Heard, valued, supported? Doctors' wellbeing during transitions triggered by COVID‐19

Abstract

Introduction: Supporting doctors' wellbeing is crucial for medical education to help minimise negative long-term impacts on medical workforce retention and ultimately patient care. There is limited study of how doctors' transitions experiences impact wellbeing, particularly socially and culturally. Multiple Multidimensional Transitions (MMT) theory views transitions as dynamic, incorporating multiple contexts and multiple domains.Using MMT as our lens, we report a qualitative analysis of how transitions experienced by doctors during the pandemic impacted on social and cultural aspects of wellbeing. Methods: Longitudinal narrative inquiry was employed, using interviews and audio-diaries. Data were collected over 6 months in three phases: (i) interviews with doctors from across the career spectrum (n = 98); (ii) longitudinal audio-diaries for 2-4 months (n = 71); (iii) second interviews (n = 83). Data were analysed abductively, narrowing focus to factors important to social and cultural wellbeing. Results: Doctors described experiencing multiple interacting transitions triggered by the pandemic in multiple contexts (workplace, role, homelife and education). Patterns identifiable across the dataset allowed us to explore social and cultural wellbeing crosscutting beyond individual experience. Three critical factors contributed to social and cultural wellbeing both positively and negatively: being heard (e.g., by colleagues asking how they are); being valued (e.g., removal of rest spaces by organisations showing lack of value); and being supported (e.g., through regular briefing by education bodies). Conclusions: This study is the first to longitudinally explore the multiple-multidimensional transitions experienced by doctors during the COVID-19 pandemic. Our data analysis helped us move beyond existing perceptions around wellbeing and articulate multiple factors that contribute to social and cultural wellbeing. It is vital that medical educators consider the learning from these experiences to help pinpoint what aspects of support might be beneficial to trainee doctors and their trainers. This study forms the basis for developing evidenced-based interventions that ensure doctors are heard, valued and supported.

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“…In a longitudinal narrative inquiry using multiple multidimensional transitions theory, which takes account of the dynamic nature of transitions, Gordon et al. explored doctors' well‐being during transitions due to the pandemic across the career continuum and multiple specialties in Scotland [ 17 ]. Doctors experienced multiple transitions during the pandemic in various contexts including workplace, role, home‐life and education.…”

Damaged, discouraged and defeated? How mindset may offer hope for healing

“…Yeager and Dweck identified those who can benefit most from mindset interventions are those at the intersection of vulnerability and opportunity—in other words, those who have a fixed mindset while being supported by a growth mindset environment 2,4,9 . Gordon and colleagues advocated for greater organisational attention in developing longitudinal and consistent support for providers by not assuming that temporary and impersonal solutions will suffice 1 . In addition, an organisation can benefit from adopting a growth mindset culture that values transparency, is willing to respond quickly to challenges and offers genuine apologies to personnel when an error has occurred.…”

“…Gordon and colleagues, however, confirmed that most healthcare providers and educators are also depleted from the trauma of transition triggered by COVID-19. 1 Most healthcare providers and educators are also depleted from the trauma of transition triggered by COVID-19.…”

“…In their research, the authors illuminate the impact of COVID‐19 on provider well‐being and the broad reach of transitional experiences across our personal and professional lives. In the process, they identified three critical factors that contribute to our social and cultural well‐being—whether we feel heard , valued and supported 1 . They highlighted the weight imposed on our various support channels, the perceived stigma within our communities about asking for help and the temporary relief provided by our organisations 1 .…”

“…Most days I ashamedly lean towards ‘empty’, and I question whether I have the capacity or potential to do anything about it. Gordon and colleagues, however, confirmed that most healthcare providers and educators are also depleted from the trauma of transition triggered by COVID‐19 1 …”