Medical trainees are at high risk for developing burnout. Introducing trainees to the risks of burnout and supporting identification and proactive responses to their 'warning' signs of compassion fatigue (CF) is critical in building resiliency. The authors developed and evaluated a burnout and CF program for third year trainees at a Canadian Medical School. Of 165 medical trainees who participated in the burnout and CF program, 59 (36%) provided evaluation and feedback of the program and its impact throughout their year. Participation included self-utilization of a validated CF and burnout tool (ProQOL) across three time-points, workshop feedback, and focus group participation. Results highlighted the importance of 1) Recognizing Individual Signs & Symptoms of Stress, CF and Burnout; 2) Normalizing Stress, CF and Burnout for Students and Physicians; 3) Learning to Manage One's Own Stress. A decrease in compassion satisfaction and increase in burnout between beginning and end of third year were found. Further outcomes highlighted the importance of learning, living and surviving CF and burnout in clerkship. Emergent theory reveals the important responsibility educators have to integrate CF and burnout programs into 'the sweet spot' that third year offers, as trainees shift from theoretical to experiential practice as future clinicians.
Objective The objective of this study was to identify essential aspects of exemplary post-discharge stroke rehabilitation as perceived by patients, care partners, rehabilitation providers, and administrators. Design We carried out an exploratory qualitative, multiple case study. Stroke network representatives from four regions of the province of Ontario, Canada each nominated one post-discharge rehabilitation program they felt was exemplary. Setting The programs included: a mixed home- and clinic-based service; a home-based service; a clinic-based service with a stroke community navigator and; an out-patient clinic-based service. Participants Participants included 32 patients, 16 of their care partners, 23 providers, and 5 administrators. Methods We carried out semi-structured qualitative interviews with patients and care partners, focus groups with providers, and semi-structured interviews with administrators. Health records of patient participants were reviewed. Using an interpretivist-informed inductive content analysis, we developed overarching categories and subcategories first for each program and then across programs. Results Across four regions with differing types of programs, exemplary care was characterized by three essential components: stroke and stroke rehabilitation knowledge, relationship built through personalized respectful care, and a commitment to high quality, person-centered care. Conclusion Exemplary post-discharge care included knowledge regarding identification and treatment of stroke-related impairment, that is, information found in best practice guidelines. However, expertise related to building relationship through providing personalized respectful care, within a mutually supportive, improvement-oriented team was also essential. Additionally, administrators played a crucial role in ensuring continued ability to deliver exemplary care.
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