It is important to recognize and mitigate the effects of trauma exposure response as it can have profound effects on personal and professional lives.Ī search for the terms trauma and secondary trauma in MedEdPORTAL displayed many publications related to clinical trauma and some publications on trauma-informed care toward the patient. This session provides a facilitated discussion to recognize and mitigate trauma exposure response. This is a concept that many physicians, particularly trainees, can relate to and observe in themselves as they progress through medical education. This session focuses on defining trauma exposure response, which is the transformation that takes place as a result of exposure to the suffering of others. Over time, multiple terms have been used to approach the concept of secondary trauma. 7 It remains to be clarified if there is a unidirectional or bidirectional causal relationship between burnout and secondary traumatic stress, 8 but secondary traumatic stress can contribute to the emotional exhaustion and depersonalization components of burnout. One meta-analysis indicated strong associations between job burnout and secondary traumatic stress. Secondary traumatic stress differs from burnout in that it can result from a single exposure to trauma versus the repeated occupational stress exposure that is characteristic of burnout. Burnout and secondary traumatic stress have both been recognized as consequences of extreme demands on human service professionals. Secondary traumatic stress is considered a form of post-traumatic stress disorder caused by experiencing repeated or extreme exposure to adverse details of a traumatic event. Secondary trauma is the emotional distress that results when an individual hears about the firsthand trauma experiences of another. This may include either primary or secondary exposure to trauma. Burnout is a pathologic condition that develops in response to prolonged occupational stressors and is characterized by three dimensions: (1) emotional exhaustion, (2) depersonalization, and (3) lack of personal achievement.Ī unique aspect of the medical profession is exposure to trauma. 6 Burnout can also lead to professional repercussions of increased turnover, decreased productivity, decreased patient satisfaction, and decreased quality of care. In 2017, 42% of physicians screened positive for symptoms of depression. 6 Burnout can lead to personal repercussions including depression, suicide, and substance abuse. 5 Embedding wellness efforts into the infrastructure of training programs is one system-level intervention to start approaching physician burnout, building community, and fostering open and honest conversations to address the unique stresses of trainees.įorty-four percent of all physicians report symptoms of burnout. Although there is value to personal resilience and individual-level interventions, reducing burnout requires organizational-directed approaches. 4 Many of these drivers will only be improved with high-level system change, and organizations that are committed to improving physician well-being must invest in system-level interventions. ![]() The key drivers of burnout include workload and job demands, control and flexibility, efficiency and resources, organizational culture and values, social support and community at work, work/life integration, and meaning in work. An embedded longitudinal wellness curriculum is one of multiple programs in place to support the well-being of residents and faculty at our institution. These topics align with the ACGME common program requirements and include relevant content and discussion topics recommended by our Resident and Fellow Wellness Committee. The additional topics included in this curriculum are (1) physician depression and suicide, (2) physician impairment, (3) burnout, and (4) resilience strategies. states that the responsibility of the program, in partnership with the sponsoring institution, to address well-being must include “policies and programs that encourage optimal resident and faculty member well-being” and “attention to resident and faculty member burnout, depression, and substance abuse.” 3Īt our institution, this session is part of a 3-year longitudinal curriculum that is built into didactics for all programs. ![]() The focus areas promote improvements to build an optimal clinical learning environment. 2 CLER has six focus areas: patient safety, health care quality, teaming, supervision, well-being, and professionalism. This has been supported by the development of the Clinical Learning Environment Review (CLER) pathways 1 and the common program requirements on well-being. Physician well-being is an important initiative of the ACGME since well-being, both psychological and emotional, is crucial to the development of the competent, caring physician.
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