Mid Career Research Articles

Physician Coaching by Professionally Trained Peers for Burnout and Well-Being

Physician burnout is problematic despite existing interventions. More evidence-based approaches are needed. To explore the effect of individualized coaching by professionally trained peers on burnout and well-being in physicians. This randomized clinical trial involved Mass General Physician Organization physicians who volunteered for coaching from August 5 through December 1, 2021. The data analysis was performed from February through October 2022. Participants were randomized to 6 coaching sessions facilitated by a peer coach over 3 months or a control condition using standard institutional resources for burnout and wellness. The primary outcome was burnout as measured by the Stanford Professional Fulfillment Index. Secondary outcomes included professional fulfillment, effect of work on personal relationships, quality of life, work engagement, and self-valuation. Analysis was performed on a modified intention-to-treat basis. Of 138 physicians enrolled, 67 were randomly allocated to the coaching intervention and 71 to the control group. Most participants were aged 31 to 60 years (128 [93.0%]), women (109 [79.0%]), married (108 [78.3%]), and in their early to mid career (mean [SD], 12.0 [9.7] years in practice); 39 (28.3%) were Asian, 3 (<0.1%) were Black, 9 (<0.1%) were Hispanic, 93 were (67.4%) White, and 6 (<0.1%) were of other race or ethnicity. In the intervention group, 52 participants underwent coaching and were included in the analysis. Statistically significant improvements in burnout, interpersonal disengagement, professional fulfillment, and work engagement were observed after 3 months of coaching compared with no intervention. Mean scores for interpersonal disengagement decreased by 30.1% in the intervention group and increased by 4.1% in the control group (absolute difference, -0.94 poimys [95% CI, -1.48 to -0.41 points; P = .001), while mean scores for overall burnout decreased by 21.6% in the intervention group and increased by 2.5% in the control group (absolute difference, -0.79 points; 95% CI, -1.27 to -0.32 points; P = .001). Professional fulfillment increased by 10.7% in the intervention group compared with no change in the control group (absolute difference, 0.59 points; 95% CI, 0.01-1.16 points; P = .046). Work engagement increased by 6.3% in the intervention group and decreased by 2.2% in the control group (absolute difference, 0.33 points; 95% CI, 0.02-0.65 points; P = .04). Self-valuation increased in both groups, but not significantly. The findings of this hospital-sponsored program show that individualized coaching by professionally trained peers is an effective strategy for reducing physician burnout and interpersonal disengagement while improving their professional fulfillment and work engagement. ClinicalTrials.gov Identifier: NCT05036993.

Advice to a Young Mathematical Biologist

This paper offers advice to early-mid career researchers in Mathematical Biology from ten past and current Presidents of the Society for Mathematical Biology. The topics covered include deciding if a career in academia is right for you; finding and working with a mentor; building collaborations and working with those from other disciplines; formulating a research question; writing a paper; reviewing papers; networking; writing fellowship or grant proposals; applying for faculty positions; and preparing and giving lectures. While written with mathematical biologists in mind, it is hoped that this paper will be of use to early and mid career researchers across the mathematical, physical and life sciences, as they embark on careers in these disciplines.

Lessons learnt from a nationally funded training and mentoring programme for early-mid career musculoskeletal researchers in Australia.

Quality training and mentoring are crucial components of successful career development for early mid career researchers (EMCRs). This paper describes the overarching framework of novel ongoing national Training and Mentoring Programme Melbourne University Sydney Queensland:Impact (MUSQ:Impact) for musculoskeletal researchers, including a description of how it was set up and established, and lessons learned from its implementation. The MUSQ:Impact programme spans four multidisciplinary musculoskeletal research teams across three universities in Australia, comprising 40-60 EMCR members. It was established to provide EMCRs with a unique learning environment and opportunities to gain exposure to, and network with, other national musculoskeletal research teams. Specific goals are to focus on core research competencies (e.g. writing skills, managing grant budgets, public speaking and media engagement, research translation), provide career mentoring, fund development activities (e.g. conference attendance, laboratory visits, skill development courses), and share training resources (e.g. data dictionaries, project summaries). A Steering Committee of 10-12 EMCR members, co-chaired by a senior researcher and one EMCR, is responsible for overseeing MUSQ:Impact and organising regular activities, including a monthly webinar series, a mentor/mentee scheme, annual group research retreats, annual infographic competition, and funding awards. An evaluation survey found that most participants perceived each activity to be beneficial and of value to their research career and development. This paper presents the structure of national training and mentoring programme that serves as a potential template for other research teams to adapt within their own contexts.

John Robert Lawrence Allen. 25 October 1932—18 October 2020

John Allen was one of the leading British geologists of the late twentieth century, who changed his primary research focus in mid career from clastic sedimentology to geoarchaeology. He read for a BSc degree in geology at the University of Sheffield, graduating with first class honours in 1955. He continued at Sheffield as a postgraduate student researching the geology of the Old Red Sandstone of the Clee Hills in Shropshire, but never submitted a PhD thesis. However, in 1958 the University of Reading offered him a research fellowship to investigate the geology of the hydrocarbon-rich River Niger delta region. In 1961 he became a lecturer in geology and a member of the new purpose-built Sedimentology Research Laboratory at Reading. The international renown of the laboratory was largely based on his prodigious sedimentological research output relating to sedimentary structures, river and coastal environments and Devonian continental deposits. He was appointed reader in 1967 and professor in 1972. In 1974 he led the founding of a taught MSc course in ‘Sedimentology and its applications’, which soon became a world leader. In 1988, in the context of the rationalization of university geology departments, Reading's department was selected for closure. However, John Allen's research esteem was such that a special case was made and a postgraduate-only institute specializing in sedimentology was established with him as director. He resigned the directorship after five years in favour of a research professorship. His objectives changed from orthodox old-rock studies to research on recent muddy estuarine sediments. By selecting the estuary of the River Severn as his new field area, he soon realized that this opened up a rich area of collaboration with colleagues in archaeology. His geological skills were subsequently applied to a range of archaeological problems. He became a key contributor to a new MSc degree course in geoarchaeology.

Career reconstruction: mid-career transformations in the Australian music industries

This article reviews current paradigms of music industry careers in order to theorise how career breaks and interruptions may be understood by music industry workers. While the career trajectories of young, independent and early-career musicians have been examined extensively, the lives of workers who are experiencing life course transformations (such as parenthood, ageing and health issues) and those who have taken a break from the music industries, are still largely under analysed. We begin with an overview of literature on this topic to highlight the ways that career transformations and ruptures have been omitted from conventional expectations about how to develop a successful music career. Then, we examine how these points of career change and interruption can be understood in an industry where the normalisation of the DIY/independent career model has itself disrupted common narratives for understanding career progression. From here, we develop the concept of music industry workers’ ‘imagined biographies’ to explore how social identity and the material circumstances of workers shape career development. We conclude by examining how ‘mid-care er’ transformations might be conceptualised in a way that is sensitive to social inequalities, identifying its relevance for understanding music industry workers’ career development in the Australian music industries.

MP25-18 DEVELOPMENT OF A CLINICAL-SCHOLAR INDEX SCORE FOR MEASURING ACADEMIC CONTRIBUTIONS IN UROLOGY

You have accessJournal of UrologyCME1 Apr 2023MP25-18 DEVELOPMENT OF A CLINICAL-SCHOLAR INDEX SCORE FOR MEASURING ACADEMIC CONTRIBUTIONS IN UROLOGY Peace Orji, Michael Kattan, Eric Klein, and Hadley Wood Peace OrjiPeace Orji More articles by this author , Michael KattanMichael Kattan More articles by this author , Eric KleinEric Klein More articles by this author , and Hadley WoodHadley Wood More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003253.18AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: The non-clinical contributions for academic urologists are not adequately captured in current administrative structures. To respond to this need in our department, we developed an academic index that would permit annual measurement of faculty non-clinical activities. METHODS: Academic activities were extracted from curriculum vitae (CV) and sorted into pre-determined categories. Categories were weighted based on discussion with department leadership. Weights were scaled 0-1 with 0 being defined as an activity that was non-essential to the mission, brought little to no external recognition or was beneath the appropriate milestone for the individual (middle author publications for a senior career staff member). 1 was defined as an activity that was essential to the department’s mission, a significant time commitment for the individual, and provided external recognition. Annual scholarly index scores were determined for all participants based on their weighted contributions for the year. RESULTS: Early career staff primarily make contributions through peer reviewed publications and presentation. Velocity of scholarly contributions was greatest during the Mid-career (MC) stage. Senior career (SC) urologists had the most diverse array of contributions of any group. Like many of the MC faculty, SC faculty demonstrated a decrease in non-clinical productivity beginning in 2018 following a shift in organizational priorities to increased clinical productivity (Figure 1 and 2). CONCLUSIONS: Non-clinical contributions of academic urologists can be quantified and tracked annually using this academic index. By doing so, leadership can more easily identify ways to support career development, which is especially important in mid-career, where individuals likely have the greatest opportunity for growth or stagnation. Finally, shifts in organization-wide priorities affect academic contributions and can be quantified by the model. Source of Funding: NA © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e350 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Peace Orji More articles by this author Michael Kattan More articles by this author Eric Klein More articles by this author Hadley Wood More articles by this author Expand All Advertisement PDF downloadLoading ...

Development of a Clinical-scholar Index Score for Measuring Academic Contributions in Urology

ObjectiveTo develop an academic index that would permit annual measurement of faculty non-clinical activities. MethodsAcademic activities were extracted from curriculum vitae (CV) and sorted into pre-determined categories. Categories were weighted based on discussion with department leadership. Weights were scaled 0-1 with 0 being defined as an activity that was non-essential to the mission, brought little to no external recognition or was beneath the appropriate milestone for the individual (middle author publications for a senior career staff member). 1 was defined as an activity that was essential to the department's mission, a significant time commitment for the individual, and provided external recognition. Annual scholarly index scores were determined for all participants based on their weighted contributions for the year. ResultsEarly career staff primarily make contributions through peer-reviewed publications and presentation. Velocity of scholarly contributions was greatest during the Mid-career (MC) stage. Senior career (SC) urologists had the most diverse array of contributions of any group. Like many of the MC faculty, SC faculty demonstrated a decrease in nonclinical productivity beginning in 2018 following a shift in organizational priorities to increased clinical productivity. ConclusionsNonclinical contributions of academic urologists can be quantified and tracked annually using this academic index. By doing so, leadership can more easily identify ways to support career development, which is especially important in mid-career, where individuals likely have the greatest opportunity for growth or stagnation. Finally, shifts in organization-wide priorities affect academic contributions and can be quantified by the model.

Harnessing the nursing and midwifery workforce to boost Australia's clinical research impact.

Harnessing the nursing and midwifery workforce to boost Australia's clinical research impact.

Psychological Wellbeing and Grit Among Freelancers in the UK Dance Industry.

The UK dance industry is composed largely of freelance workers, yet freelancers are an under-researched population within the dance science literature. The aim of this study was to investigate psychological wellbeing and grit (a combination of passion and persistence) among freelancers working in various roles in the UK dance sector. A total of 282 freelancers completed validated questionnaires tapping psychological wellbeing and grit (the 18-item Psychological Wellbeing Scale and Short Grit Scale). Analyses revealed relatively high levels of wellbeing, with participants scoring particularly high on personal growth and purpose in life (15.73 and 14.11, respectively, out of a maximum of 18). They also had high levels of grit (3.90 ± 0.33 out of a maximum of 5). Freelancers who identified as being early career reported significantly higher levels of grit than the mid and late career groups. Significant positive correlations were found between grit and the wellbeing domains of personal growth, purpose in life, and positive relations. Overall, the results of this study support previous qualitative research suggesting that a freelance dance career may provide elements of psychological wellbeing, and that passion and persistence towards long-term goals could be essential in the pursuit of a freelance career.

Cecil Edwin Henry Bawn. 6 November 1908—19 September 2003

Cecil Bawn was a physical chemist with particular expertise in chemical kinetics. Early in his career he made pioneering studies of free radical reactions in the gas phase and, during the war years, on the chemistry of high explosives. From mid career, he was one of the pioneers of polymer chemistry and established and led a strong and diverse group of polymer scientists at the University of Liverpool. He was a private and enigmatic person, with a strong sense of duty. His caring and helpful attitude was greatly appreciated locally by his students and younger faculty members. Nationally, he made outstanding service contributions to physical chemistry and polymer chemistry.

Abstract 17008: Cardiologist Adherence to Physical Activity Guidelines: Failure to Walk the Walk

Introduction: The 2019 ACC/AHA Guideline on the Primary Prevention of Cardiovascular Disease recommends adults engage in ≥ 150 minutes of moderate or ≥75 minutes of vigorous intensity aerobic activity per week to reduce cardiovascular risk. Cardiologist adherence to these guidelines is unknown. Methods: Electronic surveys were sent to 437 ACC CardioSurve cardiologists, a representative sample of current ACC members. Demographic data was collected. Respondents were asked to quantify and rate intensity of exercise in an average week. Results: Between February and March 2020, a total of 189 panelists completed the survey for a response rate of 43%, of which 13% were women. There was even representation in number of years in practice: 33% early career, 27% mid-career, and 35% late career. Cardiologists across all career stages were evenly represented; 33% early career, 27% mid-career, and 35% late career. Overall only 56% of cardiologists met exercise guidelines (Figure). Less than half participated in vigorous activity (46%) with higher prevalence among mid versus early career (58% vs 38%, p=0.035). Interventional cardiologists were less likely to meet the standards for exercise intensity compared to general cardiology (44% vs. 59%, p=0.09). Early career respondents were less likely to adhere to activity recommendations (39% vs 59%, p=0.018). Those who reported vigorous activity were more likely to strength train at least twice per week (43% vs. 15%, p &lt; 0.001). Conclusions: Nearly half of cardiologists are not adherent to the ACC recommended guidelines for aerobic activity. The impact on cardiologists’ health was not quantified, but this study suggests there is room for improvement in prevention behaviors. Since physicians are known to serve as role models for their patients, we hypothesize lack of adherence to activity guidelines may also negatively impact our patients.

Neural Control of Immunity in Hypertension: Council on Hypertension Mid Career Award for Research Excellence, 2019.

The nervous system and the immune system share the common ability to exert gatekeeper roles at the interfaces between internal and external environment. Although interaction between these 2 evolutionarily highly conserved systems has been recognized for long time, the investigation into the pathophysiological mechanisms underlying their crosstalk has been tackled only in recent decades. Recent work of the past years elucidated how the autonomic nervous system controls the splenic immunity recruited by hypertensive challenges. This review will focus on the neural mechanisms regulating the immune response and the role of this neuroimmune crosstalk in hypertension. In this context, the review highlights the components of the brain-spleen axis with a focus on the neuroimmune interface established in the spleen, where neural signals shape the immune response recruited to target organs of high blood pressure.

Impact of Surgical Experience on Operative Mortality After Reoperative Cardiac Surgery

Learning curves and skill attrition with aging have been reported to impair outcomes in select surgical subspecialties, but their role in complex cardiac surgery remains unknown. From 1986 to 2019, 2314 patients underwent reoperative cardiac surgery: coronary artery bypass grafting (n= 543), valve (n= 1527), or combined coronary artery bypass grafting and valve (n= 244). Thirty-four different surgeons in practice between 1 and 39 years were included. Standardized mortality ratio (observed-to-expected) was determined for all surgeons in each post-training year of experience. Risk-adjusted cumulative sum change-point analysis was used to define five distinct career phases: 0 to 4 years, 5 to 8 years, 9 to 17 years, 18 to 28 years, and 29 to 39 years. With 5 to 8 years and 18 to 28 years of experience, standardized mortality ratio was near unity (0.95 and 1.05, respectively) and lowest with 9 to 17 years of experience (0.78, P= .03). In the youngest experience group (0 to 4 years), observed and expected mortality were both highest, and standardized mortality ratio was elevated at 1.29, which approached statistical significance (P= .059). In the oldest experience group (29 to 39 years), expected mortality was low compared with most other groups but observed mortality increased, yielding a significantly elevated standardized mortality ratio at 1.53 (P= .032). Standardized mortality ratios with reoperative cardiac surgery were highest early and late in a surgeon's career and lowest in mid career. As surgeons gain experience, outcomes improve through the first two career decades, then stabilize in the third decade before declining in the fourth decade.

HOW TO PREVENT BURNOUT IN CARDIOLOGY

Burnout, as defined by the Maslach Burnout Inventory Survey, describes threeaspects: firstly, emotional exhaustion from being overworked, secondly,depersonalization or desensitization - a lack of compassion for patients and peersand professional efficacy and thirdly, reduced sense of accomplishment. Burnoutis the result of chronic emotional and interpersonal work place stressors The 1,2word “burnout” was originally used by Herbert Freudenberger in 1974 todescribe a state of emotional fatigue that was becoming more prevalent duringthe free clinic movement, attributed to the mismatch of resources to the needs ofpatients. Among other factors exhaustion from increased workloads and 3extended work hours combined with the stress of cognitive decision-making inthe setting of emotionally-charged situations contribute to physician burnout. In response to Waldo's article, Martin Goldman advised that the way to prevent burnout was to rely on peers, co fellows andsenior fellows seeking their advice as to how to cope with stressful situations and avoid stress. Cardiology now offers manydiverse career paths and one should sagaciously choose the right field which may be preventive, interventional, translationalresearch, cardiac imaging or heart failure. The work should lead to fulfillment. Hospital should introduce mentorship program tohelp an individual sail through the tough years of life. Choosing the right program depending on the location, volume and type oftraining is important. Cardiology is undoubtedly the most exciting field of medicine as it is truly life saving and on the cutting edge of science. Theepidemic of burnout has to be watched out and all efforts from personal counseling to organizational changes have to be put inplace to prevent it. To our trainees, the message is to enjoy the period of training, it is the most exciting and rewarding time inanyone's professional career. Mid career professionals should continue to practice cardiology and enjoy the novelty and quickresults it offer in most cases. Late in career, as the focus shifts from intervention to prevention, cardiology still has a lot to offer tokeep a doctor engaged with patients

Assessing the physiological strain of physical therapists according to work experience: A cross-sectional study

ObjectivesThis cross-sectional study aimed to assess the physiological response of physical therapists to compare the physiological workload within three groups of varying work experience and their comparative physiological responses during a 15-min recovery period. MethodsThirty therapists participated in the present study. They were divided into three groups with varying levels of work experience based on the number of years they had been in active employment: 1) Early Career (EC) group = 2–6 years); 2) Mid-Career (MC) group = 7–11 years), and 3) Late career (LC) group = over 11 years). Each group included 10 subjects comprised of both males and females. To conduct the measurements, each therapist treated one hemiplegic patient for 20 min using a passive range of motion protocol and then rested for 15 min. The maximum voluntary contraction on trapezius and deltoid muscles were tested using electromyography before and after treatment. During treatment, the muscle workload, muscle fatigue, and cardiovascular load were measured. The perceived workload was assessed using a subjective workload index (SWI) questionnaire following treatment. ResultsThe three work experience groups of physical therapists performed a similar workload. The SWI corresponded well with physiological measurement. The muscle capacity after treatment of the EC group was significantly lower than that of the MC group (p < 0.05). Notably, the right deltoid of the LC group was significantly lower than that of the MC group. ConclusionsThe physical therapists worked with a moderate, objectified workload. A 15-min rest period brought the cardiovascular load below 30% and lowered fatigue in the right deltoids. This result may indicate a musculoskeletal disorder warning signal for the physical therapists.

Work characteristics, motivational orientations, psychological work ability and job mobility intentions of older workers.

Drawing on job design theories and a conceptual framework of work-related goals and motivation in later adulthood, the aim of this paper is to explore how work-related and individual factors are separately and jointly related to psychological work ability and bridge employment intentions via late job mobility. The cross-sectional study is based on a sample of 171 older Spanish workers aged 45–65 and beyond. We differentiated between groups of older workers in mid career (45–55 years of age) and in their later careers (56 years and beyond). Our results confirm that task characteristics and, secondarily, knowledge characteristics are the most relevant factors in perceptions of psychological work ability among aged workers. Both age groups display a very marked personal mastery trait, which mediates the relationships between job characteristics and both psychological work ability and late job mobility intentions. The paper concludes with a discussion of theoretical and practical implications and suggestions for future research on the issues implied in the psychological adjustment of older workers in their mid and late careers.

Multiple constraints compromise decision-making about implantable medical devices for individual patients: qualitative interviews with physicians

BackgroundLittle research has examined how physicians choose medical devices for treating individual patients to reveal if interventions are needed to support decision-making and reduce device-associated morbidity and mortality. This study explored factors that influence choice of implantable device from among available options.MethodsA descriptive qualitative approach was used. Physicians who implant orthopedic and cardiovascular devices were identified in publicly available directories and web sites. They were asked how they decided what device to use in a given patient, sources of information they consulted, and how patients were engaged in decision-making. Sampling was concurrent with data collection and analysis to achieve thematic saturation. Data were analyzed using constant comparative technique by all members of the research team.ResultsTwenty-two physicians from five Canadian provinces (10 cardiovascular, 12 orthopedic; 8, 10 and 4 early, mid and late career, respectively) were interviewed. Responses did not differ by specialty, geographic region or career stage. Five major categories of themes emerged that all influence decision-making about a range of devices, and often compromise choice of the most suitable device for a given patient, potentially leading to sub-optimal clinical outcomes: lack of evidence on device performance, patient factors, physician factors, organizational and health system factors, and device and device market factors. In the absence of evidence from research or device registries, tacit knowledge from trusted colleagues and less-trusted industry representatives informed device choice. Patients were rarely engaged in decision-making. Physician preference for particular devices was a barrier to acquiring competency in devices potentially more suitable for patients. Access to suitable devices was further limited to the number of comparable devices on the market, local inventory and purchasing contract specifications.ConclusionsThis study revealed that decision-making about devices is complex, cognitively challenging and constrained by several factors limiting access to and use of devices that could optimize patient outcomes. Further research is needed to assess the impact of these constraints on clinical outcomes, and develop interventions that optimize decision-making about device choice for treating given patients.

HCI down under: reflecting on a decade of the OzCHI conference

In this study we present a scientometric analysis of the Australian Conference on Human---Computer Interaction (OzCHI) proceedings over the period of a decade (2006---2015). Conference proceedings were manually extracted from the ACM Digital Library and analysed. We observed OzCHI to be a popular conference attracting both submissions and citations. A group of leading researchers dominated the publication count followed by a long list of mid career academics. We observed the themes of Design, Health and Well-being and Education to be growing in importance. We also observed that full papers were cited significantly more than short papers. We conclude with a reflection on our methodology and a proposal of recommendations for the HCI/OzCHI community in Australia.

Conceptualising institutional support for early, mid, and later career teachers

In this paper we argue that institutions need to support early career teachers to learn to teach in much the same way that students who are new to higher education are supported: through integrated and intentionally designed transition strategies. We take a published student transition typology and adapt it to identify ways of supporting early career teachers. We argue that strategies within each conception of our adapted typology are necessary to support a diverse cohort of higher education teachers, not only those who begin teaching each year, but those who are in their mid and later careers.

Are Men more Intentional about their Careers than Women? An Exploration of the Career Trajectories of Indian Professionals

'Men are from Mars, Women are from Venus,' goes the popular adage. Research studies the world over have only reinforced the truth behind this statement, and we now live in a society wherein the differences in attitudes, aspirations, and intentions of both the genders have been widely acknowledged. Against this backdrop, egalitarian views that have come to supersede stereotypical notions on gender roles have paved way for women careers. However, the career progress rates of men and women are drastically different; for the record, though 27% of the entry level Indian workforce is women, only 5% of senior executives in India are so, as against a global average of 20%. Where does the change in approach or attitude (towards careers) between men and women come about? At what level and what age? Is there intentionality in career pathing by men? If so, where does it stem from? This report is based on a nation-wide survey of Indian professionals (men and women) and was aimed at finding answers to these pertinent questions. The respondents employed in the corporate sector typically belonged to distinctly different career stages namely early career, mid career, and advanced or matured career stages.