Programme SAFEDRS and Beyond Dr Fiona Moir Wednesday 7 th August 2019 Summary of Wellbeing Research SAFEDRS Wellbeing Curriculum Pastoral Care Structure and Initiatives This session ID: 1044479
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1. Wellbeing Research, Teaching and Practice in the Auckland Medical Programme: SAFE-DRS and Beyond Dr Fiona MoirWednesday 7th August 2019
2. Summary of Wellbeing ResearchSAFE-DRS Wellbeing CurriculumPastoral Care Structure and Initiatives This session 2
3. Ideas for Wellbeing Research3
4. A systematic review of the health benefits of Tai Chi for students in higher education. Preventive Medicine Reports,Integrating mindfulness and physical exercises for medical students: A systematic review. OBM Integrative and Complementary Medicine, Workplace harassment among staff in higher education: A systematic review. Asia Pacific Education ReviewSystematic reviews4
5. Currently working on “SAFE-DRS”:Final year medical students: demographics and data on physical health, mental health, alcohol use, help-seeking behaviour, personal health behaviour (e.g. exercise, smoking, nutrition) Report prevalenceComparison with general populationComparison with international sample (Canada)Correlations: demographics & questionnaire scores, personal health behaviour & questionnaire scores, patient interactions & questionnaire scores etc… Prevalence studies: comparators and associations 5
6. Pre/post, controlled trial, RCT …A peer-support and mindfulness program to improve the mental health of medical students. Teaching and Learning in MedicineThe mental health of medical students and their use of a self-help website. New Zealand Medical Journal. Prospective cohort design, also ; Intervention studies & cohort designs 6
7. Wellbeing in higher education: Cultivating a healthy lifestyle among faculty and students Preventing burnout in undergraduate and postgraduate students studying medicine. In T. N. Winston (Ed.), Handbook on burnout and sleep deprivation: Risk factors, management strategies and impact on performance and behavior The quality of life of medical students and clinicians. In A. P. Giardino, & E. R. Giardino (Eds.), Medical education: Global perspectives, challenges and future directions Summaries and comprehensive reviews (Books and Book Chapters)7
8. A conceptual model of workplace stress: The issue of accumulation and recovery and the health professional. New Zealand Journal of Employment RelationsDepression in medical students: current insights Advances in medical education and practiceSAFE-DRS: Health and wellbeing in the curriculum in the Auckland Medical Programme.Conceptual models, initiatives, perspectives and reviews 8
9. SAFE-DRS Wellbeing Curriculum9
10. WHY WE DEVELOPED ITWHERE IN CURRIULUMWHAT WE INCLUDED HOW WE TEACH AND ASSESS ITFEEDBACKSAFE-DRS10
11. INTRODUCTIONDESIGNING THE CURRICULUM:AIMSTOPICSLEARNING OUTCOMESASSESSMENTWORKSHOP OUTLINE11
12. “…with studies indicating that these (mindfulness and relaxation) reduce anxiety, psychological distress and depression… (Shapiro et al., 2000; Hassked et al., 2009; Warnecke et al., 2011)“…At the same time they facilitate the development of positive affect and immune functioning (Davidson et al., 2003), empathy and compassion, self-awareness, self-regulation and improved clinical decision-making (Epstein, 1999; Shapiro, 2000; Hassed et al., 2009).The Evidence12Why?
13. ‘Arguments’ for a HWB curriculum Doctors’ Self-care → Patient Care Doctors’ Health → Medical Error ‘Professionalism’……Societal Expectations Retention, Burnout, Morale, Job Withdrawal↓Mental Health of Students↑ Evidence for Mindfulness7/08/201913patientsmedicalprofessionwider environment
14. Applied Science for MedicineClinical and Communication SkillsHauora Maori Population Health Professional & Personal Skills (5th Domain added) Professionalism and Reflective Practice Ethics and The Law Health and Well-being (SAFE-DRS) Cultural Competence Learning and Teaching Clinical LeadershipAuckland Medical Programme Longitudinal Domains14Where?
15. AIMS:WHAT WOULD THIS PART OF A CURRICULUM BE AIMING TO ACHIEVE? (WRITE 2 OR 3 AIMS FROM THE PERSPECTIVE OF THE PROGRAMME)LEARNING OUTCOMES: ‘BY THE END OF THIS COURSE, THE STUDENT WILL BE ABLE TO …) 15What?
16. 16
17. Self Care SkillsAccess HelpFocused AttentionEmotional IntelligenceDr as Patient and ColleagueReflective PracticeStress Resistance SAFE-DRS COMPONENTS17
18. Variety and Flexibility18How We Teach Evidence-based and fun (quiz, prizes, creative)Model (a doctor and a person)Teach other technique alongside mindfulnessSmall group debrief (clinical experiences)Relevant HWB stories from doctors Give some options (choice)
19. Spiral (Re-visit/Re-inforce Topics): E.g. Emotional Intelligence Year 2: Definition, Components, Relevance for Students Year 4: Patient Interactions, Professionalism, Relevance for doctors Year 5: Leadership, Team Work module – links to videos and sites, how to improve EI)
20. Required attendance and participationWritten tutor feedbackDirect observation on wardsWritten exam questionsProgress TestsEssaysPortfolios Summative and Formative20How We Assess ..e.g
21. What Some Students Thought….. Stop forcing me to think about myself……….What Some Staff Thought Why on earth are you filling up valuable space in the curriculum with something like mindfulness’, just because it’s fashionable? Initially…..21Feedback
22. Unfortunately it also seems ‘in fashion’ to….. Make mistakesBully junior doctorsCommit suicideWish you had a different job Leave medicineUse denial and avoidanceDelay seeking helpSelf-diagnose and prescribeBlur boundariesGet divorced Suffer the consequences of stressBecome depressedBecome burnt out
23. Year 2 student evaluation (2013) n=237# = 1 missing valueStronglyDisagreeDisagreeSlightlyDisagreeSlightlyAgree AgreeStronglyAgreeThe HWB lectures/SGA have changed my self-awareness and/or behaviour regarding my personal health049698966Writing the HEP diary has changed my self-awareness regarding my personal health #61230.579.57533Writing the HEP diary has changed my behaviour regarding my personal health #8173093.561.526Practising techniques such as mindfulness in the SGA has been beneficial #31113847550
24. “The HWB lectures/Small Group Activities have changed my self- awareness and/or behaviour regarding my personal health”65% agree or strongly agree, 95% any agree“Writing the Health Enhancement Diary has changed my behaviour regarding my personal health” 37% agree or strongly agree, 77% any agree
25. Pastoral Care Structure and Initiatives 25
26. Practical SuggestionsSeparate wellbeing curriculum, wellbeing initiatives and wellbeing support structures HWB committee (status), clear TOR Learn/refer to the evidence (some at your fingertips) – STAFF and STUDENTSTie into other topics (get other staff involved) Develop pastoral care pathways and policies
27. Support for impairments: Contact Disability Services (disabilities@auckland.ac.nz)
28. www.calm@auckland.ac.nzThe Desk: https://www.thedesk.org.auUlifeline: http://www.ulifeline.orgwww.freemindfulness.orghttps://www.headspace.comwww.bigwhitewall.com
29. Summary of Wellbeing ResearchSAFE-DRS Wellbeing CurriculumPastoral Care Structure and Initiatives This session 29
30. Let it go, Let it out, Let it all unravel, Let it free, and it can be A road on which to travel.SELF-AWARENESS;SELF-REFLECTION;SELF-DEVELOPMENTThank you Please contact Fiona Moir f.moir@auckland.ac.nz