Professional Fulfillment Research Articles

Empowering physician leaders: UPMC’s breakthrough leadership development programme

In the ever-changing landscape of healthcare management, the role of physician leaders has become increasingly important. Physicians with strong leadership and management skills are well positioned to bring medical expertise to the business side of healthcare, benefiting their organisations immensely. Effective physician leaders also foster a healthier team environment, making a positive impact on their care team and patients. Traditional medical education, while strong in clinical training, typically falls short in adequately preparing physicians for leadership roles. This prompted the University of Pittsburgh Medical Center (UPMC) to launch an internal initiative to support physician leadership development. This case study looks at the journey from concept to successful implementation of UPMC’s inaugural leadership development programme for physicians. It also addresses the challenges of deploying the programme during a global pandemic and the lessons learned from the experience. Through internal surveys, UPMC recognised that physicians wanted professional growth and development opportunities. In 2017, UPMC formed an internal board of physician leaders to identify the specific learning needs of that population. In 2018, UPMC hired individuals dedicated to the creation of a leadership programme for physicians, now branded Physician Leadership Essentials (PLE). Before the programme’s launch, physicians were left to seek development outside the organisation. Following a pilot in 2019, the programme was deployed on a larger scale, starting in January 2020. As of 29 February 2024, 482 participants from various speciality and practice locations participated in 26 rolling cohorts of PLE. Twenty cohorts have completed the programme, resulting in 314 alumni. Today, there are six ongoing cohorts with 139 active participants. The programme exhibits 99.5 per cent favourability and a 92 per cent retention rate. Participants have completed 247 leadership challenge projects. This programme has fostered a culture of growth and development for physicians across UPMC and enhanced cross-functional and cross-departmental collaboration. It has also unlocked some of the untapped leadership talent of physician leaders, increasing not only their effectiveness but also their sense of professional fulfilment and engagement.

Final results of the National Oncology Mentorship Program 2023 and its impact on burnout and professional fulfilment.

Significant burnout and low professional fulfilment are noted among medical oncologists and trainees. The National Oncology Mentorship Programme (NOMP23) was designed to evaluate the impact of a 1-year mentorship program between oncology trainees (mentees) and consultants (mentors) on improving professional fulfilment and burnout. NOMP23 was a single-arm, prospective cohort study. One hundred twelve participants (56 mentors and 56 mentees) across Australia were recruited. Mentee/mentor pairs were orientated to the program virtually and met at least three times throughout 2023. The primary outcome was improvement in professional fulfilment as assessed using the Stanford Professional Fulfilment Index at conclusion of NOMP23 compared to baseline. A total of 112 participants enrolled. Eighty-six (77%) completed the baseline and 63 (56%) completed the end-of-program survey. At baseline, 82% of mentees and 77% of mentors were classified as burnt out, which reduced to 57% and 51% at the conclusion of NOMP23; a reduction of 25% and 26% (P < 0.01). Baseline professional fulfilment was 0% and 5% for mentees and mentors respectively, which improved to 21% and 34% at the end of NOMP23 (P < 0.01). However, significant reduction in feelings of regret towards oncology as a profession was seen for mentees and mentors between baseline and the conclusion of NOMP23 (40% vs 14% and 29% vs 0% respectively, P < 0.01). NOMP23 demonstrated that a centrally coordinated, low-cost mentorship program could be feasible and was of high value. Mentorship programs, alongside multifactorial institutional, state-based and national interventions to improve well-being, can help ensure a sustainable workforce.

Academic Physician and Trainee Occupational Well-Being by Sexual and Gender Minority Status

Few studies have explored the association between sexual and gender minority (SGM) status and occupational well-being among health care workers. To assess the prevalence of burnout, professional fulfillment, intent to leave, anxiety, and depression by self-reported SGM status. This cross-sectional survey study collected data from October 2019 to July 2021, from 8 academic medical institutions participating in the Healthcare Professional Well-Being Academic Consortium. The survey, including questions on SGM status, was administered to attending physicians and trainees. Statistical analyses were performed from June 1, 2023, to February 29, 2024. SGM status was determined via self-reported sexual orientation and gender identity. Primary outcomes measured were the Professional Fulfillment Index (burnout and professional fulfillment), intent to leave, and self-reported anxiety and depression using the Patient-Reported Outcomes Measurement Information System short-form 4-item measure. Of 20 541 attendings and 6900 trainees, 8376 attendings and 2564 trainees responded and provided SGM status. Of these respondents, 386 attendings (4.6%) and 212 trainees (8.3%) identified as SGM. Compared with their non-SGM peers, SGM attendings had a lower prevalence of professional fulfillment (133 of 386 [34.5%] vs 3200 of 7922 [40.4%]) and a higher prevalence of burnout (181 of 382 [47.4%] vs 2791 of 7883 [35.4%]) and intent to leave (125 of 376 [33.2%] vs 2433 of 7873 [30.9%]) (all P < .001). Compared with their non-SGM peers, SGM trainees had a lower prevalence of professional fulfillment (63 of 211 [29.9%] vs 833 of 2333 [35.7%]) and a higher prevalence of burnout (108 of 211 [51.2%] vs 954 of 2332 [40.9%]) (both P < .001). After adjusting for age and race and ethnicity, SGM attendings had higher odds of burnout than their non-SGM peers (adjusted odds ratio, 1.57 [95% CI, 1.27-1.94]; P < .001). Results for burnout were similar among the SGM trainees compared with their non-SGM peers (adjusted odds ratio, 1.47 [1.10-1.96]; P = .01). In this cross-sectional survey study of academic physicians and trainees, SGM attendings and trainees had higher levels of burnout and lower levels of professional fulfillment. SGM attendings had greater intent to leave than their non-SGM peers, but trainees did not. These disparities represent an opportunity for further exploration to retain SGM health care workers.

The Effect of Ambient Artificial Intelligence Notes on Provider Burnout.

Healthcare provider burnout is a critical issue with significant implications for individual well-being, patient care, and healthcare system efficiency. Addressing burnout is essential for improving both provider well-being and the quality of patient care. Ambient artificial intelligence (AI) offers a novel approach to mitigating burnout by reducing the documentation burden through advanced speech recognition and natural language processing technologies that summarize the patient encounter into a clinical note to be reviewed by clinicians. To assess provider burnout and professional fulfilment associated with Ambient AI technology during a pilot study, assessed using the Stanford Professional Fulfillment Index (PFI). A pre-post observational study was conducted at University of Iowa Health Care with 38 volunteer physicians and advanced practice providers. Participants used a commercial ambient AI tool, over a 5-week trial in ambulatory environments. The AI tool transcribed patient-clinician conversations and generated preliminary clinical notes for review and entry into the electronic medical record. Burnout and professional fulfillment were assessed using the Stanford PFI at baseline and post-intervention. Pre-test and post-test surveys were completed by 35/38 participants (92% survey completion rate). Results showed a significant reduction in burnout scores, with the median burnout score improving from 4.16 to 3.16 (p=0.005), with validated Stanford PFI cutoff for overall burnout 3.33. Burnout rates decreased from 69% to 43%. There was a notable improvement in interpersonal disengagement scores (3.6 vs. 2.5, p<0.001), although work exhaustion scores did not significantly change. Professional fulfillment showed a modest, non-significant upward trend (6.1 vs. 6.5, p=0.10). Ambient AI significantly reduces healthcare provider burnout and may enhance professional fulfillment. By alleviating documentation burdens, ambient AI can improve operational efficiency and provider well-being. These findings suggest that broader implementation of ambient AI could be a strategic intervention to combat burnout in healthcare settings.

The Impact of Leadership Training on Burnout and Fulfillment Among Direct Reports

SUMMARY Goal Burnout, decreased professional fulfillment, and resultant attrition across the medical professions are increasingly recognized as threats to sustainable and cost-effective healthcare delivery. While the skill level of leaders as perceived by their direct reports has been correlated with rates of burnout and fulfillment, no studies, to our knowledge, have directly evaluated whether intervention via leadership training impacts burnout and fulfillment among direct reports. The goal of this study was to evaluate the effectiveness of a leadership training intervention on direct reports’ perceptions of the leadership skills of supervising residents and subsequently on the well-being of the direct reports. Methods We implemented a leadership training program with supervising (i.e., chief) resident volunteers in two surgical residency programs. The leadership training included two sessions of approximately 2 hours each that consisted of interactive didactic and small group activities. The training focused on the following themes: defining leadership (i.e.,characteristics and behaviors), team building, fostering trust, managing conflict, navigating difficult conversations, and feedback. We administered pretraining and posttraining surveys to the direct reports (i.e., junior residents) to assess the perceived leadership skills of supervising residents, as well as burnout and professional fulfillment. Principal Findings Leadership scores significantly improved following the leadership training intervention. Additionally, improvement in leadership scores following training was positively correlated with professional fulfillment among the junior residents (direct reports). Practical Applications The results of this study suggest that incorporating leadership training into residency programs may serve as an appropriate initial intervention to improve the leadership skills of supervising residents, and in turn, improve professional fulfillment and retention among medical professionals. This intervention involved minimal cost and time investment, with potentially significant returns in combating the well-being and attrition crisis. These findings may be applicable across the healthcare field to tackle the impending healthcare worker crisis.

Productivity Benchmarking and Burnout in Psychosocial Oncology: Creating a Sustainable Care Model.

Psychosocial oncology specialists in academic medical centers are at risk for burnout as they deliver a wide range of clinical, research, educational, and administrative services in high demand work environments. No national productivity benchmarks exist for this specialty. This study examines factors contributing to burnout among academic psychosocial oncology psychologists (PSOP), presents viable productivity standards, and a sustainable care model to mitigate burnout. Psychosocial oncology specialists recruited from the American Psychosocial Oncology Society membership were surveyed to determine frequency of burnout as measured by the Mini Z, professional fulfillment via the Stanford Professional Fulfillment Index, as well as demographic, clinical practice, and systems predictors of burnout. We examine salary discrepancies by gender and race. We focus on psychologists providing services in academic medical centers. Burnout was reported by 37%-44% of psychologists and was associated with high clinical volumes, mid-career status, and less than 10% administrative time. There were no differences in burnout by gender or race. However, females earned significantly less than men at each academic rank. PSOP report high levels of burnout consistent with other oncology professionals. Critical predictors include patient volume and lack of administrative time. Mid-career providers are more vulnerable to burnout, suggesting an inflection point at which individuals may be more likely to leave the field. We recommend a benchmark for clinical volume and sufficient administrative time to support the tripartite mission (education, research, patient care) and quadruple aim (patient experience, population health, cost, worker well-being) of academic medical centers.

Determining the Level of Emotional Intelligence of Future Cynologists

The purpose of the paper is to investigate the essence of emotional intelligence (EI) as an important component for future cynologists’ fruitful work in the sphere of rehabilitation of people who have been affected by the war consiquences. The authors studied the scientific literature on EI and its role in “Human-Human” and “Human-Animal” interactions in the working sphere. The authors determined the existing EI level of students who have Cynology as their major, outlined the theoretic and empiric outcomes, and stated recommendations for improving future cynologists’ professional training. Methodology. The empirical survey had a sample of 36 respondents. They were second-year students aged 18-21, 20 were male, and 16 were female. It was conducted by means of Google Forms on the basis of “Methodology of emotional intelligence diagnosis” by N. Hall (adapted) with subsequent processing and analysis of the results. Results. The study of the literature revealed that EI is of crucial importance for future cynologists’ professional fulfillment as it is responsible for the emotional regulation of their behavior, self-motivation, empathy, etc. However, empirically, it was found out that the EI of the respondents had not been sufficiently developed, as 68% of the respondents had a low level of EI integrative index, 22% of the students had the medium level of EI integrative index. Solely 10% of the respondents were recorded to have a high-level EI integrative index. Conclusions. The outcomes of the study revealed that most respondents do not have sufficient EI development, but they have the potential to enhance it. The authors insist on the organization of special educational courses and training to develop the ability of future cynologists to understand their own emotions and the emotions of other people, emotional behavior management, self-motivation, etc.

The effects of mindfulness-focused mental performance coaching on a general surgery residency program

BackgroundBurnout is a proven challenge in surgeons and surgical trainees, associated with higher rates of attrition compared to other medical specialties. Here we report the impact of a mental performance coaching program as it relates to surgery trainee wellbeing. MethodsA mixed-format mental performance coaching program was implemented at a large academic medical center's general surgery residency over a single academic year. Survey scores related to burnout, self-efficacy, and professional fulfillment were used to analyze the impact of the program as a whole, as well as by large group, small group, and one-on-one format attendance. ResultsResidents that attended the small group or one-on-one sessions demonstrated a trend towards improved burnout and professional fulfillment. The PGY3 group attended the most small format sessions and demonstrated a significant decrease in burnout (p ​= ​0.03). ConclusionThis offers an adaptable intervention for residency programs to improve the wellbeing of their trainees.

Well-Being and Professional Fulfillment: A Study of Male and Female Educators in Ghaziabad’s Self-Financed Institutions

Well-Being and Professional Fulfillment: A Study of Male and Female Educators in Ghaziabad’s Self-Financed Institutions

Formal wellness training of academic radiology leaders improves work-life conflict.

To investigate the effect of formal leadership training of academic radiology leaders within an academic center on their own burnout and professional fulfillment. The study cohort was academic radiology leaders within one of the largest academic organizations of academic radiologists within the United States. All academic radiology leaders within the organization were electronically mailed a weblink to a confidential IRB-approved survey in April 2021. The survey included validated questions from the Stanford Professional Fulfillment Index (PFI), values alignment, teamwork, overload, and work-family conflict. Academic leaders were invited in May 2021 to participate in instructor-led formal training on leading wellness focusing on 5 core leadership skills - emotional intelligence, self-care, resilience support, demonstrating care, and managing burnout. An identical follow-up survey was electronically mailed 6 months after initial training in November 2021. The overall response rate of academic radiology leaders was 59% (19/32). For both measures, there was acceptable internal consistency (Cronbach's α = 0.63 for work exhaustion and α = 0.90 for fulfillment). There was a statistically significant improvement in work-family conflict (3.32 vs 2.86; p = 0.04). No statistically significant differences were identified for fulfillment, work exhaustion, alignment, work overload, and teamwork scores after training. Formal instruction in leading wellness improved work-life conflict for academic radiology leaders. There was no significant change in burnout, fulfillment nor organizational alignment of the leaders. Formal instruction in leading wellness raised awareness and improved work-life conflict in academic radiology leaders.

Best Practices: Burnout Is More Than Binary.

Burnout among radiologists is increasingly prevalent, with the potential for having a substantial negative impact on physician well-being, delivery of care, and health outcomes. To evaluate this phenomenon using reliable and accurate means, validated quantitative instruments are essential. Variation in measurement can contribute to wide-ranging findings. This article evaluates radiologist burnout rates globally and dimensions of burnout as reported using different validated instruments; it also provides guidance on best practices to characterize burnout. Fifty-seven studies published between 1990 and 2023 were included in a systematic review, and 43 studies were included in a meta-analysis of burnout prevalence using random-effects models. The reported burnout prevalence ranged from 5% to 85%. With the Maslach Burnout Inventory (MBI), burnout prevalence varied significantly depending on the instrument version used. Among MBI subcategories, the pooled prevalence of emotional exhaustion was 54% (95% CI, 45-63%), depersonalization was 52% (95% CI, 41-63%), and low personal accomplishment was 36% (95% CI, 27-47%). Other validated burnout instruments showed less heterogeneous results; studies using the Stanford Professional Fulfillment Index yielded a burnout prevalence of 39% (95% CI, 34-45%), whereas the validated single-item instrument yielded a burnout prevalence of 34% (95% CI, 29-39%). Standardized instruments for assessing prevalence alongside multidimensional profiles capturing experiences may better characterize radiologist burnout, including change occurring over time.

Unveiling nurses' perspectives on decent work: A qualitative exploration.

This study explores nurses' perspectives on the concept of "decent work" and the factors influencing their viewpoints. This qualitative study employed a conventional content analysis approach using face-to-face interviews. In-depth interviews were conducted with 20 registered nurses at two tertiary hospitals in Hangzhou, China, from October to November 2023. Decent work for nurses refers to their engagement in a profession within a secure, fair, and friendly practice environment where they could receive respect, support, reasonable compensation, social security, and opportunities for career development, all of which could enable nurses to recognize their intrinsic values and achieve a state of professional and personal fulfillment. Key factors that influence decent work for nurses include the work environment, societal perceptions, and individual characteristics. The concept of decent work holds paramount importance for nurses, necessitating collaborative efforts at the individual, family, institutional, and societal levels to promote the professional dignity of nurses and enhance the quality of nursing care. Policymakers should establish regional minimum wage standards for nurses, promote flexible scheduling, and support professional development through subsidized training programs. Additionally, national media campaigns and comprehensive mental health support can enhance the public image and resilience of nurses, respectively, improving their decent work perception.

Burnout Professional Fulfilment and Sleep Quality in Indian Healthcare Workers in Times of the Covid-19 Pandemic

Aim and Background: With more than 210 nations affected, the SARS-COV-2 became the most widespread worldwide pandemic. As of 14 April 2022, over 500 million cases were confirmed globally Given these numbers, it was hardly surprising that the Covid-19 epidemic significantly strained healthcare systems worldwide. This study aimed to evaluate the degree of Burnout, Professional fulfilment, and Sleep quality across various groups of healthcare professionals working during the Covid-19 pandemic and looked for any correlation between these three variables. Methods: This study employed a cross-sectional observational research design and gathered data from respondents across various regions of India through an anonymous online or paper-based questionnaire tailored to the preferences of each participating Healthcare Worker (HCW). The assessment of professional fulfilment was conducted by employing the Stanford Professional Fulfillment Index and the sleep quality of healthcare workers was determined via the use of the Pittsburgh Sleep Quality Index. The variables were analyzed using statistical tools; Chi-square test, Fisher’s Exact test,Kruskal-Wallis One Way Analysis of Variance and Spearman’s rank correlation Results: Burnout was notably higher among the HCWs with poorer Sleep quality and lower in HCWs with higher Professional Fulfilment. Correlations further revealed that Burnout scores positively correlated with Work exhaustion and Interpersonal Disengagement Conclusion: This illustrates that HCWs with poorer sleep quality and lesser professional fulfilment experienced greater burnout at work during the COVID-19 pandemic Clinical significance: These insights guide healthcare providers and policy markers to optimize the well being of Healthcare Workers and foster informed preparedness in case of future pandemics. Keywords: COVID-19, PSQI, HCW, SPFI, Burnout, Professional Fulfilment, Sleep Quality.

Association of the COVID-19 Pandemic on Employment Status Change for Practicing Pharmacists

ObjectiveThe COVID-19 pandemic resulted in health care workers experiencing temporary or permanent changes in employment due to layoffs, quits, and postpandemic increased job demand. Analyzing the association of the COVID-19 pandemic with employment changes and results of changes for practicing pharmacists and understanding the associations with demographic and work-related factors could inform practice, policy, and educational programs. This study aimed to explore the frequency, characteristics, and results of employment status changes (ESCs) experienced by pharmacists practicing pharmacy in March 2020 (ie, the start of the COVID-19 pandemic). MethodsA descriptive, cross-sectional survey research design was used to collect data from a random sample of 93,990 licensed pharmacists in the United States. The study team developed an online survey questionnaire designed to assess the impacts of the COVID-19 pandemic on pharmacists’ work and work-life. The survey items used for this study related to ESCs, work-life characteristics, work characteristics in March 2020 and 2022, and demographic variables. A total of 4947 usable responses were received between November 2022 and January 2023. ResultsOverall, 36.4% of respondents reported experiencing an ESC and approximately 70% of those reporting an ESC reported experiencing just 1 ECS. Overall, 39.5% of respondents who experienced an ESC stopped working (ie, were unemployed) pursuant to an ESC. Respondents who experienced an ESC reported significantly lower levels of work exhaustion and interprofessional disengagement and significantly higher levels of professional fulfillment in their current employment than respondents that did not experience an ESC. ConclusionThe overall increase in demand for workers in the health care sector appeared to provide opportunities for pharmacists, especially pharmacists with 1 to 10 years of experience, to change their employment situation, resulting in better work-life characteristics. Given projections of a pharmacist shortage, research, policy, and educational programs could determine the best practices to improve work settings and the work-life characteristics of practicing pharmacists to improve the health of the current pharmacist workforce.

Association of the COVID-19 Pandemic on Employment Status Change for Practicing Pharmacists

ObjectiveThe COVID-19 pandemic resulted in health care workers experiencing temporary or permanent changes in employment due to layoffs, quits, and postpandemic increased job demand. Analyzing the association of the COVID-19 pandemic with employment changes and results of changes for practicing pharmacists and understanding the associations with demographic and work-related factors could inform practice, policy, and educational programs. This study aimed to explore the frequency, characteristics, and results of employment status changes (ESCs) experienced by pharmacists practicing pharmacy in March 2020 (ie, the start of the COVID-19 pandemic). MethodsA descriptive, cross-sectional survey research design was used to collect data from a random sample of 93,990 licensed pharmacists in the United States. The study team developed an online survey questionnaire designed to assess the impacts of the COVID-19 pandemic on pharmacists’ work and work-life. The survey items used for this study related to ESCs, work-life characteristics, work characteristics in March 2020 and 2022, and demographic variables. A total of 4947 usable responses were received between November 2022 and January 2023. ResultsOverall, 36.4% of respondents reported experiencing an ESC and approximately 70% of those reporting an ESC reported experiencing just 1 ECS. Overall, 39.5% of respondents who experienced an ESC stopped working (ie, were unemployed) pursuant to an ESC. Respondents who experienced an ESC reported significantly lower levels of work exhaustion and interprofessional disengagement and significantly higher levels of professional fulfillment in their current employment than respondents that did not experience an ESC. ConclusionThe overall increase in demand for workers in the health care sector appeared to provide opportunities for pharmacists, especially pharmacists with 1 to 10 years of experience, to change their employment situation, resulting in better work-life characteristics. Given projections of a pharmacist shortage, research, policy, and educational programs could determine the best practices to improve work settings and the work-life characteristics of practicing pharmacists to improve the health of the current pharmacist workforce.

Association of the COVID-19 Pandemic on Employment Status Change for Practicing Pharmacists.

The COVID-19 pandemic resulted in health care workers experiencing temporary or permanent changes in employment due to layoffs, quits, and postpandemic increased job demand. Analyzing the association of the COVID-19 pandemic with employment changes and results of changes for practicing pharmacists and understanding the associations with demographic and work-related factors could inform practice, policy, and educational programs. This study aimed to explore the frequency, characteristics, and results of employment status changes (ESCs) experienced by pharmacists practicing pharmacy in March 2020 (ie, the start of the COVID-19 pandemic). A descriptive, cross-sectional survey research design was used to collect data from a random sample of 93,990 licensed pharmacists in the United States. The study team developed an online survey questionnaire designed to assess the impacts of the COVID-19 pandemic on pharmacists' work and work-life. The survey items used for this study related to ESCs, work-life characteristics, work characteristics in March 2020 and 2022, and demographic variables. A total of 4947 usable responses were received between November 2022 and January 2023. Overall, 36.4% of respondents reported experiencing an ESC and approximately 70% of those reporting an ESC reported experiencing just 1 ECS. Overall, 39.5% of respondents who experienced an ESC stopped working (ie, were unemployed) pursuant to an ESC. Respondents who experienced an ESC reported significantly lower levels of work exhaustion and interprofessional disengagement and significantly higher levels of professional fulfillment in their current employment than respondents that did not experience an ESC. The overall increase in demand for workers in the health care sector appeared to provide opportunities for pharmacists, especially pharmacists with 1 to 10 years of experience, to change their employment situation, resulting in better work-life characteristics. Given projections of a pharmacist shortage, research, policy, and educational programs could determine the best practices to improve work settings and the work-life characteristics of practicing pharmacists to improve the health of the current pharmacist workforce.

Exploring Nurses' Emotional Resilience and Coping Strategies in Palliative and End-of-Life Care Settings in Saudi Arabia: A Qualitative Study.

Nurses working in palliative and end-of-life care settings face significant emotional challenges due to the demanding nature of their profession. This study aimed to explore the emotional resilience of these nurses, understanding the factors that contribute to their resilience, the impact on their professional well-being and performance, and strategies to enhance resilience. A qualitative study was conducted involving 15 registered nurses from various healthcare facilities in Riyadh, Saudi Arabia. Data were collected through semi-structured interviews, document analysis, and observational data. Thematic analysis was employed to identify recurring themes. The study identified three key themes: Emotional Challenges and Resilience-Building, Support Systems and Resources for Resilience, and Professional Growth and Fulfillment as Resilience Factors. The findings revealed the emotional toll of patient suffering, highlighting resilience-building strategies, such as peer support, mindfulness, and reflective practices. Support systems, including workplace support, organizational resources, and mentorship, were identified as crucial for fostering resilience. Professional growth, a sense of purpose, and recognition emerged as factors contributing to resilience. This study underscores the importance of emotional resilience for nurses in palliative and end-of-life care settings. Healthcare organizations can enhance resilience by implementing resilience training, providing counseling services, fostering a supportive culture, and offering professional development opportunities. Addressing the emotional needs of nurses is vital for their well-being and the delivery of compassionate care.

Confronting the challenges faced by senior high school mid-level academic managers

Middle leadership has become increasingly important in the growth and development of educational institutions. However, as the demand of mid-level managers increase, so do their development needs, specifically their professional and leadership development. This study, focused on basic education, identifies the challenges faced by senior high school mid-level academic managers (MLAMs) and their coping strategies. This study used a phenomenological qualitative design, where 11 senior high school academic coordinators were interviewed. The results from the interview showed three challenges that MLAMs have encountered, namely: transition to MLAM position, management, and personal challenges. MLAMs cope with these challenges by relying on their support system, gaining assistance from their institution, establishing self-discipline, and embracing their call as mid-level managers. Despite these challenges, they gain personal and professional growth, institutional recognition, and fulfillment from their pivotal leadership roles. These results can serve as a reference for a professional development plan for MLAMs in the basic education.

Workplace support for physicians during the COVID-19 Pandemic: Did it affect burnout?

BackgroundA concern before 2020, physician burnout worsened during the COVID-19 pandemic. Little empirical data are available on pandemic workplace support interventions or their influence on burnout. We surveyed a national sample of frontline physicians on burnout and workplace support during the pandemic.MethodsWe surveyed a stratified random sample of 12,833 US physicians most likely to care for adult COVID-19 patients from the comprehensive AMA Physician Professional Data ™ file. The sample included 6722 primary care physicians (3331 family physicians, 3391 internists), 880 hospitalists, 1783 critical care physicians (894 critical care physicians, 889 pulmonary intensivists), 2548 emergency medicine physicians, and 900 infectious disease physicians. The emailed survey elicited physicians’ perceptions of organizational interventions to provide workplace support and/or to address burnout. Burnout was assessed with the Professional Fulfillment Index Burnout Composite scale (PFI-BC). Proportional specialty representation and response bias were addressed by survey weighting. Logistic regression assessed the association of physician characteristics and workplace interventions with burnout.ResultsAfter weighting, respondents were representative of the total sample. Overall physician burnout was 45.4%, significantly higher than in our previous survey. Open-ended responses mentioned that staffing shortages (physician, nursing, and other staff) combined with the increased volume, complexity, and acuity of patients during the pandemic increased job demands. The most frequent workplace support interventions were direct pandemic control measures (increased access to personal protective equipment, 70.0%); improved telehealth functionality (43.4%); and individual resiliency tools (yoga, meditation, 30.7%). Respondents placed highest priority on workplace interventions to increase financial support and increase nursing and clinician staffing. Factors significantly associated with lower odds of burnout were practicing critical care (compared with emergency medicine) OR 0.33 (95% CI 0.12 – 0.93), improved telehealth functionality OR 0.47 (95% CI 0.23 – 0.97) and being in practice for 11 years or longer OR 0.44 (95% CI 0.19–0.99).ConclusionsBurnout across frontline specialties increased during the pandemic. Physician respondents focused on inadequate staffing in the context of caring for more and sicker patients, combined with the lack of administrative efforts to mitigate problems. Burnout mitigation requires system-level interventions beyond individual-focused stress reduction programs to improve staffing, increase compensation, and build effective teams.

The Mayo Leadership Impact Index Adapted for Matrix Leadership Structures: Initial Validity Evidence.

Physician burnout has reached crisis levels. Supportive leadership is one of the strongest drivers of physician well-being, and monitoring supervisor support is key to developing well-being focused leadership skills. Existing measures of leader support were designed within "direct report" supervision structures limiting their applicability to matrixed leadership reporting structures where direct reports are not the predominant norm. Antecedently, no measure of leadership support is validated specifically for implementation in matrixed leadership structures. Adapt and validate the Mayo Leadership Impact Index (MLII) for settings with matrixed leadership structures. A psychometric validation study utilizing classical test theory and item response theory. A tripartite hospital system in the southwestern US. Physician-respondents to a 2023 cross-sectional survey. After pilot testing, the adapted MLII was examined using a unidimensional graded response model and confirmatory factor analyses. Convergent validity was investigated via correlations with professional fulfillment, perceived autonomy support, self-valuation, and peer connectedness/respect. Divergent validity was tested via correlations with burnout. Of the three candidate revisions of the MLII, the 9-item adaptation was selected for its superior validity/reliability indices. Standardized Cronbach's and Ordinal alpha coefficients were 0.958 and 0.973, respectively. CFA loadings exceeded 0.70 (p < 0.001), and coefficients of variation (R2) exceeded 0.60 for all items. GRM slope parameters indicated "high" to "very high" item discrimination. Items 2, 5, and 8 were the most informative. Positive correlations of the adapted MLII with professional fulfillment, perceived autonomy support, and peer connectedness/respect were observed, supporting convergent validity. Negative correlation with overall burnout supports divergent validity. The findings provide evidence of the adapted MLII's validity, reliability, and appropriateness for implementation within matrixed leadership settings. Prior to this study, no leadership support measure had been validated for use among the growing number of healthcare systems with matrixed leadership reporting structures.