Paediatric anaesthesia
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Paediatric anaesthesia · Jan 2021
ReviewNot a "first world problem" - care of the Anesthetist in East and Southern Africa.
Burnout and related concepts such as resilience, wellness, and taking care of healthcare professionals have become increasingly prevalent in the medical literature. Most of the work in this area comes from high-income countries, with the remainder from upper-middle-income countries, and very little from lower-middle-income or low-income countries. Sub-Saharan Africa is particularly poorly represented in this body of literature. ⋯ According to the Joint Learning Initiative Managing for Performance framework, the three essential factors for building a workforce to effectively support a healthcare system are coverage, competence, and motivation. Current efforts to build capacity in anesthesia in East and Southern Africa focus largely on coverage and competence, but neglect motivation at the risk of failing to support a sustainable workforce. In this paper, we include a review of the relevant literature, as well as draw from personal experience living and working in East and Southern Africa, to describe the unique issues surrounding burnout, resilience, and wellness in this region.
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The purpose of this educational review was to describe the challenges that may face the anesthesiologist near the end of their career and to propose strategies that will enable the individual to continue to be a productive and valued member of their Department, both clinically and by other contributions.
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Burnout is a state of emotional and physical exhaustion associated with internal and external stressors. Drivers of burnout include the expectation that we as physicians place our patients first, ahead of our own self-care; that seeking help is a sign of weakness in the culture of medicine; practice inefficiencies, including those imposed by electronic medical records; and a lack of personal resilience suffered by many physicians. The costs of burnout are high, including a decrement in the quality of care, increased turnover, and physician suicide. ⋯ We can enhance our resilience with a variety of tools, including meditation and mindfulness practice. Fortunately, these practices are becoming more mainstream and readily available to us. This article will briefly review the problem of burnout, including drivers and costs, and then focus on meditation and mindfulness practices that we may embrace in order to become more resilient.
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Paediatric anaesthesia · Jan 2021
ReviewThe "Difficult Learner" in Anesthesiology: Challenges, Pitfalls, and Recommendations.
Struggling learners often require interventions that are time-consuming and emotionally exhausting for both the trainee and faculty. Numerous barriers, including lack of resources, faculty development, and fear of legal retribution, can impede medical educators from developing and implementing robust remediation plans. ⋯ Department leadership acknowledgment and investment in training faculty on remediation strategies for learners in difficulty and providing tools to meet these challenging job demands will improve faculty's job satisfaction and overall well-being. The authors review salient literature and methodology for diagnosing learners in difficulty, with focus on a high-yield, pragmatic approach that can be taken by medical training programs, including those that lack a robust medical education infrastructure.