FRINK Linked Data Fragments server

Matches in SemOpenAlex for { <https://semopenalex.org/work/W2217644280> ?p ?o ?g. }

• W2217644280 endingPage "1184.e1" @default.
• W2217644280 startingPage "1183" @default.
• W2217644280 abstract "Stress, burnout, and depression are significant problems across the continuum of medical education. Burnout is more common among physicians than any other working Americans, estimated to be as high as 50%.1Shanafelt T.D. Boone S. Tan L. Dyrbye L.N. Sotile W. Satele D. et al.Burnout and satisfaction with work-life balance among US physicians relative to the general US population.Arch Intern Med. 2012; 172: 1377-1385Crossref PubMed Scopus (1887) Google Scholar Although the prevalence of depression in physicians is comparable with that of the general population (12% self-identified in men, 19.5% in women), the rate of suicide is much higher (particularly in women physicians),2Center C. Davis M. Detre T. Ford D.E. Hansbrough W. Hendin H. et al.Confronting depression and suicide in physicians: a consensus statement.JAMA. 2003; 289: 3161-3166Crossref PubMed Scopus (453) Google Scholar with as many as 400 each year. Increased rates of suicidal ideation have been found in medical students (11.2%)3Dyrbye L. Thomas M.R. Massie F.S. Power D.V. Eaker A. Harper W. et al.Burnout and suicidal ideation among US medical students.Ann Intern Med. 2008; 149: 334-341Crossref PubMed Scopus (855) Google Scholar and surgeons (6.3%), compared with a 3.3% prevalence in the general population.4Shanafelt T.D. Balch C.M. Dyrbye L. Bechamps G. Russel T. Satele D. et al.Special report: suicidal ideation among American surgeons.Arch Surg. 2011; 146: 54-62Crossref PubMed Scopus (506) Google Scholar Residency training is a time of high risk, with depression rates higher in residents than the general population,2Center C. Davis M. Detre T. Ford D.E. Hansbrough W. Hendin H. et al.Confronting depression and suicide in physicians: a consensus statement.JAMA. 2003; 289: 3161-3166Crossref PubMed Scopus (453) Google Scholar and burnout rates as high as 74% in pediatric residents.5Fahrenkopf A.M. Sectish T.C. Barger L.K. Sharek P.J. Lewin D. Chiang V.W. et al.Rates of medication errors among depressed and burnt out residents: prospective cohort study.BMJ. 2008; 336: 488-491Crossref PubMed Scopus (754) Google Scholar Trainees are calling for increased attention to mental health issues and well-being during residency and fellowship training.6Daskivich T.J. Jardine D.A. Tseng J. Correa R. Stagg B.C. et al.Promotion of wellness and mental health awareness among physicians in training: perspective of a national, multispecialty panel of residents and fellows.J Grad Med Educ. 2015; 7: 143-147Crossref PubMed Scopus (76) Google Scholar, 7Goldman M. Shah R. Bernstein C.A. Depression and suicide among physician trainees: recommendations for a national response.JAMA Psychiatry. 2015; 72: 411-412Crossref PubMed Scopus (77) Google Scholar, 8Jennings M. Slavin S.J. Resident wellness matters: optimizing resident education and wellness through the learning environment.Acad Med. 2015; 90: 1246-1250Crossref PubMed Scopus (104) Google Scholar Mental health issues represent a significant burden of suffering for physicians and negatively affect quality of patient care and safety outcomes, including errors and decreased adherence to best practices. In one study, anesthesia residents with burnout or depression were less likely to read about the next day's surgery or visit patients before surgery.9Oliveira G.S. Chang R. Fitzgerald P.C. et al.The prevalence of burnout and depression and their association with adherence to safety and practice standards: a survey of United States anesthesiology trainees.Anesth Analg. 2013; 117: 182-193Crossref PubMed Scopus (202) Google Scholar Medicine residents with burnout were more likely to discharge patients early to get them off their service.10Shanafelt T.D. Bradley K.A. Wipf J.E. Back A.L. Burnout and self-reported patient care in an internal medicine residency program.Ann Intern Med. 2002; 136: 358-367Crossref PubMed Scopus (1436) Google Scholar Pediatric residents with depression made 6 times more medication errors than their peers.5Fahrenkopf A.M. Sectish T.C. Barger L.K. Sharek P.J. Lewin D. Chiang V.W. et al.Rates of medication errors among depressed and burnt out residents: prospective cohort study.BMJ. 2008; 336: 488-491Crossref PubMed Scopus (754) Google Scholar Burnout has been generally associated with unprofessional behavior.11Dyrbye L. Massie Jr., F.S. Eacker A. Harper W. Power D. Durning S.J. et al.Relationship between burnout and professional conduct and attitudes among US medical students.JAMA. 2010; 304: 1173-1180Crossref PubMed Scopus (548) Google Scholar Contributors to resident stress include heavy workload, sleep deprivation, relocation issues, poor learning environments, family issues, and debt burden.12Levey R.E. Sources of stress for residents and recommendations for programs to assist them.Acad Med. 2001; 76: 142-150Crossref PubMed Scopus (200) Google Scholar Duty hour restrictions have the potential to decrease fatigue, however, the resultant shift compression and fracture of care with frequent hand-offs combine to make residents' hours in the hospital difficult. Even with duty hour restrictions, few nonsleep, nonwork hours are left in an 80-hour work week. Frustration with service-to-education imbalance can also contribute to poor morale. The psychological makeup of residents can contribute to stress of residency training. Medical students have high rates of maladaptive perfectionism, characterized by unrealistic, unattainable, or unsustainable standards of organization, order, or accomplishment. Many may also suffer from imposter syndrome: feelings of inadequacy in the face of demonstrated competence. Given less responsibility for patient care, students may graduate from medical school feeling ill-prepared to begin residency despite a high record of achievement. If they receive limited feedback early in their training, first-year residents may default to believing that they are incompetent and even dangerous. They may feel ill-equipped to face the ambiguity that attends health care, where diagnoses may be uncertain or elusive, and therapeutic options may be limited or imperfect. Although many medical students seek mental health services, substantial barriers to mental health care in residency exist including relocation and change in provider, time, less flexible schedules, and stigma.13Ey S. Moffit M. Kinzie J.M. Choi D. Girard D.E. “If you build it, they will come:” attitudes of medical residents and fellows about seeking services in a resident wellness program.J Grad Med Educ. 2013; 5: 486-492Crossref PubMed Google Scholar, 14Gross C.P. Mead L.A. Ford D.E. Klag M.J. Physician, heal thyself? Regular source of care and use of preventive health services among physicians.Arch Intern Med. 2000; 160: 3209-3214Crossref PubMed Scopus (109) Google Scholar Many residents are hesitant to disclose mental health issues for fear of being considered “weak” or out of concerns about reporting requirements related to mental health care in credentialing and licensing.15Miles S.H. A piece of my mind. A challenge to licensing boards: the stigma of mental illness.JAMA. 1998; 280: 865Crossref PubMed Google Scholar Well-being and mental health issues need to be addressed during training to promote healthier trainees in our programs and to establish self-care habits for later practice. Developing such programs requires attention to both institutional and departmental learning climates.16Dunn P.M. Arnetz B.B. Christensen J.F. Homer L. Meeting the imperative to improve physician well-being: assessment of an innovative program.J Gen Intern Med. 2007; 22: 1544-1552Crossref PubMed Scopus (129) Google Scholar At the institutional level, robust house staff mental health services must be available for acute and ongoing issues. Attention to workflow issues, adequacy of supervision, duty hours, and fatigue mitigation are mandated by the Accreditation Council for Graduate Medical Education's Clinical Learning Environment Review and its Institutional Requirements, and is assessed in the annual resident survey. We propose several initiatives that can be implemented at a departmental level to complement institutional infrastructure, beginning in orientation and continuing throughout the program, with policies, curriculum, mentoring, faculty development, and departmental leadership (Table; available at www.jpeds.com). Departmental leadership who demonstrate commitment to physician mental health and well-being is critical to the success of the described programs. A chairman's statement about the importance of self-care can shape the departmental culture. Faculty members must lead by example, working when they are healthy and encouraging trainees to do the same. Leadership can also come from a departmental resident well-being committee, as trainee input is critical to the successful development and implementation of departmental programs. The departmental orientation provides an opportunity to articulate the commitment to supporting resident health and well-being, and to destigmatize mental health care. Although orientations typically focus on compliance training and boot camp-style skills building activities, there is a need to address potential stressors and highlight available support. We also recommend a “check-in” with trainees early in the second month to discuss their performance strengths and challenges, coping with uncertainty, adjusting to the 80-hour work week, work-life balance, self-care, and learning. Departments need to develop and disseminate policies for supervision and coverage for illness and health care. Case vignettes for discussion of challenges in implementing these policies are one way to ensure that residents, faculty, and nurses know the policies and how to apply them. Residents can be provided with tools to help cope with the stresses and demands of residency and to build and maintain resilience,17Howe A. Smajdor A. Stockl A. Towards an understanding of resilience and its relevance to medical training.Med Educ. 2012; 46: 349-356Crossref PubMed Scopus (234) Google Scholar including ways to cultivate positive emotions, combat negativity bias, deal with maladaptive perfectionism and imposter syndrome, and enhance emotional self-regulation. Process groups, monthly 1-hour meetings with a facilitator in which residents discuss challenges in patient care, work-life balance, and strategies to cope with stressors can also be a useful approach.18Eckleberry-Hunt J. Van Dyke A. Lick D. Tucciarone J. Changing the conversation from burnout to wellness: physician well-being in residency training programs.J Grad Med Educ. 2009; 1: 225-230Crossref PubMed Google Scholar Unprofessional behaviors in the learning environment can cause stress and demoralization. The informal and hidden curricula, implicit and unconscious learning through ad hoc interactions, and the culture of the learning environment are powerful determinants of the professionalization of our trainees.19Hafferty F. Beyond curriculum reform: confronting medicine's hidden curriculum.Acad Med. 1998; 73: 403-407Crossref PubMed Scopus (1179) Google Scholar Creating a forum for discussion of professional lapses, exemplary professional behaviors, and challenges to professional behavior, allows a department to calibrate desired as well as unacceptable behaviors. Case vignettes can be developed as vehicles for this type of discussion, empowering residents to speak about witnessed unprofessional behaviors, and decreasing the likelihood that they will be perpetuated. A number of factors combine to make training in the new millennium a potentially isolating experience including shorter shifts, rapid turnover of teams, and an overburdened faculty attending to their own work-life balance. Structured faculty mentorship programs with clearly articulated goals and expectations can help encourage meaningful professional relationship-building between trainees and faculty. Peer mentors, recruited from senior trainees, may also be helpful. Faculty development such as training in more effective ways to teach and provide feedback in the clinical setting is essential in promoting a healthy and stimulating learning environment. Additional topics for faculty development include physician mental health and recognizing burnout and impairment in trainees. Physician mental health and well-being affects physicians, their families, and patient care. Habits of self-care should begin in residency to positively impact the training period and beyond. Studies have shown that the culture of the training environment has profound consequences on clinical outcomes.20Asch D.A. Nicholson S. Srinivas S. Herrin J. Epstein A.J. Evaluating obstetrical residency programs using patient outcomes.JAMA. 2009; 302: 1277-1283Crossref PubMed Scopus (223) Google Scholar The attitudes of the training program around physician well-being will likely impact physician job satisfaction and personal health. It is our responsibility to attend to our trainees' health and well-being and develop departmental programs for this purpose, not only to decrease suffering and suicide risk, but also to create healthy and fulfilled physicians who can provide the best patient care throughout a life-time of practice. Most importantly, training programs need to demonstrate that physician self-care is not an indulgence, but an essential component of the profession." @default.
• W2217644280 created "2016-06-24" @default.
• W2217644280 creator A5006725655 @default.
• W2217644280 creator A5083023323 @default.
• W2217644280 date "2015-12-01" @default.
• W2217644280 modified "2023-10-16" @default.
• W2217644280 title "Addressing Resident and Fellow Mental Health and Well-Being: What Can You Do in Your Department?" @default.
• W2217644280 cites W1487296641 @default.
• W2217644280 cites W1585496667 @default.
• W2217644280 cites W1980358660 @default.
• W2217644280 cites W1982844855 @default.
• W2217644280 cites W1992103059 @default.
• W2217644280 cites W1995878172 @default.
• W2217644280 cites W2016338017 @default.
• W2217644280 cites W2024903253 @default.
• W2217644280 cites W2050164480 @default.
• W2217644280 cites W2053682921 @default.
• W2217644280 cites W2092771645 @default.
• W2217644280 cites W2098209289 @default.
• W2217644280 cites W2107596060 @default.
• W2217644280 cites W2108690826 @default.
• W2217644280 cites W2119200560 @default.
• W2217644280 cites W2122088523 @default.
• W2217644280 cites W2154983676 @default.
• W2217644280 cites W2163705978 @default.
• W2217644280 cites W2168750586 @default.
• W2217644280 cites W2409262096 @default.
• W2217644280 doi "https://doi.org/10.1016/j.jpeds.2015.09.037" @default.
• W2217644280 hasPubMedId "https://pubmed.ncbi.nlm.nih.gov/26611453" @default.
• W2217644280 hasPublicationYear "2015" @default.
• W2217644280 type Work @default.
• W2217644280 sameAs 2217644280 @default.
• W2217644280 citedByCount "14" @default.
• W2217644280 countsByYear W22176442802017 @default.
• W2217644280 countsByYear W22176442802018 @default.
• W2217644280 countsByYear W22176442802019 @default.
• W2217644280 countsByYear W22176442802020 @default.
• W2217644280 countsByYear W22176442802021 @default.
• W2217644280 countsByYear W22176442802023 @default.
• W2217644280 crossrefType "journal-article" @default.
• W2217644280 hasAuthorship W2217644280A5006725655 @default.
• W2217644280 hasAuthorship W2217644280A5083023323 @default.
• W2217644280 hasBestOaLocation W22176442801 @default.
• W2217644280 hasConcept C118552586 @default.
• W2217644280 hasConcept C134362201 @default.
• W2217644280 hasConcept C512399662 @default.
• W2217644280 hasConcept C71924100 @default.
• W2217644280 hasConcept C74909509 @default.
• W2217644280 hasConceptScore W2217644280C118552586 @default.
• W2217644280 hasConceptScore W2217644280C134362201 @default.
• W2217644280 hasConceptScore W2217644280C512399662 @default.
• W2217644280 hasConceptScore W2217644280C71924100 @default.
• W2217644280 hasConceptScore W2217644280C74909509 @default.
• W2217644280 hasIssue "6" @default.
• W2217644280 hasLocation W22176442801 @default.
• W2217644280 hasLocation W22176442802 @default.
• W2217644280 hasOpenAccess W2217644280 @default.
• W2217644280 hasPrimaryLocation W22176442801 @default.
• W2217644280 hasRelatedWork W2012178436 @default.
• W2217644280 hasRelatedWork W2028233006 @default.
• W2217644280 hasRelatedWork W2154913456 @default.
• W2217644280 hasRelatedWork W2184085383 @default.
• W2217644280 hasRelatedWork W2207934733 @default.
• W2217644280 hasRelatedWork W2280850722 @default.
• W2217644280 hasRelatedWork W2435230023 @default.
• W2217644280 hasRelatedWork W2468209686 @default.
• W2217644280 hasRelatedWork W2884967889 @default.
• W2217644280 hasRelatedWork W4385683996 @default.
• W2217644280 hasVolume "167" @default.
• W2217644280 isParatext "false" @default.
• W2217644280 isRetracted "false" @default.
• W2217644280 magId "2217644280" @default.
• W2217644280 workType "article" @default.