Promoting student well-being in medical education: A behind the scenes approach (C. Brazeau)

Transcription

1 R3 - Research presentations Promoting student well-being in medical education: A behind the scenes approach (C. Brazeau) Ville-Marie, Friday, Oct. 26, 2012 (2 pm-3:30 pm)

2 Promoting student well-being in medical education: A Behind the Scenes approach A research in action presentation Chantal Brazeau, MD UMDNJ-New Jersey Medical School

3 My journey Winding road I took Grants as illustration of my evolution Many grants Problems Ultimate benefits

4 Objectives Behind the Scenes approach to support student well-being Recognize educational interventions that contribute to student well-being Examine how this can be applied to your own environment

5 My journey begins Family Medicine residency Private practice (burnout) Psychiatry residency : faculty in Family Medicine and Psychiatry

6 Initial overt approaches Physician stress / burnout lecture Relaxation techniques PBL cases / small group activities Committee on Student Affairs Individual treatment of students Other work: humanism, professionalism, grants, curriculum development

7 : Refocus My own career passion Well-being must be ingrained within the curriculum

8 Overt application: 2007 A medical school curriculum on self care, burnout and service learning to enhance quality of care Integrated lectures / activities each year and transition Improve coordination of service learning activities to improve meaning

9 Reviewers comments Compelling case of effect of stress and work dissatisfaction [ ] on quality of care Does not sufficiently address service in underserved communities

10 Research in action article Krasner, Epstein, et al. Association of an educational program in mindful communication with burnout, empathy and attitudes among primary care physicians JAMA : Year long program: mindfulness meditation, narrative medicine / reflection, appreciative inquiry (AI), self-awareness exercises, didactics, discussion

11 Research in action article Improved well-being (burnout, mood), empathy, and psychosocial beliefs (patientcentered approach) Funded by: Physician s Foundation for Health Care Excellence / NY Chapter of American College of Physicians

12 What I took from this article Inspiring: they found funders They linked interventions used in medical education (AI, narratives) to improved wellbeing using validated instruments Patient-centered approach links to my work on humanism and professionalism Links to primary care More open minded about ways to impact well-being and obtain funding

13 Next: Service learning 2010 Expanding primary care service learning opportunities for medical students in a medically underserved community using narrative medicine and mindful communication techniques to foster student well-being and satisfaction with primary care they will provide in this service experience

14 Foundation grants A program for medical student wellbeing to advance humanism and professionalism A program to enhance medical student well-being and team work Using appreciative inquiry and reflection techniques in a multi-disciplinary studentled free clinic: a hands-on model to teach professionalism

15 Now what? Re-evaluated how overt I should be in my applications while maintaining my professional integrity, my goals to support well-being, and my own work satisfaction

16 The move to Behind the Scenes Became satisfied knowing that many goals could be met with these techniques; wellbeing could be addressed even if not the highlight of the application or obvious to students

17 Service-learning 2011 Teaching innovative primary care practice models in a student-run free clinic PCMH (patient-centered attitudes) Interprofessional (AI) QA/QI activities (AI) LCME requirements (reflection) Hands-on experience in their own clinic (control / meaning)

18 Funding success!!!! Luck A better fit? But had we strayed too far from wellbeing?

19 One year later Pride of improving their own clinic (control / meaning) Interprofessional: support QA/QI projects: popular, positive Reflection sessions going well School support: good fit with the culture Change in teaching: teachable moments, more enjoyable

20 Related benefits Wellness sessions for patients evolved in sessions to help students for Step 1 Getting known from grant applications: Invited to task force / grand rounds about well-being, to be house mentor for small learning communities More meaningful relationship with students; helps my own well-being

21 My journey continues Clearer view More grants Overt Behind the Scenes

22 Lessons learned Overt approaches are important but may not attract all students or may be understood only later Behind the Scenes still requires direction by the teacher but may be better accepted Behind the Scenes May take many forms May open the door to funding Is an approach in its own right

23 Are there potential Behind the Scenes approaches in your environment?