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Nohales L, Fort E, Pelloux S, Coste C, Leblanc P, De Ternay J, Wallon M, Rolland B, Fassier JB. Occupational, academic, and personal determinants of wellbeing and psychological distress in residents: results of a survey in Lyon, France. Front Psychol 2024; 15:1347513. [PMID: 38770261 PMCID: PMC11103015 DOI: 10.3389/fpsyg.2024.1347513] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2023] [Accepted: 04/11/2024] [Indexed: 05/22/2024] Open
Abstract
Introduction The mental health of residents is a growing significant concern, particularly with respect to hospital and university training conditions. Our goal was to assess the professional, academic, and psychological determinants of the mental health status of all residents of the academy of Lyon, France. Materials and methods The Health Barometer of Lyon Subdivision Residents (BASIL) is an initiative which consists in proposing a recurrent online survey to all residents in medicine, pharmacy, and dentistry, belonging to the Lyon subdivision. The first of these surveys was conducted from May to July 2022. Participants should complete a series of validated questionnaires, including the Warwick-Edinburgh Mental Wellbeing Scale (WEMWBS), and the Kessler Psychological Distress Scale (K6), respectively, and ad-hoc questions assessing their global health and hospital and academic working conditions. A Directed Acyclic Graph (DAG) analysis was conducted prior to multivariable analyses, to explore the determinants associated with low wellbeing (WEMWBS <43) and high psychological distress (K6 ≥ 13). Results A total of 904 residents (response rate: 46.7%) participated in the survey. A low level of wellbeing was observed in 23% of participants, and was significantly associated to job strain (OR = 2.18; 95%CI = [1.32-3.60]), low social support (OR = 3.13; 95%CI = [2.05-4.78]) and the experience of very poor university teaching (OR = 2.51; 95%CI = [1.29-4.91]). A high level of psychological distress was identified for 13% of participants, and associated with low social support (OR = 2.41; 95%CI = [1.48-3.93]) and the experience of very poor university teaching (OR = 2.89, 95%CI = [1.16-7.21]). Conclusion Hospital working conditions, social support, and the perception of teaching quality, were three major determinants of wellbeing and psychological distress among health profession residents. Demographic determinants, personal life and lifestyle habits were also associated. This supports a multilevel action in prevention programs aiming to enhance wellbeing and reduce mental distress in this specific population and local organizational specificities.
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Affiliation(s)
- Ludivine Nohales
- Occupational Health and Medicine Department-CRPPE Hospices Civils de Lyon, Lyon, France
- Univ Lyon, University Lyon 1 Transport Work and Environmental Epidemiology Research and Surveillance Unit – UMRESTTE (UMR T9405), Lyon, France
| | - Emmanuel Fort
- Univ Lyon, University Lyon 1 Transport Work and Environmental Epidemiology Research and Surveillance Unit – UMRESTTE (UMR T9405), Lyon, France
| | - Sophie Pelloux
- Service de Santé Universitaire, University Claude Bernard Lyon, Lyon, France
| | - Clio Coste
- University Claude Bernard Lyon 1, Lyon, France
- Department of Radiotherapy, Léon Bérard Cancer Center, Lyon, France
| | - Pierre Leblanc
- Direction Qualité Usagers et Santé Populationnelle, Hospices Civils de Lyon, Lyon, France
- Research On Healthcare Performance (RESHAPE), Université Claude Bernard Lyon INSERM U1290, Lyon, France
| | - Julia De Ternay
- Research On Healthcare Performance (RESHAPE), Université Claude Bernard Lyon INSERM U1290, Lyon, France
- SUAL, Hospices Civils de Lyon, Bron, France
| | - Martine Wallon
- Institut des Agents Infectieux, Hospices Civils de Lyon, Lyon, France
- Waking Team, CRNL University Claude Bernard Lyon, Bron, France
| | - Benjamin Rolland
- SUAL Le Vinatier, Hospices Civils de Lyon, Bron, France
- Inserm U1028, CNRS UMR5292, University Claude Bernard Lyon 1, Bron, France
| | - Jean-Baptiste Fassier
- Occupational Health and Medicine Department-CRPPE Hospices Civils de Lyon, Lyon, France
- Univ Lyon, University Lyon 1 Transport Work and Environmental Epidemiology Research and Surveillance Unit – UMRESTTE (UMR T9405), Lyon, France
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Ramos‐Vidal I, Ruíz É. The role of self-compassion and compassion toward others in burnout syndrome in a sample of medical students. Psych J 2024; 13:113-123. [PMID: 37905913 PMCID: PMC10917092 DOI: 10.1002/pchj.692] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2023] [Accepted: 08/22/2023] [Indexed: 11/02/2023]
Abstract
Burnout produces negative effects on academic performance, and, in turn, feelings of inefficiency that are detrimental to students' psychosocial well-being. The aim of this research is to determine the effects that self-compassion and compassion toward others have on various burnout dimensions in a sample of medical students. A total of 235 medical students (61.7% women) aged between 16 and 32 years old (M = 19.82; SD = 2.37) belonging to a Colombian university participated. A cluster analysis to segment the population according to burnout was carried out along with nonparametric contrasts to identify differences in the levels of self-compassion and compassion toward others between each profile. A series of regression analyses was designed to find out how each type of compassion was associated with burnout on each profile. The cluster analysis allowed us to identify three profiles. The low-involvement profile (n = 51) is characterized by low depersonalization, intermediate levels of emotional exhaustion and personal accomplishment and exhibits low levels of self-compassion and compassion fatigue compared with the other profiles. The positive-adaptation profile (n = 104) is characterized by low depersonalization levels, intermediate degrees of emotional exhaustion and high levels of personal accomplishment and exhibits the highest levels of self-compassion and compassion fatigue compared with the other profiles. The high-demand profile (n = 104) is characterized by intermediate depersonalization levels, medium-high levels of emotional exhaustion and high levels of personal accomplishment and exhibits intermediate levels of self-compassion and low levels of compassion fatigue. Establishing profiles based on burnout allows students to be segmented and for precise knowledge to be acquired about the effects that both types of compassion have on the dimensions of burnout.
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Affiliation(s)
- Ignacio Ramos‐Vidal
- Departamento de Psicología SocialUniversidad de Sevilla, Facultad de PsicologíaSevillaSpain
| | - Érika Ruíz
- Facultad de PsicologíaUniversidad Pontificia BolivarianaMonteriaColombia
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Voltmer E, Rosta J, Köslich-Strumann S, Goetz K. Job satisfaction and work stress among physicians in Norway and Germany-A cross-sectional study. PLoS One 2024; 19:e0296703. [PMID: 38181025 PMCID: PMC10769063 DOI: 10.1371/journal.pone.0296703] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2023] [Accepted: 12/17/2023] [Indexed: 01/07/2024] Open
Abstract
PURPOSE Physicians' health and wellbeing are important albeit often neglected quality indicators of health care systems. The aims of the study were to compare job satisfaction and work stress among doctors in Germany and Norway, and to identify predictors for job satisfaction. METHODS All active physicians in Schleswig-Holstein, Germany (N = 13,304) and a nationwide sample of Norwegian physicians (N = 2,316) were surveyed in a cross-sectional design in 2021. Response rates of German and Norwegian physicians were n = 4,385 (33%) and n = 1,639 (70.8%), respectively. In addition to age, sex, and work-hours, the main outcome measures were the validated Job Satisfaction Scale (JSS) and the short form of the Effort-Reward Imbalance Questionnaire (ERI). RESULTS There were significant differences between Norwegian and German physicians in job satisfaction but with small effect sizes. All effort scores of German physicians were significantly higher and four of seven reward scores significantly lower than for their Norwegian colleagues. The proportion of German physicians in the state of a gratification crisis was significantly higher (67%) than in their Norwegian colleagues (53%). In both countries, physicians with a gratification crisis scored significantly lower on all items of job satisfaction. There were only minor gender differences in job satisfaction and effort-reward balance. Age, effort, and reward accounted for 46% of the explained variance of job satisfaction. CONCLUSIONS Lower job satisfaction and reward in some areas and higher perceived effort of physicians in Germany than in Norway are still in favor of Norwegian working conditions, but the differences seem to diminish. The high proportions of gratification crises in both countries warrants appropriate measures for prevention and health promotion.
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Affiliation(s)
- Edgar Voltmer
- Institute of Social Medicine and Epidemiology, University of Lübeck, Lübeck, Germany
| | - Judith Rosta
- Institute for Studies of the Medical Profession, Oslo, Norway
| | | | - Katja Goetz
- Institute of Family Medicine, University Medical Centre Schleswig-Holstein, Lübeck, Germany
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Morrison GM, Di Cocco BL, Goldberg R, Calderwood AH, Schulman AR, Enestvedt B, Yu JX. Impact of parental status on US medical student specialty selection. Arch Womens Ment Health 2023; 26:785-791. [PMID: 37632568 DOI: 10.1007/s00737-023-01366-5] [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] [Received: 05/04/2023] [Accepted: 08/21/2023] [Indexed: 08/28/2023]
Abstract
Medical training occurs during peak childbearing years for most medical students. Many factors influence specialty selection. The aims of this study were (i) to determine whether being a parent is a major deciding factor when picking a specialty and (ii) whether parents are more drawn to family-friendly specialties than non-parents. The authors performed a multicenter web-based survey study of medical students enrolled in Oregon Health and Science University, Dartmouth's Geisel School of Medicine, and University of Michigan Medical School. The 27-item instrument assessed parenthood status, specialty preference, specialty perceptions, and factors influencing specialty choice. A total of 537 out of 2236 (24.0%) students responded. Among respondents, 59 (10.9%) were current or expecting parents. The majority (359, 66.8%) were female and 24-35 years old (430, 80.1%). Of the students who were parents or expecting, 30 (50.9%) were female, and the majority (55, 93.2%) were partnered. Top specialties preferred by both parents and non-parents were family medicine, emergency medicine, obstetrics and gynecology (OB/GYN), internal medicine, psychiatry, and pediatrics. Specialties rated most family-friendly included family medicine, dermatology, pediatrics, psychiatry, radiology, emergency medicine, and pathology. The specialties rated least family-friendly were surgery, neurosurgery, orthopedic surgery, plastic surgery, and OB/GYN. These rankings were the same between groups. Passion for the field, culture of the specialty, and quality of life were the top three factors students considered when choosing a specialty. Being a parent or future parent ranked more highly for parents than non-parents, but was not in the top three factors for either group. US Medical School parents report that being a parent influenced their medical specialty choice "strongly" or "very strongly." However, being a parent was not weighed as heavily as passion for the field, culture of the specialty, and quality of life. These student-parents are entering perceived "non-family friendly" specialties at similar rates as their peers. US Medical school training and simultaneous parenting is daunting, yet student parents are putting their passion first when making a career choice. They must be supported.
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Affiliation(s)
- Georgia Mae Morrison
- Oregon Health & Science University, School of Medicine, 3181 SW Sam Jackson Park Road, Portland, OR, 97239, USA.
| | | | | | - Audrey H Calderwood
- Geisel School of Medicine at Dartmouth, Hanover, NH, USA
- Dartmouth Institute of Health Policy and Clinical Practice, Lebanon, NH, USA
| | - Allison R Schulman
- Division of Gastroenterology and Hepatology, Ann Arbor, MI, USA
- Division of General Surgery at University of Michigan School of Medicine, Ann Arbor, MI, USA
| | | | - Jessica X Yu
- Division of Gastroenterology and Hepatology, Oregon Health and Science University, Portland, OR, USA
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Peisah C, Sheppard A, Benbow SM, Loughran-Fowlds A, Grayson S, Gunton JE, Kataria A, Lai R, Lele K, Quadrio C, Wright D, McLean L. Operationalising the Family-Friendly Medical Workplace and the Development of FAM-MED, a Family-Friendly Self-Audit Tool for Medical Systems: A Delphi Consensus. Healthcare (Basel) 2023; 11:1679. [PMID: 37372796 DOI: 10.3390/healthcare11121679] [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: 05/17/2023] [Revised: 06/02/2023] [Accepted: 06/04/2023] [Indexed: 06/29/2023] Open
Abstract
Globally, the call for Family-Friendly (FF) workplaces is loud and clear. However, this call is inaudible in medical workplaces, despite both well-established benefits of FF workplaces across businesses and well-known effects of work-family conflict on the well-being and practice of doctors. We aimed to use the Delphi consensus methodology to: (i) operationalise the Family-Friendly medical workplace and (ii) develop a Family-Friendly Self-Audit tool for medical workplaces. The expert medical Delphi panel was deliberatively recruited to capture a breadth of professional, personal, and academic expertise, diversity of age (35-81), life stage, family contexts and lived experience of dual commitments to work and family, and diversity of work settings and positions. Results reflected the inclusive and dynamic nature of the doctor's family and the need to adopt a family life cycle approach to FF medical workplaces. Key processes for implementation include holding firms to zero discrimination; flexibility and openness to dialogue and feedback; and a mutual commitment between the doctor and the department lead to best meet the doctor's individualised needs while still ensuring optimal patient care and team support and cohesion. We hypothesise that the Department Head may be the key to implementation but recognise the workforce constraints to realising these aspirational systemic shifts. It is time we acknowledge that doctors have families, to narrow the gap between identifying as a partner, mother, father, daughter, son, grandparent, and identifying as a doctor. We affirm the right to be both good doctors and good family members.
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Affiliation(s)
- Carmelle Peisah
- Faculty of Medicine and Health, The University of Sydney, Sydney, NSW 2006, Australia
- Discipline of Psychiatry and Mental Health, Faculty of Medicine, University of New South Wales, Sydney, NSW 2052, Australia
| | | | - Susan Mary Benbow
- Centre for Ageing and Mental Health, Faculty of Health and Social Care, University of Chester, Chester CH1 4BJ, UK
| | | | | | - Jenny E Gunton
- Faculty of Medicine and Health, The University of Sydney, Sydney, NSW 2006, Australia
- Westmead Hospital, Sydney, NSW 2145, Australia
- Westmead Institute for Medical Research, Sydney, NSW 2145, Australia
| | - Anuradha Kataria
- Faculty of Medicine and Health, The University of Sydney, Sydney, NSW 2006, Australia
| | - Rosalyn Lai
- Discipline of Psychiatry and Mental Health, Faculty of Medicine, University of New South Wales, Sydney, NSW 2052, Australia
- Royal North Shore Hospital, Sydney, NSW 2065, Australia
| | - Kiran Lele
- Faculty of Medicine and Health, The University of Sydney, Sydney, NSW 2006, Australia
| | - Carolyn Quadrio
- Discipline of Psychiatry and Mental Health, Faculty of Medicine, University of New South Wales, Sydney, NSW 2052, Australia
| | - Danette Wright
- Blacktown Hospital, Sydney, NSW 2148, Australia
- School of Medicine, Western Sydney University, Sydney, NSW 2751, Australia
| | - Loyola McLean
- Faculty of Medicine and Health, The University of Sydney, Sydney, NSW 2006, Australia
- Westmead Psychotherapy Programme for Complex Traumatic Disorders, Cumberland Hospital, Sydney, NSW 2145, Australia
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Zhang Y, Dugan AG, El Ghaziri M, Siddique S, Punnett L. Work-Family Conflict and Depression Among Healthcare Workers: The Role of Sleep and Decision Latitude. Workplace Health Saf 2023; 71:195-205. [PMID: 36636904 PMCID: PMC10655495 DOI: 10.1177/21650799221139998] [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] [Indexed: 01/14/2023]
Abstract
BACKGROUND Healthcare workers report a higher incidence of depression than the general population. Work-family conflict is a risk factor, but the mechanisms explaining its association with depression are not well understood. This study examines the potential mediating and moderating role of sleep and decision latitude in translating work-family conflict into depression. METHODS In 2018, a cross-sectional survey was collected from healthcare workers (n = 1,059) in five public sector facilities in the northeast United States. The survey included questions on participants' work-family conflict, depression, sleep duration and disturbances, decision latitude, and other work environments and socio-demographic characteristics. Multivariable linear and Poisson regression modeling were used to examine associations among variables. FINDINGS There was a significant association between work-family conflict and depression (β = 2.70, p < .001). Sleep disturbances, although not short sleep duration, partially mediated this association. The association between work family-conflict and depression was stronger among workers with low decision latitude. CONCLUSIONS Depression was prevalent among healthcare workers and was associated with work-family conflict. Sleep disturbances served as a significant mediator, while decision latitude modified the strength of the association. APPLICATION TO PRACTICE Evidence-based interventions seeking to alleviate the effect of work-family conflict and improve healthcare workers' mental health should consider promoting employee sleep quality and improving employees' decision-making on the job.
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Yan S, Li C, Zhang J, Wu Y, Tian M, Liu L, Zhou X, Zheng J, Jiang N. Work-family conflict and its related factors among emergency department physicians in China: A national cross-sectional study. Front Public Health 2023; 11:1092025. [PMID: 37020815 PMCID: PMC10067613 DOI: 10.3389/fpubh.2023.1092025] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2022] [Accepted: 02/27/2023] [Indexed: 03/22/2023] Open
Abstract
BackgroundWork-family conflict is common among emergency department physicians. Identifying the factors associated with work-family conflict is key to reducing its negative impact on mental health and work attitudes. However, the work-family conflict of Chinese emergency department physicians and the related factors have been scarcely studied.ObjectiveThis study aimed to investigate the current status and related factors of work-family conflict among Chinese emergency department physicians.MethodsA national cross-sectional study was conducted among emergency department physicians in China from June 2018 to August 2018. A standard questionnaire was used to investigate the demographic characteristics, work-related factors, and work-family conflict of emergency department physicians. The generalized linear regression analysis was used to identify the related factors of work-family conflict.ResultsA total of 10,457 licensed emergency department physicians participated in the study. The average score of work-family conflict among the enrolled emergency department physicians was 19.27 ± 3.94, and the prevalence of high levels of work-family conflict was 69.19%. The multivariable regression analysis showed that emergency physicians who were female (linear regression coefficient, −0.25; SE, 0.08; P = 0.002), older than 40 years (linear regression coefficient,−0.53; SE, 0.14; P < 0.001), and earning more than 4,000 CNY per month (e.g., 4,001~6,000 vs. ≤4,000 CNY: linear regression coefficient, −0.17; SE, 0.09; P = 0.04) had lower work-family conflicts. However, emergency department physicians who were married (linear regression coefficient, 0.37; SE, 0.11; P < 0.001), highly educated (linear regression coefficient, 0.46; SE, 0.10; P < 0.001), had a high technical title (e.g., intermediate vs. junior technical title: linear regression coefficient, 0.61; SE, 0.09; P < 0.001), worked in a high-grade hospital (e.g., tertiary hospital vs. emergency center: linear regression coefficient, 0.38; SE, 0.11; P < 0.001), had a higher frequency of night shifts (e.g., 6~10 night shifts per month vs. 0~5 night shifts per month: linear regression coefficient, 0.43; SE, 0.10; P < 0.001), self-perceived shortage of physicians in the department (linear regression coefficient, 2.22; SE, 0.08; P < 0.001), and experienced verbal abuse (linear regression coefficient, 1.48; SE, 0.10; P < 0.001) and physical violence (linear regression coefficient, 0.84; SE, 0.08; P < 0.001) in the workplace had higher work-family conflict scores.ConclusionMost emergency department physicians in China experience a high-level work-family conflict. Hospital administrations are recommended to develop family-friendly workplace policies, establish a scientific shift system, and keep the number of emergency department physicians to meet the demand to reduce work-family conflict.
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Affiliation(s)
- Shijiao Yan
- Department of Emergency Medicine, Hunan Provincial Key Laboratory of Emergency and Critical Care Metabolomics, Hunan Provincial Institute of Emergency Medicine, Hunan Provincial People's Hospital/The First Affiliated Hospital, Hunan Normal University, Changsha, China
- School of Public Health, Hainan Medical University, Haikou, China
| | - Changjun Li
- Department of Neurology, The Central Hospital of Wuhan, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Jiali Zhang
- Department of Social Medicine and Health Management, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yafei Wu
- Department of Social Medicine and Health Management, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Mengge Tian
- Department of Social Medicine and Health Management, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Li Liu
- Office of Academic Research, The Central Hospital of Wuhan, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Xuan Zhou
- Department of Anesthesiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Jianwei Zheng
- Department of Biliary-Pancreatic Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Jianwei Zheng
| | - Nan Jiang
- Department of Social Medicine and Health Management, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- *Correspondence: Nan Jiang
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Williams-Yuen J, Shunmugam M, Smith H, Jarvis-Selinger S, Hubinette M. COVID as a catalyst: medical student perspectives on professional identity formation during the COVID-19 pandemic. CANADIAN MEDICAL EDUCATION JOURNAL 2022; 13:13-21. [PMID: 35875433 PMCID: PMC9297251 DOI: 10.36834/cmej.73444] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
BACKGROUND As a result of the COVID-19 pandemic, a national decision was made to remove all medical students from clinical environments resulting in a major disruption to traditional medical education. Our study aimed to explore medical student perspectives of professional identity formation (PIF) during a nationally unique period in which there was no clinical training in medical undergraduate programs. METHODS We interviewed fifteen UBC medical students (years 1-4) regarding their perspectives on PIF and the student role in the setting of the COVID-19 pandemic. Data were analysed iteratively and continuously to create a codebook and identify themes of PIF based on interview transcripts. RESULTS We identified three key themes: (1) Medical students as learners vs contributing team members (2) Decreased competency as a threat to identity and (3) Doctors as heroes. CONCLUSIONS The impact of disruptions due to COVID-19 catalyzed student reflections on their role within the healthcare system, as well as the role of self-sacrifice in physician identity. Simultaneously, students worried that disruptions to clinical training would prevent them from actualizing the identities they envisioned for themselves in the future. Ultimately, our study provides insight into student perspectives during a novel period in medical training, and highlights the unique ways in which PIF can occur in the absence of clinical exposure.
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Affiliation(s)
| | - Mahesh Shunmugam
- Faculty of Medicine, University of British Columbia, British Columbia, Canada
| | - Haley Smith
- Faculty of Medicine, University of British Columbia, British Columbia, Canada
| | - Sandra Jarvis-Selinger
- Faculty of Pharmaceutical Sciences, University of British Columbia, British Columbia, Canada
| | - Maria Hubinette
- Faculty of Medicine, University of British Columbia, British Columbia, Canada
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Olm M, Roos M, Hapfelmeier A, Schneider D, Gensichen J, Berberat PO, Schneider A. Increased professionalization and lower burnout scores were associated with structured residency training program: results of a cross sectional survey. MEDICAL EDUCATION ONLINE 2021; 26:1959284. [PMID: 34323662 PMCID: PMC8330728 DOI: 10.1080/10872981.2021.1959284] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/20/2021] [Revised: 07/13/2021] [Accepted: 07/20/2021] [Indexed: 06/13/2023]
Abstract
The competence centre for Residency Training in Family Medicine Bavaria (CCRTB) was established to improve the quality of postgraduate medical education by offering training and mentoring programmes for residents, and by providing train-the-trainer and mentoring courses for supervisors. Beyond that, regional Residency Training Networks (RTN) on avoluntary basis were developed to facilitate structured and efficient clinical rotation programs. Primary aim was to investigate the burden of burnout and the development of professionalism among CCRTB-residencies within a cross-sectional study. Secondary aim was to evaluate differences between CCRTB-residents with and without participation in aregional RTN. Burnout was determined with the Maslach Burnout Inventory (MBI), comprising the scales emotional exhaustion, depersonalization, and personal accomplishment. Ambulatory professionalization was evaluated using the German Professional Scale (Pro-D), comprising the scales professionalism towards the patient, towards other professionals, towards society, and towards oneself. Statistical significance of group differences was calculated by nonparametric tests. Multivariable linear regression modelling was performed to estimate the independent impact of professionalization and RTN participation on burnout scores. 347 CRRTB residents in ambulatory postgraduate training were invited, 212 (61.1%) participated, and 197 (92.9%) were included in our analyses. Lower emotional exhaustion and depersonalization, and increased personal accomplishment was associated with increased professionalisation, which was significant for nearly all Pro-D scales (p ≤ 0.05). RTN residents showed higher professionalism towards the patient (p = 0.031), other professionals (p = 0.012), and towards the society (p = 0.007) than residents of unstructured programs, and higher levels of personal accomplishment (p < 0.05). Early and efficient professionalization might be akey to reduce burnout and to establish asatisfying career in family medicine. Train-the-trainer and mentoring concepts should be implemented regularly for the training of residents. Thus, increased engagement in medical didactics should be aprerequisite for accreditation as atraining practice for residents.
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Affiliation(s)
- Michaela Olm
- TUM School of Medicine, Institute of General Practice and Health Services Research, Technical University of Munich, Munich, Germany
| | - Marco Roos
- Kompetenzzentrum Weiterbildung Allgemeinmedizin Bayern (KWAB), Erlangen, Germany
- Institute of General Practice, Friedrich-Alexander University Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Alexander Hapfelmeier
- TUM School of Medicine, Institute of General Practice and Health Services Research, Technical University of Munich, Munich, Germany
- TUM School of Medicine, Institute of Medical Informatics, Statistics and Epidemiology, Technical University Munich, Munich, Germany
| | - Dagmar Schneider
- Kompetenzzentrum Weiterbildung Allgemeinmedizin Bayern (KWAB), Erlangen, Germany
- Koordinierungsstelle Allgemeinmedizin, Munich, Germany
| | - Jochen Gensichen
- Kompetenzzentrum Weiterbildung Allgemeinmedizin Bayern (KWAB), Erlangen, Germany
- Institute of General Practice and Family Medicine, University Hospital of the Ludwig-Maximilians University of Munich, Munich, Germany
| | - Pascal O. Berberat
- TUM Medical Education Center, School of Medicine, Technical University of Munich, Munich, Germany
| | - Antonius Schneider
- TUM School of Medicine, Institute of General Practice and Health Services Research, Technical University of Munich, Munich, Germany
- Kompetenzzentrum Weiterbildung Allgemeinmedizin Bayern (KWAB), Erlangen, Germany
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Fendel JC, Aeschbach VM, Schmidt S, Göritz AS. The impact of a tailored mindfulness-based program for resident physicians on distress and the quality of care: A randomised controlled trial. J Intern Med 2021; 290:1233-1248. [PMID: 34369618 DOI: 10.1111/joim.13374] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
BACKGROUND Many resident physicians suffer from distress, which endangers their individual health and the quality of care. OBJECTIVE To examine the impact of a tailored mindfulness-based program (MBP) for resident physicians on distress and the quality of care. METHODS A single-centre, two-armed, longitudinal randomised controlled trial. The intervention group took part in an 8-week, tailored MBP that included a coursebook. The MBP was followed by a 4-month maintenance phase. The active control group received the coursebook for self-study. Assessments were at baseline (t0, 0 months), after the intervention (t1, 2 months), after the maintenance phase (t2, 6 months), and at follow-up (t3, 12 months). The primary outcome was a change in burnout at t2. Secondary outcomes included perceived stress, mental distress, perceived job strain, depression, anxiety, hair cortisol secretion, self-reported medical errors and third-party ratings by patients, supervisors and colleagues. RESULTS Seventy-six participants were randomised to the intervention and 71 to the control group. The intervention group showed greater improvements in the primary outcome (burnout at t2, d = 0.32, p = 0.046), in perceived stress (d = 0.31, p = 0.046) and perceived job strain (d = 0.33, p = 0.026) at t1, and in supervisor rated empathy (d = 0.71, p = 0.037) and colleague rated attentiveness (d = 0.85, p = .006) at t2. There was no difference between groups in the other outcomes. CONCLUSION A tailored MBP for resident physicians improved burnout and might have improved other aspects of distress and the quality of care.
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Affiliation(s)
- Johannes C Fendel
- Department of Occupational and Consumer Psychology, Institute of Psychology, University of Freiburg, Freiburg, Germany.,Department for Psychosomatic Medicine and Psychotherapy, Medical Faculty, Medical Centre, University of Freiburg, Freiburg, Germany
| | - Vanessa M Aeschbach
- Department of Occupational and Consumer Psychology, Institute of Psychology, University of Freiburg, Freiburg, Germany.,Department for Psychosomatic Medicine and Psychotherapy, Medical Faculty, Medical Centre, University of Freiburg, Freiburg, Germany
| | - Stefan Schmidt
- Department for Psychosomatic Medicine and Psychotherapy, Medical Faculty, Medical Centre, University of Freiburg, Freiburg, Germany
| | - Anja S Göritz
- Department of Occupational and Consumer Psychology, Institute of Psychology, University of Freiburg, Freiburg, Germany
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Navinés R, Olivé V, Fonseca F, Martín-Santos R. Work stress and resident burnout, before and during the COVID-19 pandemia: An up-date. MEDICINA CLINICA (ENGLISH ED.) 2021; 157:130-140. [PMID: 35005240 PMCID: PMC8721440 DOI: 10.1016/j.medcle.2021.04.005] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/27/2021] [Accepted: 04/06/2021] [Indexed: 02/05/2023]
Affiliation(s)
- Ricard Navinés
- Unidad Funcional de Psiquiatría, Departamento de Medicina, Instituto de Neurociencias, Universidad de Barcelona (UB), Barcelona, Spain.,Societat Catalana de Psiquiatria i Salut Mental (SCPiSM), Barcelona, Spain
| | - Victoria Olivé
- Unidad Funcional de Psiquiatría, Departamento de Medicina, Instituto de Neurociencias, Universidad de Barcelona (UB), Barcelona, Spain.,Servicio de Prevención de Riesgos Laborales, Hospital Clínic, Barcelona, Spain
| | - Francina Fonseca
- Societat Catalana de Psiquiatria i Salut Mental (SCPiSM), Barcelona, Spain.,Grupo de Investigación en Adicciones, Instituto de Investigación Médica Hospital del Mar (IMIM), Universidad Autònoma de Barcelona, Instituto de Neuropsiquiatría y Adicciones (INAD), Red de Trastornos Adictivos (RediTA), Barcelona, Spain
| | - Rocío Martín-Santos
- Grupo de Investigación en Vulnerabilidad, Psicopatología y Género, Servicio de Psiquiatría y Psicología, Programa de Atención al Personal Sanitario, Hospital Clínic, IDIBAPS, CIBERSAM, Barcelona, Spain.,Unidad Funcional de Psiquiatría, Departamento de Medicina, Instituto de Neurociencias, Universidad de Barcelona (UB), Barcelona, Spain.,Societat Catalana de Psiquiatria i Salut Mental (SCPiSM), Barcelona, Spain
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[Work stress and resident burnout, before and during the COVID-19 pandemia: An up-date]. Med Clin (Barc) 2021; 157:130-140. [PMID: 34083069 PMCID: PMC8101798 DOI: 10.1016/j.medcli.2021.04.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2021] [Revised: 04/02/2021] [Accepted: 04/06/2021] [Indexed: 11/23/2022]
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Taiwo F, Adesegun O, Idowu A, Mene A, Imaralu J, Adekoya A, Osibowale B. Assessment of resident doctors' perception of postgraduate medical education in Nigeria using the SPEED tool: A pilot study. NIGERIAN JOURNAL OF MEDICINE 2021. [DOI: 10.4103/njm.njm_172_20] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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