scholarly journals Power and physician leadership

BMJ Leader ◽  
2019 ◽  
Vol 3 (3) ◽  
pp. 92-98 ◽  
Author(s):  
Anurag Saxena ◽  
Diane Meschino ◽  
Lara Hazelton ◽  
Ming-Ka Chan ◽  
David A Benrimoh ◽  
...  
Keyword(s):  
Interprofessional Education ◽  
Meaning Making ◽  
Well Being ◽  
Power Bases ◽  
Physician Leadership ◽  
Abuse Of Power ◽  
Inappropriate Use ◽  
Physician Leaders ◽  
Study Power ◽  
The Impact

Power and leadership are intimately related. While physician leadership is widely discussed in healthcare, power has received less attention. Formal organisational leadership by physicians is increasingly common even though the evidence for the effectiveness of physician leadership is still evolving. There is an expectation of leadership by all physicians for resource stewardship. The impact of power on interprofessional education and practice needs further study. Power also shapes the profession’s attempts to address physician and learner well-being with its implications for patient care. Unfortunately, the profession is not exempt from inappropriate use of power. These observations led the authors to explore the concept and impact of power in physician leadership. Drawing from a range of conceptualisations including structuralist (French and Raven), feminist (Allen) and poststructuralist (Foucault) conceptualisations of power, we explore how power is acquired and exercised in healthcare systems and enacted in leadership praxis by individual physician leaders (PL). Judicious use of power will benefit from consideration and application of a range of concepts including liminality, power mediation, power distance, inter-related use of power bases, intergroup and shared leadership, inclusive leadership, empowerment, transformational leadership and discourse for meaning-making. Avoiding abuse of power requires moral courage, and those who seek to become accountable leaders may benefit from adaptive reflection. Reframing ‘followers’ as ‘constituents or citizens’ is one way to interrupt discourses and narratives that reinforce traditional power imbalances. Applying these concepts can enhance creativity, cocreation and citizenship-strengthening commitment to improved healthcare. PLs can contribute greatly in this regard to further transform healthcare.

scholarly journals Training interprofessional faculty in humanism and professionalism: a qualitative analysis of what is most important

2022 ◽  
Vol 9 (1) ◽  
pp. 46-47
Author(s):  
Elizabeth A Rider ◽  
Deborah D. Navedo ◽  
William T. Branch, Jr.
Keyword(s):  
Identity Formation ◽  
Learning Environments ◽  
Interprofessional Education ◽  
Well Being ◽  
Care Quality ◽  
Self Awareness ◽  
Use Of Self ◽  
Important Thing ◽  
Relational Capacities ◽  
The Impact

Introduction: The capacity of healthcare professionals to work collaboratively influences faculty and trainees’ professional identity formation, well-being, and care quality. Part of a multi-institutional project*, we created the Faculty Fellowship for Leaders in Humanistic Interprofessional Education at Boston Children’s Hospital/ Harvard Medical School. We aimed to foster trusting relationships, reflective abilities, collaboration skills, and work together to promote humanistic values within learning environments. Objective: To examine the impact of the faculty fellowship from participants’ reports of “the most important thing learned”. Methods: We studied participants’ reflections after each of 16 1½ hour fellowship sessions. Curriculum content included: highly functioning teams, advanced team formation, diversity/inclusion, values, wellbeing/renewal/burnout, appreciative inquiry, narrative reflection, and others. Responses to “What was the most important thing you learned?” were analyzed qualitatively using a positivistic deductive approach. Results: Participants completed 136 reflections over 16 sessions–77% response rate (136/176). Cohort was 91% female; mean age 52.6 (range 32-65); mean years since completion of highest degree 21.4; 64% held doctorates, 36% master’s degrees. 46% were physicians, 27% nurses, 18% social workers, 9% psychologists. 27% participated previously in a learning experience focusing on interprofessional education, collaboration or practice. Most important learning included: Relational capacities/ Use of self in relationships 96/131 (73%); Attention to values 46/131 (35%); Reflection/ Self-awareness 44/131 (34%); Fostering humanistic learning environments 21/131 (16%). Discussion: Results revealed the importance of enhancing relational capacities and use of self in relationships including handling emotions; attention to values; reflection/self-awareness and recognition of assumptions; and fostering humanistic learning environments. These topics should receive more emphasis in interprofessional faculty development programs and may help identify teaching priorities. *Supported in part by a multi-institutional grant from the Josiah Macy, Jr. Foundation (Dr. Branch as PI; Dr. Rider as site PI).

Interprofessional Intervention to Support Mature Women: A Case Study

2015 ◽  
Vol 21 (3) ◽  
pp. 134-143 ◽  
Author(s):  
Judith M. Pechacek ◽  
Diana Drake ◽  
Carrie Ann Terrell ◽  
Carolyn Torkelson
Keyword(s):  
Women’S Health ◽  
Women's Health ◽  
Health Care Providers ◽  
Interprofessional Education ◽  
Well Being ◽  
Collaborative Practice ◽  
Health Needs ◽  
Care Providers ◽  
The Impact

Understanding the impact interprofessional teamwork has on patient outcomes is of great interest to health care providers, educators, and administrators. This article describes one clinical team, Women’s Health Specialists, and their implementation of an interprofessional health intervention course: “Mindfulness and Well-being: The Mature Woman” (MW: MW) to support mature women’s health needs in midlife (age 40–70 years) and empower patient involvement in self-care. The provider team works to understand how their interprofessional education and collaborative practice (IPECP) interventions focused on supporting midlife women are associated with improved quality and clinical outcomes. This case study describes the work of the Women’s Health Specialists clinic in partnership with the National Center for Interprofessional Education and Collaborative Practice to study the impact an interprofessional team has on the health needs of women in midlife. This article summarizes the project structure, processes, outputs, and outcomes. Data collection, analysis, strategy, and next steps for future midlife women’s projects are also discussed.

scholarly journals Keep Calm and Carry On: The Relations Between Narrative Coherence, Trauma, Social Support, Psychological Well-Being, and Cortisol Responses

2021 ◽  
Vol 12 ◽  
Author(s):  
Lauranne Vanaken ◽  
Tom Smeets ◽  
Patricia Bijttebier ◽  
Dirk Hermans
Keyword(s):  
Social Support ◽  
Turning Point ◽  
Meaning Making ◽  
Traumatic Event ◽  
Stress Test ◽  
Well Being ◽  
Narrative Coherence ◽  
Anxiety Levels ◽  
The Impact ◽  
Thematic Coherence

In order to explain trauma resilience, previous research has been investigating possible risk and protective factors, both on an individual and a contextual level. In this experimental study, we examined narrative coherence and social support in relation to trauma resilience. Participants were asked to write about a turning point memory, after which they did the Maastricht Acute Stress Test, our lab analog of a traumatic event. Following, half of the participants received social support, whereas the other half did not. Afterwards, all participants wrote a narrative on the traumatic event. Moment-to-moment fluctuations in psychological and physiological well-being throughout the experiment were investigated with state anxiety questionnaires and cortisol measures. Results showed that narratives of traumatic experiences were less coherent than narratives of turning point memories. However, contrary to our predictions, coherence, and, in particular, thematic coherence, related positively to anxiety levels. Possibly, particular types of thematic coherence are a non-adaptive form of coping, which reflect unfinished attempts at meaning-making and are more similar to continuous rumination than to arriving at a resolution. Furthermore, coherence at baseline could not buffer against the impact of trauma on anxiety levels in this study. Contrary to our hypotheses, social support did not have the intended beneficial effects on coherence, neither on well-being. Multiple explanations as to why our support manipulation remained ineffective are suggested. Remarkably, lower cortisol levels at baseline and after writing about the turning point memory predicted higher coherence in the trauma narratives. This may suggest that the ability to remain calm in difficult situations does relate to the ability to cope adaptively with future difficult experiences. Clinical and social implications of the present findings are discussed, and future research recommendations on the relations between narrative coherence, social support, and trauma resilience are addressed.

scholarly journals The Perceived Impact of COVID-19 on Student Well-Being and the Mediating Role of the University Support: Evidence From France, Germany, Russia, and the UK

2021 ◽  
Vol 12 ◽  
Author(s):  
Maria S. Plakhotnik ◽  
Natalia V. Volkova ◽  
Cuiling Jiang ◽  
Dorra Yahiaoui ◽  
Gary Pheiffer ◽  
...  
Keyword(s):  
University Students ◽  
Degree Completion ◽  
Meaning Making ◽  
Well Being ◽  
Equation Modeling ◽  
Mediating Role ◽  
University Support ◽  
Perceived Impact ◽  
The Impact ◽  
Job Prospects

The rapid and unplanned change to teaching and learning in the online format brought by COVID-19 has likely impacted many, if not all, aspects of university students' lives worldwide. To contribute to the investigation of this change, this study focuses on the impact of the pandemic on student well-being, which has been found to be as important to student lifelong success as their academic achievement. Student well-being has been linked to their engagement and performance in curricular, co-curricular, and extracurricular activities, intrinsic motivation, satisfaction, meaning making, and mental health. The purpose of this study was to examine how student perceptions of their degree completion and future job prospects during the pandemic impact their well-being and what role university support plays in this relationship. We used the conservation of resources theory to frame our study and to develop five hypotheses that were later tested via structural equation modeling. Data were collected from 2,707 university students in France, Germany, Russia, and UK via an online survey. The results showed that university support provided by instructors and administration plays a mediating role in the relationship between the perceived impact of COVID-19 on degree completion and future job prospects and levels of student well-being. Student well-being is decreased by their concerns for their degree completion but not by their concerns for future job prospects. In turn, concerns for future job prospects affect student well-being over time. These results suggest that in a “new normal,” universities could increase student well-being by making support to student studies a priority, especially for undergraduates. Also, universities should be aware of the students' changing emotional responses to crisis and ensure visibility and accessibility of student support.

Employee motivation factors

2015 ◽  
Vol 11 (2) ◽  
pp. 92-106 ◽  
Author(s):  
David Conrad ◽  
Amit Ghosh ◽  
Marc Isaacson
Keyword(s):  
Well Being ◽  
Employee Motivation ◽  
Job Security ◽  
Leadership Education ◽  
Active Part ◽  
Positive Energy ◽  
Content Type ◽  
Quality Healthcare ◽  
Physician Leaders ◽  
The Impact

Purpose – Motivation is a widely explored topic and numerous studies have been done to determine motivation importance and implementation. However, no studies have been identified that investigate what motivators are most important to physicians and if physician leaders agree with the importance physicians place on specific motivational aspects. The purpose of this paper is to investigate this missed management learning opportunity. Design/methodology/approach – A fully inclusive sampling of all (n=2,547) public-practice physicians and physician leaders (clinic and hospital employed, non-private practice) in Minneapolis and St. Paul Minnesota was conducted in the summer and fall of 2013. The surveys were sent in a link via a web survey software program by the study researchers. The surveys were anonymous and minimally intrusive, asking only for perspectives regarding the most important motivational elements by physicians and physician leaders. Findings – Generally, the responses were surprisingly similar between physicians and physician leaders. The two statistically different motivators – interesting work and job security – were ranked as more important by physicians than the physician leaders. This suggests that leaders should be more attentive to ensuring variety, challenge, and engagement is an active part of the physicians’ work. This also suggests that managers should emphasize and reinforce the fact that – if it is the case – jobs are secure and that staffing stability is a key goal for management. As Kovach (1987) suggests, as employees’ income increases, money becomes less of a motivator and as employees get older, interesting work becomes more of a motivator. Research limitations/implications – Conclusions and generalizations can be made about the population sampled. Practical implications – The two statistically different motivators – interesting work and job security – were ranked as more important by physicians than the physician leaders. This suggests that leaders should be more attentive to ensuring variety, challenge, and engagement is an active part of the physicians’ work. This also suggests that managers should emphasize and reinforce the fact that – if it is the case – jobs are secure and that staffing stability is a key goal for management. Social implications – As this study reveals, physicians have clear preferences when it comes to workplace motivation. It is not unreasonable then to determine that the more satisfied the employee, the better he or she will perform. Accordingly, the environment that managers create for their employees must be one that is constructive to positive energy. If employees feel happy when they are working, then they will be naturally encouraged to work, thus producing improved quality healthcare for patients. Originality/value – What are the most important motivators for physicians and do physician leaders understand what motivators are to enhance physician productivity, well-being, and morale? Answers to this question may be beneficial to designing leadership education that enhances the understanding of the impact effectively identified and effectively applied motivation techniques may have on employee behavior and attitudes. Insights will also benefit the design of motivational structures and methods in the healthcare workplace.

Unique benefits of physician leadership – an American perspective

2014 ◽  
Vol 27 (4) ◽  
pp. 272-282 ◽  
Author(s):  
Peter Angood ◽  
Diane Shannon
Keyword(s):  
Public Attitudes ◽  
Healthcare Delivery ◽  
Leadership Competencies ◽  
Career Stage ◽  
Physician Leadership ◽  
Healthcare Organizations ◽  
Content Type ◽  
Physician Leaders ◽  
The Usa ◽  
The Impact

Purpose – This paper aims to present the argument that effective physician leadership is needed to improve the quality and efficiency of healthcare delivery in the USA and around the world. Design/methodology/approach – This paper is based on an in-depth literature review, interviews with physician leaders and a study of the competencies required for physicians to successfully lead healthcare organizations. Findings – The paper finds that a clear need exists for training to improve specific leadership competencies among physicians, regardless of their career stage or career path. Research limitations/implications – Limited research has been conducted on the value of physician leadership and its impact on quality outcomes and patient safety. Practical implications – This paper establishes the need for physician leadership in healthcare organizations. Social implications – This paper will influence public attitudes within the healthcare sphere on the value that physician leaders can bring to healthcare. Originality/value – This paper fulfils a need for more study on the impact that physician leadership brings to quality and patient care, and establishes the need for physician leaders to obtain specific leadership competencies.

scholarly journals Music for Wellness: An 8-Week Study of the Psychosocial Effects of Music Therapy on Cancer Patients

2018 ◽  
Vol 4 (Supplement 2) ◽  
pp. 115s-115s
Author(s):  
D. Tynan ◽  
G. Skaczkowski ◽  
J. Hedigan ◽  
C. Wilson
Keyword(s):  
Music Therapy ◽  
Cancer Patients ◽  
Complementary Therapies ◽  
Meaning Making ◽  
Well Being ◽  
Comprehensive Cancer Center ◽  
Therapy Program ◽  
Patient Reported ◽  
Treatment Research ◽  
The Impact

Background: Music therapy offers patients a way to address the psycho-social impacts of a cancer diagnosis and treatment. Research suggests that complementary therapies, such as music and art therapy, provide an opportunity for patients to express their emotions and make meaning of their experiences, as well as providing social connections to other patients. A better understanding of the specific benefits that may be achieved from these programs and the mechanism through which this might occur will help us better tailor services to patients' needs. While an increasing number of cancer care centers now offer complementary therapies as a way to support patients with cancer, there are few prospective evaluations that examine the benefits derived from program completion beyond patient satisfaction measures. Aim: The aim of this project is to examine the impact of music therapy on specific patient reported outcomes and the factors that influence how and why this occurs. Methods: Participants in an 8-week group music therapy program will be asked to complete a suite of measures prior to program commencement, and at 1-week and 1-month postprogram completion. Measures include core constructs of well-being such as distress, quality of life and symptom severity, as well as constructs specifically targeted by the music therapy program, such as meaning making, emotional expression and social connectedness. A waitlist control will provide comparison data at comparable time-points. Results: The music therapy program will run from April-May 2018, with the postprogram evaluation being completed in June 2018. Preliminary data will be presented and the suitability of this method will be considered. Conclusion: In the context of a comprehensive cancer center in Victoria, Australia, we will present data on the effectiveness of a music therapy program for addressing patients' well-being. We will discuss implications for the provision of supportive care for cancer patients and survivors and how the design of future programs might be tailored to achieve key outcomes.

scholarly journals Impact of COVID-19 on Meaning Making of Dementia Caregivers in Hong Kong: From the Generational Perspectives

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 245-246
Author(s):  
Reynold Leung ◽  
W Q Lou Vivian
Keyword(s):  
Hong Kong ◽  
Depressive Symptoms ◽  
Generation X ◽  
Meaning Making ◽  
Well Being ◽  
Dementia Caregivers ◽  
Two Generations ◽  
Education Support ◽  
The Impact ◽  
Mental Well Being

Abstract This study examined the impact of COVID-19 on meaning making among adult children dementia caregivers and the association with caregiver mental well-being. Adult caregivers (n=601) from two generations, 1946-1964 (Baby Boomers) and 1965-1980 (Generation X), were recruited in Hong Kong between October 2019 and June 2020. Participants were assessed on depressive symptoms (PHQ-9) and meaning making (Finding Meaning Through Caregiving Scale-FMTC). Generation X scored higher on sense of loss (p = 0.04) and lower on provisional meaning of FMTC (p=0.017). Moreover, an interaction effect (p=0.003) between generation and COVID-19 were found. During the pandemic, Generation X caregivers were more likely to suffer from higher losses, higher depressive symptoms (>23.2% moderate to severe) and lower provisional meaning (p=0.03) compared to their boomer counterparts. The level of meaning making is more important to Generation X caregivers, especially in COVID-19 situation. Government should consider generation-responsive services and education support in guiding service implementation.

Measuring Impact of Stress in Sandwich Generation Caring for Demented Parents

GeroPsych ◽  
2014 ◽  
Vol 27 (4) ◽  
pp. 171-179 ◽  
Author(s):  
Laurence M. Solberg ◽  
Lauren B. Solberg ◽  
Emily N. Peterson
Keyword(s):  
Factor Analysis ◽  
Exploratory Factor Analysis ◽  
Social Worker ◽  
Resource Availability ◽  
Well Being ◽  
Sandwich Generation ◽  
Item Questionnaire ◽  
Significant Difference ◽  
Adult Caregivers ◽  
The Impact

Stress in caregivers may affect the healthcare recipients receive. We examined the impact of stress experienced by 45 adult caregivers of their elderly demented parents. The participants completed a 32-item questionnaire about the impact of experienced stress. The questionnaire also asked about interventions that might help to reduce the impact of stress. After exploratory factor analysis, we reduced the 32-item questionnaire to 13 items. Results indicated that caregivers experienced stress, anxiety, and sadness. Also, emotional, but not financial or professional, well-being was significantly impacted. There was no significant difference between the impact of caregiver stress on members from the sandwich generation and those from the nonsandwich generation. Meeting with a social worker for resource availability was identified most frequently as a potentially helpful intervention for coping with the impact of stress.

Efficacy of Crisis Intervention

Crisis ◽  
1999 ◽  
Vol 20 (2) ◽  
pp. 78-85 ◽  
Author(s):  
Thomas Reisch ◽  
Petra Schlatter ◽  
Wolfgang Tschacher
Keyword(s):  
Crisis Intervention ◽  
Intervention Program ◽  
Suicide Ideation ◽  
Indirect Evidence ◽  
Well Being ◽  
Term Therapy ◽  
Contributing Factors ◽  
Step Therapy ◽  
Long Term Therapy ◽  
The Impact

This study assesses the efficacy of the treatment approach implemented in the Bern Crisis Intervention Program, where particular emphasis is placed on the remediation of suicide ideation and suicidal behavior, and depression, fear, and phobia are generally considered to be contributing factors. Four questionnaires addressing psychopathology, emotional well-being, social anxiety, and personality were administered prior to and after the treatment of 51 patients over a period of 2 to 3 weeks. The reduction of symptoms contributing to suicidal ideation and behavior was interpreted as indirect evidence of an antisuicidal effect of the program. Significant improvements were found in the psychopathology ratings, with depression and anxiety showing the largest reductions. The impact on personality and social phobia, however, was only moderate, and on average patients still exhibited symptoms after attending the program. This residual symptomatology points to the necessity of introducing a two-step therapy approach of intensive intervention targeted at the precipitating causes of the crisis, augmented by long-term therapy to treat underlying problems.

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