SELFCARE AND WELLBEING AS PROFESSIONAL COMPETENCE IN THE COVID-19 PANDEMIC: RESIDENTS´ WELLBEING PROGRAM
DOI:
https://doi.org/10.17501/24246700.2021.7152Keywords:
higher education, educational innovation, hybrid postgraduate medical education, residents’ wellbeing, COVID-19Abstract
International studies have reported that quality in patient care and safety, as well as the personal well-being of resident doctors, may suffer a detriment if a highly demanding or hostile clinical training environment is present. The objective of the Professionalism and Wellbeing Program for Medical Residents implemented by a university in northern Mexico is to integrate strategies for the development of wellbeing as a professional competence, and to contribute to strengthening clinical training environments, with the intention of improving personal selfcare, wellbeing, and patient care. The program was implemented with the 290 medical residents of the 17 specialty programs from March 2019 and, additionally, an hybrid model was implemented due to the COVID-19 pandemic from April 2020 to date. In February 2019 and 2020, medical residents participated in the induction sessions of the Professionalism and Wellbeing Program and at least in 3 sessions through the semester, in 2019 face-to-face and in 2020 virtually. The chiefs and co-chiefs of residents were trained in a Workshop so they could help other residents in adverse situations. Among the virtual strategies, we implemented an online website, an electronic form for residents´ wellbeing and mentoring follow-up, individual virtual counseling and Balint groups in Zoom. From April 2020 to February 2021, 220 residents registered online their wellbeing follow-up. The topics of greatest interest for discussion selected by the participants (n= 51) in the Balint group sessions were: emotional well-being in health professionals (94.1%) and burnout syndrome (94.1%). These initiatives aim to strengthen the training processes of education, professionalism, and humanism, with the residents as an expression of the social responsibility of the profession to contribute to selfcare, wellbeing, and patient’s care.
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References
Botros, M. & Cooper, A. (2020). The Hidden Curriculum of the COVID-19 Pandemic. Journal of Graduate Medical Education, 12(5), 550–552. https://doi.org/10.4300/JGME-D-20-00502.1
Byrne, L., Holmboe, E., Kirk, L., & Nasca, T. (2021). GME on the Frontlines—Health Impacts of COVID-19 Across ACGME-Accredited Programs. J Grad Med Educ, 13(1), 145–152. https://doi.org/10.4300/JGME-D-20-01539.1
Cordero, M.A., Guerra, D., Felix, C., Davila, J.A. (2017). Programa de profesionalismo y bienestar para médicos residentes (Abstract). Investigación en Educación Médica, Vol. 6, Num. 22, 2017, pp. e37.
Davis, O. C., & Nakamura, J. (2010). A proposed model for an optimal mentoring environment for medical residents: a literature review. Academic medicine: journal of the Association of American Medical Colleges, 85(6), 1060–1066. https://doi.org/10.1097/ACM.0b013e3181dc4aab
Drolet, B. C., & Rodgers, S. (2010). A comprehensive medical student wellness program--design and implementation at Vanderbilt School of Medicine. Academic medicine: journal of the Association of American Medical Colleges, 85(1), 103–110. https://doi.org/10.1097/ACM.0b013e3181c46963
Dyrbye, L. N., Satele, D., Sloan, J., & Shanafelt, T. D. (2014). Ability of the physician well-being index to identify residents in distress. Journal of graduate medical education, 6(1), 78–84. https://doi.org/10.4300/JGME-D-13-00117.1
Dyrbye, L. N., Lipscomb, W., & Thibault, G. (2020). Redesigning the Learning Environment to Promote Learner Well-Being and Professional Development. Academic medicine: journal of the Association of American Medical Colleges, 95(5), 674–678. https://doi.org/10.1097/ACM.0000000000003094
Dyrbye, L. N., Leep Hunderfund, A. N., Winters, R. C., Moeschler, S. M., Vaa Stelling, B. E., Dozois, E. J., Satele, D. V., & West, C. P. (2020). The Relationship Between Burnout and Help-Seeking Behaviors, Concerns, and Attitudes of Residents. Academic medicine: journal of the Association of American Medical Colleges, 10.1097/ACM.0000000000003790. Advance online publication. https://doi.org/10.1097/ACM.0000000000003790
Elliott, A. C., Hynan, L. S., Reisch, J. S., & Smith, J. P. (2006). Preparing data for analysis using microsoft Excel. Journal of investigative medicine: the official publication of the American Federation for Clinical Research, 54(6), 334–341. https://doi.org/10.2310/6650.2006.05038
Fargen, K. M., Drolet, B. C., & Philibert, I. (2016). Unprofessional Behaviors Among Tomorrow's Physicians: Review of the Literature With a Focus on Risk Factors, Temporal Trends, and Future Directions. Academic medicine: journal of the Association of American Medical Colleges, 91(6), 858–864. https://doi.org/10.1097/ACM.0000000000001133
Goldhamer, M., Pusic, M. V., Co, J., & Weinstein, D. F. (2020). Can Covid Catalyze an Educational Transformation? Competency-Based Advancement in a Crisis. The New England journal of medicine, 383(11), 1003–1005. https://doi.org/10.1056/NEJMp2018570
Hu, Y. Y., Ellis, R. J., Hewitt, D. B., Yang, A. D., Cheung, E. O., Moskowitz, J. T., Potts, J. R., Buyske, J., Hoyt, D. B., Nasca, T. J., & Bilimoria, K. Y. (2019). Discrimination, Abuse, Harassment, and Burnout in Surgical Residency Training. The New England journal of medicine, 381(18), 1741–1752. https://doi.org/10.1056/NEJMsa1903759
Jennings, M. L., & Slavin, S. J. (2015). Resident Wellness Matters: Optimizing Resident Education and Wellness Through the Learning Environment. Academic medicine: journal of the Association of American Medical Colleges, 90(9), 1246–1250. https://doi.org/10.1097/ACM.0000000000000842
Kalet, A. & Chou, C.L. (2014). Remediation in Medical Education: A Mid-course Correction. New York: Springer.
Kashiwagi, D. T., Varkey, P., & Cook, D. A. (2013). Mentoring programs for physicians in academic medicine: a systematic review. Academic medicine: journal of the Association of American Medical Colleges, 88(7), 1029–1037. https://doi.org/10.1097/ACM.0b013e318294f368
National Academies of Sciences, Engineering, and Medicine; National Academy of Medicine; Committee on Systems Approaches to Improve Patient Care by Supporting Clinician Well-Being. (2019). Taking Action Against Clinician Burnout: A Systems Approach to Professional Well-Being. Washington, DC: The National Academies Press (US). doi.org/10.17226/25521
Nease, D., Lichtenstein, A., Pinho-Costa, L., Hoedebecke, L. (2018). Balint 2.0: A virtual Balint group for doctors around the world. The International Journal of Psychiatry in Medicine, 2018, Vol. 53(3) 115–125. https://doi.org/10.1177%2F0091217418765036
Rakowsky, S., Flashner, B. M., Doolin, J., Reese, Z., Shpilsky, J., Yang, S., Smith, C. C., & Graham, K. (2020). Five Questions for Residency Leadership in the Time of COVID-19: Reflections of Chief Medical Residents From an Internal Medicine Program. Academic medicine: journal of the Association of American Medical Colleges, 95(8), 1152–1154. https://doi.org/10.1097/ACM.0000000000003419
Ripp, J. A., Privitera, M. R., West, C. P., Leiter, R., Logio, L., Shapiro, J., & Bazari, H. (2017). Well-Being in Graduate Medical Education: A Call for Action. Academic medicine: journal of the Association of American Medical Colleges, 92(7), 914–917. https://doi.org/10.1097/ACM.0000000000001735
Schwartz, D. A., Connerney, M. A., Davila-Molina, M., & Tummalapalli, S. L. (2020). Resident Mental Health at the Epicenter of the COVID-19 Pandemic. Academic medicine: journal of the Association of American Medical Colleges, 10.1097/ACM.0000000000003768. Advance online publication. https://doi.org/10.1097/ACM.0000000000003768
Valdez, J., López, M., Jiménez, M., Díaz Elizondo, J.A., Dávila Rivas, J.A., Olivares, S. (2020). Preparing to help: response strategy of schools of medicine and health sciences to COVID-19 pandemic [Me preparo para ayudar: respuesta de escuelas de medicina y ciencias de la salud ante COVID-19]. Inv Ed Med., 9, 1-11. https://doi.org/10.22201/facmed.20075057e.2020.35.20230
Valdez-García, J. E., Eraña-Rojas, I. E., Díaz Elizondo, J. A., Cordero-Díaz, M. A., Torres-Quintanilla, A., Esperón-Hernández, R. I., & Zeron-Gutiérrez, L. (2020). The role of the medicine student in COVID-19 pandemic. A shared responsibility. [El papel del estudiante de medicina ante la pandemia de COVID-19. Una responsabilidad compartida]. Cirugia y cirujanos, 88(4), 399–401. https://doi.org/10.24875/CIRU.M20000066
Valencia, O., Cordero, M.A., Dávila Rivas, J.A., García Maya, R., De la Rosa, S. (2019). Resident Physician Mentoring Program: Design and Implementation [Programa de mentoreo para médicos residentes: diseño e implementación] (Abstract). ARS MEDICA Revista de Ciencias Médicas. Vol. 44, Suplement 1.
Weiner, S. (2020). Starting residency during a pandemic: What will change? What will stay the same? [News]. Association of American Medical Colleges. Retrieved from: https://www.aamc.org/news-insights/starting-residency-during-pandemic-what-will-change-what-will-stay-same