By: Andrea Rawley
Promoting wellness is a top priority at uOttawa. It has been a pressing topic recently at the School of Medicine, and acknowledged as a priority since 2014 at the Department of Family Medicine. David Tobin, Director of Community Teaching Practices and current Chairman of the Resident resiliency committee is very proud of the Department’s commitment and hard work towards resident wellbeing over the past few years. Dr. Tobin’s leadership efforts have been instrumental in putting resiliency initiatives at the forefront of the postgraduate program.
At the beginning of the new academic year, Dr. Tobin presents to the incoming cohort of residents about what it means to be resilient and offers his help at anytime to those that need it. He hopes to instill a clear message to residents that it is normal to feel overwhelmed and experience burnout, but to understand how to incorporate positive coping skills in order to bounce back from their adversities before it gets unmanageable.
Dr. Tobin was responsible for planning the Annual Community Preceptor Retreat and viewed this as a prime opportunity to coach our community and rural preceptors about the importance of fostering resilience within our residents. It was a beautiful day to gather at the charming and picturesque Wakefield Mill and Conference Centre on March 23, 2018, which marked the 8th Annual Community Preceptor Retreat.
Dr. Millaray Sanchez-Campos, Assistant Professor at the DFM, and co-founder of the Academy of Mindfulness and Contemplative studies with University of Ottawa Brain and Mind institute, guided the group on a mindfulness workout at the beginning of the day. This is the art of engaging mindfully in our daily life to promote mind-body awareness by practicing meditation, deep breathing, yoga and other techniques. Practicing mindfulness for a few minutes every day takes a lot of discipline, but the research shows it can enhance four attributes that we all naturally possess and use daily: attentive observation, critical curiosity, informed flexibility, and an ability to match the appropriate response to the situation at hand and presence.1
Lynn Bloom, Registered Clinical Social Worker and Adjunct Professor with the Faculty of Medicine, led the next portion of the session on collaborative and narrative practices. She has extensive knowledge and experience teaching reflective writing workshops to residents and faculty from a humanitarian framework. Narrative medicine is defined as the use of language and literature to explore deeper meanings about patient encounters. The group had an opportunity to practice narrative writing after listening to an established set of ground rules. One member of the audience shared a piece of work with the audience, followed by an interviewing and discussion phase from the perspectives of the listeners and the storyteller.
Dr. Alan Ng and Dr. Deanna Mercer presented next on their collaborative work on learning to love and teach the difficult clinical encounter. The group broke into small groups to discuss the factors, challenges and potential solutions with respect to teaching residents about how to manage difficult clinical encounters. This session naturally transitioned from the first session since mindfulness and narrative writing improves physicians’ ability to be effective in difficult clinical interactions. This was applicable to community preceptors’ teaching environment who are often “teaching on the fly” and running parallel clinics alongside their resident. Preceptors learned about the different frameworks to use in busy clinical settings to teach around the difficult clinical encounter. Dr. Alan Ng has done an enormous amount of teaching on the patient centered clinical method in the consultation and the use of Humanities in family medicine education.
Dr. Deanna Mercer MD FRCPC, Assistant professor at the uOttawa Department of Psychiatry, is a subject expert on physician empathy and led an interactive discussion on understanding and using empathy effectively. Deanna described the four components of empathy: affective resonance, perspective taking, compassionate behavior and emotion regulation and demonstrated how to use these to improve clinical outcomes in a difficult clinical encounter.
After lunch, Dr. Tobin presented on how to coach your resident on resiliency. Drawing on his fist hand experience of helping residents in need, he facilitated three breakout sessions to help better prepare preceptors with the knowledge and tools to build resiliency within your resident. First, the group developed a checklist of the signs and symptoms of resiliency breakdown, differentiating between resiliency breakdown and wellness issues. Second, a resiliency checklist was developed to learn how to gauge a resident’s level of resilience throughout their residency. Last, the group examined a case study about a struggling resident and summarized the ways in which they can help.
After a full day of learning and socializing, faculty members enjoyed some free time and took advantage of the beautiful setting and amenities in Wakefield, followed by a delicious dinner. A huge thank you to all of our participants – we look forward to another great retreat next year!
1Epstein and Krasner: Association of an educational program in mindful communication with burnout, empathy and attitudes among primary care physicians. JAMA 302:12, 1284-1293