1. Key Points from DCT Forum Nov 6 2016
21st Prevocational Medical Education Forum

2. Theme Physician Well Being
This slide show includes
Some notes on of the 3 sessions: Mindfulness, burnout, mentorship programs
Summary of discussion on burnout ‘risk factors’ and how we can prevent burnout
Some additional notes from ‘Wellmed ‘conference 2016 to share
Some references/links to resources
Please see the slide shows and resources generously provided by our 3 speakers

3. Session 1: Mindfulness pamela Lovell
Value of practising mindfulness – both JMOs & supervisors
Introduce mindfulness into JMO self-care program
Excellent mindfulness apps available

4. Session 2: Burnout Steve bagi
What is burnout
Product of imbalance in a)work-life demands, b) job-person fit & c) work input-acknowledgement
Work related
What isn’t burnout
Exhaustion – often a component but many other factors/drivers involved with BO
Depression – may be a consequence of BO.
Pathogenesis
Drivers of burnout (Maslach & Leiter) – 6 critical areas
Workload, loss of control, inadequate reward, community related (eg conflict), lack of fairness, conflict of values.
Accumulation of ‘residual emotion’ concept
Inadequate regulation of emotional response to specific moments/events => residual emotion
Over time residual emotion accumulates etc, nb. often what triggers a ‘break down’ can seem a relatively minor issue (the straw that breaks the camels back)

5. Session 2: Burnout Steve bagi
Incidence : 50 – 70% (Australian figures)
Early JMO years particularly high risk
Self reporting influenced by perceived career and insurance implications
Importance to raise awareness and understanding to help break down barriers to disclosure

6. Session 2: Burnout Steve bagi
Risk factors for JMOs:
Uncertainty (jobs, careers,)
Mismatch of expectations (role, workplace, supervisors)
Poor levels of job satisfaction (feel undervalued)
Difficult transition from student to doctor
Power imbalance in the workplace
Older graduates with more life stressors (debts, family)
“just a number” in large institutions
Competitiveness for training pathways
Disillusionment around training experience
Unsupportive organizational culture
“Grooming” students to be at risk – not equipped to deal with failure (e.g. underperformance, unable to get onto training program, supervisor or patient complaints)

7. Session 2: DCT Burnout steve bagi
Risk factors for DCTs
Transition from clinician to manager – no preparation or training
Trying to achieve ideal goals in a “real world” e.g. achieving the best supervision for JMOs
Making decisions with little training for decisional making
Taking an unpopular stand (because it is the right thing to do)

8. Session 2: preventing burnout
Introduce to JMOs the concept of “failure” using authentic leaders – using own stories of when things went wrong and how things will improve
Little things we can do to prevent burnout:
Peer mentoring
Debriefing
Providing a physical space doctors can spend time together – to discuss issues that concern them in a safe place
Acknowledge hard work & effort – e.g. thank the JMOs at the end of a busy ED shift/ bring in a box of chocolates to share
Pass on good feedback that you receive.
Be a positive role model for JMOs & other senior staff – develop a positive culture
List 3 good things you have done at the end of each day
Duke ‘WISER’ study
Training for JMOs on mindfulness & self care, and resilience
Offer information sessions of issues that concern JMOs – careers, finance, income protection etc.
Employ a well-being officer

9. Session 3: mentorship julian wilcocks
Definition of mentorship – it is NOT supervision: be mindful of conflict of interest
Teach/learn coaching skills – very valuable
Mentorship needs to be voluntary
Mentors need to be trained
Its not just a coffee & a chat.
Mentoring needs to be structured
Effectiveness of near-to-peer mentorship
Introduce mentoring of medical students to JMOs/interns – develop the culture