Projects
The vitality of doctors and other healthcare professionals is important for the quality of healthcare. Doctors’ vitality has become a much-discussed topic in the media and in scientific research in recent years. The research paints a clear picture. Doctors’ vitality is increasingly coming under pressure from demanding and changing working conditions such as the high pressure on production, the emotional burden of the work and the increased administrative burden. Both research and clinical practice often focus on reduced vitality (such as burnout) and the associated negative consequences for patient care. Nowadays, however, increasing attention is being paid to improving working conditions and doctors’ vitality. The research group Professional Performance & Compassionate Care carried out a project called ‘Professionaliteit in Vitaliteit’ [Professionalism in Vitality] and is currently promoting educational projects to increase doctors’ vitality.
Professionalism in Vitality
In 2016 we, together with VeiligheidNL and Medox, received a grant from the Dutch Ministry of Social Affairs and Employment for the project ‘Professionalism in Vitality’. This project involved the development of an evidence-based vitality module which was subsequently piloted. Its aim was to facilitate doctors and departments in improving their working conditions and vitality. We completed the project successfully in September 2017. The vitality programme we developed comprises a) a vitality measurement, b) a facilitated group discussion of the results, and c) a team training course in communication and team job crafting. Contact us for more information.
Education
The research group is represented in education in the Bachelor’s Degree programme ‘Opmaat naar de Praktijk’ [Prelude to Clinical Practice] and in residency training (DOO). In the undergarduate programme, Bachelor students discuss with interns the concept of vitality and what they – and hospitals – do to be able to work (and continue to work) with enthusiasm and energy. For residents a two-day course ‘The Vital Resident’ is offered, providing scientific evidence regarding professional performance and work-related well-being. In the course, these doctors practise exploring and improving their own vitality.
Increasing numbers of PhD candidates at the AMC and in other teaching hospitals are experiencing problems associated with their study programmes. There are complaints about supervision, about the content of research and about the PhD candidates’ well-being. The quality of PhD candidates’ programmes therefore need to be improved.
The ReSQuE (Research Supervision Quality Evaluation) project is attempting to contribute to improving the quality of the programmes by focusing on the educational climate. The assumption is that improving the educational climate will help to improve the quality of the programmes. In line with the project, research will be conducted into the programme and the supervision of PhD candidates at the AMC. The research aims to monitor the educational climate in research groups. A measurement instrument focusing on the various elements of the educational climate in research groups will also be developed in the project. The measurement instrument will be used to monitor the educational climate.
The project is currently at the stage of developing the instrument. Information on the various elements which are important for the educational climate in research groups has been gathered using focus groups. These elements will later become the different themes in the measurement instrument. We are currently working on scientifically and theoretically substantiating the elements that have been found. The next step will be to draw up items.
You can track the project and its status through the website.
From 2020, a new requirement for the individual re-registration of medical specialists (a.k.a. revalidation or Maintenace of Certification) will come into force. From then on, specialists will be obliged to evaluate their personal performance once every five years with the help of feedback from colleagues in their immediate working environment, and to discuss the results which emerge with an independent coach. This is known as the IFMS requirement: Individual Performance of Medical Specialists.
AMC approach
At the AMC, professional performance researchers have developed an IFMS approach at the request of the Executive Board and in conjunction with medical specialists, heads of departments and the HR department. In this model:
- The primary focus is on the professional development of the specialist. The specialist and the professional development coach will work on a specific development goal in a session lasting two hours.
- The coaches are mainly medical specialists working at the AMC. The medical specialists can choose their own coaches but they may not choose someone from their own division.
- The coaches have been trained to conduct an appreciative, positive and solution-driven developmental interview in line with the DANA method developed by Annemiek Nooteboom in conjunction with the research group Professional Performance & Compassionate Care.
- Supervised periodical peer review meetings are arranged for the coaches.
- Feedback will be gathered using evidence-based tools (such as INCEPT, SETQ).
- The IFMS activities will be evaluated by means of scientific research.
The approach has been recorded in a protocol. Various UMCs have gratefully made use of the AMC model. Please contact us if you are interested in hearing more about it.
Quality of Care and Quality of Caring: developing a compassion intervention for physicians
Compassion is crucial for the quality of healthcare. How do physicians in training (residents) and patients describe compassion within Amsterdam UMC? How can compassion be fostered and developed? This project – financed by the research institute Amsterdam Public Health, program Quality of Care (APH QoC) aimed at developing a compassion intervention for residents and sought answers to these questions.
Here you will find the report of the project: link.
In an interview study Maarten Debets and colleagues investigated
the understanding and perceptions of both patients and residents about
compassionate care. Patients and residents have similar and varying
understandings of compassionate care at the same time. Understanding these
differences can aid compassion in medical practice. Based on the findings, three
topics are suggested to improve compassion in residents: (1) train residents
how to ask for patients’ compassion needs, (2) address residents’ limiting
beliefs about the concept and practice of compassion, and (3) acknowledge the art
and science of medicine cannot be separated. Curious for the publication?
Please keep an eye on our website.
Would you like to know more about this project? Feel free to contact: r.bogerd@amsterdamumc.nl
Happy in & at work! This new movement stands for the wellbeing of young physicians.
On the 20th of november was the launch of this new movement Happy in & at Work. The new generation of young doctors (residents and gp’s in training) organized a national debate on what determines professional fulfillment for them. The organizations of young medical specialists and young GPs call for all healthcare stakeholders to be part of this movement and help remove barriers for physicians’ wellbeing and make meaning in work a high priority. Doctors and patients alike will benefit form more mental fit and professionally fulfilled doctors. In preparation of the national launch the research group PP&CC wrote a paper The Wellbeing of The New Generation Doctors (Dutch). We will continue to be closely involved and look forward to the next steps.
The Dutch Association for Cardiologists (NVVC) was afraid that the well-being of her members is being jeopardized by the high work pressure (Dutch) cardiologists often experience. In order to act properly, the union’s Quality Committee aimed to get insight in this well-being of her members. It planned to do an inventory which should function as the foundation for future recommendations and a so called “standard” for a healthy cardiology practice in the Netherlands. The inventory and accompanying research is being performed by PP&CC.
Rosa Bogerd is in the lead of the inventory and presentation/ reporting of the results. Together with the team we made a questionnaire, existing of the literature’s most prominent constructs related to burn-out and fulfilment, that will provide insight into well-being, work pleasure and professional fulfilment, work pressure, time for patients, resilience, feedback culture, team atmospheres, etc amongst Dutch cardiologists. The questionnaire was filled out bij 374 cardiologists. The results have been analyzed and will be guiding in setting the associations’ Quality of Care guidelines. On top of that, the results have been written down in two separate scientific articles that were published, please see the links below this article.
Here is a sneak peak of the results:
- Aspects in the ‘organization of practice’ domain were found to be less important in predicting cardiologists’ well-being than often assumed. Important predictors were more often found in the domain of culture of wellness and individual resilience characteristics.
- Increasing job resources, like autonomy and meaningful patient contact, is more effective for enhancing cardiologists’ well-being than decreasing job demands, like the administrative burden.
- Take home message: enhancing cardiologists’ work-related well-being? Make room for the resilient cardiologist with a satisfying work-home balance, who experiences meaning in work.
The structure of postgraduate medical education (PGME) in the Netherlands has seen some considerable changes in the last decades. Educators have to facilitate a broader curriculum, while taking into consideration the individual needs of residents in their careers. Moreover, challenges in healthcare in general, like an increasing demand of care combined with a decrease in the number of physicians, have impacted PGME as well. In spite of these developments, educators are expected to provide high quality educational programs to residents. But how are these educators facilitated in completing these tasks? And what constitutes an ideal educators’ climate?
Our research group aims to answer these questions in the research project ‘Educators climate in postgraduate medical education’. In this project we will try to elucidate the educators climate as a whole, as experienced by members of educational teams. Knowledge about the factors that help educators feel supported in their jobs is essential to continue to provide optimal support in the future. Therefore we want to eventually contribute to the job satisfaction of educators, and to the quality of postgraduate medical education.
Are you interested in this project, and would you like to know more about it? Please do not hesitate to contact principle investigator Anne van Graafeiland (a.w.vangraafeiland@amsterdamumc.nl).