This Friday, our weekly meeting of “Everyday History Society” had a very interesting extended discussion on the issue of Burnout which we had examined in brief previously
Dr.V.Natarajan (Nattu Bhai) summarized the article findings and discussion of McManus et al –Stress Burnout and doctors: attitudes to work are determined by personality and learning style. (BMC Medicine 2004:2:29)
Some interesting points which emerged from the subsequent discussions
Attitude of service helps
Dr.Emad Tabana who originally trained in Iraq and has seen the Yemeni , Libyan, Canadian systems of medicine related his change in attitude which led to improvement.
“Till 4th year I used to faint at the sight of blood. One day, I was in the casualty and many persons with serious injuries were brought in. I wanted to help them out, and I spent a long time doing so. After a few hours, when I was immersed in helping the wounded I realized that my clothes were full of blood. But I was no longer afraid of blood. From that day, my attitude was not to focus on my fears but to try and help the patients.”
Does our Exam system foster a particular style of learning?
“To pass the exams one should know the examination system, to practice the subject one needs an understanding”..This old aphorism has been going on in different medical circles in some form or other.
If one does not know the MCQs in the Question bank of the past 10 years, one is not going to be able to even qualify for the entrance in Post graduate courses.
If one does not know the over 30 differential diagnosis of Solitary Pulmonary nodule one cannot hope to pass your MD exams.
But if you have to run a practice or manage a department, these MCQs and Differential diagnosis are not going to help.
So where are we going to find the balance.
Probably it depends on which phase and level of practice one is.
Interesting framework for discussion
The meeting was interesting as the article gave a useful reference to discuss
different issues relating to learning, personality, work stress and practice as
related to modern medicine.
These can be applied to any field.
The following are some of the main headings under which they approached
Those interested can go through the main article
BMC Medicine 2004, 2:29 doi:10.1186/1741-7015-2-29
Approaches to work
Surface disorganised: Feeling overwhelmed by work. For example, being unsure what is needed to complete a task, finding it difficult to organise time effectively, reading things without really understanding them.
Surface rational: Preference for order, detail, and routine. For example likes to know precisely what is expected, puts of a lot of effort into memorising important facts when learning something new.
Deep approach: Integrative approach that leads to personal understanding. For example, tries to relate new ideas to situations where they might apply.
Choice-independence: Perception of control over what one does and how one does it.
Supportive-receptive: Perception that help is available in the workplace and colleagues are understanding.
Workload: Perception of heavy workload and having to cope alone.
The three separate components of burnout. Note: burnout on the MBI is indicated by higher scores on the emotional exhaustion and depersonalisation scales, and lower scores on the scale of personal accomplishment.
Emotional exhaustion: Reduced energy and job enthusiasm; emotional and cognitive distancing from the job.
Depersonalisation: Cynicism; lack of engagement and distancing from patients; treatment of patients as inanimate, unfeeling objects.
Personal accomplishment: A sense of efficacy and effectiveness; of involvement, commitment and engagement; of capacity to innovate, change and improve.
Differences in motivation and process of the surface, deep and strategic approaches to learning assessed in the Study Process Questionnaire
Motivation Completion of the course Fear of failure
Process Rote learning of facts and ideas
Focussing on task components in isolation
Little real interest in content
Motivation Interest in the subject
Process Relate ideas to evidence
Integration of material across courses
Identifying general principles
Motivation Achieving high grades
Competing with others
To be successful
Process Use techniques that achieve highest grades
Level of understanding Patchy and variable
Some interesting quotes from the article
The child is the father of man….William Wordsworth
Genes are not destiny, so neither personality nor learning style are destiny,
Nurture interacts with nature.
The education forms the common mind,
Just as the twig is bent, the tree’s inclined…..Alexander Pope
Concluding thoughts of Sir William Osler (1849–1919), one of the most distinguished
physicians of the nineteenth and early twentieth century, who recognised that only
some doctors are happy in their professional lives:
“To each one of you the practice of medicine will be very much as you make it –
to one a worry, a care, a perpetual annoyance; to another, a daily joy and a life
of as much happiness and usefulness as can well fall to the lot of man.”
Everyday History themes
This article forms a series of different trends of Every day history
observed in our group.
Some other suggested reading for those interested are as follows.
For “Mass Observation themes” see blogs
Mass Observation –Tripoli
Conversations in Faith and Belief
Musings around Easter-Remembering St.Augustine of Hippo
Mass Observation –Malta
Exploring Spiritual Traditions-Ta Pinu monastery Gozo
Conversations on Identity-Workshops in Malta
For “History of Humanity series” see blogs
Remembering Hay Market
Remembering Studs Terkel.
For “Management related issues in context of Libya-see articles
For issues related to Arab Spring-Libyan experiences
Using “Life Story interview guidelines interview series” see articles
One year on-What is the Change https://prashantbhatt.com/2012/02/19/one-year-on-what-is-the-change/
Friends of Bouazizi http://www.chowk.com/Views/World/Friends-of-Bouazizi
Shafshoofa Maleshi http://www.chowk.com/Views/World/Shafshoofa-Maleshi-Tripoli-is-Free
Saluting our Ladies with the Lamp http://www.tripolipost.com/articledetail.asp?c=12&i=8357
Next theme-concluding thoughts
The theme of Burnout forms part of a series of examining our
Conditions which was started by the review of Aneez Ismail’s article
“Asian Doctors in the NHS:Service and betrayal”.
British Journal of General Practice, October 2007.
This forms part of an attempt to have more informed discussions in
Our Reading groups and Everyday history society fora.
After some preliminary discussions on the nature of peasant movements
On the occasion of 25th May-which is observed as Naxalbari day in India
we will examine the different types of historiography in relation to working
people’s movements. In this we explore the themes of Structural Functionalism
as espoused by Radcliffe Brown, the Indian peasant struggles and conceptual frameworks
provided by Marxist historiography and the counter-point of Subaltern historiography.
The works and critic of the innovative thinker Ranajit Guha come to mind.
For this the root article which will form a framework for discussion is L.S.Vishwanath’s
“Peasant Movements in Colonial India An Examination of Some Conceptual Frameworks”
Economic and Political Weekly January 13, 1990
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