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Knoedler L, Dean J, Knoedler S, Kauke-Navarro M, Hollmann K, Alfertshofer M, Helm S, Prantl L, Schliermann R. Hard shell, soft core? Multi-disciplinary and multi-national insights into mental toughness among surgeons. Front Surg 2024; 11:1361406. [PMID: 38645505 PMCID: PMC11027567 DOI: 10.3389/fsurg.2024.1361406] [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: 12/25/2023] [Accepted: 03/15/2024] [Indexed: 04/23/2024] Open
Abstract
Background With the prevalence of burnout among surgeons posing a significant threat to healthcare outcomes, the mental toughness of medical professionals has come to the fore. Mental toughness is pivotal for surgical performance and patient safety, yet research into its dynamics within a global and multi-specialty context remains scarce. This study aims to elucidate the factors contributing to mental toughness among surgeons and to understand how it correlates with surgical outcomes and personal well-being. Methods Utilizing a cross-sectional design, this study surveyed 104 surgeons from English and German-speaking countries using the Mental Toughness Questionnaire (MTQ-18) along with additional queries about their surgical practice and general life satisfaction. Descriptive and inferential statistical analyses were applied to investigate the variations in mental toughness across different surgical domains and its correlation with professional and personal factors. Results The study found a statistically significant higher level of mental toughness in micro-surgeons compared to macro-surgeons and a positive correlation between mental toughness and surgeons' intent to continue their careers. A strong association was also observed between general life satisfaction and mental toughness. No significant correlations were found between the application of psychological skills and mental toughness. Conclusion Mental toughness varies significantly among surgeons from different specialties and is influenced by professional dedication and personal life satisfaction. These findings suggest the need for targeted interventions to foster mental toughness in the surgical community, potentially enhancing surgical performance and reducing burnout. Future research should continue to explore these correlations, with an emphasis on longitudinal data and the development of resilience-building programs.
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Affiliation(s)
- Leonard Knoedler
- Division of Plastic Surgery, Department of Surgery, Yale School of Medicine, New Haven, CT, United States
- Department of Plastic, Hand and Reconstructive Surgery, University Hospital Regensburg, Regensburg, Germany
| | - Jillian Dean
- University of Pittsburgh School of Medicine, Pittsburgh, PA, United States
| | - Samuel Knoedler
- Division of Plastic Surgery, Department of Surgery, Yale School of Medicine, New Haven, CT, United States
| | - Martin Kauke-Navarro
- Division of Plastic Surgery, Department of Surgery, Yale School of Medicine, New Haven, CT, United States
| | - Katharina Hollmann
- Division of Hand, Plastic and Aesthetic Surgery, Ludwig-Maximilians-University Munich, Munich, Germany
| | - Michael Alfertshofer
- Division of Hand, Plastic and Aesthetic Surgery, Ludwig-Maximilians-University Munich, Munich, Germany
- Department of Oromaxillofacial Surgery, Ludwig-Maximilians-University Munich, Munich, Germany
| | - Sabrina Helm
- Division of Hand, Plastic and Aesthetic Surgery, Ludwig-Maximilians-University Munich, Munich, Germany
| | - Lukas Prantl
- Department of Plastic, Hand and Reconstructive Surgery, University Hospital Regensburg, Regensburg, Germany
| | - Rainer Schliermann
- Faculty of Social and Health Care Sciences, Regensburg University of Applied Sciences, Regensburg, Germany
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Mouchabac S, Adrien V, Diot T, Renaud MC, Carrié A, Bourla A, Ferreri F. Insights into medical students' perceptions of work culture during the COVID-19 pandemic: a mixed method study. BMC MEDICAL EDUCATION 2024; 24:21. [PMID: 38172850 PMCID: PMC10765811 DOI: 10.1186/s12909-023-04936-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/02/2023] [Accepted: 12/05/2023] [Indexed: 01/05/2024]
Abstract
BACKGROUND The COVID-19 pandemic brought about profound social changes that affected students worldwide. These changes had both psychological and economic consequences, and also led to the adoption of new teaching methods. It can also have an impact on work culture, which is the collective set of values, norms, and practices within a specific profession, shaping how individuals in that field behave, communicate, and identify with their work. The aim of the study was to examine medical students' perception of professional culture during the COVID-19 crisis when they voluntarily participated in the healthcare network established, outside of university placements, for the management of COVID patients. METHODS A questionnaire study based on the vignette methodology was conducted among third-year medical students. Drawing from three scenarios in which students were variably engaged in crisis management, it included questions about their perceptions of the medical profession, their motivation, and their sense of belonging to the profession. RESULTS 352 students responded to the survey. The pandemic had both a positive and a negative impact on students' perceptions of the medical profession. Cluster analysis using a k-means algorithm and principal component analysis revealed three clusters of students with different perceptions of the medical profession. The first cluster, which represented the majority of students, corresponded to a relatively positive perception of the profession that was reinforced during the pandemic. In the second cluster, students' perceptions were reinforced still further, and particular importance was attached to field experience. Students in the third cluster had the most negative perceptions, having been shaken the most by the pandemic, and they attached little importance to field experience. CONCLUSIONS The analysis highlighted the importance of students being able to adapt and draw on a range of resources during the COVID-19 pandemic. This underscores the need for work cultures that support adaptability and coping. Further research is needed to understand its long-term effects on students' perceptions of the medical profession and to identify interventions that could support students in the aftermath of this difficult period.
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Affiliation(s)
- Stephane Mouchabac
- Department of Psychiatry, Saint-Antoine Hospital, Sorbonne University, AP-HP, Paris, F-75012, France.
- Infrastructure for Clinical Research in Neurosciences (iCRIN), Paris Brain Institute, Paris, France.
| | - Vladimir Adrien
- Department of Psychiatry, Saint-Antoine Hospital, Sorbonne University, AP-HP, Paris, F-75012, France
- Infrastructure for Clinical Research in Neurosciences (iCRIN), Paris Brain Institute, Paris, France
| | - Thomas Diot
- Department of Psychiatry, Saint-Antoine Hospital, Sorbonne University, AP-HP, Paris, F-75012, France
| | | | - Alain Carrié
- Faculty of Medicine, Sorbonne University, Paris, France
| | - Alexis Bourla
- Department of Psychiatry, Saint-Antoine Hospital, Sorbonne University, AP-HP, Paris, F-75012, France
- Infrastructure for Clinical Research in Neurosciences (iCRIN), Paris Brain Institute, Paris, France
| | - Florian Ferreri
- Department of Psychiatry, Saint-Antoine Hospital, Sorbonne University, AP-HP, Paris, F-75012, France
- Infrastructure for Clinical Research in Neurosciences (iCRIN), Paris Brain Institute, Paris, France
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Prazeres F, Castro L, Teixeira A. The role of social support as a moderator between resilience and levels of burden of multimorbidity management among general practitioners: a cross-sectional study in Portugal. Fam Pract 2023:cmad109. [PMID: 38001040 DOI: 10.1093/fampra/cmad109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2023] Open
Abstract
BACKGROUND Multimorbidity management poses significant challenges for general practitioners (GPs). The aim of this study is to analyse the role of resilience and social support on the burden experienced by GPs in managing patients with multiple health conditions in Portugal. METHODS Cross-sectional quantitative study conducted among GPs in Portugal using an online questionnaire that included validated measurement tools: Questionnaire of Evaluation of Burden of Management of Multimorbidity in General and Family Medicine (SoGeMM-MGF), European Portuguese Version of the Resilience Scale (ER14), and the Oslo Social Support Scale-3 (OSSS-3) in Portuguese. A multiple linear regression analysis was conducted to examine the factors influencing the burden of managing multimorbidity. RESULTS Two hundred and thirty-nine GPs were included, with 76.6% being female and a median age of 35 years. Most participants were specialists (66.9%) and had less than a decade of experience managing multimorbidity. Over 70% had not received specific training in multimorbidity. Female GPs and those with a higher proportion of multimorbid patients in the registries experienced higher burden levels. A multivariate regression model with moderation revealed that the effect of resilience on burden varied depending on the level of social support. Higher resilience was associated with higher burden in the "Poor Social Support" category, while it was associated with lower burden in the "Moderate Social Support" and "Strong Social Support" categories, although not statistically significant. CONCLUSIONS The study highlights the importance of GPs' social support and resilience in managing the burden of multimorbidity, with poor social support potentially worsening the effects of high resilience.
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Affiliation(s)
- Filipe Prazeres
- Department of Medical Sciences, Faculty of Health Sciences, University of Beira Interior, Covilhã, Portugal
- Family Health Unit Beira Ria, Gafanha da Nazaré, Portugal
- CINTESIS@RISE, MEDCIDS, Faculty of Medicine of the University of Porto, Porto, Portugal
| | - Luísa Castro
- CINTESIS@RISE, MEDCIDS, Faculty of Medicine of the University of Porto, Porto, Portugal
- School of Health of Polytechnic of Porto, Porto, Portugal
- MEDCIDS-Department of Community Medicine, Information and Decision in Health, Faculty of Medicine, University of Porto, Porto, Portugal
| | - Andreia Teixeira
- CINTESIS@RISE, MEDCIDS, Faculty of Medicine of the University of Porto, Porto, Portugal
- MEDCIDS-Department of Community Medicine, Information and Decision in Health, Faculty of Medicine, University of Porto, Porto, Portugal
- AdiT-LAB, Instituto Politécnico de Viana do Castelo, Viana do Castelo, Portugal
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Ushimoto T, Murasaka K, Sakurai M, Ishizaki M, Wato Y, Kanda T, Kasamaki Y. Physicians' Resilience as a Positive Effect of COVID-19. JMA J 2023; 6:365-370. [PMID: 37941699 PMCID: PMC10628123 DOI: 10.31662/jmaj.2022-0192] [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: 10/21/2022] [Accepted: 08/02/2023] [Indexed: 11/10/2023] Open
Abstract
People devoid of COVID-19 may exhibit mental health problems, such as anxiety disorders, depression, panic attack, insomnia, emotional disorder, and suicidal actions. Healthcare workers (HCWs) may also exhibit these problems. Physicians should be careful an "at-risk" population. Physicians revealed higher levels of resilience than the popular workers. Humans with stronger resilience have lower feeling of anxiety and depression. We investigated the risk to physicians from an infected environment to infected patients during the pandemic. The social and psychological support of all HCWs, particularly physicians, is significant in the fight against this pandemic. Physicians working with patients with COVID-19 should set enough time to relax, sleep, and spend time with family. Resilience in physicians facing COVID-19 can induce post-traumatic growth in the future.
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Affiliation(s)
- Tomoyuki Ushimoto
- Department of Emergency Medicine, Kanazawa Medical University, Uchinada, Japan
| | - Kenshi Murasaka
- Department of Emergency Medicine, Kanazawa Medical University, Uchinada, Japan
| | - Masaru Sakurai
- Department of Emergency Medicine, Kanazawa Medical University, Uchinada, Japan
| | - Masao Ishizaki
- Department of Emergency Medicine, Kanazawa Medical University, Uchinada, Japan
| | - Yukihiro Wato
- Department of Emergency Medicine, Kanazawa Medical University, Uchinada, Japan
| | - Tsugiyasu Kanda
- Department of Community Medicine, Kanazawa Medical University, Uchinada, Japan
- Department of General Medicine, Kanazawa Medical University Himi Municipal Hospital, Himi, Japan
| | - Yuji Kasamaki
- Department of Community Medicine, Kanazawa Medical University, Uchinada, Japan
- Department of General Medicine, Kanazawa Medical University Himi Municipal Hospital, Himi, Japan
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Debets M, Jansen I, Lombarts K, Kuijer-Siebelink W, Kruijthof K, Steinert Y, Daams J, Silkens M. Linking leadership development programs for physicians with organization-level outcomes: a realist review. BMC Health Serv Res 2023; 23:783. [PMID: 37480101 PMCID: PMC10362722 DOI: 10.1186/s12913-023-09811-y] [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: 02/23/2023] [Accepted: 07/12/2023] [Indexed: 07/23/2023] Open
Abstract
BACKGROUND Hospitals invest in Leadership Development Programs (LDPs) for physicians, assuming they benefit the organization's performance. Researchers have listed the advantages of LDPs, but knowledge of how and why organization-level outcomes are achieved is missing. OBJECTIVE To investigate how, why and under which circumstances LDPs for physicians can impact organization-level outcomes. METHODS We conducted a realist review, following the RAMESES guidelines. Scientific articles and grey literature published between January 2010 and March 2021 evaluating a leadership intervention for physicians in the hospital setting were considered for inclusion. The following databases were searched: Medline, PsycInfo, ERIC, Web of Science, and Academic Search Premier. Based on the included documents, we developed a LDP middle-range program theory (MRPT) consisting of Context-Mechanism-Outcome configurations (CMOs) describing how specific contexts (C) trigger certain mechanisms (M) to generate organization-level outcomes (O). RESULTS In total, 3904 titles and abstracts and, subsequently, 100 full-text documents were inspected; 38 documents with LDPs from multiple countries informed our MRPT. The MRPT includes five CMOs that describe how LDPs can impact the organization-level outcomes categories 'culture', 'quality improvement', and 'the leadership pipeline': 'Acquiring self-insight and people skills (CMO1)', 'Intentionally building professional networks (CMO2)', 'Supporting quality improvement projects (CMO3)', 'Tailored LDP content prepares physicians (CMO4)', and 'Valuing physician leaders and organizational commitment (CMO5)'. Culture was the outcome of CMO1 and CMO2, quality improvement of CMO2 and CMO3, and the leadership pipeline of CMO2, CMO4, and CMO5. These CMOs operated within an overarching context, the leadership ecosystem, that determined realizing and sustaining organization-level outcomes. CONCLUSIONS LDPs benefit organization-level outcomes through multiple mechanisms. Creating the contexts to trigger these mechanisms depends on the resources invested in LDPs and adequately supporting physicians. LDP providers can use the presented MRPT to guide the development of LDPs when aiming for specific organization-level outcomes.
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Affiliation(s)
- Maarten Debets
- Amsterdam UMC, Medical Psychology, Univ of Amsterdam, Amsterdam Public Health, AMC, Meibergdreef 9, 1105AZ, Amsterdam, Netherlands.
| | - Iris Jansen
- Amsterdam UMC, Medical Psychology, Univ of Amsterdam, Amsterdam Public Health, AMC, Meibergdreef 9, 1105AZ, Amsterdam, Netherlands
| | - Kiki Lombarts
- Amsterdam UMC, Medical Psychology, Univ of Amsterdam, Amsterdam Public Health, AMC, Meibergdreef 9, 1105AZ, Amsterdam, Netherlands
| | - Wietske Kuijer-Siebelink
- School of Education, Research On Responsive Vocational and Professional Education, HAN University of Applied Sciences, Nijmegen, Netherlands
- Research On Learning and Education, Radboud University Medical Centre, Radboudumc Health Academy, Nijmegen, Netherlands
| | - Karen Kruijthof
- Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam Public Health, De Boelelaan 1117, Amsterdam, Netherlands
| | - Yvonne Steinert
- Faculty of Medicine and Health Sciences, Institute of Health Sciences Education, McGill University, Montreal, Canada
| | - Joost Daams
- Medical Library, Amsterdam University Medical Centers, Amsterdam, Noord-Holland, Netherlands
| | - Milou Silkens
- Department of Health Services Research & Management, City University of London, London, UK
- Erasmus School of Health Policy & Management, Erasmus University, Rotterdam, Netherlands
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2022 Central Surgical Association presidential address: Grit and resilience in surgery. Surgery 2023; 173:562-566. [PMID: 36572619 DOI: 10.1016/j.surg.2022.11.034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2022] [Accepted: 11/29/2022] [Indexed: 12/25/2022]
Abstract
Grit is a personality trait that is defined as passion and perseverance for a long-term goal. Resilience is defined as the ability to recover or adjust to misfortune or change. The 2 concepts are inexorably intertwined. Surgery residents demonstrate higher average grit scores than the general population. Increased levels of grit predict success in many areas of life and are positively correlated with satisfaction in surgery residency. Decreased levels of grit correlate with burnout, attrition, and suicidality in resident surgeons. Personal grittiness can be increased by a focused interest in an area, deliberate goal-directed practice, finding a calling in life, and cultivating hope and resilience. Resilience, like grit, can be nurtured over time with deliberate steps. Grit and resilience are important in residency training, and training programs can be tailored to promote a wise environment, with demanding, yet supportive, departments. Organizational grit can be boosted by seeking to maximize successful attributes of dynamic organizations.
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The Relationship between Emotional Stability, Psychological Well-Being and Life Satisfaction of Romanian Medical Doctors during COVID-19 Period: A Cross-Sectional Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19052937. [PMID: 35270629 PMCID: PMC8910741 DOI: 10.3390/ijerph19052937] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/17/2022] [Revised: 02/24/2022] [Accepted: 02/28/2022] [Indexed: 02/01/2023]
Abstract
Due to the COVID-19 pandemic, as well as the fast progression of modern society, occupational stress has recently reached alarming levels with consequences for doctors’ psychological well-being. The aim of this study was to analyze the relationship among emotional stability, psychological well-being, and life satisfaction of medical doctors. We conducted a cross-sectional study on 280 medical doctors from Romania between February 2021 and September 2021, in the period between the third and fourth pandemic waves, who were evaluated by the DECAS, ASSET, and Satisfaction with Life scales. Our results showed that emotional stability is negatively correlated with psychological well-being (r = −0.526, p < 0.000) and positively correlated with life satisfaction (r = 0.319, p < 0.0001). Between psychological well-being and life satisfaction, we found a negative correlation (r = −0.046, p < 0.001). This study shows that there is a correlation among emotional stability, psychological well-being, and life satisfaction, which is why it can be considered that Romanian doctors have generated coping mechanisms during the COVID-19 pandemic.
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