Achieving Career Satisfaction: Personal Goal Setting and Prioritizing for the Clinician Educator

Lifelong development in medicine: a thematic analysis of coaching goals throughout medical careers

OBJECTIVES

Healthcare grapples with staff shortages and rising burnout rates for medical students, residents and specialists. To prioritise both their well-being and the delivery of high-quality patient care, it becomes imperative to deepen our understanding of physicians' developmental aims and needs. Our first aim is, therefore, to gain comprehensive insights into the specific developmental aims physicians prioritise by examining the coaching goals they set at the beginning of coaching. Since physicians face distinct roles as they advance in their careers, our second aim is to highlight similarities and differences in developmental aims and needs among individuals at various medical career stages.

DESIGN

We conducted a qualitative analysis of 2571 coaching goals. We performed an inductive thematic analysis to code one-half of coaching goals and a codebook thematic analysis for the other half. Our interpretation of the findings was grounded in a critical realist approach.

SETTING

Sixteen hospitals in the Netherlands.

PARTICIPANTS

A total of 341 medical clerkship students, 336 medical residents, 122 early-career specialists, 82 mid-career specialists and 57 late-career specialists provided their coaching goals at the start of coaching.

RESULTS

The findings revealed that coachees commonly set goals about their career and future, current job and tasks, interpersonal work relations, self-insight and development, health and well-being, nonwork aspects and the coaching process. Furthermore, the findings illustrate how the diversity of coaching goals increases as physicians advance in their careers.

CONCLUSIONS

Our findings underscore the significance of recognising distinct challenges at various career stages and the necessity for tailoring holistic support for physicians. This insight holds great relevance for healthcare organisations, enabling them to better align system interventions with physicians' needs and enhance support. Moreover, our classification of coaching goals serves as a valuable foundation for future research, facilitating a deeper exploration of how these goals influence coaching outcomes.

[Goal-setting in Plastic Surgery using the SMART principle]

INTRODUCTION

The process of continuous acquisition of surgical expertise is a key element in registrar training. The principle of active, self-directed learning, which is regularly applied in medical school, can also be used to gain surgical expertise in registrar training.

METHODS

Surgical training can be compared to acquiring expertise in music or sport, where both intellectual and manual capabilities are required. Specific training principles, including analysis, goal setting, practice and reflection on the process, are commonly encountered in these fields. Smart goal setting is preferred in order to ensure compliance and a successful strategy. This can also be used in plastic surgery training.

APPLICATION

Surgical principles as well as partial or complete surgical procedures can be practiced using the smart principle. The fragmentation of a larger task into smaller units allows rapid acquisition of surgical expertise without impeding patient safety.

DISCUSSION

Surgical training today happens in a setting caught between economic and medicolegal challenges. The reduction of case load requires simulation practice as well as self-directed learning - which has been shown to improve outcomes. The smart principle allows distinct goal setting which can improve compliance of the student and increase success. As this form of learning is not intuitive to all individuals, supervisors and mentor can support trainees in the acquisition of surgical expertise using this principle.

Faculty motivations for leading clinical clerkship electives: A qualitative study

PURPOSE

Faculty are motivated to pursue clinician-educator careers out of a sense of purpose, duty, connectedness, satisfaction, and mastery. Yet, many suffer from burnout due to a lack of funding, resources, and competing clinical demands. Reasons for clinician-educator participation in unfunded educational leadership positions are underexplored. This study examined faculty members' reasons for volunteering and remaining as clerkship elective directors, an unfunded leadership position.

METHODS

In this qualitative study, the authors conducted 17 semi-structured interviews with clerkship elective directors in March 2021. The authors conducted a thematic analysis of deidentified transcripts using motivation theories as a lens.

RESULTS

Directors' motivations to engage in this unfunded educational leadership position stemmed from their existing clinician-educator identity and a sense of purpose and duty. Directors are sustained by the satisfaction derived from witnessing the positive impact they have on learners' career development and skills building, the impact of learners on the clinical environment, as well as personal benefits in the mastery of educator skills and enhanced visibility as educators.

CONCLUSIONS

Unfunded educational leadership positions can advance clinician-educators' commitment to learners and alter the learning environment. Strategies for faculty recruitment and retention in unfunded leadership positions include ensuring meaningful contact with learners, as well as opportunities for personal career development through skills building and enhanced visibility through recognition.

Twelve-step Approach for Academic Development Planning in Academic Surgery: Climbing the Academic Uphill With Strong and Steady Steps

MINI-ABSTRACT

Surgical trainees and young academic surgeons should understand the specifics of the career they are pursing, and surgeon mentors should enhance their leadership roles and support the recruitment and retainment of academic surgeons through effective academic career support and strategic planning. Utilizing academic development planning can serve as an essential tool as both mentors & mentees navigate different career choices towards achieving a successful and sustainable academic career advancement.

Does being a coach benefit clinician-educators? A mixed methods study of faculty self-efficacy, job satisfaction and burnout

INTRODUCTION

Coaching is a growing clinician-educator role. Self-efficacy is a powerful faculty motivator that is associated positively with job satisfaction and negatively with burnout. This study examines self-efficacy, job satisfaction, and burnout in coaches and other clinician-educators.

METHODS

We conducted a mixed methods study using a quantitative survey followed by qualitative interviews of faculty at the University of California, San Francisco. Coaches (funded 20% full-time equivalents), faculty with other funded education positions ("funded"), and faculty without funded education positions ("unfunded") completed a 48-item survey addressing self-efficacy (teaching, professional development, and scholarship), job satisfaction, and burnout. Data were analyzed using analysis of variance followed by post-hoc tests and chi-square tests. To elaborate quantitative results, we conducted qualitative interviews of 15 faculty and analyzed data using framework analysis.

RESULTS

202 of 384 faculty (52.6%) responded to the survey; 187 complete surveys were analyzed. Teaching self-efficacy was similar across groups. Coaches and funded educators had significantly higher professional development self-efficacy and job satisfaction than unfunded educators. Burnout was more prevalent in coaches and unfunded educators. Qualitative analysis yielded three themes: sources of reward, academic identity, and strategies to mitigate burnout. Educator roles provide reward that enhances self-efficacy and job satisfaction but also generate competing demands. Coaches cited challenges in forming professional identities and working with struggling learners.

DISCUSSION

The coaching role provides faculty with benefits similar to other funded educator roles, but the particular demands of the coach role may contribute to burnout.

Moderating effects of national culture on the psychological contract breach and outcome relationship: a meta-analysis

Purpose

This paper contains a meta-analysis of the psychological contract literature published in the last two decades. The aim of this paper was to investigate the moderating role of national culture in the individual-level relationships between psychological contract breach (PCB) and two important work outcomes, namely job performance (in-role and organizational citizenship behaviors) and turnover (actual and intended).

Design/methodology/approach

After an extensive literature search, 134 studies were found which matched the authors’ aim. The authors then incorporated national cultural scores based on the GLOBE study to include country-level scores to identify how the PCB relationships with these four outcomes vary across cultures.

Findings

The findings indicate that national cultural practices moderated the associations between PCB and the four outcomes, yet, no significant moderations for uncertainty avoidance practices.

Originality/value

While existing research has examined the impact of the breach on work outcomes such as job performance and turnover, there are few empirical studies that examine how national cultural practices influence the relationships between psychological contract breach and job performance and turnover. The authors address this need by investigating and creating a deeper insight into how cultural practices such as institutional collectivism, performance-orientation, power-distance, future orientation and gender egalitarianism moderate the relationships between PCB and job performance and turnover.

Self-development Tools Utilized by Plastic Surgeons: A Survey of ASPS Members

The plastic surgery literature is devoid of research on the topic of professional development tools that may be used to enhance performance as a plastic surgeon. After an extensive review of the medical literature, we selected the most frequently referenced professional development tools utilized by plastic surgeons, which included the following: goal setting, positive visualization, scheduled practice, critically analyzing mistakes, professional development conferences, involvement in sports, motivational videos, podcasts & audiobooks, daily morning routines, self-development books, and advice from mentors.

METHODS

A 10-question survey was sent to 2542 members of the American Society of Plastic Surgeons (ASPS). The algorithm used to select ASPS members to survey was based on member demographics that would best reflect the views of the entire active society membership. Responses were compared based on demographic factors such as type of practice, gender, and age.

RESULTS

A total of 286/2542 (11.25%) ASPS members participated in the survey. Analyzing mistakes (96.3%), goal setting (88.51%), and advice from mentors (85.2%) were most commonly attributed to self-development. Respondents in an academic practice favored conferences and advice from mentors. Participants in a solo practice favored self-help books and morning routines. No statistical differences were observed based on training background.

CONCLUSIONS

ASPS members attribute their professional development to setting measurable goals, carefully analyzing surgical mistakes, and guidance from mentors. This information opens the door for continued analysis of professional development within plastic surgery as well as supplement training practices at the resident and post-graduate level.

Wellness for the Future: Cultural and Systems-based Challenges and Solutions

The goal of the 2019 Society for Academic Emergency Medicine Consensus Conference was to explore the current cultural and systemic issues in emergency medicine that impact the individual well-being of every emergency physician and to make recommendations for future study. Burnout is epidemic in emergency medicine. Physician wellness is required to enhance patient clinical outcomes as well as to ensure professional satisfaction and longevity. For conference preparation, a consensus steering committee was created, and a decision was made to use the groundbreaking model of the National Academy of Medicine's "Factors Affecting Clinician Well-Being and Resilience" to further identify areas of needed study. On May 14, 2019, the Wellness Consensus Conference was attended by over 50 faculty physicians from across the United States. These attendees discussed key concepts and prior research presented by content experts. Groups of participants engaged in crowdsourcing techniques to consolidate ideas derived from those discussions. These consensus concepts were recorded and are presented within this article. A repetitive theme noted at the conference was the overwhelming effect of the system and organization factors on individual physician well-being. The concept of ongoing assessment of professional fulfillment over the life span of the emergency physician was felt to be crucial in guiding wellness and resilience interventions in a timely manner. Examining ways to enable physicians to flourish rather than experience burnout are strong future directions for study.

"A Friendly Place to Grow as an Educator": A Qualitative Study of Community and Relationships Among Medical Student Coaches

PURPOSE

The rise of coaching programs in medical education sparks questions about ways to support physician coaches in learning new educational practices specific to coaching. How coaches learn from one another is of particular interest considering the potential value of social learning. Using communities of practice as a conceptual framework, the authors examine the sense of community and relationships among coaches in a new medical student coaching program, the value of this community, and the facilitators and barriers influencing community development.

METHOD

In this qualitative study, investigators conducted 34 interviews with physician coaches at 1 institution over 2 years (2017-2018) and observed 36 coach meetings. Investigators analyzed interview transcripts using thematic analysis and used observation field notes for context and refinement of themes.

RESULTS

Coaches described a sense of community based on regular interactions; shared commitment to medical education; and new roles with similar experiences, joys, and challenges. They valued the sense of camaraderie and support, learning from one another, and opportunities for professional growth that strengthened their identities as educators and enhanced job satisfaction. Facilitators of community included regular meetings, leadership and administrative support, and informal opportunities to interact outside of meetings. Barriers included time constraints and geographic challenges for coaches at off-site locations.

CONCLUSIONS

The sense of community among coaches was a valued and beneficial part of their coaching experience. Coaches' interactions and relationships promoted skill acquisition, knowledge transfer, professional development, and career satisfaction. Thus, incorporating support for social learning in coaching programs promotes coach faculty development.