The role of feedback in ameliorating burnout

Gordon, Emily K.; Baranov, Dimitry; Fleisher, Lee A.

doi:10.1097/aco.0000000000000583

Cited by 13 publications

(9 citation statements)

References 33 publications

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“…Medical students widely fear loss of empathy in a depersonalizing healthcare system (Eisenstein, 2018), and indeed this may be one reason why travel to distant sites to interact with patients in indigenous settings remains cathartically appealing. Perhaps GHEs can be offered to enhance resilience among medical trainees and clinicians who seek to regain meaning in their practice through empathic communication with patients as they express a common sense of shared humanity (Center et al, 2003;Gordon, Baranov, & Fleisher, 2018;Kline, Harford, & Culp, 2018). Walker, R. J., Campbell, J.…”

Section: Discussionmentioning

confidence: 99%

The Potential Impact of Morality on Medical Student Global Health Participation

Rowe¹,

Post²

2019

GJHS

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Interest in global health experiences (GHEs) has surged in the last decade throughout undergraduate medical education. Positive clinical and cultural learning impacts are well described; however, the moral and motivational typology of the globally minded medical student are yet to be elucidated. We surveyed 85 US medical students, 41 who participated in a GHE during medical school and 44 who did not, to examine their sense of moral association with local community, Americans, and all of humanity. Measures of empathy and spirituality were also administered, as well as a qualitative prompt to elicit reasons for participating, or not, in a GHE. The results of logic regression analysis suggest that the strongest predictors of GHE participation are strong, geographically non-specific identification with ‘all humanity’ [OR=1.31, P<0.01, 95% CI, 1.07–1.59], as well as participation in an abroad experience prior to medical school [OR 141, P<0.01, 95% CI, 10.1–1960]. While respondent groups did not differ significantly in their association with local community, incremental increase in identification with ‘Americans’ decreased likelihood of IME participation by 20% [P=0.02, 95% CI, 0.67–0.96]. No significant effect was found between participant groups in response to empathy or spirituality scales. This pilot study demonstrates that a global regard for ‘all humanity’ may motivate GHE participation while a strong national association diminishes its likelihood.

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Section: Discussionmentioning

confidence: 99%

The Potential Impact of Morality on Medical Student Global Health Participation

Rowe¹,

Post²

2019

GJHS

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“…Finally, feedback should be specific, starting with asking the trainee to identify specific strengths and areas for improvement, and then finding real-life examples to foster this discussion. When done well, feedback has been shown in industry to reduce burnout and increase engagement (Sexton et al 2018), and it has been proposed by others as a tool to reduce medical trainee burnout (Gordon, Baranov, and Fleisher 2018).…”

Section: The Seven Spiritual Work Of Mercy As a Framework To Preventmentioning

confidence: 99%

The Spiritual Works of Mercy as a Tool to Prevent Burnout in Medical Trainees

Shaniuk

2020

Linacre Q

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Burnout is highly prevalent among physicians and is associated with negative patient outcomes. Furthermore, medical training is a particularly vulnerable time as studies show that medical students, residents, and fellows experience burnout and emotional exhaustion at higher rates than both the general population and physicians in practice. Multiple recent studies have demonstrated the practice of religion and spirituality to be protective against burnout in trainees. Can Catholic academic physicians transfer these protective benefits of religion and spirituality to their trainees, who are at the highest risk, and who may or may not share their faith? An ancient Catholic tradition, the Seven Spiritual Works of Mercy, may hold the key. The Spiritual Works of Mercy are listed by the US Conference of Catholic Bishops as Counseling the Doubtful, Instructing the Ignorant, Admonishing the Sinner, Comforting the Sorrowful, Forgiving Injuries, Bearing Wrongs Patiently, and Praying for the Living and the Dead. Using this as a framework, examples of evidenced-based actions from the literature that have been shown to either prevent burnout or to improve the day-to-day experience of medical trainees were discussed. Examples include encouraging trainees to express doubts or to debrief after difficult and saddening cases. Academic physicians can provide instruction, feedback, or admonishment; demonstrate forgiveness of errors; and model the way in bearing wrongs patiently, all while uplifting their trainees in prayer. The Spiritual Works of Mercy can thus become a framework for academic physicians to uplift their trainees’ spirits and potentially prevent against burnout. Summary: Burnout is highly prevalent in medical students and in doctors during their residency or fellowship training, but multiple studies have shown regular practice of Religion and Spirituality to be protective against burnout. The Seven Spiritual Works of Mercy (Counsel the Doubtful, Instruct the Ignorant, Admonish the Sinner, Comfort the Sorrowful, Forgive All Injuries, Bear Wrongs Patiently and Pray for the Living and the Dead) provide a framework of powerful examples for teaching physicians, particularly Catholic teaching physicians, to uplift their students and potentially transfer this benefit to reduce their students’ risk for burnout.

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“…We have summarized the moderators of physician stress (Table). Although some of them are intuitive, many have supporting evidence 3, 4, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17. For demands , the typical set of roles that physicians play are listed, although these will vary for each person.…”

Section: Updated Modelmentioning

confidence: 99%

“…Personal resilience is “the capacity to respond to stress in a healthy way so that goals are achieved at minimal psychological cost.” 4 Workplace resilience can be described as “adaptive reserve” or a work team's ability to adjust mindset and actions as they coordinate care, address quality improvement, and streamline workflows 5 . Resilience of both individuals and workplace teams can be influenced by relationship-centered communication and other practices that enhance insight and mindfulness 4, 5, 10, 11, 12, 13, 14, 15, 16, 17TablePersonal and Workplace Moderators of Physician StressDemandsControlSupportResiliencePersonal Factors • Caretaker role • Income needs • Partner's work• Dependents' schedules• Commute time• Home help• Relationships• Partner support• Family support• Community support• Mindfulness4, 5• Self-care (healthy diet, sleep, exercise)• Gratitude 11 • Compassion for self and others 12 Workplace Factors • Work role • Work hours • Panel size • Time pressure 3 • Case mix 3 • Team staffing 9 • Documentation 10 • Work schedule• Work responsibility 10 • Productivity 3 • Team members' responsibilities 9 • Work resources• Leadership style 8 • Work culture 8 • Values alignment• Supportive colleagues 3 • Team function 5 • Supportive relationships• Team relationships10, 13• Communication10, 13• Managing conflict5, 15• Feedback5, 15• Psychological safety 17 …”

Section: Updated Modelmentioning

confidence: 99%