Janeway Society First Friday Seminar May 5, 2023

Transcript

• 00:00Welcome to Janeway Society.
• 00:01I'm the Addy for any who don't know me.
• 00:03It's my pleasure to be able
• 00:05to introduce doctor Jeff.
• 00:06Jeff, Jeff, Jeff, Jeff,
• 00:07we'll go Jeff I made,
• 00:09I added Jeffrey for some reason.
• 00:11We'll stick with Jeff as it says on the
• 00:13paper, but good to see you all here.
• 00:14Good to know that some of
• 00:16you are online as well.
• 00:17And as you can see from the title slide
• 00:19he's going to be talking about wellbeing
• 00:21in the academic and academic medicine.
• 00:23I'll let him kind of give the description
• 00:24of the actual time we'll have together,
• 00:26but also wanted to give you all
• 00:28an introduce introduction to him.
• 00:29So Doctor Jeff Dewey is an MD and
• 00:32also has an MHS and is Assistant
• 00:34Professor of Neurology with a
• 00:36specialty and neuromuscular Medicine
• 00:37here at the Yale School of Medicine.
• 00:39He received his MD Kumlade from
• 00:41Boston University and a Masters of
• 00:43Health Science and Medical Education
• 00:44from the Yale School of Medicine,
• 00:47completed his preliminary internal
• 00:48medicine training at Beth Israel
• 00:50Deaconess Medical Center in Boston,
• 00:52and a neurology residency and
• 00:54neuromuscular medicine fellowship at Yale
• 00:57New Haven Hospital Prior to joining in 2018.
• 01:00He serves as a Clerkship Director
• 01:02and Associate Program Director in
• 01:04Department Neurology and as the
• 01:05Director of Resident Wellness and
• 01:07Department of well-being and the
• 01:09Department of well-being Officer.
• 01:10He coordinates well-being initiatives
• 01:12within the residency program,
• 01:13and the department has a lot of different
• 01:15initiatives and roles he's been
• 01:17involved in which he may share about.
• 01:18But I just also wanted to mention
• 01:20that his research centers around
• 01:22the promotion of thriving among
• 01:24graduate medical trainees through
• 01:25principles of appreciative inquiry.
• 01:27Positive psychology,
• 01:28change management and
• 01:30organizational leadership.
• 01:31So definitely the right person
• 01:32to leave the session today and
• 01:33we're grateful that you've taken
• 01:34time out to be here with us.
• 01:36Thanks so much.
• 01:38Yeah, thank you for having me.
• 01:40I'm excited to be here. I've,
• 01:42I've heard of this group and so it's
• 01:44really nice to see you all in person.
• 01:49I define academic medicine broadly.
• 01:51I recognize that we have both clinicians and
• 01:53nonclinicians in the audience and so we'll.
• 01:56Talk about data relevant to both
• 01:58populations and then we're going to,
• 02:00so we'll talk about some data,
• 02:02we'll do a little bit of self
• 02:05reflection in terms of imposter
• 02:06syndrome and then we're actually
• 02:07going to do an activity together to
• 02:09develop a personal mission statement.
• 02:11So this won't be all me talking,
• 02:13which is usually a good thing because you
• 02:16don't need to hear me talk for an hour.
• 02:18So let me see if I can advance my slides.
• 02:21Just reflect for a second in your career,
• 02:25in your life.
• 02:26Are you thriving or are you just surviving?
• 02:28Are you just getting by and you
• 02:31don't have to answer this out loud,
• 02:32but I just want you to ponder it for
• 02:34a second and think about where you
• 02:36lie on that spectrum between just
• 02:38getting by and really nailing it,
• 02:40and where you would like to be
• 02:44in what direction.
• 02:44What move you would like to make
• 02:48so burnout is a hot topic.
• 02:52I'm a neurologist.
• 02:53I can share that in neurology alone.
• 02:55In the past few years there's
• 02:57been many articles on burnout.
• 02:59And as a neurologist I know that about
• 03:0260% of our practicing faculty and
• 03:04about 75% of our residents experience
• 03:06at least one symptom of burnout.
• 03:11Medicine in general is prone to burnout.
• 03:15You can see here The
• 03:17writing's a little small but.
• 03:19There are lots of different
• 03:21specialties listed here and the
• 03:23percent reporting burnout range
• 03:24is anywhere from 30 to almost 70%.
• 03:27So that's quite the
• 03:31quite the range and also quite the
• 03:34issue facing academic medicine.
• 03:36I mean, we're having a physician shortage
• 03:38and this is one of the reasons why if
• 03:41you look at work life balance, again,
• 03:44there's quite a range ranging anywhere from.
• 03:493839% satisfied to up to 60% satisfied,
• 03:52but no one's batting 1000 and so in.
• 03:55That maybe is not to be expected.
• 03:58Unfortunately.
• 03:58My specialty is toward the bottom,
• 04:00as you can see.
• 04:01But some specialties do better than others,
• 04:04and if you've actually plot
• 04:05them on a scatter plot,
• 04:06you can see across specialties that
• 04:08some specialties are in the green.
• 04:11They're where you want to be.
• 04:12They have low burnout,
• 04:13high work, life satisfaction.
• 04:15Some specialties are at risk near
• 04:18these orange or yellow boxes,
• 04:20and some specialties are in dire straits.
• 04:22They're having high rates of burnout and low
• 04:24rates of personal work life satisfaction.
• 04:27And that's quite an issue that we
• 04:28need to face as an academic medicine
• 04:31center and certainly as a field.
• 04:35The the data is not that much
• 04:37better for for research scientists.
• 04:39So this is coming from a Nature
• 04:41study a couple years ago that
• 04:43looked at a few thousand scientists.
• 04:45And ask them about symptoms of burnout
• 04:48and the box you want to focus on.
• 04:50Are these orange boxes here.
• 04:52So feeling less I'm achieving
• 04:54less than I should.
• 04:56Feeling that there is more work to do than
• 04:58I practically have the ability to do.
• 05:01Feeling as if I don't have enough
• 05:02time to plan experiments or projects.
• 05:04Feeling run down and drained of
• 05:07physical or emotional energy.
• 05:08Feeling that organizational politics
• 05:10or bureaucracy frustrate my ability to
• 05:13do a good job. Feeling that I want.
• 05:15I am not getting what I want out of
• 05:17my job and feeling under an unpleasant
• 05:20level of pressure to succeed.
• 05:22So anywhere from 30 to 45% of respondents
• 05:25feel this frequently or always.
• 05:27That's a pretty scary number.
• 05:29What's even scarier is when you add in
• 05:31those that feel it rarely or occasionally.
• 05:33That means the vast majority of research
• 05:36scientists are feeling this to some degree,
• 05:39any one of these symptoms.
• 05:45There's a little bit of a difference
• 05:47between academic scientists
• 05:48and scientists in industry.
• 05:50So if you look,
• 05:51this is from the same survey,
• 05:52if you look at those who say their
• 05:54their work life satisfaction or
• 05:56their job satisfaction has improved,
• 05:58it's about 21% in the past year in academia,
• 06:0233% in industry.
• 06:03And then that's reflected vice versa
• 06:05in those who feel it have worsened.
• 06:07So about 58% of academic
• 06:09scientists felt their life,
• 06:11their job satisfaction has worsened
• 06:13in the past year.
• 06:14As compared to 44% of of industry
• 06:17and the numbers staying the same
• 06:19are about equal across both.
• 06:25Here we're seeing head to head a
• 06:28comparison of burnouts and contributors in
• 06:30biomedical scientists in the blue column,
• 06:33nurses in the orange column
• 06:35practicing physicians in the Gray
• 06:37and resident physicians in yellow.
• 06:39So pretty much a cross section
• 06:42of an academic Medical Center.
• 06:44Personal burnout was highest
• 06:45among the nurses and residents.
• 06:47Work related burnout was similar,
• 06:49but I thought was kind of interesting
• 06:51was that patient client burnout was
• 06:53highest among biomedical scientists
• 06:54and they define this kind of loosely.
• 06:57So clients could be funding sources,
• 07:00clients could be administrators,
• 07:01clients could be PI's,
• 07:03but some some person that the
• 07:05scientist feels they have to answer to.
• 07:08And in that case the burnout
• 07:09was much higher for biomedical
• 07:11scientists as compared to.
• 07:13Clinicians and their patients,
• 07:18if you look at contributing factors to
• 07:21burnout stratified by risk of burnout,
• 07:24those with the high burnout risk
• 07:27seem to be most impacted by work life
• 07:29interference and publication pressure.
• 07:31Those with the sort of overextended or
• 07:33medium risk risk were highly impacted
• 07:35by work life interference and to a
• 07:37lesser degree of publication pressure.
• 07:39Job insecurity plays a role.
• 07:42As does workload,
• 07:42but not as strongly in these
• 07:44higher risk of burnout groups.
• 07:48Conversely, if you look at protective
• 07:51factors in the high burnout group,
• 07:53meaningfulness is one of
• 07:55the most protective factors.
• 07:56So the ability to find meaning in one's work,
• 07:58and we'll talk a little bit
• 08:00about how you do that later on.
• 08:02Learning opportunities are protective,
• 08:04social support from colleagues
• 08:05and supervisors are protective,
• 08:07and job control,
• 08:08especially in the high burnout risk.
• 08:11Could be quite protective and job control,
• 08:13meaning the ability to tailor one's career
• 08:15or what's sometimes called job crafting.
• 08:22We actually did a study of the
• 08:26academic community here at Yale
• 08:28and we surveyed 588 providers,
• 08:30looking at their burnout and their wellbeing,
• 08:33but also what stand,
• 08:34what pressures are they facing in
• 08:36terms of their academic careers?
• 08:38And we looked at 7 pressure points.
• 08:40The standards for academic promotion.
• 08:42The standards for clinical productivity,
• 08:44which of course only applies
• 08:46to the physicians.
• 08:47Protecting time for research and innovation.
• 08:49Protecting time for education and mentorship.
• 08:52Protecting time for
• 08:53leadership responsibilities.
• 08:55Procuring grants or funding
• 08:56support for scholarly work,
• 08:58and procuring access to data or
• 09:01support for statistical analysis.
• 09:03And we had people rank these on a 5 point
• 09:05Likert scale and we dichotomize them.
• 09:07So if you were one through 3.
• 09:09We felt this to be a low prevalence stressor.
• 09:12If you were four or five,
• 09:13we felt this to be a high
• 09:15prevalence stressor.
• 09:18This is a scale that you may want
• 09:20to take on your own at some point.
• 09:21It's called the professional
• 09:23fulfillment index.
• 09:23It was developed at Stanford.
• 09:25It's been validated in academic clinicians,
• 09:28but I think is equally applicable
• 09:30to research scientists as well.
• 09:32And they asked you a couple of questions.
• 09:35So one, one question is related to.
• 09:38A sense of dread.
• 09:40They ask you about physical exhaustion
• 09:42at work, Loss of enthusiasm,
• 09:44emotional exhaustion.
• 09:45These are some of the defining
• 09:47features of burnout.
• 09:48They also ask you about empathy.
• 09:50Empathy with your patients,
• 09:51with your colleagues,
• 09:52sensitivity to others emotions,
• 09:53interest in talking with patients or feeling
• 09:56connected with patients or colleagues.
• 09:58So this was how we measured
• 10:02burnout and job fulfillment.
• 10:03And then we looked at how the
• 10:06stressors related to this.
• 10:08So if you look at the
• 10:10prevalence of stressors,
• 10:10the highest prevalence was
• 10:12protecting time for research,
• 10:13actually followed by protect by
• 10:16clinical demands for so demands
• 10:18for clinical productivity,
• 10:20protecting time for leadership and education,
• 10:22securing funding support and
• 10:24then to a lesser degree,
• 10:26promotion standards and statistics.
• 10:29If you break this down by gender,
• 10:31those identifying as women that
• 10:33experience this much higher
• 10:35than those identifying as men.
• 10:37That's not a huge surprise based
• 10:39on what we know about burnout
• 10:40in academic medicine.
• 10:44Similarly, those who identify as nonwhite
• 10:46experience to a higher degree these
• 10:48stressors than those identifying as white,
• 10:50with the exception of statistical support.
• 10:55What gets interesting is when you start to
• 10:57break this down by age and career stage.
• 10:59So if you look at the prevalence of
• 11:01all stressors by age, they tend to
• 11:03be highest in the 40 to 49 group,
• 11:05and these are sort of the mid career.
• 11:07Positions or scientists to a lesser degree,
• 11:12the later career 50 to 59 group and
• 11:15then if you break it down by position,
• 11:17there was a clear risk profile
• 11:20for associate professors.
• 11:21So those in the associate professor
• 11:24position have across the board a higher
• 11:26level of these stressors and then to a
• 11:29lesser degree the assistant professor.
• 11:31Good news is once you make professor
• 11:32a lot of this drops off.
• 11:33So just keep going I guess.
• 11:36I don't know.
• 11:39So again, these associate professors
• 11:41and those in the mid career middle
• 11:44age ranges tend to be at highest risk
• 11:47if you map this against burnout.
• 11:48So the prevalence of burnout,
• 11:50the those in whom a stressor is
• 11:53present were significantly more
• 11:54likely to be burned out across
• 11:56almost all of the stressors.
• 11:57So each one of these can be an
• 12:00individual predictor of burnout.
• 12:04Similarly, they convert some pretty high odds
• 12:06ratios of burnout when they're prevalent.
• 12:08So this is these are patients who answered
• 12:10or or sorry respondents who answered
• 12:12four or five on their their Likert scale,
• 12:15the highest being clinical
• 12:16demands less relevant for the non
• 12:18clinicians in the audience.
• 12:20However, pressure for education
• 12:21and leadership also conferred
• 12:23significantly high odds ratios as
• 12:25did the standards for promotion
• 12:27and protecting time for research.
• 12:32So. We know that academic physicians,
• 12:36academic scientists,
• 12:37have a fairly high stress profile.
• 12:40We know what some of those stressors are.
• 12:43Mitigating them is a little bit different.
• 12:46There are other contributors to wellbeing,
• 12:48however, so we talked a little
• 12:50bit about work life Balance.
• 12:51We know that work life balance is
• 12:53poor across many medical specialties.
• 12:56I don't have any data on work life
• 12:58balance and biomedical scientists.
• 13:00However, anecdotally,
• 13:01I know that it's not great.
• 13:03I've heard a lot of them telling me I work
• 13:062 full time jobs for the price of 1, right?
• 13:08Because you have your research,
• 13:09but then you have committees,
• 13:10you have thesis reviews,
• 13:12you have other reviewing duties.
• 13:14So there really is a lot of risk
• 13:18factors for poor work life balance.
• 13:21The other thing we're going to
• 13:22talk about is imposter syndrome.
• 13:23So I'm not going to ask for a show of hands,
• 13:25but what I am going to do is actually give
• 13:28you a chance to participate anonymously.
• 13:31So grab your phones if you
• 13:32don't have it out already.
• 13:34You can either scan the QR code
• 13:36or you can go to mentee.com and
• 13:38enter this code and we're going
• 13:40to take a little imposterism quiz
• 13:43and we'll see how you do.
• 13:44So I'll give you a second to pull it up.
• 13:48So
• 14:00the instructions are still at the top of
• 14:02the screen if you haven't pulled it up yet,
• 14:04but go ahead and just answer these questions.
• 14:05This is totally anonymous,
• 14:07but I think it's it's helpful
• 14:10to see how we're doing.
• 14:11So the first question is,
• 14:13I can give the impression that I'm
• 14:15more competent than I really am.
• 14:17The next one is when people praise
• 14:19me for something I've accomplished,
• 14:20I'm afraid I won't be able to live up to
• 14:22their expectations of me in the future.
• 14:25And then the last is I'm afraid people
• 14:27important to me may find out that I'm
• 14:29not as capable as they think I am.
• 14:32These are taken from an item or a tool
• 14:34called the Clans Imposterism scale.
• 14:37So clans developed this scale.
• 14:38She was a researcher.
• 14:41Researching women in leadership
• 14:43positions and companies,
• 14:44and this is where imposter syndrome
• 14:47was first defined.
• 14:48But she's since developed the scale that
• 14:50can be applied to anybody in any position,
• 14:55so we have some imposters in the group.
• 14:59That's Okay. Imposter syndrome is
• 15:03extremely common in biomedical science,
• 15:05extremely common in academic medicine.
• 15:09Let's look at a couple more
• 15:11questions from the scale.
• 15:12It's hard for me to accept
• 15:14accomplishments or praise about my
• 15:16intelligence or accomplishments.
• 15:17Sorry, accept compliments.
• 15:19At times I feel success has
• 15:21been due to some kind of luck,
• 15:24and sometimes I'm afraid others
• 15:25will discover how much knowledge
• 15:27or ability I really lack.
• 15:38This is about what I usually
• 15:39see when I do this with groups.
• 15:41So don't feel that you're
• 15:43particularly bad at this.
• 15:45And really, there is no good or bad.
• 15:46There just is.
• 15:47We'll talk a little bit about
• 15:49combating imposturism in a second. All
• 15:55right, great. Let me switch
• 15:58back to my slides here.
• 16:03The phenomenon of imposter
• 16:04syndrome has been recognized.
• 16:05If you haven't read this article,
• 16:07this is where a lot of the
• 16:08data I've shared on scientists
• 16:09and burnout has come from.
• 16:10It was a Nature article in 2021,
• 16:13but they made the case that
• 16:15imposterism is really a blight
• 16:17on academic science in general,
• 16:19and it's held back a lot of careers.
• 16:25I would argue that in some instances,
• 16:29imposterism is appropriate.
• 16:31I talked to my residents a lot about.
• 16:33Their first time down in the emergency room
• 16:35seeing a patient with an acute stroke.
• 16:37If they don't feel like a bit of
• 16:39an impostor in that situation,
• 16:41I would be a little bit worried.
• 16:42It's their first time doing
• 16:44something new and something scary.
• 16:46However, when it causes distress,
• 16:49when it causes you to not seize
• 16:51opportunities or to turn down
• 16:53chances for career advancement,
• 16:54when it impacts the quality of your work,
• 16:57then it becomes a syndrome
• 16:59and becomes pathologic.
• 17:01Of course,
• 17:01we have to acknowledge that there
• 17:03are other contributors to wellbeing,
• 17:04systemic racism and sexism
• 17:06being very prominence.
• 17:12So what can be done?
• 17:13I think I've maybe shared with you the scope
• 17:16of the problem ad nauseam at this point.
• 17:18We have a problem with burnout.
• 17:19We have a problem with imposterism.
• 17:21So what can be done?
• 17:22Well, first, I think we can work to combat
• 17:25or perhaps even embrace imposterism.
• 17:28So thinking about it as a normal.
• 17:30Phenomenon of someone who's not a narcissist,
• 17:33essentially because that would
• 17:35be someone who didn't experience
• 17:37imposterism in any scenario.
• 17:39Maybe it's something we
• 17:40can welcome and befriend.
• 17:41However, there are ways to combat it as well.
• 17:44So we've done a study with some medical
• 17:46interns and looked at how they approach
• 17:50imposterism and how it affects them.
• 17:52And the way to think about
• 17:54imposterism is a refractive error.
• 17:56So if you think about, you're the
• 17:58lens through which you view the world.
• 18:00Imposterism leads to a different
• 18:02perceived outcome than the actual outcome.
• 18:05In other words, you see something
• 18:07as different than it actually is.
• 18:09And there are some ways that this happens
• 18:11through what we call cognitive distortions.
• 18:14So here are some popular
• 18:16cognitive distortions.
• 18:17One is all or nothing thinking.
• 18:19For instance,
• 18:19I know nothing about statistics,
• 18:20their form of bad scientist tunnel vision,
• 18:24focusing on the one negative
• 18:26aspect of a much bigger situation.
• 18:29I really struggled to answer that question.
• 18:31This whole presentation was bad.
• 18:33They're going to think less of
• 18:34me for having given this talk.
• 18:35I worry about that today.
• 18:38Catastrophizing.
• 18:38If this experiment fails,
• 18:39my research career is screwed, right.
• 18:41Everything depends on this one
• 18:43project or experiment.
• 18:45And then attribution,
• 18:46error where you see the good things as
• 18:48luck and the bad things as being deserved.
• 18:51So I really got lucky that
• 18:52this experiment worked out.
• 18:54I really got lucky that this talk went well.
• 18:56Not I prepared.
• 18:57For this,
• 18:58and I executed it in a good fashion.
• 19:03So if you can recognize your
• 19:05cognitive distortions,
• 19:06then you can use a little bit of
• 19:08cognitive behavioral therapy on
• 19:09yourself and actually dispute them.
• 19:10So the first key is to notice them,
• 19:13notice the distortion, try and figure out,
• 19:15do a little bit of introspection.
• 19:16What am I thinking that's causing
• 19:19me to feel like an imposter?
• 19:21The next is to label the distortion
• 19:23for what it is.
• 19:24And this is straight out of
• 19:26cognitive behavioral therapy.
• 19:27And then dispute it.
• 19:28So if you're thinking about all
• 19:30or nothing thinking, I know,
• 19:31I know nothing about statistics,
• 19:33well, maybe that's not true.
• 19:34Maybe I just don't really know
• 19:36how to do an ANOVA very well.
• 19:40So if you can notice, label,
• 19:41and dispute, you can actually
• 19:43combat imposterism and tone it down
• 19:45other ways to combat imposterism.
• 19:47Or to have a mentor, someone who
• 19:49can reassure you when you need it.
• 19:51Talk to colleagues. Share.
• 19:52Be open about your imposterism.
• 19:54We learn from.
• 19:55Our little survey that a lot of
• 19:57people feel these things and
• 19:58so the more we talk about them
• 20:00the more we normalize them.
• 20:05I recommend being an ally and
• 20:06I recommend finding an ally
• 20:08And this is this is this applies to
• 20:10a lot of the different contributors
• 20:11to wellbeing we talked about.
• 20:13But allyship behaviors are numerous
• 20:16and you can employ any of these today.
• 20:19So having a willingness to learn
• 20:22more and explore personal biases.
• 20:24Speaking out about and against
• 20:26prejudice when you see it.
• 20:28Being an upstander.
• 20:30Creating an environment in
• 20:31which individuals from oppressed
• 20:33or marginalized groups,
• 20:33voices are heard and valued.
• 20:37Fostering psychological safety
• 20:38in your learning environments.
• 20:41Offering sustained and appropriate
• 20:44mentorship to individuals
• 20:45of marginalized backgrounds.
• 20:47Elevating the voices and work of
• 20:50people from marginalized groups.
• 20:51And encouraging creativity and flexibility
• 20:53to move away from the status quo.
• 20:55Any of these behaviors are
• 20:57the behaviors of good allies.
• 20:58So if you want to be an ally,
• 21:00these are the things you can do.
• 21:01If you want to find an ally,
• 21:02look for those who are doing these
• 21:05behaviors and make them your
• 21:06mentors and your your advocates.
• 21:13The next thing you can do is
• 21:14seek what's called eustress.
• 21:15So eustres is a phenomenon that
• 21:17we've explored a little bit.
• 21:18We did a interview study of.
• 21:21Neurology residents, and we asked them
• 21:24about peak experiences in their career.
• 21:26So when were they at their best?
• 21:28What were their peak moments?
• 21:30When were they thriving?
• 21:31And they gave us some interesting quotes.
• 21:34This was one quote that I got.
• 21:36They were talking about
• 21:37their rotation in the Ed.
• 21:39They said, I honestly feel like it was hard.
• 21:40It was super hard.
• 21:41It was busy. It was hard.
• 21:42It was also exciting and it was like,
• 21:44you're doing neurology for the
• 21:46first time and this is awesome.
• 21:48And I really was.
• 21:49Interested in the sort of
• 21:51a contrast in this quote.
• 21:53They use the word hard a lot
• 21:55and they use the word busy and
• 21:57these things are thought to be
• 21:59negative aspects of an experience.
• 22:01But they also were excited and they
• 22:03felt that it was an awesome experience
• 22:04despite how hard and busy it was.
• 22:06So this kind of contrast I thought
• 22:08was interesting and it really got me
• 22:10interested in this topic of eustress.
• 22:12So eustress is a is a physiologic phenomenon.
• 22:16Actually it was defined many years ago.
• 22:19But it's since been adapted
• 22:22as a psychological phenomenon,
• 22:23So as a physiologic phenomenon,
• 22:25it is cellular stress that induces
• 22:28a growth or adaptive response.
• 22:31As a psychological phenomenon,
• 22:33it's stress that induces an adaptive
• 22:36change or psychological growth.
• 22:38And this is as opposed to distress,
• 22:39which can be destructive.
• 22:41Eustress is productive.
• 22:42So if you look at this curve here on
• 22:44the right, in any task or situation.
• 22:48You can sort of range anywhere from
• 22:51bored to burnt out and somewhere in the
• 22:56middle is this optimal range of performance.
• 22:58So if things are not stressful enough,
• 23:01you actually can be too bored.
• 23:05You can be calm,
• 23:06you can be stagnant,
• 23:07you don't grow.
• 23:08If things are too stressful,
• 23:10you break down,
• 23:11you become ill,
• 23:13you have bad psychological reactions,
• 23:14and you burn out.
• 23:16Right in the middle is where you
• 23:18feel energized and focused and
• 23:20optimum and so you want to find
• 23:22tasks and schedule your your life
• 23:24and and your your workload in a
• 23:26way that puts you in this optimal
• 23:28performance if you're a mentor.
• 23:29Similarly you want to help
• 23:31your mentees find this eustress
• 23:34point in their in their work.
• 23:36This has actually been investigated
• 23:38in nurses and it was positively
• 23:40correlated with engagement.
• 23:40So the more you stressed they were,
• 23:43the more engaged they were.
• 23:44What was interesting is they felt just
• 23:46like that quote that we saw positive
• 23:48and negative emotions at the same time.
• 23:50So it's not necessarily a positive
• 23:53experience in the moment you feel stressed,
• 23:56but you can also be excited,
• 23:58it can be uncomfortable and it
• 24:00may not be apparent in real time.
• 24:02So the other thing I recommend that you do,
• 24:04especially if you have mentees,
• 24:05is to review with them some
• 24:07of their experiences in a
• 24:09reflective way and say you know,
• 24:11how are you feeling.
• 24:12Did you feel this eustress?
• 24:13Were you excited?
• 24:15Was it a growth experience for you?
• 24:18Growth experiences usually
• 24:19only become growth experiences
• 24:20when we reflect on them,
• 24:22so having this reflection is critical.
• 24:26The next thing I'd recommend is how
• 24:28to how to find your place of flow.
• 24:30Who's heard of flow before? Of hands?
• 24:33Yeah, so flow is a pretty popular phenomenon.
• 24:36This also came to me based
• 24:38on a quote from a resident.
• 24:40So this resident was talking
• 24:42about being on night flow.
• 24:43They said when you're the only
• 24:44one responsible for a patient,
• 24:45you feel this incredible burden or you just
• 24:48kind of have to you go into this like,
• 24:50I don't know,
• 24:51the superpower and you do things you
• 24:53never thought you could actually do.
• 24:55It's like you're thinking about
• 24:56things you never actually thought
• 24:57you would think about,
• 24:58only because someone's life
• 24:59is really at stake here.
• 25:01So this resident was in flow.
• 25:04So flow is is really a foundational.
• 25:07Concept in positive psychology.
• 25:09It was developed by Mihail Chicks at Mihail.
• 25:12It's been written about in in books and
• 25:14talked about in popular literature.
• 25:16It's widely recognized in athletes,
• 25:18so a lot of athletes,
• 25:18when they're in the zone,
• 25:20are in flow. Similarly,
• 25:22artists find themselves in flow quite a bit.
• 25:25It's a state of total absorption,
• 25:27and you've probably felt this perhaps
• 25:29when you're doing an experiment or
• 25:31if you're caring for a patient and
• 25:33you're really absorbed in what you're
• 25:35doing and you feel in the zone.
• 25:37And it has some found
• 25:39foundational characteristics.
• 25:40So it's characterized by intense
• 25:44concentration and presence,
• 25:46emerging of action and awareness.
• 25:47Meaning you sort of aren't
• 25:49thinking about what you're doing,
• 25:50you're just doing it.
• 25:51You actually lose the awareness of self.
• 25:54You have a perception of total
• 25:56control over your actions.
• 25:58You lose perception of time.
• 25:59So hours can go by and you're doing
• 26:02this activity and you find intrinsic
• 26:04reward from the activity itself.
• 26:06When we studied residents,
• 26:07we found that this state
• 26:08was highly desirable,
• 26:09meaning they wanted to feel
• 26:10flow again and again and again,
• 26:12and they tended to gravitate towards
• 26:15situations that gave them flow.
• 26:17It does require intrinsic
• 26:18value in the activity,
• 26:19meaning the activity has
• 26:21to be rewarding for itself,
• 26:22not for what you get from it,
• 26:24but that varies from individual
• 26:26to individual and it needs to
• 26:28be challenging to some degree.
• 26:29And that this is where EUSTRESS
• 26:30comes into play.
• 26:31You don't necessarily have to be
• 26:33interested in the activity so.
• 26:35You have to see that it's valuable,
• 26:37but you don't need to be interested in it.
• 26:38And the way we we learned this
• 26:40was a lot of residents found it
• 26:42in rotations that they'd had no
• 26:43interest in going into as a field,
• 26:45but they still experience flow
• 26:47as part of their rotation.
• 26:51And then it really helps to develop
• 26:52and revisit your personal mission.
• 26:54And this is where we're going to
• 26:55spend the rest of our time together.
• 26:56And I'm going to stop talking
• 26:58and let you do some thinking.
• 26:59So let me drop this into the chat and zoom.
• 27:05And then I'm going to pass around a
• 27:07little bit of a worksheet for everybody.
• 27:09Let's see Chance.
• 27:17So if you're following along,
• 27:18you can download this sheet.
• 27:24So mission Statement is a concise
• 27:26explanation of your reason for existence.
• 27:29It's why you are what you are.
• 27:30It's why you do what you do.
• 27:32It explains your aims and your values.
• 27:35It's used in decision making.
• 27:39So a lot of people will turn to
• 27:41their mission statement to help
• 27:42them make difficult decisions and
• 27:44it's a source of reinvigoration.
• 27:45So it's something you can refer to again
• 27:48and again as you go through your careers.
• 27:51It's something you can come back to and
• 27:53adapt as your as your admissions change.
• 27:56I'll give you some examples here.
• 27:57So this is the mission statement
• 28:00of our neurology residency.
• 28:01We aim to train future leaders in neurology.
• 28:04Neurologists meet a consistently high
• 28:06standard of Clinical Excellence.
• 28:07But who also contribute to the advancement
• 28:09of the field through research,
• 28:10administration, education,
• 28:11global health, and advocacy.
• 28:16This is the mission statement
• 28:17of an organization that I
• 28:18work with called the A/C GME.
• 28:20The mission of the A/C GME is to
• 28:22improve healthcare and population
• 28:23health by assessing and enhancing
• 28:25the quality of resident and fellow
• 28:27physicians education through the
• 28:31advancements in accreditation education.
• 28:32Yeah, well, good, you're going to fix that.
• 28:35Hopefully.
• 28:43There
• 29:01we go. Okay.
• 29:06So what makes a good mission statement?
• 29:07It's concise, it's long term,
• 29:10it's future oriented,
• 29:11it takes into account your skills,
• 29:13traits and values.
• 29:15And it's something that you revisit
• 29:18often and revise with frequency.
• 29:20So. You have a worksheet.
• 29:22If you're on zoom, you should be
• 29:24able to get it from the chat box.
• 29:26I want you to take a few minutes
• 29:27and just think individually about
• 29:29the two questions on page one.
• 29:31So the questions are when do I feel the
• 29:35most meaningful moments in my work?
• 29:36Describe in detail why are these
• 29:38moments so meaningful and what
• 29:40are my values as an individual and
• 29:42how do my values shape my work?
• 29:44This is a list of values from Brené Brown.
• 29:47It's I think it's readable even though
• 29:49the print's a little bit small.
• 29:51If you're not sure what value
• 29:52your values are,
• 29:53read through this list and
• 29:54see what jumps out at you.
• 29:55Pick three to five.
• 29:56So take a few minutes and just think
• 29:58about these first two questions.
• 30:22I should have had some music to play.
• 30:54I'll give you a fair warning.
• 30:55I'm going to ask you to talk
• 30:57to people around you soon,
• 30:58so have some ideas ready to share.
• 31:15You'll know you're coming up with
• 31:16meaningful moments if they feel
• 31:18good when you write about them,
• 31:19if they get you excited.
• 31:41I'll give you about two more minutes,
• 31:46one and two. Yep, both. Both questions.
• 31:50Just on page one though.
• 32:35Take about one more minute.
• 32:39Be bullet points. Doesn't
• 32:41have to be perfect sentences.
• 33:49Anybody want to share their values?
• 34:00OK, great.
• 34:11Trust, creativity, loyalty,
• 34:13integrity and honesty. Great.
• 34:19Anybody else? Yeah.
• 34:27Hope and kindness, knowledge and vision.
• 34:31I like it. Yeah,
• 34:42Vulnerability and safety? Great.
• 34:46So hopefully these feel like
• 34:48you identify with them, right?
• 34:50These these are things that speak
• 34:51to you on a deeper level. You can.
• 34:54There are many other values than this list.
• 34:56If you put ones down that
• 34:57are not on this list, great.
• 34:59This was just there to help you.
• 35:02All right.
• 35:03So now we're going to move on to page 2.
• 35:05We're not going to take 10 minutes for this.
• 35:07We'll probably take 5 minutes,
• 35:14Answer the questions on page two,
• 35:15and then when you're done,
• 35:16I want you to find someone near
• 35:18you and discuss your answers.
• 35:19So share them with someone around you.
• 35:21We know that. As with goal setting,
• 35:25with mission setting,
• 35:26it's more powerful when you
• 35:28share with somebody else.
• 35:30So take a few minutes to think about
• 35:32your answers to these questions.
• 35:33How would I describe my work
• 35:35and mission to another person,
• 35:36and what change would I like
• 35:37to have made in two years time?
• 35:39And then when you're ready,
• 35:41find someone and discuss.
• 35:44If you're on zoom,
• 35:45you can just discuss with your office
• 35:48mate or think quietly to yourself.
• 39:22I sense this is a shy group.
• 39:25I won't force you to share
• 39:26with anyone, but feel free.
• 39:27I'll give you a couple more minutes
• 39:29to just get your thoughts down and
• 39:31if you're if you're ready to chat.
• 40:24Yeah, so I can
• 40:32so switch. So it's very
• 40:45funny.
• 40:50So.
• 41:56I hear some great conversations
• 41:58take two more minutes.
• 42:25Oh
• 42:36yeah.
• 42:56Yes.
• 43:29Right. I hear some great conversations.
• 43:31I'm loathe to interrupt them.
• 43:34But I also want you to have a
• 43:36chance to complete the exercise.
• 43:39So let's move on to the last page.
• 43:44And this is where the rubber meets the road.
• 43:46So it's now time to craft
• 43:47your mission statement.
• 43:48You've explored your values.
• 43:49You've explored what's meaningful to you.
• 43:52You've looked at your vision for the future.
• 43:54You've talked about it with somebody else,
• 43:56and maybe that helped you
• 43:57clarify it a little bit.
• 43:58So now it's time to actually
• 44:00put down a mission statement.
• 44:01So on the last page you have
• 44:03a place to write it.
• 44:04This is a first draft.
• 44:06It's okay if it's not perfect
• 44:07because you're going to come
• 44:08back to this and revise it
• 44:09periodically throughout your career.
• 44:12But if you're looking for
• 44:14some ways to get started,
• 44:17these are some prompts you can use.
• 44:19It is my goal to.
• 44:20I believe I value my vision is to.
• 44:23The change I hope to see is the
• 44:25people I hope to impact our success
• 44:27looks like and I will overcome
• 44:29challenges by or anything else
• 44:30you want you can say it is my
• 44:33mission too and go from there.
• 44:35But try to try to craft a statement
• 44:37that's one or two sentences and really
• 44:40captures the values and the vision that
• 44:43you put down on the pages one and two.
• 44:45So I'll give you a moment to
• 44:47do that and then we're going
• 44:48to I'm going to put up the.
• 44:52Slide again and I would love
• 44:54for people to share their
• 44:56missions so we can all read them.
• 44:58So as soon as you've got it up,
• 45:00back on to mentee and type it
• 45:01in and we'll see them pop up.
• 45:05And
• 45:13you can, if you're on Zoom,
• 45:14you can use the mentee as well.
• 48:34All right, we have our first submission.
• 48:39Beautiful.
• 49:24Excellent.
• 49:37I see that we're at 5:00 till keep.
• 49:40Keep going, keep typing them in.
• 49:41But I I also will feel any questions
• 49:43in the last five minutes here.
• 49:45Keep an eye on the screen as
• 49:47other people's missions pop up.
• 49:48I get inspired reading your missions.
• 49:50So I'm sure you'll get
• 49:52inspired reading each other's.
• 49:53What you've created here is a commitment
• 49:55to something bigger than yourself.
• 49:57And when we talk about meaning and work
• 49:59as a protective factor against burnout.
• 50:02That's one of the biggest things you
• 50:03can have is that kind of a commitment.
• 50:04So I hope that you'll pin this to
• 50:08your your desk or put it somewhere
• 50:09where you can look at it often,
• 50:11come back to it, revise it,
• 50:13change the language around,
• 50:15but make it your friend and make
• 50:17it your your companion as you face
• 50:19the challenges in your career.
• 50:21So I'll say thank you and take any questions.
• 50:40Nice.
• 50:47Yeah.
• 50:56So I come back to it
• 50:59probably once a month,
• 51:01but then ad hoc as well.
• 51:02So if I'm really struggling
• 51:04with the decision or just
• 51:05feeling down or whatever,
• 51:07then I come back and
• 51:08review it a little bit.
• 51:13At least every couple of months
• 51:16or or anytime there's a big shift
• 51:18in your career, things like that.
• 51:24I noticed that the character
• 51:26limit on the mentee page is
• 51:27200 characters. Do you recommend
• 51:30keeping it that short or brief?
• 51:33I'm
• 51:39not sure anybody hear me.
• 51:44Well, thanks for being game to do
• 51:46something a little outside the box.
• 51:47I hope it was helpful to you and I enjoyed
• 51:49doing it with you and it was really
• 51:51again a pleasure to be here. Thanks.