Vicki Flynn, M.D.

Department of Psychiatry

University of Arkansas for Medical Sciences

A Positive Approach to

Professional Development

Peer reviewed and accepted for anoral presentation at AmericanPsychiatric Association (APA) AnnualMeeting, April 27 2020. Cancelled dueto COVID-19 pandemic

Objectives

• Recognize challenges and opportunities at different stages of development

• Identify virtues and character traits to enhance throughout career

• Gain an understanding of professional burnout – potential causes, consequences, and solutions

Background

• Most people spend a third of their adult lives at work, making wellbeing at work a key component of their overall wellbeing (1)

• Transitions in training, job search, and a career can be both exciting and challenging, with the potential for self-doubt, imposter syndrome, burnout, turnover, and early career transition

• Positive psychology and psychiatry are approaches to mental health, rather than mental illness, with an emphasis on enhancement of positive psychosocial traits, promotion of positive change, and development of wellbeing(2–5)

Positive Psychological Traits

• Positive psychosocial factors (PPSF) include positive social and environmental influences and internal positive psychological traits (PPT)

• PPTs originate from the positive psychology movement which focuses on circumstances and processes that yield successful and optimal functioning in individuals, groups, and institutions

• Enhancement of PPTs is helpful for both personal and professional development

Challenges and Opportunities

• Individuals face unique challenges and opportunities as they progress through various stages of their profession

• These challenges can be viewed through a developmental lens, similar to Erikson’s psychosocial development model, and traversed by enhancement of various character strengths and virtues

Challenges and Opportunities

Professional Development: Opportunities,

Challenges, and Character TraitsStage of Career Opportunities and Challenges Erikson developmental

phaseAssociated Virtue

Student Knowledge acquisition;Test based performance evaluation

Autonomy vs. Shame and doubt Curiosity and Optimism

Apprenticeship Learning to apply acquired knowledge;Supervised application of acquired knowledge;Skill based performance evaluation

Industry vs. Inferiority Love of Learning

Early Career Transition to young professional; Independent application of knowledge; Skill based performance evaluation

Professional Identity vs. Role Confusion

Vitality and Zest

Mid-Career Professional mastery and wisdom; Leadership and mentorship development

Intimacy vs. Isolation Social and Emotional Intelligence

Late Career Expert professional mastery; Knowledge and skill transfer to trainees

Generativity vs. Stagnation Perspective, Kindness, and Gratitude

Retirement Transition from professional life; Evaluation of personal and professional life accomplishments

Integrity vs. Ego Despair Appreciation of Beauty and Excellence

Important Character Traits

• Curiosity and Optimism▫ Curiosity accounts for 10% of the variance of learning and performance (19) with greater

curiosity associated with greater learning, engagement, and performance (20)

▫ Individuals with high levels of optimism tend to attribute positive outcomes to internal, stable factors and negative outcomes to external, temporary factors (2)

Point in Career Developmental stage Character Trait or Virtue

Student and Trainee Autonomy vs. Shame and Doubt

Curiosity and Optimism

Important Character Traits

• Love of Learning▫ Enjoy learning for the sake of learning and are able to self-regulate efforts to persevere,

despite challenge and frustration (18)

▫ Beneficial for life-long learners in nearly every field – healthcare, business, education, finance – as advancements in technology rapidly change daily operations and communication avenues to exchange information

▫ Developing love of learning as a strength leads to increased opportunities for skill development and gaining value from learning by increased confidence, competence and an optimistic sense of possibility

Point in Career Developmental stage Character Trait or Virtue

Apprenticeship Industry vs. Inferiority Love of Learning

Important Character Traits

• Vitality or Zest▫ Vitality is a positive energy from within that energizes and motivates the self and others

▫ Vigor, enthusiasm, spirit

▫ Vitality is increased by

Self-motivated activities with a perceived internal locus of causality(24)

Exercise and a healthy lifestyle (25-27)

Coaching and training workshops (28)

Environmental (nature) and social contacts (29-31)

Point in Career Developmental stage Character Trait or Virtue

Early-Career Professional Identity vs. Role Confusion

Vitality

Important Character Traits

• Social and Emotional Intelligence (SEI)▫ Skills of self-awareness, self-regulation, motivation, empathy, and social skill

Identify emotion in faces, voices, and designs; use this information to facilitate cognitive activities; understand what this means in relationships; manage and regulate emotions of the self and others; use social information to facilitate cooperation; and identify social relationships and hierarchies among groups(18)

▫ Goleman argues this may be more important than IQ for successful leadership(32)

▫ Acceptance and Commitment Therapy (ACT) practices to build skills Recognize thought and emotion patterns, label thoughts and emotions, accept ideas and emotions with

an open attitude, and act based on values(32)

▫ Strengthening emotional agility and social-emotional intelligence can alleviate stress, reduce errors, increase innovation, and improve performance(32)

Point in Career Developmental stage Character Trait or Virtue

Mid-Career Intimacy vs. Isolation Social and Emotional Intelligence

Important Character Traits

• Perspective and Gratitude

▫ Gratitude arises from belief that one benefitted from actions of another; it is acknowledgement of this gift, appreciation and recognition of the value of that gift(18)

▫ Late career individuals who benefitted from assistance of another often give back to trainees and early career individuals. Their generativity and inclusion positively affects the development of trainees and early career professionals

▫ Two work-related gratitude diary entries per week decrease perceived stress at work(33)

▫ Generating gratitude in the workplace through various gratitude interventions increases job satisfaction(34)

Point in Career Developmental stage Character Trait or Virtue

Late-Career Generativity vs. Stagnation Perspective, Kindness, Gratitude

Important Character Traits

• Appreciation of Beauty in Excellence

▫ Individuals who have reached later phases of their career and retirement theoretically reach what Maslow would describe as the “peak experience” of one’s career

▫ Peak experiences capitalize on a gained appreciation and include a selfless attitude, receptive and humble cognition, enhanced ability to see, hear, and connect with others, and a view of the world as good and beautiful despite conflicts and suffering(35)

▫ Appreciative inquiry has been studied to celebrate excellence in a community, with the goal of further increasing positivity and excellence(36)

Point in Career Developmental stage Character Trait or VirtueRetirement Integrity vs. Ego Despair Appreciation of Beauty and

Excellence

Professional Burnout

• Emotional exhaustion, depersonalization, low sense of personal accomplishment

• Of concern for healthcare, as rates exceed 50% in students, trainees, and early career professionals(7–13)

• Affects ability to successfully navigate challenges throughout professional development, especially during role transition where burnout rates are higher

• Professional and personal consequences▫ Depression, maladaptive coping (alcohol or drug use), broken relationships, work errors,

decreased satisfaction, and intent to leave one’s job

Potential Solutions

Organizational

LeadershipIndividual

Potential Solutions

• Individual▫ Interventions of mindfulness training, meditation, gratitude exercises or reengagement

with hobbies(33,34,49–52,60,61)

• Organization / Leadership▫ Specific interventions to target proposed drivers for engagement or burnout – values

and culture, meaning, flexibility, community, resources, workload, and work-life integration (11)

▫ Address the psychological needs of employees, cultivate organization-employee relationships, and sponsor leadership development in order to develop comradery and excellence (63)

Potential Solutions

• Professional coaching▫ A results-oriented method of enhancing self-awareness, drawing on individual

strengths, questioning self-defeating thoughts and beliefs, examining new perspectives, and aligning personal values with professional duties (64)

▫ International Coaching Federation (ICF) defines the goal of coaching as a partnership with a client to inspire them to reach their full potential through a thought provoking, question driven, creative process (16)

Summary

• Individuals face unique challenges and opportunities as they progress through various stages of their profession

• Challenges seen through a developmental lens, like Erikson’s psychosocial development model, are traversed by enhancement of strengths and virtues

• Professional burnout is associated with personal and professional consequences

• Interventions to improve satisfaction and reduce burnout at individual, organization, or leadership levels should be specific, not universal

• A professional coach or mentor guides in professional developmental challenges

Thank you!

• Please contact me with follow up questions, comments, or thoughts.

• Vicki Flynn, MD▫ vflynn@uams.edu

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