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Seitz KP, Baclig NV, Stiller R, Chen A. Implementation of a Near-Peer Support Program to Improve Trainee Well-Being after Patient Safety Events. ATS Sch 2023; 4:423-430. [PMID: 38196673 PMCID: PMC10773491 DOI: 10.34197/ats-scholar.2023-0011ps] [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: 01/27/2023] [Accepted: 07/24/2023] [Indexed: 01/11/2024] Open
Abstract
Adverse events can take an emotional toll on physicians, which, left unprocessed, can have negative impacts on well-being, including burnout and depression. Peer support can help mitigate these negative effects. Structured programs train physicians to aid colleagues in processing work-related experiences and emotions such as guilt and self-doubt. Although such programs are common for faculty, peer support for resident physicians has not been adequately addressed, and few programs have been described in the literature. Residency is a vulnerable time of professional identity formation, and providing support has specific challenges. The power dynamics and distance between lived experiences limit the utility of faculty peer support programs. Some institutions have trained residents to provide peer support, but widespread implementation may be difficult because of limited resident time and comfort in providing support. Chief residents (CRs), however, are close to residents in training yet experienced enough to afford perspective and are uniquely situated to provide "near-peer" support. We describe the implementation of a CR near-peer support program in which an established peer support framework was adapted to add elements specific to resident stressors and CR-resident relationships. One faculty member and two outgoing CRs lead a 2-hour workshop that is built into existing CR onboarding to ensure sustainability. The workshop combines large-group didactics and small-group breakouts, using clinical vignettes and simulated near-peer support conversations. To date, 36 CRs have been trained. CR near-peer support can serve as a model for programs in which true resident peer support is not feasible.
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Affiliation(s)
- Kevin P. Seitz
- Division of Allergy, Pulmonary, and
Critical Care, Department of Medicine, Vanderbilt University Medical Center,
Nashville, Tennessee
| | - Nikita V. Baclig
- Department of Medicine, David Geffen
School of Medicine, University of California, Los Angeles, Los Angeles,
California; and
| | - Robin Stiller
- Department of Medicine, University of
Washington School of Medicine, Seattle, Washington
| | - Anders Chen
- Department of Medicine, University of
Washington School of Medicine, Seattle, Washington
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Magaldi M, Perdomo JM, López-Baamonde M, Chanzá M, Sanchez D, Gomar C. Second victim phenomenon in a surgical area: Online survey. REVISTA ESPANOLA DE ANESTESIOLOGIA Y REANIMACION 2021; 68:504-512. [PMID: 34764069 DOI: 10.1016/j.redare.2020.11.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/17/2020] [Accepted: 11/05/2020] [Indexed: 06/13/2023]
Abstract
BACKGROUND AND AIM OF STUDY An effective and accessible first source of support for second victims (SV) is usually the colleagues themselves, who should have tools to help emotionally and detect the unusual course of a SV. The aim of this work is to assess health professionals' perception of the phenomenon, as well as their capability to apply psychological first aid. MATERIAL AND METHODS Observational descriptive study through online surveys answered anonymously. Participants were different health professionals from surgical area, mainly from a third-level hospital. RESULTS 329 responses, 67 anaesthesiologists, 110 anaesthesiologists in training, 152 nurses. 78.4% had felt SV, more frequent among anaesthesiologists; however, 58% had never heard of the term. Guilt was the most frequent emotion. Residents were more afraid of judgmental colleagues and thought more about drop out their training. From those who sought help, most did it through a colleague, but most did not feel useful in helping a SV. 66% affirmed there is a still punitive, evasive or silent culture about medical incidents. CONCLUSIONS Despite the frequency of the phenomenon there is still lack of knowledge of the term SV. Impact of the phenomenon is heterogenous and changes based on experience and responsibility. Colleagues are the first source of emotional help but there is a lack of tools to be able to provide it. Institutions are urged to create training programs so that professionals can guarantee «psychological first aid».
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Affiliation(s)
- M Magaldi
- Servicio de Anestesiología y Reanimación, Hospital Clínic de Barcelona, Barcelona, Spain; Grupo de Simulación SimClínic, Hospital Clínic de Barcelona, Barcelona, Spain.
| | - J M Perdomo
- Servicio de Anestesiología y Reanimación, Hospital Clínic de Barcelona, Barcelona, Spain; Grupo de Simulación SimClínic, Hospital Clínic de Barcelona, Barcelona, Spain
| | - M López-Baamonde
- Servicio de Anestesiología y Reanimación, Hospital Clínic de Barcelona, Barcelona, Spain; Grupo de Simulación SimClínic, Hospital Clínic de Barcelona, Barcelona, Spain
| | - M Chanzá
- Servicio de Anestesiología y Reanimación, Parc de Salut Mar, Barcelona, Spain
| | - D Sanchez
- Asistencia médica integral, Teladoc Health, Barcelona, Spain
| | - C Gomar
- Servicio de Anestesiología y Reanimación, Hospital Clínic de Barcelona, Barcelona, Spain; Grupo de Simulación SimClínic, Hospital Clínic de Barcelona, Barcelona, Spain
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3
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Magaldi M, Perdomo JM, López-Baamonde M, Chanzá M, Sanchez D, Gomar C. Second victim phenomenon in a surgical area: online survey. REVISTA ESPANOLA DE ANESTESIOLOGIA Y REANIMACION 2021; 68:S0034-9356(20)30320-0. [PMID: 34006368 DOI: 10.1016/j.redar.2020.11.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/17/2020] [Revised: 10/30/2020] [Accepted: 11/05/2020] [Indexed: 11/30/2022]
Abstract
BACKGROUND AND AIM OF STUDY An effective and accessible first source of support for second victims (SV) is usually the colleagues themselves, who should have tools to help emotionally and detect the unusual course of a SV. The aim of this work is to assess health professionals' perception of the phenomenon, as well as their capability to apply psychological first aid. MATERIAL AND METHODS Observational descriptive study through online surveys answered anonymously. Participants were different health professionals from surgical area, mainly from a third-level hospital. RESULTS 329 responses, 67 anaesthesiologists, 110 anaesthesiologists in training, 152 nurses. 78.4% had felt SV, more frequent among anaesthesiologists; however, 58% had never heard of the term. Guilt was the most frequent emotion. Residents were more afraid of judgmental colleagues and thought more about drop out their training. From those who sought help, most did it through a colleague, but most did not feel useful in helping a SV. 66% affirmed there is a still punitive, evasive or silent culture about medical incidents. CONCLUSIONS Despite the frequency of the phenomenon there is still lack of knowledge of the term SV. Impact of the phenomenon is heterogenous and changes based on experience and responsibility. Colleagues are the first source of emotional help but there is a lack of tools to be able to provide it. Institutions are urged to create training programs so that professionals can guarantee «psychological first aid».
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Affiliation(s)
- M Magaldi
- Servicio de Anestesiología y Reanimación. Hospital Clínic de Barcelona, Barcelona, España; Grupo de Simulación SimClínic. Hospital Clínic de Barcelona, Barcelona, España.
| | - J M Perdomo
- Servicio de Anestesiología y Reanimación. Hospital Clínic de Barcelona, Barcelona, España; Grupo de Simulación SimClínic. Hospital Clínic de Barcelona, Barcelona, España
| | - M López-Baamonde
- Servicio de Anestesiología y Reanimación. Hospital Clínic de Barcelona, Barcelona, España; Grupo de Simulación SimClínic. Hospital Clínic de Barcelona, Barcelona, España
| | - M Chanzá
- Servicio de Anestesiología y Reanimación. Parc de Salut Mar, Barcelona, España
| | - D Sanchez
- Asistencia médica integral. Teladoc Health, Barcelona, España
| | - C Gomar
- Servicio de Anestesiología y Reanimación. Hospital Clínic de Barcelona, Barcelona, España; Grupo de Simulación SimClínic. Hospital Clínic de Barcelona, Barcelona, España
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Lo C, Yu J, Görges M, Matava C. Anesthesia in the modern world of apps and technology: Implications and impact on wellness. Paediatr Anaesth 2021; 31:31-38. [PMID: 33119935 DOI: 10.1111/pan.14051] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2020] [Revised: 10/19/2020] [Accepted: 10/22/2020] [Indexed: 02/01/2023]
Abstract
Recent decades have seen an unprecedented leap in digital innovation, with far-reaching implications in healthcare. Anesthesiologists have historically championed the adoption of new technologies. However, the rapid evolution of these technologies has outpaced attempts at studying their potential impact on healthcare providers' well-being. This document introduces several categories of workplace technologies commonly encountered by the anesthesiologist. We examine examples of novel technology and the impact of these digital interventions on the anesthesiologist's well-being. We also review popular personalized technology aimed at improving wellness and the impact on well-being examined. Finally, technology acceptance models are introduced to improve technology adoption, which, when appropriately applied, may minimize the negative impacts of technology on anesthesiologists' well-being. Incorporating quantitative, serial assessments of well-being as part of technology implementation are proposed as a future direction for examining the wellness impact of technology on anesthesiologists.
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Affiliation(s)
- Calvin Lo
- Department of Anesthesiology and Pain Medicine, The Hospital for Sick Children, Toronto, ON, Canada.,Department of Anesthesiology and Pain Medicine, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Julie Yu
- Department of Anesthesiology and Pain Medicine, The Hospital for Sick Children, Toronto, ON, Canada.,Department of Anesthesiology and Pain Medicine, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Matthias Görges
- Research Institute, BC Children's Hospital, Vancouver, BC, Canada.,Department of Anesthesiology, Pharmacology & Therapeutics, University of British Columbia, Vancouver, BC, Canada
| | - Clyde Matava
- Department of Anesthesiology and Pain Medicine, The Hospital for Sick Children, Toronto, ON, Canada.,Department of Anesthesiology and Pain Medicine, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
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Romito BT, Okoro EN, Ringqvist JRB, Goff KL. Burnout and Wellness: The Anesthesiologist's Perspective. Am J Lifestyle Med 2020; 15:118-125. [PMID: 33786030 DOI: 10.1177/1559827620911645] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2019] [Accepted: 02/18/2020] [Indexed: 11/15/2022] Open
Abstract
Burnout syndrome results from unmanaged chronic workplace stress. It is characterized by emotional exhaustion, lack of a sense of personal accomplishment, and depersonalization. Burnout is associated with the development of poor work-related outcomes, mental health disorders, substance abuse, and cardiovascular disease. Burnout in physicians and other health care providers can negatively affect patient care. The prevalence of burnout in anesthesiology is among the highest of all medical specialties, with rates approaching 40%. Unique risk factors for the development of burnout in anesthesiologists may include environmental social isolation, long work hours, lack of control over one's career, and the presence of certain personality traits that select for a career in anesthesia. System-based interventions targeting workplace contributions to burnout and individual resilience and mindfulness training can be helpful in reducing burnout symptoms. Future research efforts examining both the health care environmental structure and the specific burnout risk factors for anesthesiologists will help produce targeted treatment strategies for members of the anesthesiology community.
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Affiliation(s)
- Bryan T Romito
- Department of Anesthesiology and Pain Management, The University of Texas Southwestern Medical Center, Dallas, Texas
| | - Ejike N Okoro
- Department of Anesthesiology and Pain Management, The University of Texas Southwestern Medical Center, Dallas, Texas
| | - Jenny R B Ringqvist
- Department of Anesthesiology and Pain Management, The University of Texas Southwestern Medical Center, Dallas, Texas
| | - Kristina L Goff
- Department of Anesthesiology and Pain Management, The University of Texas Southwestern Medical Center, Dallas, Texas
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The Abbreviated Maslach Burnout Inventory Can Overestimate Burnout: A Study of Anesthesiology Residents. J Clin Med 2019; 9:jcm9010061. [PMID: 31888017 PMCID: PMC7020051 DOI: 10.3390/jcm9010061] [Citation(s) in RCA: 41] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2019] [Revised: 12/10/2019] [Accepted: 12/23/2019] [Indexed: 11/24/2022] Open
Abstract
The Maslach Burnout Inventory for healthcare professionals (MBI-HSS) and its abbreviated version (aMBI), are the most common tools to detect burnout in clinicians. A wide range in burnout prevalence is reported in anesthesiology, so this study aimed to ascertain which of these two tools most accurately detected burnout in our anesthesiology residents. The MBI-HSS and aMBI were distributed amongst 86 residents across three hospitals, with a total of 58 residents completing the survey (67.4% response rate; 17 male and 41 female). Maslach-recommended cut-offs for the MBI-HSS and the aMBI with standard cut-offs were used to estimate burnout prevalence, and actual prevalence was established clinically by a thorough review of multiple data sources. Burnout proportions reported by the MBI-HSS and aMBI were found to be significantly different; 22.4% vs. 62.1% respectively (p < 0.0001). Compared to the actual prevalence of burnout in our cohort, the MBI-HSS detected burnout most accurately; area under receiver operating characteristic of 0.99 (95% confidence interval (CI): 0.92–1.0). Although there was a good correlation between the MBI-HSS and aMBI subscale scores, the positive predictive value of the aMBI was poor; 33.3% (95% CI:27.5–39.8%), therefore caution and clinical correlation are advised when using the aMBI tool because of the high rates of false-positives.
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