Purpose The Professional Development Coaching Program (PDCP) is a physician coaching program founded on the principles of positive psychology that has been shown to improve burnout and well-being in residents. The experience of the physician faculty coaches is not well understood. We studied the impact of a longitudinal coaching intervention on the experience of coaches. Methods From 2017 to 2019, faculty from Surgery, Pediatrics, and Medicine at an academic medical center participated as coaches in the PDCP. Coaches underwent training in positive psychology and coaching skills and coached trainees for one or two years. Surveys were performed at baseline, after 1 year (EOY-1), and after 2 years of coaching (EOY-2). Outcomes include burnout and professional fulfillment (Stanford Professional Fulfillment Index), well-being (PERMA), and experience with coaching skills. Surveys from each timepoint were paired and analyzed through bivariate analyses and multivariate linear regression. Results Of the 136 coaches who participated, 44% submitted sufficient data for paired analysis. There was no change from pre-to post-in primary outcomes on bivariate analysis. On linear regression, burnout and PERMA scores declined from baseline but did not change from EOY-1 to EOY-2. Coaches reported increased coping skills on EOY surveys compared to baseline. Confidence with coping skills was associated with low burnout, high professional fulfillment, and high PERMA. Conclusions These findings create a profile of physician coaches and demonstrate both the benefits and changes in burnout and well-being that they experience. Larger studies with comparison groups can further explore the effects of coaching on the coach.
Background Cubital tunnel syndrome (CuTS) is the second most common peripheral neuropathy in the United States. All three current surgical treatment approaches, consisting of in situ decompression, medial epicondylectomy, and transposition, require large curvilinear incisions and dissections that cross the medial epicondyle. However, the use of a large curvilinear incision may not be necessary for in situ decompression and may be achieved with small incisions proximal and distal to the medial epicondyle. This may limit the risk of peri-incisional pain and numbness, similar to the benefits provided by endoscopy. Objective The aim of this study is to evaluate a minimally invasive tunneling approach for in situ ulnar nerve decompression utilizing 2 cm incisions proximal and distal to the medial epicondyle. Methods A retrospective chart review was performed for patients at Emory University Hospital with CuTS who underwent minimally invasive tunneling for in situ decompression. Seven cases were identified. Patient demographics and data on post-operative complications were collected. Pre-operative severity was graded as a Modified McGowan severity. The primary outcome was evaluated using the post-surgical Messina Criterion. Secondary outcomes were reports of peri-incisional pain or numbness evaluated at follow-up. Descriptive statistics are presented. Results Pre-operatively, one of the seven cases was Grade I McGowan and the remaining six were Grade 2a or 2b. Post-operatively, on the Messina Criterion, four of seven patients were rated as having “Good” outcomes, two of seven had “Fair”, while one of seven had “Poor.” There was one post-operative surgical site infection. Among the other six cases, there were no reports of peri-incisional pain or numbness. Conclusions The use of less-invasive tunneling approach to in situ decompression yielded positive outcomes in this case series with no reports of peri-incisional pain or numbness. A prospective trial may be useful to explore the theoretical benefits of this novel tunneling approach.
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