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Year 3 - FoPC > FPC3 Tutorial 2 - Sustainability, Resilience and Occupational Health (A&B Groups) > Flashcards

FPC3 Tutorial 2 - Sustainability, Resilience and Occupational Health (A&B Groups) Flashcards

1
Q

GMC guidance – supporting students with mental health conditions:

Mild-to-moderate mental health conditions are common and can affect 15–25% of the general population at any one time. They include what?

A
  • depression
  • generalised anxiety disorder
  • panic disorder
  • social anxiety disorder
  • obsessive compulsive disorder
  • post-traumatic stress disorder
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2
Q

However, medical students have a higher prevalence of _________ and ______ than the general population, so it is important for medical schools to identify these students and ______ them in the right way, although they must not treat students themselves

Some students may need adjustments to their training to support them while they are unwell

A

depression

anxiety

support

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3
Q

It is extremely important that medical students have not only the clinical skills and knowledge to move from medical school to the Foundation Programme but also have the ________ and _____ techniques to help them face difficult ____________ as their careers progress

A

resilience

coping

circumstances

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4
Q
  • The GMC continue to work with medical schools to ensure that emotional _________ training is a regular and integral part of the medical curriculum
  • Both medical students and doctors in training have specific training modules in their curriculum that explain the implications should they be subject to a serious _________ and investigation
A

resilience

complaint

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5
Q
  • The GMC continue to work with medical students and doctors in training to promote its _________ requirements
  • The GMC continue to work with all medical schools to ensure its standpoint on recreational drug use and _______ is better communicated to students
A

regulatory

alcohol

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6
Q

what is GMC guidance on supporting students with mental health conditions?

A

Promoting well-being - • As well as supporting students who have mental health conditions, medical schools should also promote well-being among all of their students

Some of the ways that medical schools can do this include:

  • delivering group learning exercises focusing on how to deal with stress
  • providing and promoting online resources on keeping healthy, including advice on healthy lifestyles
  • providing sessions on techniques such as mindfulness and meditation, and providing opportunities for physical exercise and yoga, which some people find useful to help them manage their stress levels
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7
Q

What is Resilience?

A

The Oxford Dictionary -

  • ‘Resilience’ (a term imported from the language of physics) as: The capacity to recover quickly from difficulties; toughness, or the ability of a substance or object to spring back into shape; elasticity
  • This term is also used in other disciplines such as physiology and psychology to refer to a person’s ability to resist adversity without resulting in physical or psychological disability
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8
Q

Resilience is an emotional competence or a personality __________ that deals with negative effects of _____ and promotes adaptation

Resilience can also, however, be an acquired virtue or behaviour and requires continuous __________

Resilience encompasses several _________ including self-efficiency; self-control; self-regulation; planning and perseverance

The medical profession, as many other professions, can be very stressful and we need to maintain emotional __________ and resilience

A

characteristic

stress

improvement

dimensions

wellbeing

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9
Q

The following was taken from a summary about elite athletes. Similarities to medical students?

A
  • High internal and external expectations
  • Win at all costs attitude
  • Parental pressures
  • Long practices
  • Excessive time demands
  • Perfectionism
  • Potential for inconsistent coaching
  • Cycle of above can cause stress
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10
Q

What are the personal strengths underpinning resilience?

A
  • High frustration tolerance
  • Self acceptance
  • Self belief
  • Humour
  • Perspective
  • Curiosity
  • Adaptability
  • Meaning
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11
Q

what are behaviours supporting resilience?

A
  • Building/having support networks – positive relationships
  • Reflective ability
  • Assertiveness
  • Avoiding procrastination
  • Developing goals – realistic plans and ability/motivation to follow them through
  • Time management
  • Work – life balance
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12
Q

What are the challenges to resilience within a medical career?

A

burnout

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13
Q

what are the different sources of burnout?

A
  • Personal
  • Professional
  • Systemic
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14
Q

what are the different personal sources of burnout?

A
  • Perfectionism, denial, avoidance, micromanaging, unwilling to seek help
  • Being too conscientious
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15
Q

what are the different professional sources of burnout?

A
  • Culture of invulnerability
  • Culture of presenteeism
  • Blame culture/silence
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16
Q

what are the different systemic sources of burnout?

A
  • Overwork, shiftwork, lack of oversight
  • Chaotic work environments
  • Lack of teamwork, fractured training
17
Q

How might stress or burnout present in medical students?

A

The struggling student:

  • Repeatedly failing or nearly failing
  • Handing in work late
  • Poor attendance
  • Absence due to illness
  • Behavioural issues
  • Fitness to practice issues
  • Lack of engagement with the course
  • Poor communication with staff, peers and patients
18
Q

Resilience in practice - what may the initial reaction be?

A

• Doubt, anger, fear, worry, misunderstood, unappreciated, sorrow, regret

19
Q

Resilience in practice - what may resilience cause?

A
  • Lead to reflection - Did I make the right decision, could I have done things differently?, Discuss with peers - SEA
  • Lead to improvement - Do I need to learn anything to prevent the same happening again?
  • Lead to returning wiser and better - How will I communicate better? Will I change my practice in the future?
20
Q

what are some factors aiding resilience?

A
  • Intellectual interest - Job satisfaction, career progression, variability (if wanted), capacity to develop special interest
  • Self awareness and self reflection - Recognise and accept personal limits, establish boundaries in doctor-patient relationship, less self critical. Aided by mindfulness based stress reduction
  • Time management and work life balance - Ensuring time for hobbies, leisure, relaxation, self expression
  • Continuing professional development
  • Support including team working - Supportive relationships within and out-with medicine
  • Mentors - Help trainees adapt to change and react to stress
21
Q

It is not all about personal change/resilience, what else is important?

A

Professional attitudes:

  • Changing sense of perfectionism, presenteeism, culture of silence
  • Better support for those struggling or after difficult events

Societal attitudes:

  • Changing culture of blame, reduce perceived threat of complaints
  • Public acceptance of mistakes? Patients’ personal responsibility for health?

Structural changes:

•Improved shift patterns, better work – life balance, less fractured training, regular breaks, a cup of tea

22
Q

A conceptual model of Medical Student Well-being: Promoting Resilience and Preventing Burnout

A
  • Referenced in earlier paper (‘Doctors need to be supported not trained in resilience’) as the Unified Model
  • A coping reserve that can be filled or emptied
  • Personality traits, temperament and coping style form the internal structure
  • Omits importance of organisational and sociocultural issues
23
Q

Where can I access help if I need it?

A

The Counselling Service is part of Student Support Services but is open to all members of the University community - students and staff alike. The Counselling Service is located at 5 Dunbar Street, Aberdeen, opposite Block B, Edward Wright Building. There are self-help resources and further details available on the counselling service website

Student Welfare Officer:

The Student Welfare Officer is always available to students should they have any worries about their life in Aberdeen. The Officer has a wealth of experience in dealing with students’ problems, ranging from worries about leaving home, family difficulties, financial issues, to problems with health and poor performance at university. If the Officer cannot help solve the problem, they will source the appropriate help and if necessary, initiate the first contact

24
Q

Occupational medicine

A
25
Q

what is an occupational history?

A
  • An occupational and environmental history is a chronological list of all the patient’s employment with the intention of determining whether work has caused ill health, exacerbated an existing health problem or has ill health had an impact on the patient’s capacity to work
  • A shortened history is possible within a GP consultation if the problem is acute and likely related to current work
26
Q

How might you determine from the history whether an illness is related to an individual’s work?

A
  • A description of the present and previous jobs from leaving school.
  • Identifying any exposure to chemicals or other hazards e.g. stress, overwork, adverse working environment, in this situation is the fact that role largely sedentary exacerbating or causing his back pain?
  • Did the symptoms improve when not exposed / not at work e.g. at weekends, holidays?
  • Determine the duration and intensity of exposure e.g. was it so noisy it was impossible to communicate
  • Is personal protection used e.g. what kind of mask? Or equally is an appropriate chair / desk provided?
  • What maintenance is in place for the protection measures?
  • Do others suffer similar symptoms?
  • Are there known environmental hazards in use?
  • Any hobbies, pets, worked overseas, moonlighting?
27
Q

what is a fit note?

A

This replaced the ‘sick note ‘ in April 2010.

It’s purpose is to facilitate earlier discussion about returning to work and about rehabilitation.

It now includes items of consideration for employers when signing a patient’s return to work.

It can only be completed by a Doctor

It is advice to patients as employees, is not binding on the employer and does not affect Statutory Sick Pay

It is required if the patient has been off more than 7 consecutive days ( including non working days)

28
Q

what is occupational health and its role?

A

For patients who are off for longer periods of time or with more complex needs, referral to a specialist occupational health service is an option.

•Occupational health specialists are ideally and uniquely placed to support and help people stay in work and live full and healthy lives

They play a key role in ensuring the health and well being of the working population by preventing work-related ill health and providing specialist rehabilitation advice

They provide independent, impartial advice to employers and employees on the effects of work on health and the effects of health on work

29
Q

what are different fit note options?

A
  • Phased return to work - Start with reduced hours each day and build up - help build capacity again and allow time for rehab
  • Altered hours - Work at different times of day e.g. are early mornings hardest?
  • Amended duties - Change in work practice or content e.g. less time sitting or breaking up the day differently to allow more movement - shorter surgeries, built in breaks etc
  • Workplace adaptation - e.g. changes to seating to support back better
30
Q

what are the effects of unemployment on health?

A
  • There is a strong association between worklessness and poor health. This may be partly a health selection effect, but it is also to a large extent cause and effect. There is evidence that unemployment is generally harmful to health, including:
  • Higher mortality;
  • Poorer general health, long-standing illness, limiting longstanding illness;
  • Poorer mental health, psychological distress, minor psychological/psychiatric morbidity;
  • Higher medical consultation, medication consumption and hospital admission rates
  • There is evidence that re-employment leads to improved self-esteem, improved general and mental health, and reduced psychological distress and minor psychiatric morbidity. The magnitude of this improvement is more or less comparable to the adverse effects of job loss
31
Q

what is the definition of sustainability?

A

The Cambridge Dictionary defines sustainability the ability to be

“Able to continue over a period of time”

32
Q

What is sustainability within the NHS?

A

This could be looked at in a couple of ways.

It could be looked at in relation to low carbon clinical care and the environment.

It could be looked at in relation to the ability of the NHS to “Continue over time”

In Scotland we have a National Policy Document “Realistic Medicine” that in part relates to this. We will cover this next term.

33
Q

How is Low Carbon Clinical Care and NHS Sustainability done?

A

Prioritise Environmental Health

Substitute harmful chemicals with safer alternatives. Reduce and safely dispose of waste

Use energy efficiently and switch to renewable energy. Reduce water consumption

Improve travel strategies

Purchase and serve sustainably grown food

Safely manage and dispose of pharmaceuticals

Adopt greener building design and construction. Purchase safer more sustainable products

34
Q

What would low Carbon Clinical Care look like?

A

Be better at preventing conditions

Give greater responsibility to patients in managing their health.

Be leaner in service design and delivery

Use the lowest carbon technologies

35
Q

what is the focus on travel?

A

Transport accounts for almost 25% of all fossil fuel greenhouse gas emissions

Cutting emissions through walking and cycling and less vehicle use brings large health benefits e.g. reduction in diabetes, CV disease and depression

36
Q

What modifications to health related travel would have an impact on reducing the carbon footprint of health delivery and improve personal health?

A

Reduce the need to travel: teleconferencing, video conferencing for follow-up appointments where clinical examination not needed. One stop clinics where consultation, diagnostic testing and management plan all done on the same day in the same facility. Multiple clinics on the same day – coordinating care between different specialities for the same patient

Better ways to travel: car pooling, car sharing, fuel efficient vehicles (hybrid or electric), health service transport e.g. buses to transport patients to and from clinics and hospital

Institutional plans e.g. providing facilities for people to cycle to work, utilise bus services. Incentivise active travel – reduce car parking spaces, cycle to work schemes to provide for the purchase and use of bikes, encourage walking to work or incentivise use of public transport

Year 3 - FoPC (4 decks)

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