MANAGING TRANSITIONS - University of Toronto...MANAGING TRANSITIONS SAMPLE PRESENTATION Christopher...
Transcript of MANAGING TRANSITIONS - University of Toronto...MANAGING TRANSITIONS SAMPLE PRESENTATION Christopher...
MANAGING
TRANSITIONS SAMPLE PRESENTATION
Christopher Hurst M.Ed,
Office of Resident Wellness
Transitions
Whether a change in one’s daily routine is an
intentional change, a sudden surprise that gets
thrust upon one, or a growing awareness that one
is moving into a life stage characterized by
increasing or decreasing stability, it will trigger a
cycle of reactions and feelings that is predictable.
(Adams et al. 1976)
Overview of Session
• Identify transitional processes in the workplace that
challenge personal and professional well-being
• Become familiar with a psychological model of transition
• Explore available options for successfully adapting to
transitional challenges
Mindfulness & Noticing
• Curiosity
• Attentive observation
• Open mindedness
• Presence
Mindfulness in Medicine; Rochester School of Medicine
What Transitions are you Going Through
in Your Workday/Personal Life?
What are the Pressures and Stresses
Related to Transitions?
Office of Resident Wellness Top Ten Presenting Issues 2006 - 2011
0% 2% 4% 6% 8% 10% 12% 14% 16%
Uncertainty with career choice
Desire to transfer to another Program
Underperforming
Workplace relationships
Stress
Mood disorders
Marital/partner/relationship
Depression
On remediation
Anxiety
What is Being Left Behind?
Transition Cycle
Eos Life-Work Resource Center
http://www.eoslifework.co.uk/transprac.htm#T1
Increased Anxiety “I feel anxiety is going to
consume me”
“I can’t sleep from worrying”
Low Mood “I’m exhausted”
“I can’t get motivated”
Loss of Control “I feel completely
overwhelmed”
Uncertainty “I don’t know what’s expected of
me”
“Everything is new and
unfamiliar”
Decreased Confidence “I feel like I don’t know anything”
“I don’t know if this is right for me
anymore?”
Adaptive Steps
Well
Being
Feel
Good
Okay
Distress/
Despair
Difficulties breaking into the system. Guilt for “neglecting my family”
Faculty
Well
Being
Feel
Good
Okay
Distress/
Despair
Resident
Well
Being
Feel
Good
Okay
Distress/
Despair Felt my education
goals in specific
rotation were not
met.
What Does Your Transitional
Curve Look Like?
Feel Good
OK
Distress/
Despair
Well
Being
Time
Transition Graph
What Do You Notice When You
Look at Your Graph?
How Do You Manage to Perform Well Despite
the Stress of Transitions?
What feelings, thoughts and actions help you
cope?
What Relationships Helped?
Mark them down on your graph.
Don’t let circumstances dictate who you get to be…
- Vik Maraj
Narrative Exercise
• Think of a transition time when you handled a
stressful situation in a way that reflected how you
want to be as a physician.
• How did you manage to perform well despite the
stress?
• Who else was involved, and how did they contribute?
• What lessons from this story are useful to you?
Take 10 Minutes
For the storyteller:
• What happened?
• How did you manage to perform well despite the stress?
• Who else was involved, and how did they contribute?
• What aspects of the context made a difference?
• What lessons from this story are useful to you?
For the listener:
• Be attentive, don’t interrupt.
• Ask questions to help your partner clarify and provide details.
• Don’t talk about your own ideas or experiences.
• Use reflective questions and empathy when appropriate.
Debrief
Transition Factors
Lockyer J, Wycliffe-Jones, Raman M, Sandhu A, Fidler H. Moving into medical practice
In a new community. The transition experience. JCEHP 2011; 31(3).
Skillful Transitions
• Is there an area ( internal, external, professional,
location) where you need to develop additional
strategies?
• Is there a new strategy that you want to try out as
a controlled experiment in the selected area?
Attention and Arousal
Arousal not only affects the absolute amount of cognitive
resource available, it also affects the effectiveness with which it
is allocated. For example, in more stressful contexts, attention
becomes highly focused on tasks we identify as being of
dominant importance. Peripheral (or, more accurately, less
dominant) stimuli are not attended to — referred to in the stress
literature as tunnel vision. In addition, our ability to differentiate
between relevant cues and irrelevant cues is impaired, often
resulting in a perseveration of attention on a narrow, sometimes
inappropriate set of stimuli. Therefore, in states of high arousal,
our ability to allocate our attention effectively can deteriorate.
Coming Back to Resilience
Knowing When to Slow Down
When your stress levels are high, when you’re feeling rushed, when the problem is complicated or there are unexpected complications, when team conflicts arise:
• Step back for a moment
• Take a few breaths, bringing your awareness to each inhalation and exhalation.
• Expand your awareness to your physical sensations, expand your awareness to the situation at hand --- look closely at the details of the situation without judging
• Focus on priorities - what do you need to do next?
• Focus on the next most important task
Adapted from: Mindfulness in Medicine: What is it? Ted Bober & Ann Davidson, Physician Health Program, OMA 2011
RESIDENT WELLNESS
RESOURCE BOOKLET
RESIDENT WELLNESS RESOURCE BOOKLET
E-couch • A self-help, interactive program with modules for depression, generalized anxiety and worry, social anxiety,
relationship breakdown, and loss and grief. It provides evidence- based information and teaches strategies
drawn from cognitive, behavioral, and interpersonal therapies, as well as relaxation and physical activity
techniques.
• URL: http://www.ecouch.anu.edu.au/welcome
MoodGym • An innovative, interactive web program designed to prevent depression. It consists of five modules, an
interactive game, anxiety and depression assessments, downloadable relaxation audio, a workbook, and
feedback assessment.
Overcoming Perfectionism • This information package is designed to help you understand what is helpful and unhelpful about being a
perfectionist. The goal is not for you to give up your high standards altogether, but to learn to pursue healthy
high standards rather than unrelenting high standards that negatively impact your life. This Infopax is
organized into modules that are designed to be worked through in sequence. We recommend that you
complete one module before going on to the next. Each module includes information, worksheets, and
suggested exercises or activities.
CALM • Computer Assisted Learning for the Mind contains podcasts and audio files that can be easily uploaded to
mobile devices. The tunes included within this website are geared towards mental resilience, managing
stressors, healthy relationships, and meaning in life
Where To Go For Help: Office of Resident Wellness
Dr. Susan Edwards
Director (Tues, Thurs) 946-4015
Christopher Hurst, M.Ed.
Wellness Consultant
416-978-6861 [email protected]
Diana Nuss, Office Coordinator
Assistant To Dr. Susan Edwards and Christopher Hurst 416-946-3074 [email protected]
What Can the PGME Office Do For Me?
• Appointment with the Director of Resident Wellness
• Advice
• Advocacy
• Referrals to appropriate providers for stress and other issues
• Speak to resident groups
Where To Go For Help:
University of Toronto
• www.utoronto.ca
• Sexual Harassment Officer
• Anti-racism and Cultural Diversity Officer
Family Care Office
• www.familycare.utoronto.ca
• 416-978-0951
Where to Go For Help: Physician Health Program, OMA
• Confidential assessment and triage for all physicians
experiencing difficulty with stress, mental health or
substance use issues.
• www.phpoma.org or 1 800 851-6606
Where To Go For Help: PAIRO (Professional Internes and Residents Association)
• www.pairo.org or 979-1182
• Local PAIRO rep
• 24 hour crisis line 1-866-HELPDOC
• Information for internationally funded residents
• Resident Well Being Committee
• Advice on rights of residents
Comments? Questions?
Thanks