject to thematic analysis supported by the framework approach and informed by sociological methods and theory. SETTING New South Wales, Australia. PARTICIPANTS Medical oncologists (n=22), including 9 female and 13 male participants, at a range of career stages. RESULTS Four key themes were derived from the analysis: (1) increasing fractional employment relative to opportunities for full-time positions and uncertainty about future opportunities; (2) tightening in role diversity, including reducing time available for research, mentoring, professional development and administration; (3) emerging flexibility of medical oncology as a specialty and (4) impact of fractional-as-norm on workforce sustainability and quality of care. CONCLUSION Fractional appointments are viewed as increasing in oncology and the broader consequences of this major shift in medical labour remain unexamined. Such appointments offer potential for flexible work to better suit the needs of contemporary oncologists; however, fractional work also presents challenges for personal and professional identity and vocational engagement. Fractional appointments are viewed as having a range of consequences related to job satisfaction, burnout and service delivery. Further research is needed to provide a critical examination of the multiple impacts of workforce trends within and beyond oncology.
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Affiliation(s)
- Emma Kirby
- Centre for Social Research in Health, UNSW, Sydney, New South Wales, Australia
| | - Alex Broom
- School of Social and Political Sciences, The University of Sydney, Sydney, New South Wales, Australia
| | - Deme Karikios
- Medical Oncology, Nepean Cancer Care Centre, Nepean Hospital, Penrith, New South Wales, Australia
- Sydney Medical School, University of Sydney, Sydney, New South Wales, Australia
| | - Rosemary Harrup
- Department of Medical Oncology/Haematology, Royal Hobart Hospital, Hobart, Tasmania, Australia
| | - Zarnie Lwin
- Cancer Care Services, Royal Brisbane and Women's Hospital, Herston, Queensland, Australia
- School of Medicine, University of Queensland, Brisbane, Queensland, Australia
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Izgi M, Basaran B, Ankay Yilbas A, Uzun S, Pamuk AG, Kanbak M. Factors affecting the preference of anesthesia residents regarding subspecialty training. BMC MEDICAL EDUCATION 2019; 19:342. [PMID: 31492125 PMCID: PMC6728952 DOI: 10.1186/s12909-019-1782-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/28/2018] [Accepted: 08/30/2019] [Indexed: 06/10/2023]
Abstract
BACKGROUND There is scant information about the factors that influence the career decisions of anesthesia residents in Turkey. The aim of this study was to determine the preferences of anesthesia residents in Turkey regarding future career and subspecialty training plans and practice location, and to determine the factors that influence those preferences. METHODS A 21-item e-questionnaire was administered to anesthesia residents who were registered with at least one of the two societies of anesthesiologists in Turkey. Data were collected on demographics and preferences regarding subspecialty training and future practice location. RESULTS The response rate of the survey was 41.04%. The percentages of participants who intended to pursue a fellowship in intensive care and algology were 12.1 and 23.1%, respectively; 21.7% of participants did not intend to pursue any fellowship training and the decision of 43.1% of the participants was uncertain. The most popular reasons for pursuing a fellowship were to perform compulsory service in a better place (47.2%) and improve earning potential (43.1%). Forty-two percent of participants did not intend to pursue any fellowship training because of their attention to general anesthesiology practice and 15.2% because of the additional compulsory service obligation following the training. CONCLUSIONS This study showed that the desirability of sub-specialization among anesthesia residents in Turkey could be accepted as low. This result seems to be associated with the additional compulsory service obligation.
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Affiliation(s)
- Murat Izgi
- Faculty of Medicine, Department of Anesthesiology and Reanimation, Hacettepe University, Altindag, Ankara, Turkey
| | - Betul Basaran
- Konya Training and Research Hospital, Clinics of Anesthesiology and Reanimation, University of Health Sciences, Konya, Turkey
| | - Aysun Ankay Yilbas
- Faculty of Medicine, Department of Anesthesiology and Reanimation, Hacettepe University, Altindag, Ankara, Turkey
| | - Sennur Uzun
- Faculty of Medicine, Department of Anesthesiology and Reanimation, Hacettepe University, Altindag, Ankara, Turkey
| | - Almıla Gulsun Pamuk
- Faculty of Medicine, Department of Anesthesiology and Reanimation, Hacettepe University, Altindag, Ankara, Turkey
| | - Meral Kanbak
- Faculty of Medicine, Department of Anesthesiology and Reanimation, Hacettepe University, Altindag, Ankara, Turkey
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Bogler T, Lazare K, Rambihar V. Female family physicians and the first 5 years: In pursuit of gender equity, work-life integration, and wellness. CANADIAN FAMILY PHYSICIAN MEDECIN DE FAMILLE CANADIEN 2019; 65:585-588. [PMID: 31413031 PMCID: PMC6693601] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Affiliation(s)
- Tali Bogler
- Lecturer in the Department of Family and Community Medicine at the University of Toronto in Ontario, and a staff family physician at St Michael's Hospital in Toronto
| | - Kim Lazare
- Assistant Professor in the Department of Family and Community Medicine at the University of Toronto, and a staff family physician and Postgraduate Curriculum Lead at North York General Hospital in Toronto
| | - Vanessa Rambihar
- Assistant Professor and Associate Program Director Admissions, Awards and Recruitment in the Department of Family and Community Medicine at the University of Toronto, and a staff family physician at Women's College Hospital in Toronto
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Bogler T, Lazare K, Rambihar V. [Not Available]. CANADIAN FAMILY PHYSICIAN MEDECIN DE FAMILLE CANADIEN 2019; 65:e372-e375. [PMID: 31413044 PMCID: PMC6693592] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Affiliation(s)
- Talia Bogler
- Chargée de cours au Département de médecine familiale et communautaire de l'Université de Toronto (Ontario), et médecin de famille à l'hôpital St Michael's de Toronto
| | - Kim Lazare
- Professeure adjointe au Département de médecine familiale et communautaire de l'Université de Toronto et médecin de famille et responsable du programme d'études postdoctorales au North York General Hospital à Toronto
| | - Vanessa Rambihar
- Professeure adjointe et directrice associée du programme Admissions, prix et recrutement au Département de médecine familiale et communautaire de l'Université de Toronto, et médecin de famille au Women's College Hospital à Toronto
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Templeton K, Bernstein CA, Sukhera J, Nora LM, Newman C, Burstin H, Guille C, Lynn L, Schwarze ML, Sen S, Busis N. Gender-Based Differences in Burnout: Issues Faced by Women Physicians. NAM Perspect 2019. [DOI: 10.31478/201905a] [Citation(s) in RCA: 61] [Impact Index Per Article: 12.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
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Altannir Y, Alnajjar W, Ahmad SO, Altannir M, Yousuf F, Obeidat A, Al-Tannir M. Assessment of burnout in medical undergraduate students in Riyadh, Saudi Arabia. BMC MEDICAL EDUCATION 2019; 19:34. [PMID: 30683088 PMCID: PMC6347822 DOI: 10.1186/s12909-019-1468-3] [Citation(s) in RCA: 35] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/11/2017] [Accepted: 01/16/2019] [Indexed: 05/16/2023]
Abstract
BACKGROUND To assess the prevalence of burnout symptoms among preclinical and clinical medical students studying at AlFaisal University in Riyadh, Saudi Arabia. METHODS A cross-sectional study was conducted using Maslach Burnout Inventory questionnaire on 276 medical students from Alfaisal University, Riyadh, Saudi Arabia. The study was approved by Alfaisal University research ethics committee. Chi-square test was used to identify statistically significant differences, and binary logistic regression was used to identify predictors of burnout. RESULTS 276 entered into final data analysis with a mean age 20.62 ± 1.58, of whom 54% were males, and 46% were females. The overall burnout prevalence was 13.4%, of which PA was the most prevalent domain of burnout with 64.9%. Female gender was a significant predictor of EE and DP [OR = 4.34; 95% Cl 1.86-10.13; P-value 0.001] and [OR = 2.01; 95% Cl 1.07-3.79; P-value 0.030] respectively as per multivariate analysis for demographic characteristics. Regarding the total level of burnout, females (75.7%) had significantly higher levels of burnout compared to males (41.4%); (P-value < 0.001). CONCLUSION Burnout is prevalent among medical student. Gender was found to exhibits effect on the burnout. Mutual proactive strategies and reactive coping mechanisms between the students and the universities are encouraged to prevent and reduce burnout among medical students.
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Affiliation(s)
- Youssef Altannir
- College of Medicine, Alfaisal University, P.O. Box 50927, Takhasusi Road, Riyadh, 11533 Saudi Arabia
| | - Wedad Alnajjar
- College of Medicine, Alfaisal University, P.O. Box 50927, Takhasusi Road, Riyadh, 11533 Saudi Arabia
| | - Syed Osama Ahmad
- College of Medicine, Alfaisal University, P.O. Box 50927, Takhasusi Road, Riyadh, 11533 Saudi Arabia
| | - Mustafa Altannir
- College of Medicine, Alfaisal University, P.O. Box 50927, Takhasusi Road, Riyadh, 11533 Saudi Arabia
| | - Fouad Yousuf
- College of Medicine, Alfaisal University, P.O. Box 50927, Takhasusi Road, Riyadh, 11533 Saudi Arabia
| | - Akef Obeidat
- College of Medicine, Alfaisal University, P.O. Box 50927, Takhasusi Road, Riyadh, 11533 Saudi Arabia
| | - Mohamad Al-Tannir
- Clinical & Applied Research Department, Research Center, King Fahad Medical City, P.O. Box 59046, Riyadh, 11525 Saudi Arabia
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Ye J, Wang H, Wu H, Ye L, Li Q, Ma XY, Yu X, Zhang H, Luo X. Burnout among obstetricians and paediatricians: a cross-sectional study from China. BMJ Open 2019; 9:e024205. [PMID: 30782730 PMCID: PMC6352802 DOI: 10.1136/bmjopen-2018-024205] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
OBJECTIVES Hospitals devoted to maternal and child health represent unique healthcare institutions in China. Healthcare professionals in these hospitals attend to health services for women and children, and also provide technical services and support for district maternal and children's healthcare as well as family planning. However, few studies have examined occupational burnout among doctors employed in these hospitals. This research addresses the gap in the literature. METHODS A cross-sectional survey of obstetricians and paediatricians from 11 maternal and child health hospitals across China was conducted May through June 2017. A total of 678 people completed a self-administered questionnaire. The survey included questions about demographics, doctor-patient relationships and networks of support as well as characteristics designed to capture the occurrence of burnout, such as emotional exhaustion, cynicism and professional efficacy. T-test, variance and multiple regression analyses were used to examine the data. RESULTS The research revealed that 56.6% of obstetricians and paediatricians exhibited signs of occupational burnout. Poor doctor-patient relationships and high average number of weekly hours worked contributed to burnout. Additionally, low family support corresponded to physicians' low sense of professional efficacy. CONCLUSIONS Several factors have contributed to occupational burnout among paediatricians and obstetricians at maternal and child health hospitals in China, including lack of family support, poor doctor-patient relationships and heavy workloads.
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Affiliation(s)
- Junying Ye
- Xinqiao Hospital, Army Medical University, Chongqing, China
- Chongqing Health Center for Women and Children, Chongqing, China
| | - Huan Wang
- Department of Medical Administration, Southwest Hospital, Army Medical University, Chongqing, China
- Department of Medical Administration, The 987 Hospital of PLA, Baoji, Shanxi Province, China
| | - Hao Wu
- Xinqiao Hospital, Army Medical University, Chongqing, China
| | - Liaosha Ye
- Department of Medical Administration, The Army General Hospital, Beijing, China
| | - Qi Li
- Department of Foreign Languages, School of Basic Medical Sciences, Army Medical University, Chongqing, China
| | - Xiang-yu Ma
- Department of Epidemiology, Army Medical University, Chongqing, China
| | - Xiaodong Yu
- Department of Medical Administration, The 987 Hospital of PLA, Baoji, Shanxi Province, China
| | - Hua Zhang
- Chongqing Health Center for Women and Children, Chongqing, China
| | - Xu Luo
- Department of Medical Administration, Southwest Hospital, Army Medical University, Chongqing, China
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Fargen KM, Hirsch JA. Neurointerventionalists, stroke and burnout. J Neurointerv Surg 2018; 10:811-812. [DOI: 10.1136/neurintsurg-2018-014304] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/30/2018] [Indexed: 11/04/2022]
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Szafran O, Woloschuk W, Torti JMI, Myhre D. Well-being of family medicine graduates. CANADIAN FAMILY PHYSICIAN MEDECIN DE FAMILLE CANADIEN 2017; 63:e432-e439. [PMID: 29025820 PMCID: PMC5638491] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
OBJECTIVE To determine family medicine graduates' professional and personal well-being, general health status, stress levels, coping strategies, and the degree to which they felt supported or isolated in professional life; and to compare findings by sex, practice location, and location of medical school (Canadian medical graduates [CMGs] vs international medical graduates [IMGs]). DESIGN Retrospective, cross-sectional survey. SETTING University of Alberta in Edmonton and the University of Calgary in Alberta. PARTICIPANTS A total of 651 graduates who completed one of the family medicine residency programs during 2006 to 2011. MAIN OUTCOME MEASURES Using a 5-point Likert scale, graduates rated their general health status, their personal and professional well-being, their level of stress, and the degree to which they felt supported or isolated in professional life. Respondents also identified important life events, their caregiving roles, and stress-coping strategies. RESULTS Of 651 graduates, 307 (47.2%) responded to the survey. Personal and professional well-being and general health status were rated as very good or excellent by 72.0%, 76.6%, and 74.7% of graduates, respectively. Overall, 39.3% reported high or extremely high levels of stress, with CMGs exhibiting significantly higher stress levels than IMGs (P = .02). Stress scores were inversely related to personal and professional well-being and health status. In terms of coping strategies, a significantly greater proportion of female than male graduates reported talking to colleagues (76.5% vs 64.3%; P = .026) and seeking professional counseling (18.7% vs 6.1%; P = .002). Also, a significantly greater proportion of IMGs than CMGs (52.9% vs 32.5%; P = .003), as well as those in rural (35.8%) or urban (49.3%) practices than those in metropolitan locations (30.1%) (P = .03), turned to spiritual or religious practices for stress management. Of all respondents, 54.8% felt highly or extremely supported and 18.4% felt isolated in their professional lives. CONCLUSION While family medicine graduates are primarily healthy and have a strong sense of personal and professional well-being, many experience high levels of stress. Coping strategies generally include social contact with family, friends, or colleagues and differ by sex, whether respondents are CMGs or IMGs, and practice location. Professional isolation appears to be prevalent in both rural and urban practice locations. Physician well-being programs should include a multifaceted approach to accommodate a range of physician preferences.
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Affiliation(s)
- Olga Szafran
- Associate Director of Research in the Department of Family Medicine at the University of Alberta in Edmonton.
| | - Wayne Woloschuk
- Director of Program Evaluation in the Office of Undergraduate Medical Education in the Cumming School of Medicine at the University of Calgary in Alberta
| | - Jacqueline M I Torti
- Graduate research assistant in the Department of Family Medicine at the University of Alberta
| | - Douglas Myhre
- Associate Dean of Distributed Learning and Rural Initiatives in the Cumming School of Medicine at the University of Calgary
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Bau JT, Frolkis AD, Nathoo N, Yipp BG, Hollenberg MD, Beck PL. Career and research outcomes of the physician-scientist training program at the University of Calgary: a retrospective cohort study. CMAJ Open 2017; 5:E395-E401. [PMID: 28506972 PMCID: PMC5498177 DOI: 10.9778/cmajo.20160103] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Physician-scientists are integral to medical research, with medical programs throughout Canada invested in training hybrid physician-scientists. Few data exist as to whether these programs are generating the diversity, gender equity and numbers of trainees essential for the future of medical research and teaching. We aimed to identify factors that contribute to research productivity, diversity and retention of individuals as physician-scientists. METHODS We completed a retrospective cohort study, for the period 1973 to 2015, of the University of Calgary Leaders in Medicine Program in Calgary, Alberta. Participants were coregistered in graduate (master's or PhD) and medical degree programs. Primary outcomes included number of publications and the eventual career paths of graduates, with individuals characterized as physicians or physician-scientists on the basis of these metrics. RESULTS Of the 307 individuals who were coregistered in or had completed a joint graduate and medical degree, 125 (40.7%) were PhD students/graduates, and 182 (59.3%) were master's trainees/graduates. While in the joint program, male PhD students consistently published more frequently than female PhD students. There was no significant difference in publication records between male and female master's students. Of the 172 individuals who were 5 years or more beyond graduation, 47 (27.3%) were classified as physician-scientists; these individuals consisted of 28 (40.6%) of the 69 PhD graduates and 19 (18.4%) of the 103 master's graduates. INTERPRETATION Overall, our study shows that graduates receiving both clinical and research training, through master's or PhD programs, continue to be involved in research in their subsequent careers.
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Affiliation(s)
- Jason T Bau
- Affiliation: Cumming School of Medicine, University of Calgary, Calgary, Alta
| | - Alexandra D Frolkis
- Affiliation: Cumming School of Medicine, University of Calgary, Calgary, Alta
| | - Nabeela Nathoo
- Affiliation: Cumming School of Medicine, University of Calgary, Calgary, Alta
| | - Bryan G Yipp
- Affiliation: Cumming School of Medicine, University of Calgary, Calgary, Alta
| | - Morley D Hollenberg
- Affiliation: Cumming School of Medicine, University of Calgary, Calgary, Alta
| | - Paul L Beck
- Affiliation: Cumming School of Medicine, University of Calgary, Calgary, Alta
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Schmit Jongbloed LJ, Cohen-Schotanus J, Borleffs JCC, Stewart RE, Schönrock-Adema J. Physician job satisfaction related to actual and preferred job size. BMC MEDICAL EDUCATION 2017; 17:86. [PMID: 28494758 PMCID: PMC5425993 DOI: 10.1186/s12909-017-0911-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/15/2016] [Accepted: 04/20/2017] [Indexed: 06/07/2023]
Abstract
BACKGROUND Job satisfaction is essential for physicians' well-being and patient care. The work ethic of long days and hard work that has been advocated for decades is acknowledged as a threat for physicians' job satisfaction, well-being, and patient safety. Our aim was to determine the actual and preferred job size of physicians and to investigate how these and the differences between them influence physicians' job satisfaction. METHOD Data were retrieved from a larger, longitudinal study among physicians starting medical training at Groningen University in 1982/83/92/93 (N = 597). Data from 506 participants (85%) were available for this study. We used regression analysis to investigate the influence of job size on physicians' job satisfaction (13 aspects) and ANOVA to examine differences in job satisfaction between physicians wishing to retain, reduce or increase job size. RESULTS The majority of the respondents (57%) had an actual job size less than 1.0 FTE. More than 80% of all respondents preferred not to work full-time in the future. Respondents' average actual and preferred job sizes were .85 FTE and .81 FTE, respectively. On average, respondents who wished to work less (35% of respondents) preferred a job size reduction of 0.18 FTE and those who wished to work more (12%) preferred an increase in job size of 0.16 FTE. Job size influenced satisfaction with balance work-private hours most (β = -.351). Physicians who preferred larger job sizes were - compared to the other groups of physicians - least satisfied with professional accomplishments. CONCLUSIONS A considerable group of physicians reported a gap between actual and preferred job size. Realizing physicians' preferences as to job size will hardly affect total workforce, but may greatly benefit individual physicians as well as their patients and society. Therefore, it seems time for a shift in work ethic.
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Affiliation(s)
- Lodewijk J. Schmit Jongbloed
- Schmit Jongbloed Advies, Hofbrouckerlaan 30, 2341 LP Oegstgeest, The Netherlands
- University Medical Center Groningen and University of Groningen, A. Deusinglaan 1, 9713, AV Groningen, The Netherlands
| | - Janke Cohen-Schotanus
- University Medical Center Groningen and University of Groningen, A. Deusinglaan 1, 9713, AV Groningen, The Netherlands
| | - Jan C. C. Borleffs
- University Medical Center Groningen and University of Groningen, A. Deusinglaan 1, 9713, AV Groningen, The Netherlands
| | - Roy E. Stewart
- University Medical Center Groningen and University of Groningen, A. Deusinglaan 1, 9713, AV Groningen, The Netherlands
| | - Johanna Schönrock-Adema
- University Medical Center Groningen and University of Groningen, A. Deusinglaan 1, 9713, AV Groningen, The Netherlands
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Houpy JC, Lee WW, Woodruff JN, Pincavage AT. Medical student resilience and stressful clinical events during clinical training. MEDICAL EDUCATION ONLINE 2017; 22:1320187. [PMID: 28460570 PMCID: PMC5419301 DOI: 10.1080/10872981.2017.1320187] [Citation(s) in RCA: 82] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/03/2023]
Abstract
BACKGROUND Medical students face numerous stressors during their clinical years, including difficult clinical events. Fostering resilience is a promising way to mitigate negative effects of stressors, prevent burnout, and help students thrive after difficult experiences. However, little is known about medical student resilience. OBJECTIVE To characterize medical student resilience and responses to difficult clinical events during clinical training. DESIGN Sixty-two third-year (MS3) and 55 fourth-year (MS4) University of Chicago medical students completed surveys in 2016 assessing resilience (Connor Davidson Resilience Scale, CD-RISC 10), symptoms of burnout, need for resilience training, and responses to difficult clinical events. RESULTS Medical student mean resilience was lower than in a general population sample. Resilience was higher in males, MS4s, those without burnout symptoms, and students who felt able to cope with difficult clinical events. When students experienced difficult events in the clinical setting, the majority identified poor team dynamics among the most stressful, and agreed their wellbeing was affected by difficult clinical events. A majority also would prefer to discuss these events with their team later that day. Students discussed events with peers more than with attendings or residents. Students comfortable discussing stress and burnout with peers had higher resilience. Most students believed resilience training would be helpful and most beneficial during MS3 year. CONCLUSIONS Clinical medical student resilience was lower than in the general population but higher in MS4s and students reporting no burnout. Students had some insight into their resilience and most thought resilience training would be helpful. Students discussed difficult clinical events most often with peers. More curricula promoting medical student resilience are needed.
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Affiliation(s)
| | - Wei Wei Lee
- Department of Medicine, University of Chicago, Chicago, IL, USA
| | | | - Amber T. Pincavage
- Department of Medicine, University of Chicago, Chicago, IL, USA
- CONTACT Amber T. Pincavage University of Chicago, 5841 South Maryland Ave, MC 3051 L326, Chicago, IL60637, USA
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Iannello P, Mottini A, Tirelli S, Riva S, Antonietti A. Ambiguity and uncertainty tolerance, need for cognition, and their association with stress. A study among Italian practicing physicians. MEDICAL EDUCATION ONLINE 2017; 22:1270009. [PMID: 28178917 PMCID: PMC5328324 DOI: 10.1080/10872981.2016.1270009] [Citation(s) in RCA: 63] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/05/2023]
Abstract
UNLABELLED Medical practice is inherently ambiguous and uncertain. The physicians' ability to tolerate ambiguity and uncertainty has been proved to have a great impact on clinical practice. The primary aim of the present study was to test the hypothesis that higher degree of physicians' ambiguity and uncertainty intolerance and higher need for cognitive closure will predict higher work stress. Two hundred and twelve physicians (mean age = 42.94 years; SD = 10.72) from different medical specialties with different levels of expertise were administered a set of questionnaires measuring perceived levels of work-related stress, individual ability to tolerate ambiguity, stress deriving from uncertainty, and personal need for cognitive closure. A linear regression analysis was performed to examine which variables predict the perceived level of stress. The regression model was statistically significant [R2 = .32; F(10,206) = 8.78, p ≤ .001], thus showing that, after controlling for gender and medical specialty, ambiguity and uncertainty tolerance, decisiveness (a dimension included in need for closure), and the years of practice were significant predictors of perceived work-related stress. Findings from the present study have some implications for medical education. Given the great impact that the individual ability to tolerate ambiguity and uncertainty has on the physicians' level of perceived work-related stress, it would be worth paying particular attention to such a skill in medical education settings. It would be crucial to introduce or to empower educational tools and strategies that could increase medical students' ability to tolerate ambiguity and uncertainty. ABBREVIATIONS JSQ: Job stress questionnaire; NFCS: Need for cognitive closure scale; PRU: Physicians' reactions to uncertainty; TFA: Tolerance for ambiguity.
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Affiliation(s)
- Paola Iannello
- Department of Psychology – Research Unit on Decision-making Processes in Emergency Medicine, Catholic University of the Sacred Heart, Milan, Italy
- CONTACT Paola Iannello Department of Psychology, Catholic University of the Sacred Heart, Largo Gemelli, 1, Milan20123, Italy
| | - Anna Mottini
- Department of Psychology – Research Unit on Decision-making Processes in Emergency Medicine, Catholic University of the Sacred Heart, Milan, Italy
| | - Simone Tirelli
- Department of Psychology – Research Unit on Decision-making Processes in Emergency Medicine, Catholic University of the Sacred Heart, Milan, Italy
| | - Silvia Riva
- University of Milan, Department of Health Sciences, Milan, Italy
| | - Alessandro Antonietti
- Department of Psychology – Research Unit on Decision-making Processes in Emergency Medicine, Catholic University of the Sacred Heart, Milan, Italy
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Abstract
Despite approximately equal numbers of male and female medical school graduates, women are entering academic medicine at a lower rate than their male colleagues. Of those who do assume a faculty position, female faculty members report higher levels of burnout, often attributable to gender-specific difficulties in clinical expectations and maintenance of work-life balance. Many of these struggles are attributable to issues that are amenable to supportive policies, but these policies are inconsistent in their availability and practice. This commentary presents evidence for inconsistencies in the day-to-day experience of female faculty members, and proposes solutions for the mitigation of the challenges experienced more often by female faculty members with the goal of diversifying and strengthening academic medicine.
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Affiliation(s)
- Lisa Cassidy-Vu
- 1 Wake Forest Baptist Medical Center, Winston-Salem, NC, USA
| | - Keli Beck
- 1 Wake Forest Baptist Medical Center, Winston-Salem, NC, USA
| | - Justin B Moore
- 1 Wake Forest Baptist Medical Center, Winston-Salem, NC, USA
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Schonfeld TL, Schmid KK, Boucher-Payne D. Incorporating Spirituality into Health Sciences Education. JOURNAL OF RELIGION AND HEALTH 2016; 55:85-96. [PMID: 25404167 DOI: 10.1007/s10943-014-9972-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
Researchers are beginning to collect empiric data about coping mechanisms of health science students. Yet, there is an important aspect of coping with stress that is only partially addressed in health sciences curricula: students' spiritual well-being. In this essay, we describe a course in spirituality and health care that we offered to fourth-year medical students, as well as a small empirical study we conducted to assess students' spiritual needs and practices. We then offer reflections on the broad applicability of this work to students in the health sciences more generally, including suggestions for curriculum interventions that may ensure students' success.
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Affiliation(s)
- Toby L Schonfeld
- Master of Arts in Bioethics Program, School of Medicine, Emory University, Center for Ethics, 1531 Dickey Drive, Atlanta, GA, 30322, USA.
| | - Kendra K Schmid
- Department of Biostatistics, College of Public Health, University of Nebraska Medical Center, Omaha, NE, USA
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