47th Annual Convention; Online; 2021
All times listed are Eastern time (GMT-4 at the time of the convention in May).
Event Details
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Burnout and Bias: Assessing Medical Student Well-Being and Patient Care from a Contextual Perspective |
Sunday, May 30, 2021 |
3:00 PM–3:50 PM |
Online |
Area: CSS; Domain: Applied Research |
Chair: Ramona Houmanfar (University of Nevada, Reno) |
Discussant: Marianne L. Jackson (California State University, Fresno) |
CE Instructor: Ramona Houmanfar, Ph.D. |
Abstract: Medical students and healthcare professionals are at an increased risk for experiencing clinically relevant levels of distress (e.g., burnout, depression, and suicidal ideations), compared to the general population. The onset of clinically relevant levels of distress appear to emerge during the first few years of students’ medical education. If symptoms are left unidentified and therefore, untreated – students are likely to continue to practice maladaptive coping strategies during residency. These patterns of maladaptive coping are likely to recur throughout one’s career, which impacts the quality of patient care provided to diverse patient populations. Individuals are more likely to engage in brief immediate relational responding (BIRRs) under conditions of time pressure and stress. Without evidence-based approaches for managing BIRRs (i.e., implicit bias), medical providers are ill equipped to meet the needs of patients’ diverse cultural nuances, which contributes to the prevalence of healthcare disparities. This symposium will provide an overview of ways in which contextual behavioral scientists can measure, report, and teach about burnout and well-being with the medical student and healthcare provider populations – to help providers not only manage their biases towards themselves (i.e., self-stigmatization) but to also manage their biases toward their patients (i.e., implicit bias). |
Instruction Level: Intermediate |
Keyword(s): burnout, implicit bias, medical education, well-being |
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Assessment of Medical Student Burnout: Toward an Implicit Measure to Address
Current Issues |
GREGORY SCOTT SMITH (The Chicago School of Professional Psychology; University of Nevada, Reno School of Medicine), Ramona Houmanfar (University of Nevada, Reno), Nicole Jacobs (University of Nevada School of Medicine), Mary Froehlich (University of Nevada Reno School of Medicine), Alison Szarko (University of Nevada, Reno), Brooke M. Smith (Western Michigan University), Timothy Baker (University of Nevada School of Medicine), Melissa Patricia Piasecki (University of Nevada Reno School of Medicine) |
Abstract: The feasibility of implicitly assessing medical student burnout was explored, using the Implicit Relational Assessment Procedure (IRAP), to measure longitudinal student burnout over the first two years of medical school and directly compare it with an existing explicit measure of burnout (Maslach Burnout Inventory; MBI). Three
successive cohorts of medical students completed both implicit and explicit measures of burnout at several time points during their first two years of medical school. Both assessments were conducted via the internet within a one-week period during the first week of medical school, the end of the first year of medical school, and the end of the second year, though not all cohorts were able to complete the assessments at all time points. Mixed effects models were used to compare the two measures directly, as well as to evaluate changes over time in each measure separately. Minimal correspondence was observed between the implicit and explicit measures of burnout on a within-subject basis. However, when analyzed separately, all sub-scales of both measures detected significant change over time in the direction of greater levels of burnout, particularly during the first year of medical school. Results suggest the IRAP is able to assess implicit attitudes related to burnout among medical students. The IRAP detected consistent improvements in positive implicit attitudes toward medical training during students’ second year, which was not detected by the MBI. The finding indicates a unique aspect of the burnout construct is captured by IRAP. |
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The Impact of Acceptance and Commitment Training on Well-Being in Medical Education |
ALISON SZARKO (University of Nevada, Reno), Ramona Houmanfar (University of Nevada, Reno), Gregory Scott Smith (The Chicago School of Professional Psychology; University of Nevada, Reno School of Medicine), Nicole Jacobs (University of Nevada School of Medicine), Kian Assemi (University of Nevada, Reno), Brooke M. Smith (Western Michigan University), Timothy Baker (University of Nevada School of Medicine), Melissa Patricia Piasecki (University of Nevada School of Medicine) |
Abstract: Medical students are at a disproportionate risk for experiencing clinically significant levels of distress and burnout as a product of their workplace environment (i.e., the healthcare industry). Significant levels of distress and burnout seem to emerge within the first few years of students’ undergraduate medical education. Remediation strategies such as wellness trainings have been recommended and integrated into medical school curricula as a preventative approach. This longitudinal study utilized the Acceptance and Action Questionnaire-II (AAQ-II) and the Implicit Relational Assessment Procedure (IRAP) to determine the of impact of Acceptance and Commitment Training (ACT) on the well-being of students across the first two years of medical school. The preliminary results indicate that the overall medical student population maintained their levels of psychological well-being during the first two years of medical school. Additionally, students who were identified as “at-risk” for experiencing significant levels of burnout demonstrated statistically significant improvements in their AAQ-II scores following an ACT for Student Well-Being curriculum. Implications and next steps for this line of research will be discussed. |
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