Medical School Faculty and Staff Well-being Post COVID-19 Pandemic Follow-up.

The workplace is an important setting for health protection, health promotion, and disease prevention programs. In the school setting, employee health and well-being programs can address many physical and emotional concerns of school staff. This systematic review summarizes evidence-based approaches from employee health and well-being interventions supporting nutrition and physical activity (PA) in a variety of workplace settings. The 2-phase systematic review included a search for articles within systematic reviews that met our criteria (addressing employee health and well-being programs; published 2010-2018; Phase 1) and the identification of individual articles from additional searches (addressing school-based employee interventions; published 2010-2020; Phase 2). We included 35 articles. Across all studies and types of interventions and workplace settings, findings were mixed; however, multicomponent interventions appeared to improve health behaviors and health outcomes among employees. Schools can apply this evidence from employee health and well-being programs in various workplace settings to implement coordinated and comprehensive employee health and well-being programs. Employee health and well-being programs may be effective at supporting nutrition and PA. Schools can use findings from employee health and well-being programs in workplaces other than schools to support school staff.

Background: In schools, teachers are often tasked with implementing mental health and well-being programmes. However, little is known about teachers’ views on and experiences with implementing these programmes. Aim: The aim of this systematic review was to explore teachers’ views and experiences of mental health and well-being intervention programmes developed to promote and protect student mental health. Methods: A systematic review of the empirical literature was conducted using the following databases: Academic Search Complete, APA PsycArticles, APA PsycInfo, British Education Index, Education Full Text (H.W. Wilson), ERIC, Social Sciences Full Text (H.W. Wilson), and SocINDEX with Full Text. Findings: Seven papers met the inclusion criteria. Teachers reported several challenges to the successful implementation of mental health and well-being programmes, including a lack of time allotted in the curriculum, insufficient training, and inadequate interagency support. There was evidence of conflicting opinions regarding the role of teachers in supporting students. Conclusion: It is recommended that mental health and well-being are viewed as central to schools’ ethos and that teachers are adequately prepared to implement programmes.

Building Emotional Resilience at the Workplace

A significant majority of Australian schools now include school-based well-being and/or social emotional learning (SEL) programmes and initiatives within their school timetable. These programmes are delivered, often with significant investment of money and time, in an attempt to successfully nurture social, emotional and academic competency and promote positive mental health within the staff and student community. This chapter explores the impact of the school context on the effectiveness of these programmes. The key aspects of school context considered here are the school social environment, the overall school culture and the school climate. These features of school context encompass important aspects of schooling that have an impact on how SEL and well-being programmes are implemented. The chapter proposes that Australian schools need to more carefully consider how the messages being delivered by any well-being and SEL programme can be assimilated into the wider school context. They also need to give greater consideration as to how that wider context can successfully accommodate the aims of each and every well-being and SEL programme. Overall, the findings of the chapter strongly suggest that Australian schools need to implement SEL and well-being programmes with a far wider consideration of context than is currently evident.

Business sector in developed countries faces financial losses related to health problems of their employees. These expenses are related to economic as well as to human losses. Therefore it is important to enhance employee well-being in order to prevent these problems. Traditional understanding of health mostly stresses the problem solving strategy, thus neglecting the search of factors, strengthening both the individual and the organization well-being. Compared to other EU countries, a subjective happiness level in Lithuania is rather low, therefore, a thorough study of positive psychological and social factors, encouraging personality development applicable to an organizational setting, creates a new impulse for the search of a harmonious combination of the person and the organization. Having this in mind the project aiming at developing a comprehensive model of the employee and the workplace well-being, based on biopsychosocial understanding of health and promoting positive healthrelated factors in an organization, was initiated. The object of the study is positive psychosocial factors affecting the employee and the workplace well-being. The present article presents a generalised view on the benefits of the employee and his workplace well-being interventions based on a thorough analysis of research literature of foreign and Lithuanian scientists. The authors introduce an Integrated Theoretical Model of Employee Well-being and Positive Work Environment. The model was formed based on the literature analysis. Publications for the analysis were collected from databases using keywords such as ‘organization’, ‘well-being’, ‘wellness’. The model is based on the biopsychosocial understanding of health including the interplay of healthrelated biological, social and psychological factors, as well as emphasizing promotion of the health-affecting positive psychosocial factors. The methods of the study were analysis of scientific literature, expert survey, comparison and generalisation. Effectiveness of employee health, well-being and positive work environment interventions . Most research findings on the benefits of health and wellbeing programmes in organizations confirm positive impact of the programmes upon the employee health and wellbeing: employees become more healthy, health costs are reduced, employee morale increased, productivity enhanced, decreased turnover, sick-leaves, increased employee endurance, self-esteem, sharpness of mind, new social bonds are created (Ginn, Henri, 2003). Therefore attention should be drawn on promotion not only of biological, but also of psychological and social wellbeing which is beneficial not only for employees, but for organizations as well. Separation of positive psychosocial factors affecting employee and workplace well-being. The literature analysis was performed in two phases: a) well-being models were analysed, b) analysis was focused on expanding the existing models by separate health and well-being related factors. Such an organization of the systematic literature analysis allowed to make a thorough list of well-being-related factors. These factors were grouped into several groups: a) individual characteristics of an employee determining employee well-being in general (sense of coherence, purpose and meaning in life, orientation towards personality growth, positive attitude towards life, positive affectivity, emotional intellect, playfulness, spirituality and values, general health and wilful personal responsibility for it; b) specific psychological personality characteristics related to a specific job (subjective satisfaction with one’s job and career, finding meaning in one’s job, job involvement, organizational commitment, psychological empowerment); c) interaction between the employee and the organization (a balance between professional and personal life having leisure time); d) organizational factors having impact on the employee well-being (sense of control and job demands, work conditions, work schedule, safety, organizational resources); e) quality of social relationships in the organization (positive organizational climate, organizational culture and healthpromoting organizational values, social support, characteristics of the leader); f) context of personality life (political and social formation, quality of personal relationships, positive interpersonal relationships, social network). Elaboration of the Integrated Theoretical Employee Well-being and Positive Workplace Model. The above-mentioned factors were combined into a model consisting of three basic groups of factors: individual psychological as well as organizational factors, mediated by home-work balance, within the context of broader social circumstances. The Integrated Theoretical Model of Employee Well-being and Positive Work Environment creates theoretical basis for practical intervention programmes in organizations. The Model needs to be empirically verified in order to assess the significance of its components on the employee well-being and positive work environment. This research was funded by a grant (No.MIP- 145/2010) from the Research Council of Lithuania.

Public and private sector interest in employee wellbeing has grown steadily in the past 20 years. Arguably the most visible manifestation of this interest is workplace health promotion and wellbeing (WorkWell) programs, which can be found in various guises within many contemporary organisations. Despite their recent proliferation, research in this area has focused mainly on how participation in these programs impacts upon a narrow range of factors related to finance (e.g. health care costs) and productivity (e.g. absenteeism). Whilst the focus of these programs is invariably positive (insofar as they aim to improve physical, psychological and social functioning), it cannot be assumed that employees will be positively disposed towards them. Indeed, empirical and anecdotal evidence suggests that employee participation is a widespread challenge when implementing WorkWell initiatives. This paper introduces the concept of employee receptivity and reviews an array of factors that may influence participation. After reviewing pilot data from an employee wellbeing research project, three primary conclusions are presented. First, that participation may be low because such programs may not provide employees with what they most need. Second, that employee receptivity may be an important factor in making decisions about the implementation of WorkWell programs. Finally, there may be times when organisations would be far better served by concentrating on basic human relations issues than making sizable investments in formal, structured employee wellbeing programs.

Wellbeing programmes are often initiated in organisations based on an assumption that they will promote employee engagement and performance. But the specific elements of a wellbeing programme are rarely evaluated for their efficacy. This case study reports on the development and refinement of a wellbeing programme at a large multi-site European organisation, analysing the utility of wellbeing offerings and the impact of the programme on employee wellbeing over the course of five years. Results from two internal surveys were analysed. The first, conducted at 18-month intervals between 2009 and 2014, evaluated employee engagement. The second, a tailored wellbeing survey conducted in 2014, measured employee wellbeing and perceptions of the individual wellbeing programme offerings. A number of key findings emerged: the wellbeing programme was highly regarded and reported to have a positive impact on employee engagement, some elements of the programme were better received than others, and there were significant differences in the wellbeing levels of different groups. Regression analyses provide evidence for the need to take account of individual employees’ current levels of wellbeing when tailoring a wellbeing programme for them, with current wellbeing predicting up to 11% of the variance in preference for different elements of the programme. Results highlight some of the complexities that organisations should be aware of when understanding employee wellbeing, including the effect of national culture, job grade and current wellbeing levels. This case study provides insight into the development of a wellbeing programme and evidence for its positive contribution to employee engagement.

Curriculum Management and Governance Structure ♦ The medical school adopted a centralized governance structure with its revised curriculum in 1992. ♦ Centralized governance has worked very well to ensure student achievement, interdisciplinary approaches to teaching and learning, ample and centralized support for medical education, and high-quality courses and instructors. ♦ Under the guidance of the associate dean for medical education, the curriculum is managed by directors in Component I, Component II, and Components III and IV, who all meet biweekly as a working committee. ♦ Component directors and assistant directors are appointed and funded by the associate dean for medical education. ♦ Major policy issues are managed by the Curriculum Policy Committee (CPC), which is composed of elected and appointed faculty members and medical students. ♦ A rigorous evaluation system, managed by a distinct office and staff with direction from a medical school faculty member, is monitored by the CPC. Office of Education ♦ The school's centralized governance structure for undergraduate medical education is administered through the Office of Medical Education. ♦ The associate dean for medical education has consolidated all activities in support of the curriculum for the MD degree in the medical school's Learning Resource Center (LRC), where students and faculty have access to support staff and resources, computers and printers, professional computer consultants, computer-based faculty development stations, small-group study rooms, classrooms and lecture halls, microscopes, the standardized patient program, and clinical skills examination rooms. Budget to Support Educational Programs ♦ The associate dean for medical education provides guidance and funding to faculty who lead each of the components of the curriculum (component directors and assistant directors), as well as the director and assistant directors of the Introduction to the Patient course, the standardized patient program, and the comprehensive clinical assessment. ♦ There is also centralized funding available for curriculum innovations and improvements, including development of new courses, sequences, and electives; new approaches to education and assessment; and computer-based enhancements and exercises. Funding for the curriculum and curriculum leaders was established in 1992 and has been increased by the dean over the last several years. ♦ In 1997, the school began quantifying the cost of medical education using an activity-based cost-accounting model. With information from faculty and administrators applied to the model, the school is now redistributing funding to departments based on actual educational costs, and also centralizing additional funding to support medical education under the aegis of the associate dean for medical education. Valuing Teaching ♦ The dean's office directly funds faculty members who are key leaders and administrators in the medical school curriculum. ♦ In the first two years, every faculty member with three or more contact hours in the curriculum is evaluated by students; in the clinical years students evaluate residents and faculty with whom they work. ♦ Individual faculty, course/clerkship directors, and department chairs may request student evaluations at any time. ♦ Documentation of the amount and quality of teaching provided is required by the medical school's promotion committees; a teaching portfolio template is provided via the Web for faculty to document their teaching contributions. ♦ All teaching faculty are encouraged to use evaluations of their courses and access to educational experts and computer consultants to develop innovative approaches to teaching and learning. Funding for such efforts is provided to faculty by the associate dean for medical education. ♦ The medical school has expanded its recognition of teaching by adding the Medical Student Award for Teaching Excellence to its more traditional awards. This award recognizes those faculty evaluated most highly by the medical students for their outstanding teaching, and is bestowed on eight faculty each year. CURRICULUM RENEWAL PROCESS Learning Outcomes ♦ The school's goals of medical education were created by the faculty in 1991, prior to development of the revised curriculum. The goals state specifically expectations for medical student progress and achievement in the curriculum. ♦ The goals were reviewed and formally reaffirmed by the faculty and the medical school executive committee in 1996. ♦ A curriculum blueprint, updated by faculty every two or three years, identifies specific knowledge, skills, and competencies every medical student must possess prior to graduation from medical school. This blueprint is used as a guide for content in all four years of the curriculum. ♦ Each course, sequence, and clerkship has specific published objectives to be met by medical students as measured by the course director; each clerkship director also has responsibility for ensuring student learning in specific areas (e.g., signs and symptoms) identified and agreed upon by the faculty director of the clinical years and the clerkship directors. Changes in Pedagogy Over the past decade biomedical research has become less based in the traditional scientific disciplines, and more integrative, especially with the expansion of knowledge in molecular biology and medical genetics. Further, learning occurs most effectively in a context that simulates the setting in which knowledge and skills will be applied. ♦ The first- and second-year medical curriculum is designed to enhance integration across the biomedical sciences with presentation of material and learning experiences in a clinical context, including communication and physical examination skills. ♦ Small-group discussions, laboratories, and computer/Web-based exercises augment traditional instruction, and weekly clinically-based multidisciplinary conferences re-inforce learning. ♦ The school is in the process of integrating specific disciplines into segments of the curriculum across all four years. ♦ Multiculturalism, complementary medicine, and geriatrics are just a few of the topics that are being integrated into the context of existing courses and sequences, with a focus on the patient's perspective. The topics are presented to students in the manner in which patients will present their medical problems to their physicians. This approach will encompass traditional and computer/Web-based instruction, standardized patient exercises, and patients and role models in clinics and hospitals. ♦ The effectiveness of the core curriculum and its integration into existing educational programs is assessed annually; methods will include the Comprehensive Clinical Assessment. ♦ An “educational consultant” model will also be implemented, which will allow students who have seen a particular patient in the clinic or who have worked through a case to present questions via the Web to a UM specialist, who will respond within 24 hours. ♦ Student progress in the specific disciplines is assessed at least once a year, and models to allow students to assess their own knowledge and skill in these areas are being developed. ♦ Instructional modules available via the Web have been introduced in several of the required clerkships to ensure consistent student learning and mastery of required material. The modules were developed by clerkship directors and their colleagues with computer consultants in the Office of Medical Education; they are case-based, interactive, and incorporate self-paced instruction and self-assessment components. ♦ Instructional standardized patient instructor (SPI) exercises have been incorporated across all four years of the curriculum; SPIs are also used for assessment of student knowledge and skills in most of the stations on the Comprehensive Clinical Assessment. ♦ All of the student encounters are videotaped, and students with marginal or failing performances return to review and discuss their encounters with the faculty director of the SPI program, prior to repeating the exercise. ♦ Communications skills and professionalism in encounters with SPIs are reviewed separately, and students must perform satisfactorily to receive a passing grade. Students must pass all SPI exercises to be promoted and to graduate. Application of Computer Technology ♦ Medical students are not required to own their own computers, but support is available to those who bring computers with them to medical school. ♦ There are 90 computers in the Learning Resource Center (LRC), another 26 computers in medical student study areas to which they have access 24 hours a day, seven days a week, and 15 computers in the UM Hospitals medical student call rooms. There are also “E-mail express” computers available to students in the LRC and the student study areas. ♦ The school has created Web-based “Coursepages” for medical students, through which students have access to a variety of information, services, and original educational materials developed by LRC computer consultants with medical school faculty. Using the Coursepages, students can access a variety of administrative and educational materials, including interactive educational materials developed by medical school faculty, calendars and schedules, and quiz and exam scores. They can submit “queries” about exam items, check course and clerkship grades, complete course and teacher evaluations, submit changes of their addresses, check their university accounts, and access Medline and other Web-based resources. Students can use and take practice quizzes. ♦ Required first-year quizzes are administered weekly to students via the Web in the LRC. The third-year pattern-recognition examinations, administered five times throughout the year, are also available to students via the Web. ♦ The LRC's faculty development stations provide faculty with state-of-the-art hardware, software, and professional consultation to introduce them to technology they can use to upgrade existing teaching materials or create new computer-based materials for use in the classroom. There is no charge to the faculty for use of the stations or for consultation. Changes in Assessment ♦ The Comprehensive Clinical Assessment (CCA), an OSCE-format examination, measures knowledge, skills, and competencies the faculty have identified as fundamental for graduation. ♦ The CCA is a four-hour examination comprising 12 stations that each student undergoes early in the fourth year. ♦ Content varies year to year to ensure appropriate sampling of critical clinical skills and competencies, and is determined by a faculty director and committee using the curriculum blueprint as a guide. ♦ To graduate, students must pass each station and the CCA overall, and must also pass a cross-station professional-skills component of the exam. ♦ With funding from the National Board of Medical Examiners Medical Education Research Fund, the school has expanded efforts to learn more about medical student self-assessment. Over the last several years, the school has examined self-assessment in each year of medical school and across a wide range of tasks, and has also explored predictors and behavioral implications of self-assessment accuracy. Studies to date have yielded a number of findings, including (1) self-assessment accuracy does not appear to relate to personal or academic variables, including academic performance, academic background or preparation, ethnicity, or gender, and (2) self-assessment accuracy may be slightly greater with more familiar tasks, suggesting a possible role for learning and experience. Upcoming studies focus on the dynamics of self-assessment and self-directed learning in medical education, and begin to examine interventions that might augment these skills. One study extends previous work from undergraduate medical education into graduate medical education, and another compares problem-based learning with learning in a more traditional curriculum to study both generalizability of previous results and the impact of curricular format on self-assessment and self-directed learning. Clinical Experiences ♦ Clinical experiences begin early in the first year with students' shadowing physicians in physicians' offices and clinic settings. Small-group discussions of specific topics, with each group facilitated by a physician and an educational expert, augment the shadowing experience. ♦ In the second year, each student is assigned to a clinical skills instructor (CSI) with whom the student will conduct five histories and physical exams throughout the year. There are two new models in place for the CSI experiences: The first model is focused on early clinical skills and is predicated on bringing the patient and the physician—teacher to the student in a student-centered educational setting within the LRC. Physicians and their patients meet with individual students in the LRC clinical skills laboratories. Students do a history and physical exam on the patient under supervision, write up findings/observations, and present the patient to the faculty. This approach provides the opportunity for direct real-time feedback to the students, with videotaping availability to critique student—patient interactions, including communication skills. The second model is based at the Northeast Ann Arbor ambulatory care facility, and is designed to enhance clinical education in the ambulatory setting in a structured rotation involving student, patient, and physician. Again, the experience is centered on the student—patient interaction, with supervision and feedback from the physician—teacher. Students spend one half day in clinic with physicians. Each student meets independently with a patient and conducts a history and physical exam. While the student writes up findings and observations, the physician examines the patient the student has seen. The student then presents the patient to the physician, who provides direct real-time feedback/instruction to the student, which may include returning to meet with the patient. ♦ Each of the clinical clerkships provides students with in-patient and outpatient educational experiences to ensure that specific learning objectives are met. “Educational consultants” (see changes in Pedagogy section above) who are specialists in specific domains will augment learning that occurs as students encounter real patients in the hospitals and clinics. Clerkship faculty can also develop computer- and patient-based cases; students can work through the cases to ensure mastery of specific competencies and seek input and guidance from the Educational Consultants. Curriculum Review Process ♦ In 1992 the school developed and adopted a centralized system for evaluation of the curriculum and teaching. ♦ The Curriculum Evaluation Office is managed by the director of the Office of Educational Resources and Research (OERR), who provides analyses of evaluation data and information and recommendations to faculty curriculum directors, the associate dean for medical education, and the Curriculum Policy Committee. A research associate manages the curriculum evaluation process and data, with assistance from an academic secretary. ♦ The Curriculum Policy Committee oversees the evaluation process and receives and acts on evaluation reports. ♦ The school evaluates six distinct areas of the curriculum, using a variety of internal and external measurements. Data are collected throughout each of the four years and at the conclusion of each academic year, and a full evaluation cycle is completed every four years. Follow-up evaluations of students by residency program directors occur one and three years after graduation. See Table 1 for more information about the evaluation process.TABLE 1: The Evaluation Process♦ Evaluation instruments. The annual survey instruments are organized to measure achievement of the ten goals of medical education. To facilitate the comparison of students' educational experiences across all four components, comparable evaluation instruments are structured with a core of common items. Though different evaluation forms are used to assess clinical and basic science teaching, core evaluation items are included on all forms. Course, sequence, and clerkship directors may add additional items to their course, sequence, or clerkship evaluation instruments in order to capture information relevant to their unique educational offerings. ♦ Student evaluations of teachers and curriculum Components I and II: Students are randomly assigned to four different cohorts (approximately 42 students per cohort), each of which is responsible for evaluating selected educational experiences during a half semester. Thus, 100% of the class is involved in the evaluation process, but no student is involved for more than half of a term. During their assigned half-term, students are asked to complete evaluations of faculty presentations, courses, and multidisciplinary conferences. All faculty with three or more hours of contact with students are evaluated, and faculty with fewer contact hours can request to be evaluated. All students participate in end-of-year component surveys. Components III and IV: In Component III, all students complete clerkship and clinical faculty teaching evaluations at the conclusion of each of the required clerkships. Each Friday, all students complete an evaluation on the Component III weekly seminars. The overall Component III experience is evaluated at the middle and end of the academic year by all students. In Component IV, all students are asked to complete an evaluation of their first six months of clinical rotations. At the end of Component IV, students are asked to complete an evaluation of Component IV overall, and also to share their impressions of the four-year curriculum. Two years ago, the school shifted its evaluation process from paper-and-pencil to Web entry. Students can now enter their evaluations and comments directly via the Web, and the program allows easy tracking of students to remind those who have not completed their evaluations. Program in Professionalism ♦ The University of Michigan Medical School has developed a comprehensive program to ensure that students understand the importance of professionalism in medical practice and acquire appropriate professional skills prior to graduation. ♦ The program begins during orientation to medical school with an oncologist who presents one of his or her patients and the patient's spouse. They all speak candidly to the class about the patient's cancer, the patient's relationship with the physician, the patient's personal and medical experiences since diagnosis, and the effects of the illness on the patient's life and family. Students are then encouraged to participate, and many ask probing and thoughtful questions about the difficulty of breaking bad news to patients, the essence and significance of the physician—patient—family relationship, trust, compassion, ethics, and personal and professional values and beliefs. ♦ The program in professionalism is incorporated throughout the four years of medical school, with assessments and feedback along the way. Specific components are physician—patient presentations (in the first and second years) small-group discussions (based on specific cases and experiences) scripted encounters with standardized patients (in all four years) role models (in all four years) concern/commendation cards assessment of professional behavior on all clinical clerkships assessment of professional behavior on the annual Comprehensive Clinical Assessment formal presentations by physicians about professional behavior (orientation, seminars in medicine, specific course/clerkship exercises) ♦ During the standardized patient encounters, the clinical clerkships, and the Comprehensive Clinical Assessment, student professionalism is assessed as a separate domain and followed longitudinally. Those students whose skills are below a certain level are provided with feedback and required to complete and pass remedial exercises. Demonstration of appropriate and consistent professional characteristics is a stated and published requirement for graduation. Future Goals and Challenges ♦ There will be an increased emphasis on the development of communication skills and recognition of the importance of the personal and social context in providing health care to patients. ♦ There will be a continued emphasis on and assessment of professionalism and professional characteristics. ♦ There will be incorporation of additional student-centered learning approaches into the curriculum (e.g., the Educational Consultant model). ♦ The integration of specific topics and assessment of mastery throughout the four-year curriculum will be continued. ♦ There will be continued development of educational experiences to prepare students for practice in evolving health care delivery settings and medical management models.

Purpose The purpose of this study is to examine the well-being initiatives and programs offered to full-time communication employees and identifies antecedents of employee subjective well-being and commitment in the workplace (e.g. organizational attention to mental health in the workplace and perceived organizational support, POS). Design/methodology/approach Guided by organizational support theory (OST), we conducted an online survey with 262 full-time communication professionals. Findings The data show that a variety of well-being initiatives and programs (e.g. mental health assistance programs and flexible working hours) are offered to communication employees, who receive this information from various sources (e.g. emails and announcements at employee meetings). Additionally, the number of well-being initiatives also positively predicted organizational attitudes and attention to mental health in the workplace. Supporting OST, attitudes and attention to mental health in the workplace positively predicted POS, which subsequently predicted subjective well-being and organizational commitment. Research limitations/implications The study offers practical implications around the communication professionals’ experience in employee well-being and culture. Perspectives from internal communication teams will help organizations leverage their efficiency in creating a supportive work culture around mental well-being and contribute to the understanding of well-being in communication industries. Theoretically, we extended the range of OST, by testing the theory in a new context of communication professionals during the pandemic. Originality/value Although communication professionals carry a critical internal communication role in actively promoting employee mental health, well-being and healthy organizational cultures, very little research has been dedicated to investigating how they handle these subjects themselves. Therefore, this study provides original value by focusing on the perceptions, knowledge and action taken by communication professionals when responding to organizations’ well-being programs/initiatives offerings during the peak of COVID-19 and the factors that influence communication professionals’ subjective well-being.

BackgroundMental health has long been recognised as a major global health issue. Some work-related characteristics have been identified to be associated with common mental health problems, and thus the workplace is an important venue for the prevention of mental health problems and promoting mental wellness. Burnout is one of the important aspects of workplace organisational stressors and, in recent years, the lack of mental health literacy has also been identified as a fundamental issue. Studies have demonstrated that an improvement in mental health literacy is an effective measure for enhancing mental well-being. It would be prudent to combine an organisation-directed component and the enhancement of mental health literacy in an intervention programme. This trial will examine the novel approach of an intervention aiming to provide an evidence-based prevention programme.MethodsThis study utilised a wait-listed cluster randomised control trial design. Using branch offices as the primary sampling units, employees from three large companies in different industries will be recruited. Upon enrolment and after the baseline assessment of the outcome measures, participants nested in the branch offices will be allocated to the intervention or wait-listed arms. The intervention programme comprises of two main elements: an organisation-directed component and individual-directed psychoeducation training. This intervention will be delivered by a senior social worker well-versed in workplace issues over a period of 3 months. The trial will determine whether an integrated workplace mental health literacy and well-being programme is effective in increasing the mental health literacy scores and reducing burnout and stress scores, as measured by standardised and validated scales.DiscussionIf the trial results are in line with the hypothesis that supports the efficacy of the intervention programme, this will provide an evidence-based approach for an effective workplace mental well-being intervention programme that could not only enhance the understanding of mental health issues, but also reduce work-related burnout and stress as well as increase workers’ quality of life.Trial registrationAustralian New Zealand Clinical Trials Registry (ANZCTR), ACTRN12619000464167. Registered prospectively on 20 March 2019.

The oil and gas sector operates within uniquely demanding environments characterized by high-risk activities, remote operations, extended shift rotations, and diverse workforce configurations that generate substantial occupational stressors extending beyond conventional workplace challenges. Despite significant investments in safety management systems, the industry continues to grapple with persistent mental health challenges, cultural norms that discourage vulnerability, and operational gaps that undermine employee wellbeing and organizational effectiveness. This research examines how strategically designed employee-centric wellbeing programs can serve as catalytic mechanisms for transforming workplace culture within the oil and gas sector, with particular emphasis on initiatives encompassing psychological and social risk management, ergonomic interventions, and comprehensive wellness infrastructure that promote mental health, workplace inclusion, and employee engagement.Employing a convergent parallel mixed-methods research design, this study integrates quantitative survey data from 1,247 employees across four multinational oil and gas organizations with qualitative evidence from 47 semi-structured interviews, seven focus group discussions, and organizational document analysis. The research examines relationships between wellbeing program engagement, psychosocial safety climate, and employee outcomes including psychological wellbeing, work engagement, perceived organizational support, workplace inclusion, and turnover intentions, while exploring implementation dynamics, leadership practices, and contextual factors shaping program effectiveness.Findings demonstrate that comprehensive wellbeing programs generate substantial improvements across multiple organizational levels. Employees with high program utilization exhibited significantly superior psychological wellbeing scores (18.3 points higher on WHO-5 index), enhanced work engagement, strengthened organizational commitment, and reduced turnover intentions compared to low-utilization counterparts. Structural equation modeling confirmed that psychosocial safety climate functions as a critical mediating mechanism, accounting for 42-47% of program effects on employee outcomes. Qualitative analysis revealed that programs catalyze cultural transformation by normalizing mental health discourse, disrupting stigmatizing norms, and signaling authentic organizational care. Particularly significant is the amplifying role of care-centered leadership, wherein leaders who model vulnerability, prioritize employee welfare, and enact small acts of recognition accelerate cultural shifts and enhance program effectiveness exponentially.Organizational performance indicators corroborate employee-level benefits, with participating organizations documenting turnover reductions of 23-31%, safety incident rate decreases of 18-27%, and absenteeism declines averaging 14.7% following program implementation. However, implementation challenges including middle management resistance, access barriers for remote/offshore workers, and systematic exclusion of contractor populations require intentional design solutions. Differential impacts across operational contexts underscore the necessity of context-adapted interventions rather than standardized approaches.These findings carry profound implications for the oil and gas industry and analogous high-risk sectors. Employee-centric wellbeing programs represent strategic organizational investments that enhance not only humanitarian outcomes but operational excellence, safety performance, talent retention, and competitive positioning. The research demonstrates that authentic care for employee wellbeing enhances rather than conflicts with business objectives, challenging false dichotomies between human welfare and organizational performance. For sustainable cultural transformation, organizations must move beyond programmatic offerings to embrace comprehensive approaches encompassing care-centered leadership development, psychosocial risk management, inclusive program design ensuring equitable access across diverse workforce populations, and systematic evaluation frameworks. The study advocates for industry-wide adoption of evidence-informed wellbeing initiatives and identifies critical directions for future research including longitudinal effectiveness studies, technology-enabled intervention evaluation, and cross-sector comparative analyses to advance knowledge translation and accelerate cultural evolution toward human-centered organizational paradigms within high-risk industries.

The Liaison Committee on Medical Education (LCME) requires that well-being programs must be "effective." Yet most medical schools do not robustly assess their well-being programs. Most evaluate their programs using one question on the Association of American Medical College's annual Graduation Questionnaire (AAMC GQ) survey for fourth-year students on their satisfaction with well-being programs, which is inadequate and nonspecific and only assesses a specific time in training. In this perspective, we, as members of the AAMC Group on Student Affairs (GSA) - Committee on Student Affairs (COSA) Working Group on Medical Student Well-being, suggest adapting Kern's 6-step approach to curriculum development as an effective framework to guide the development and evaluation of well-being programs. We suggest strategies for applying Kern's steps to well-being programs, with attention to conducting needs assessments, identifying goals, implementation, and evaluation and feedback. While each institution will have unique goals emerging from their needs assessment, we put forth five common medical student well-being goals as examples. Applying a rigorous and structured approach to developing and evaluating undergraduate medical education well-being programs will involve defining a guiding philosophy and clear goals and implementing a strong assessment strategy. This Kern-based framework can help schools meaningfully assess the impact of their initiatives on student well-being.

PurposeThe purpose of this paper is to examine the evaluation of a universal, mental well-being and mindfulness programme in a UK graduate entry medical school.Design/methodology/approachMixed methods used in the paper were the measurement of mental well-being and mindfulness in two cohorts at three time points over 15 months; descriptive, regression and repeated measures analysis with post hoc pairwise comparisons; qualitative interviews with purposive sample of 13 students after one year analysed thematically; and spontaneous anonymous feedback on the course.FindingsThe course was a surprise to students, and reactions were mixed. Respect for its contents grew over the first year. Most students had actively implemented a well-being strategy by the end of the course, and an estimated quarter was practicing some mindful activity. In the context of an overall decline in well-being and limited engagement with mindfulness practice, increases in mindfulness were protective against this decline in both cohorts (p<001). A small minority of students thought that the course was a waste of time. Their attitudes influenced engagement by their peers. The mindfulness and well-being practices of the facilitators were evident to students and influenced perceived effects.Research limitations/implicationsThe uncontrolled nature of this observational study and low response rates to the survey limit conclusions. Further research in other medical education settings is needed.Practical implicationsResults are encouraging, suggesting modest benefit in terms of changing attitudes and practices and a modest protective effect on the well-being of students who engaged.Originality/valueThis is the first study of a universal well-being and mindfulness programme in a UK medical school. Universal programmes are rare and evaluation studies are scarce.

October 2015 saw the presentation of the Royal Society for Public Health (RSPH) Health & Wellbeing Awards. The winners were 26 truly inspirational organisations who are facilitating health improvement by enabling and empowering their staffand/or the communities and individuals they serve. Regardless of their size or sector, their commitment to leadership is of the highest level, with innovative strategies which address the wider social determinates of health.The RSPH Awards are not a competitive scheme; instead, they provide organisations with the opportunity to reflect on their work against set criteria1 and to win an award based on their own merit. It has three categories, each indicating a level of good practice and innovation as well as benchmarks to support the continuous development of organisations.The first category is the One Year Award, given to organisations that demonstrate a planned approach to developing their health improvement capability and practice. The winners this year are as follows:* Cancer Focus Northern Ireland for their Well Aware programme - an innovative public health intervention which empowers older people to take control of their health. It achieves this by helping participants feel more confident about seeking advice and accessing existing services. During 2015, the organisation delivered 21 Well Aware sessions and carried out more than 250 health checks.* Charlton House for their Passport to Health programme which improves the health and wellbeing of employees at Gatwick airport by encouraging healthy eating. This involves an employee nutritional education programme alongside the enhancement of the nutritional profile of the food that is available to staff.* Do Something Different for their Health and Wellbeing programmes - a digitally delivered 'nudge' service that encourages people in Hertfordshire to take steps to improve their emotional wellbeing, mental health, lifestyle and obtain a healthy weight, all delivered via text and email. Over a thousand residents of Hertfordshire have already signed up and are using this service effectively.* GE Money Home Lending for their HealthAhead programme. This programme is designed to improve the health of GE's employees and their families. It has been built into the organisation's goals and objectives and constantly shaped by the team on site; 87% of GE's stafffeel that the company is committed to promote health at work.* Health for All Leeds for their Health Trainers programme - an effective behaviour change intervention designed to help the most deprived and vulnerable groups in Leeds make changes to their lifestyles and achieve better health. Last year, their team of health trainers helped over 160 families and over 5,000 adults and children to adopt healthier lifestyles.* Network Rail for their CardiffArea, Signalling Renewals project which aims to ensure that the entire workforce returns home fit and without injury. The project has an innovative and creative approach to integrating health and wellbeing into a health and safety context. All their activities are highly accessible and designed to meet the needs of their workforce, which is predominantly male. Last year at one of their awareness events, they had 200 staffin attendance, where over 50% received a health check.* Sefton Council for their Partnership for Health programme which involves all health-promoting organisations from across statutory, voluntary, community and private sectors in Sefton. As well as joining forces to deliver projects, they also work together to achieve better health and wellbeing for their own staff. Their efforts managed a 29% reduction in sickness absence levels across all the organisations involved.* Sirona Care and Health for their Taking It Personally programme which provides information, advice and support to enable disadvantaged people, improving access to training, education and work opportunities. …

An introduction: (comprising context and problem statement) The Consultant Cardiologist highlighted that a large proportion of his patients attending the Heart Function Clinic presented with a number of modifiable risk factors, which if dealt with could improve their quality of life.He recognized that he could not treat the condition alone (medical model) but had to treat the patient as a whole (holistic model), with family involvement where possible. This involved integrated care and partnership working, (right care, by right person, at right time), with the Health and Wellbeing Advisor’s (HAWA), helping patients to address their lifestyle issues, thus freeing up clinician time. Short description of practice change implemented: Patients attending the Heart Function Clinic are referred to the Health and Wellbeing Clinic by the Consultant Cardiologist or Specialist nurse, if they feel the patient would benefit from participating in the programme for alcohol, tobacco, weight or mental health issues and meet the criteria. Aim and theory of change: To demonstrate the effectiveness of delivering health behaviour change interventions to patients with pre existing heart disease Targeted population and stakeholders: Patients attending the Heart Function Clinic, Family members, Health and Wellbeing Advisor, Consultant Cardiologist and Specialist nurse. Timeline: In September 2012, NHS Ayrshire & Arran commenced delivery of the Health and Wellbeing (HAW) Programme in Cardiology. Over a year, 60 patients participated in the programme. Highlights: (innovation, Impact and outcomes) The 31 patients who attended 3 or more appointments were invited to participate in the evaluation. 22 patients took part in the telephone interviews, 3 of which were the wives who joined the Programme to support their husband. • 91% said they had learned something new about living healthy lifestyles. • 77% said Programme had made them feel better, reasons being physical comfort, from weight loss, increased sense of happiness and feeling relaxed. • 73% reported significant improvement in their quality of life 15th International Conference on Integrated Care, Edinburgh, UK, March 25-27, 2015 1 International Journal of Integrated Care – Volume 15, 27 May – URN:NBN:NL:UI:10-1-117079– http://www.ijic.org/ • Almost 70% said their health had improved as a result of the Programme and almost half said their doctor had confirmed health improvement • 77% reported their spouse/children had made lifestyle changes. • 73% viewed Programme as good or excellent The programme offered patients the opportunity to be seen by the HAWA while at an existing appointment, or at a venue suitable to them. It also allowed patients to decide what issues they would like to address as a priority, (as opposed to the issue they were referred with), and set their own goals. Comments on sustainability: The initial pilot has been extended and now includes patients attending the chest pain clinic. The long term vision is to embed this service within existing clinics by training Cardiology staff to deliver the Health and Wellbeing programme. Comments on transferability: The model has been used to expand delivery of the health and Wellbeing programme to patients with Respiratory Disease and Rheumatoid Arthritis. Conclusions: (comprising key findings) The Programme has successfully supported people to make health behavioural changes. It has further impacted on the health of carers and family members demonstrating the programme to be preventative and anticipatory care in action. The programme has proven itself to be clinically and financially effective as patients are able to be seen in their own community and some patients now require to see their consultant less frequently due to the improvement in their clinical symptoms. Discussions: An unanticipated development in the programme was the decision to allow spouses and other family members to become involved. Family members are now encouraged to participate in the programme to support the patient and promote a family approach Lessons learned: It was initially envisaged that most patients referred would be newly diagnosed with heart failure. However, many of these patients said that they needed to come to terms with their condition before contemplating making any changes to their lifestyle. Therefore, targeting of individuals who are in a stable condition, appears to have more positive outcomes.