Improved Perceptions of Education and Wellness Among General Surgery Residents and Faculty After the Implementation of Outpatient Scribes

2021 ◽  
pp. 000313482110249
Author(s):  
Steven Tohmasi ◽  
Ariana Naaseh ◽  
Sean Thompson ◽  
Brian R. Smith
Keyword(s):  
General Surgery ◽  
Residency Program ◽  
Overall Response Rate ◽  
Resident Education ◽  
Well Being ◽  
High Rate ◽  
Surgical Trainees ◽  
Strongly Agree ◽  
Perceptions Of Education

Background Recent studies have revealed a high rate of burnout among general surgery (GS) residents. Efforts to design and implement interventions to mitigate fatigue in surgical trainees are critical. Our aim was to assess the educational and wellness impact of outpatient scribe utilization at an academic GS residency program. Methods Electronic surveys were sent to 38 GS residents and 15 faculties who used outpatient scribes for at least 12 months. Questions were scored on a 5-point Likert scale with answers of “Strongly agree” or “Agree” representing affirmative responses. Results Thirty residents and 14 faculty completed the survey, resulting in an 83% overall response rate. Twenty-eight (93%) residents and 12 (86%) faculty believed that scribes decrease the daily workload of trainees. Twenty-seven (90%) residents felt that scribes allow them more time to focus on patient care and improve the quality of their surgical education. Ninety-three percent of residents (n = 28) and faculty (n = 13) believed that scribes enhance resident well-being. Twenty-four (80%) residents reported that scribes help improve adherence to duty hour restrictions. Twenty-five (83%) residents believed that utilizing scribes is an effective fatigue mitigation strategy for surgical training programs. Conclusion Our findings demonstrate that the implementation of an outpatient scribe program at an academic GS residency program may enhance resident education and wellness.

Quality of Life Change and Individual Differences in Stimulus Screening in Relation to Incidence of Illness

1977 ◽  
Vol 41 (1) ◽  
pp. 267-278 ◽  
Author(s):  
Albert Mehrabian ◽  
Marion Ross
Keyword(s):  
Quality Of Life ◽  
Individual Differences ◽  
Well Being ◽  
High Rate ◽  
Life Change ◽  
Emotional States ◽  
Life Changes ◽  
Comprehensive Description ◽  
High Arousal

A considerable amount of evidence indicates that a high rate of life changes—a source of continued and unavoidable arousal—is detrimental to health and psychological well-being. The present study hypothesized that sustained high-arousal states are unpreferred and that the persistence of unpreferred emotional states is harmful. Using a conceptual framework for a comprehensive description of emotional states and the differential preferences for these, it is possible to make more precise predictions on the illness consequences of emotionally unpreferred life changes. Particular hypotheses which received support were that more arousing life changes are more conducive to illness; that among the more arousing life changes, unpleasant changes are associated with more illness than pleasant ones; that unpleasant life changes are more detrimental to health when combined with dominance-inducing life changes; and that arousing life changes are particularly harmful to more arousable (non-screening) individuals.

scholarly journals Adult Children’s Migration and Health-Related Quality of Life Among Older Nepalese Adults

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 92-93
Author(s):  
Ghimire Ghimire ◽  
Devendra Singh ◽  
Sara McLaughlin ◽  
Dhirendra Nath ◽  
Hannah McCarren ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Adult Children ◽  
Well Being ◽  
High Rate ◽  
Health Related Quality ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Related Quality ◽  
Health Related

Abstract Traditionally, adult children have served as primary caretakers and providers for older Nepalese adults. However, out-migration of adult children for employment and other opportunities is increasing. Health-related quality of life (HRQOL) in older Nepalese adults in general and in the context of adult children’s migration is poorly understood. This study aims to assess HRQOL of older Nepali adults and its relationship with adult children’s migration. We used existing cross-sectional survey data on 260 older adults from the Krishnapur municipality, which has witnessed a high rate of adult migration. HRQOL was assessed using the SF-12, which provides a physical (PCS) and mental (MCS) health component. Scores for PCS and MCS range from 0-100; a higher score indicates better HRQOL. Simple and multiple linear regression were used to assess correlates of HRQOL. Participants had suboptimal HRQOL [mean (±SD): PCS =40.4±9.2 and MCS=45.2±7.7]. After adjusting for covariates, adult children’s migration was associated with lower MCS scores (β: -2.33, 95%CI: -4.21, -0.44). Individuals with more than one child had higher MCS scores (β: 2.14, 95%CI: 0.19, 4.09). Females (β: -3.64, 95%CI: -7.21, -0.06) and those with a history of unemployment (β: -6.36, 95%CI: -10.57, -2.15) had lower PCS scores than their respective counterparts. The presence of one or more chronic conditions was associated with significantly lower PCS and MCS. Our findings suggest that out-migration of adult children may negatively effect HRQOL among older Nepali adults, specifically their psychological well-being. Additional research is needed to investigate potential moderating factors that may serve as important buffers.

scholarly journals Are Canadian urology residency programs fulfilling the Royal College expectations?: A survey of graduated chief residents

2014 ◽  
Vol 8 (3-4) ◽  
pp. 109 ◽  
Author(s):  
Bassel G. Bachir ◽  
Armen G. Aprikian ◽  
Wassim Kassouf
Keyword(s):  
Surgical Procedures ◽  
Royal College ◽  
Residency Program ◽  
Overall Response Rate ◽  
Well Being ◽  
Indirect Hernia ◽  
Residency Programs ◽  
Reconstructive Urology ◽  
Open Pyeloplasty ◽  
Future Work

Introduction: We assess outgoing Canadian urology chief residents’ well-being, their satisfaction with their surgical training, and their proficiency in surgical procedures throughout their residency program.Methods: In 2012 an anonymous survey was sent by email to all 29 graduated urology chief residents across Canada. The survey included a list of all urologic surgical procedures listed by the Royal College of Physicians and Surgeons of Canada (RCPSC). According to the A/B/C classification used to assess competence in these procedures (A most competent, C least competent), we asked chief residents to self-classify their competence with regards to each procedure and we compared the final results to the current RCPSC classification.Results: The overall response rate among chief residents surveyed was 97%. An overwhelming majority (96.4%) of residents agreed that the residency program has affected their overall well-being, as well as their relationships with their families and/or partners (67.8%). Overall, 85.7% agreed that research was an integral part of the residency program and 78.6% have enrolled in a fellowship program post-graduation. Respondents believed that they have received the least adequate training in robotic surgery (89.3%), followed by female urology (67.8%), andrology/sexual medicine/infertility (67.8%), and reconstructive urology (61.4%). Interestingly, in several of the 42 surgical procedures classified as category A by the RCPSC, a significant percentage of residents felt that their proficiency was not category A, including repair of urinary fistulae (82.1%), pediatric indirect hernia repair and meatal repair for glanular hypospadias (67.9%), open pyeloplasty (64.3%), anteriorpelvic exenteration (61.6%), open varicocelectomy (60.7%) and radical cystoprostatectomy (33.3%). Furthermore, all respondents (100%) believed they were deficient in at least 1 of the 42 category A procedures, while 53.6 % believed they were deficient in at least 10 of the 42 procedures.Conclusions: Most residents agree that their residency program has affected their overall well-being as well as their relationships with their families and/or partners. There is also a clear deficiency in what outgoing residents perceive they have achieved and what the RCPSC mandates. Future work should concentrate on addressing this discrepancy to assure that training and RCPSC expectations are better aligned.

scholarly journals To bed or not to bed: the sleep question?

2019 ◽  
Vol 96 (1139) ◽  
pp. 520-524 ◽  
Author(s):  
Chris Brown ◽  
Tarig Abdelrahman ◽  
Wyn Lewis ◽  
John Pollitt ◽  
Richard Egan,
Keyword(s):  
Sleep Quality ◽  
Median Time ◽  
Rem Sleep ◽  
Well Being ◽  
Sleep Efficiency ◽  
Sleep Diary ◽  
Surgical Trainees ◽  
European Working ◽  
Light Sleep

BackgroundSleep deprivation and fatigue from long-shift work impacts doctors’ personal safety, inhibits cognitive performance and risks clinical error. The aim of this study was to assess the sleep quality of surgical trainees participating in European Working Time Directive-compliant training rotations within a UK deanery.MethodsA trainee cohort numbering 38 (21 core, 17 higher surgical trainees, 29 men and 9 women, median age 31 (25–44 years)) completed a sleep diary over 30 days using the Sleep Time (Azumio) smartphone application and triangulated with on-call rosters to identify shift patterns. The primary outcome measure was sleep quality related to rostered clinical duties.ResultsConsecutive 1152 individual sleep episodes were recorded. The median time asleep (hours:min) was 6:29 (5:27–7:19); the median sleep efficiency was 86% (80%–93%); the median light sleep (hours:min) was 2:50 (1:50–3:49); and the median rapid eye movement (REM) sleep (hours:min) was 3:20 (2:37–4:07). Significant adverse sleep profiles were observed in trainees undertaking emergency on-call duty when compared with elective (non-on-call) duty; the median time asleep (hours:min) 5:49 vs 6:43 (p<0.001); the median sleep efficiency was 85% vs 87% (p<0.001); the median light sleep (hours:min) was 2:16 vs 2:58 (p<0.001); and REM sleep (hours:min) was 2:57 vs 3:27 (p<0.001). Recovery of sleep duration, efficiency and quality necessitated five full days of time.ConclusionSurgical emergency on-call duty adversely influences sleep quality. Proper consideration of fail-safe rota design, prioritising sleep hygiene, recovery and well-being, allied to robust patient safety and quality of care should be made a priority.

scholarly journals Novel Changes in Resident Education during a Pandemic: Strategies and Approaches to Maximize Residency Education and Safety

2020 ◽  
Vol 24 (03) ◽  
pp. e267-e271
Author(s):  
Jared Johnson ◽  
Michael T. Chung ◽  
Michael A. Carron ◽  
Eleanor Y. Chan ◽  
Ho-Sheng Lin ◽  
...  
Keyword(s):  
Patient Care ◽  
Residency Program ◽  
Resident Education ◽  
Geographical Location ◽  
Well Being ◽  
Residency Education ◽  
Training Experience ◽  
The Third ◽  
The Core ◽  
Traditional Training

Abstract Introduction The COVID-19 pandemic has led to a reduction in surgical and clinical volume, which has altered the traditional training experience of the otolaryngology resident. Objective To describe the strategies we utilized to maximize resident education as well as ensure patient and staff safety during the pandemic. Methods We developed a system that emphasized three key elements. First and foremost, patient care remained the core priority. Next, clinical duties were restructured to avoid unnecessary exposure of residents. The third component was ensuring continuation of resident education and maximizing learning experiences. Results To implement these key elements, our residency divided up our five hospitals into three functional groups based on geographical location and clinical volume. Each team works for three days at their assigned location before being replaced by the next three-person team at our two busiest sites. Resident teams are kept completely separate from each other, so that they do not interact with those working at other sites. Conclusions Despite the daily challenges encountered as we navigate through the COVID-19 pandemic, our otolaryngology residency program has been able to establish a suitable balance between maintenance of resident safety and well-being without compromise to patient care.

scholarly journals Feasibility and clinical usefulness of the Unified Protocol in women survivors of violence

2022 ◽  
Author(s):  
Jorge Osma ◽  
Alba B. Quilez-Orden ◽  
Vanesa Ferreres-Galán ◽  
María C. Meseguer ◽  
Silvia Ariza
Keyword(s):  
Women Survivors ◽  
Family Relationships ◽  
Public Health Problem ◽  
Well Being ◽  
High Rate ◽  
Reliable Change Index ◽  
Unified Protocol ◽  
Group Format

AbstractViolence against women is a serious public health problem. Worldwide, one in three women experiences violence throughout their lives. According to the triple vulnerability theory, being a survivor of violence could constitute a psychological vulnerability that would favor the appearance of emotional disorders, affecting their health, their style of parenting, and family well-being. The objective of this study is to verify the feasibility and usefulness of Unified Protocol (UP) in a group format for improving emotion regulation in women survivors of violence attended in the Specific Child and Adolescent Intervention Team (SCAIT), a social community service. The sample consists of 11 women who have experienced different types of violence who received the UP through 11 weekly, two-hour long and in group format sessions. Assessments were conducted at pre and post intervention and at 3, 6, and 12 months follow-up. The results of the Multivariate Analysis of Variance (MANOVA) show an increase in quality of life (including family relationships), self-esteem and extraversion scores, and a reduction in interference (including family life), neuroticism, somatization, anxiety, emotional lack of control, negative affect, depression, and emotional rejection scores. This evolution of the scores with the MANOVA takes into account all the evaluation time points (post, and follow-up at 3, 6 and 12 months). The results were statistically significant (p < 0.05), and had large effect sizes (η2p > 0.14). In addition, the reliable change index was calculated to assess the change at an individual level of each of the participants for the different outcomes. 90.9% of the participants rated the quality of the program received as “excellent” and we obtained a high rate of session attendance (82.64%). These results justify the need for randomized controlled clinical studies to demonstrate the feasibility and clinical efficacy of the UP in this context. This intervention would allow to address the needs of this population, by offering them comprehensive care and improving their mental health from a biopsychosocial model. Likewise, it might indirectly improve the well-being of the rest of the family members.

scholarly journals Challenges faced by investigators in conduct of oncology trials during COVID-19 pandemic at Tata Memorial Centre: a cross-sectional survey

2020 ◽  
Vol 7 (4) ◽  
pp. 235
Author(s):  
Devanshi Kalra ◽  
Abhidnya Desai ◽  
Amit Joshi ◽  
Gouri Pantvaidya
Keyword(s):  
Clinical Trials ◽  
Overall Response Rate ◽  
Virus Disease ◽  
Well Being ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Research Participants ◽  
Trial Conduct ◽  
New Methods

<p class="abstract"><strong>Background: </strong>Novel corona virus disease 2019 (COVID-19) pandemic has impacted health care sector adversely and its major impact is seen especially in the field of oncology. One of the areas of cancer care that has been affected is the conduct of clinical trials. Various challenges have emerged in front of the investigators in providing proper treatment and care to the research participants and moreover in safeguarding the rights, safety and well-being of the research participants.</p><p class="abstract"><strong>Methods: </strong>A questionnaire survey was conducted among the oncologists from the major specialties (medical, surgical and radiation) during the lockdown period to assess the challenges faced in conduct of clinical trials during this pandemic.</p><p class="abstract"><strong>Results:</strong> A total of 110 questionnaires were circulated. Of the 110 questionnaires distributed at the Tata Memorial Centre, 50 responded. The overall response rate was 45.45% (50 responses). Majority of investigators (96%) reported that the pandemic affected the initiation of new trials in oncology. 86% investigators reported that COVID-19 situation has resulted in more protocol deviations than usual for ongoing trials also 62% investigators expressed that the quality of the trial data may get affected due to pandemic.</p><p class="abstract"><strong>Conclusion: </strong>Our survey reports that the majority of the researchers are encountering major challenges in conducting clinical trials in an oncology setting during this pandemic. Despite these challenges in trial conduct, efforts are being made by the investigators and their team to adapt to the new methods for effective management of patients in clinical trials.</p>

Perceived Overprotection and Its Association With Quality of Life in Dementia

GeroPsych ◽  
2019 ◽  
Vol 32 (3) ◽  
pp. 125-134
Author(s):  
Mechthild Niemann-Mirmehdi ◽  
Andreas Häusler ◽  
Paul Gellert ◽  
Johanna Nordheim
Keyword(s):  
Quality Of Life ◽  
Patient Autonomy ◽  
Positive Association ◽  
Well Being ◽  
Negative Association ◽  
Significant Positive Association ◽  
Cross Sectional ◽  
People With Dementia ◽  
Mental Well Being

Abstract. To date, few studies have focused on perceived overprotection from the perspective of people with dementia (PwD). In the present examination, the association of perceived overprotection in PwD is examined as an autonomy-restricting factor and thus negative for their mental well-being. Cross-sectional data from the prospective DYADEM study of 82 patient/partner dyads (mean age = 74.26) were used to investigate the association between overprotection, perceived stress, depression, and quality of life (QoL). The analyses show that an overprotective contact style with PwD has a significant positive association with stress and depression, and has a negative association with QoL. The results emphasize the importance of avoiding an overprotective care style and supporting patient autonomy.

Ego Psychoanalytic Rorschach Interpretation

2017 ◽  
Vol 38 (1) ◽  
pp. 22-32 ◽  
Author(s):  
Irving B. Weiner
Keyword(s):  
Differential Diagnosis ◽  
Sequence Analysis ◽  
Treatment Planning ◽  
Well Being ◽  
Adjustment Difficulties ◽  
Behavioral Features ◽  
Defensive Style ◽  
Cognitive Slippage ◽  
Interpretive Process

Abstract. This article concerns the utility of ego psychoanalytic perspectives in Rorschach interpretation. Psychoanalytic ego psychology focuses on how people cope with events in their lives and how effectively they can meet challenges to their sense of well-being. The way people deal with experienced distress constitutes their defensive style and determines to a large extent what kind of person they are. Adequate defenses against anxiety promote comfortable and productive adjustment, whereas ineffective defenses typically cause adjustment difficulties and susceptibility to psychological disorders. In Rorschach assessment, the nature and effectiveness of a person’s defensive style can often be identified with a sequence analysis that integrates the structural, thematic, and behavioral features in the protocol. In particular, the sequential quality of responses, especially preceding and following instances of cognitive slippage, can help identify causes of upsetting concerns, defensive efforts to alleviating these concerns, and the adequacy of these defensive efforts in restoring equanimity. This interpretive process is illustrated with attention to implications for differential diagnosis and treatment planning in the Rorschach protocol of a 20-year-old suicidal woman.

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