Everyday history -Burnout dissected

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

See blog: https://prashantbhatt.com/2012/05/20/check-burnout-forum/

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)

Radiology department-LBMC, different professionals, managers, doctors, dentists,Staff nurses, radiographers of different nationalities and backgrounds have varying approaches to Issues.. Our Front desk Manager- Mohamed Shweki has an interesting style.. will not get Burnt out easily .. see blog- Learning From Shweki-https://prashantbhatt.com/2012/04/08/learning-from-mohamed-shwki/

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 4^th 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.

Main headings

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.

Workplace climate

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.

Many components are required to run a healthcare institution : The Information Technology and Accounts team in our organization has a mix of young and not-so-young and each have a different energy which make a creative whole.

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

Surface

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

Deep

Motivation Interest in the subject

Vocational relevance

Personal understanding

Process Relate ideas to evidence

Integration of material across courses

Identifying general principles

Strategic

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

A poster at the San Francisco Church-Dahra-Tripoli: Examining spiritual traditions as relevant to the common people we explore their faith and meaning which different expatriate communities find in them. In themes relating to subaltern historiography we are not dismissive of faith based groups as is the case observed in some other forms of historiography.
For some interesting insights –see blog
https://prashantbhatt.com/2011/12/30/tripoli-reading-group-year-end-meeting/

Conversations in Faith and Belief

https://prashantbhatt.com/2012/04/13/conversations-on-faith-and-belief/

Musings around Easter-Remembering St.Augustine of Hippo

https://prashantbhatt.com/2012/04/29/musings-around-easter-remembering-st-augustine-of-hippo/

Mass Observation –Malta

Exploring Spiritual Traditions-Ta Pinu monastery Gozo

https://prashantbhatt.com/2012/05/15/exploring-community-spiritual-traditions-ta-pinu-sanctuary-gozo/

Conversations on Identity-Workshops in Malta

https://prashantbhatt.com/2012/03/02/conversations-on-identity/

For “History of Humanity series” see blogs

Remembering Hay Market

https://prashantbhatt.com/2012/05/01/the-eight-hour-day-remembering-hay-market-in-tripoli/