Colin West

9/ Next week: a closer look at self-valuation! /fin

Associations of Well-Being Measures With Suicidal Ideation in Surgeons In a 2023 national survey of surgeons, nearly one out of 7 surgeons reported thoughts of suicide in the past year. This study aimed to assess the rela…

8/ The paper offers a number of specific suggestions for both individual and programmatic efforts that should be explored further
Associations of Well-Being Measures With Suicidal Ideation in Surgeons www.sciencedirect.com/science/arti...

7/ Nurturing training and practice environments that foster professional fulfillment, resilience, self-valuation, and community may offer important benefits to well-being across its entire spectrum

6/ These results are cross-sectional, but they suggest that in addition to addressing depression and other mental health diagnoses there may be complementary opportunities to help reduce suicidal ideation

5/ Respondents with higher loneliness scores: aOR 1.45 for SI (p<.001)

4/ Respondents with higher:
Professional fullfillment: aOR 0.51 for SI (p<.001)
Resilience: aOR 0.82 (p=.001)
Self-valuation: aOR 0.83 (p<.001) – teaser: more on this one next week!

3/ Among 622 students, trainees, and practicing surgeons, 1 in 4 reported a prior mental health disorder diagnosis and 13% reported SI in the prior 12 months. After adjusting for prior mental health disorders, what were the results?

2/ Suicidal ideation is not rare among physicians, with prior work from this team finding a frequency of 1 in 7 surgeons over the previous year. This study explored factors associated with suicidal ideation in this group. The results were … well, not surprising but additive.

Associations of Well-Being Measures With Suicidal Ideation in Surgeons In a 2023 national survey of surgeons, nearly one out of 7 surgeons reported thoughts of suicide in the past year. This study aimed to assess the rela…

1/ Welcome to Edition 296 of West’s Well-Being Wednesday! Today I’ll focus on a study of well-being domains and suicidal ideation in surgeons, with @jessigold1.bsky.social and others
Associations of Well-Being Measures With Suicidal Ideation in Surgeons www.sciencedirect.com/science/arti...

13/ “If we allow perfection to be the enemy of progress, we risk missing opportunities for greater evidence-informed steps forward to benefit health care professionals and patients.”

12/ As I conclude, “Clearly, many studies of HCP burnout and well-being have important limitations. We should not let these limitations obscure larger gains in knowledge of effective interventions over time, even as more work is needed.”

10/ “Third, modest effects of well-being interventions on continuous scales may result in larger effects in aggregate across entire professions and therefore still be meaningful. These effects may also take time to develop (or may not be sustained over time).”

8/ Second, observational studies exist and are excluded from this systematic review. “… although causal inference from observational study designs is weaker, these studies can offer insight into interventions to prioritize for future research and support findings from trials.”

Colleagues Meeting to Promote and Sustain Satisfaction (COMPASS) Groups for Physician Well-Being: A Randomized Clinical Trial To evaluate physician small groups to promote physician well-being in a scenario with provided discussion topics but without trained facilitators, and…

6/ One of our prior trials is cited as an example, but “how might a study of physician small groups blind participants to their trial-arm assignment?”
Colleagues Meeting to Promote and Sustain Satisfaction (COMPASS) Group... www.sciencedirect.com/science/arti...

4/ My comments: “First, lack of blinding is identified as a major limitation of existing burnout intervention research, although for behavioral interventions this limitation may be unavoidable.”

Advancing Health Care Professional Well-Being: Progress in the Face of Imperfection | Annals of Internal Medicine

2/ I’m not going to fully review that paper, but rather focus on some of my perspectives shared in my invited editorial
Advancing Health Care Professional Well-Being: Progress in the Face of Imperfection @annalsofim.bsky.social www.acpjournals.org/doi/10.7326/...

Efficacy of Individual-Level Interventions to Mitigate the Risk for Burnout Among Health Care Professionals: A Systematic Review and Meta-analysis of Randomized Controlled Trials: Annals of Internal M... Background: There is limited evidence of the strategies to mitigate burnout among all health care professionals (HCPs). Purpose: To evaluate the effectiveness of all interventions to mitigate burnout ...

1/ Welcome to Edition 295 of West’s Well-Being Wednesday! Today I’ll add context to my recent editorial on this paper from @annalsofim.bsky.social
www.acpjournals.org/doi/10.7326/...

14/ Join me again next week for the next thread in this serial! /fin

13/ “If we allow perfection to be the enemy of progress, we risk missing opportunities for greater evidence-informed steps forward to benefit health care professionals and patients.”

12/ As I conclude, “Clearly, many studies of HCP burnout and well-being have important limitations. We should not let these limitations obscure larger gains in knowledge of effective interventions over time, even as more work is needed.”

11/ This means that ideally outcomes across several time points would be considered as physician experiences evolve over time.

10/ “Third, modest effects of well-being interventions on continuous scales may result in larger effects in aggregate across entire professions and therefore still be meaningful. These effects may also take time to develop (or may not be sustained over time).”

9/ Dichotomized outcomes also have limitations, but have been associated with consequential outcomes and need not be disregarded.

8/ Second, observational studies exist and are excluded from this systematic review. “… although causal inference from observational study designs is weaker, these studies can offer insight into interventions to prioritize for future research and support findings from trials.”

7/ “If this is infeasible or impossible, does this mean such studies offer little insight into meaningful solutions to promote well-being, particularly if participants are blinded to key study hypotheses and intentions as was the case in the referenced trial?”

Colleagues Meeting to Promote and Sustain Satisfaction (COMPASS) Groups for Physician Well-Being: A Randomized Clinical Trial To evaluate physician small groups to promote physician well-being in a scenario with provided discussion topics but without trained facilitators, and…

6/ One of our prior trials is cited as an example, but “how might a study of physician small groups blind participants to their trial-arm assignment?”
Colleagues Meeting to Promote and Sustain Satisfaction (COMPASS) Group... www.sciencedirect.com/science/arti...

5/ “In such situations, it is important to evaluate risk of bias broadly across several domains of assessment, balancing both strengths and weaknesses.”

4/ My comments: “First, lack of blinding is identified as a major limitation of existing burnout intervention research, although for behavioral interventions this limitation may be unavoidable.”

3/ Overall, the source systematic review identified substantial heterogeneity among existing trials. This is to be expected when interventions approach a problem from multiple angles and multiple job roles are included.

Advancing Health Care Professional Well-Being: Progress in the Face of Imperfection | Annals of Internal Medicine

2/ I’m not going to fully review that paper, but rather focus on some of my perspectives shared in my invited editorial
Advancing Health Care Professional Well-Being: Progress in the Face of Imperfection @annalsofim.bsky.social www.acpjournals.org/doi/10.7326/...