Doctor wellbeing: debriefs with peers vital

Reflecting on my experience as an early career paediatric oncologist, it is apparent that the coronavirus disease 2019 (COVID-19) pandemic has caused us to rethink our own values and goals.

When something is taken away, such as the ability to see loved ones and friends, you realise how important it is.

In this piece, I discuss how we can improve doctors’ wellbeing as new ways of working become more ingrained. Last week, I discussed balancing oncology and motherhood during the pandemic.

First, the COVID-19 pandemic has illustrated the value of human interaction.

Let us break down the Zoom or Teams silos that we established during this period. We need to support young scientists, young doctors and doctors-in-training as we make the transition from virtual to in-person meetings.

Let us move away from multitasking on our computers through to conducting thoughtful and meaningful hybrid or in-person meetings. In late 2022, I experienced the buzz of speaking at a face-to-face conference. It was magical seeing people smile.

In my view, it will be vital for doctors to have more in-person opportunities to connect and learn, to practise skills critical for us to do our jobs. Medical students and trainees have had fewer opportunities during the COVID-19 pandemic for face-to-face teaching. The conventional bedside medical student tutorials were replaced by virtual equivalents during lockdowns.

A cardiology examination with a palpable thrill and systolic murmur on a real patient may therefore be a shock after the touch screen learning of the early pandemic years. Similarly for a more advanced medical trainee, key communication skills, such as delivering bad news or creating complex management plans, may need to be a focus.

Second, I believe that as a medical community, we need to promote debrief practices for ourselves. In our new hybrid virtual world, a colleague in difficulty may go undetected for longer than before.

Medical professionals should be offered and encouraged to participate in active debriefs after challenging patient situations rather than only at times of crisis. This will promote and build resilience. In-person debriefs will be important to enhance communication.

Non-verbal cues and spontaneous communication during debriefs may provide insight into the mental and emotional needs of ourselves and our colleagues. It may be easier and more impactful to share freely in person rather than put up your virtual hand or write something in a virtual chat.

However, there may be some colleagues who will require individual debriefs, as it really does take courage to share our experiences openly. Regular individual sessions may be helpful to provide a forum outside work and home to talk through our experiences, which can be confronting and emotionally burdensome.

Third, we could target formalised mentoring programs to support our colleagues, especially at times of transition or increased responsibility. Transition points present with increased vulnerability and self-doubt, particularly in this new world of hybrid and virtual meetings.

Improved mentoring could be valuable for doctors, especially where the therapeutic relationship is challenged or where it affects clinician self-confidence. Social media and online information seeking is increasing the complexity of doctor–patient interactions, requiring new skills to navigate this.

If I could take learnings from the past three years, it would be to have more self-confidence in times of self-doubt, to find a mentor for regular debriefs, and to meet in-person when possible.

Promoting self-awareness and healthy patient boundaries are critical to ensure that we, the current medical community, can continue to do what we do well: looking after the holistic needs of our patients and families. This requires more than just a touch screen.

As we move forward, we need to incorporate the hybrid virtual world and to reinvigorate the human touch. Thankfully, social events with friends and family are now possible. We have navigated the “no hugs in 2020” to the awkward “do we hug in 2022?” situation.

We can now meet without masks, overseas travel is possible, and face-to-face overseas conferences are back on the agenda. “To go in person or not to go in person”, that is the question.

We also need to acknowledge the enormous strain that the COVID-19 pandemic has placed on all of us – on medical systems, health professionals and scientists worldwide, as well as on the patient and family experience of navigating the health system at times of crisis.

Amid the ever-changing global backdrop of uncertainty, and now the war in Ukraine, let us focus on recreating the social fabric of society. We need to celebrate our successes and appreciate those families who will be forever grateful for our care, no matter the result.

Debriefing and supporting everyone in the new hybrid virtual reality is something worth investing in and encouraging for all.

Dr Marion Mateos is a paediatric oncologist based at the Kids Cancer Centre in Sydney and clinical academic in the School of Clinical Medicine at the University of New South Wales.

This is the second article in a two-part series from oncologist and clinical academic Dr Marion Mateos. Read part one where she discusses balancing oncology and motherhood during the COVID-19 pandemic.

The statements or opinions expressed in this article reflect the views of the authors and do not necessarily represent the official policy of the AMA, the MJA or InSight+ unless so stated. 

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