Implementation of a “Cases and Conundrums” Conference Among Early Career Internal Medicine Clinicians

John C. Matulis; Suzette Barakat

doi:10.1370/afm.2743

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RE: "Cases and Conundrums" promotes healthcare worker well-being
Elizabeth A Kelsey

Published on: 28 December 2021
RE: Great work!
Danielle J O'Laughlin

Published on: 13 December 2021
RE:
Luke T Hafdahl

Published on: 06 December 2021
RE:
Brittany Strelow

Published on: 21 November 2021

Published on: (28 December 2021)
Page navigation anchor for RE: "Cases and Conundrums" promotes healthcare worker well-being
RE: "Cases and Conundrums" promotes healthcare worker well-being
Elizabeth A Kelsey, Nurse Practitioner, Mayo Clinic
Well-being is a state that addresses physical, mental, and social dimensions of an individual’s life.(1) While healthcare providers have extensive training to diagnosis and treat physical and mental health conditions, social determinants of health continue to draw more attention. In particular, social connectedness has shifted during the COVID-19 pandemic in both personal and professional settings. It has been suggested that choosing the term “physical distancing” over “social distancing” may have been more tactful to encourage social connection, in what evolved into new formations, from the start of the COVID-19 pandemic.(2) As a result, loneliness and isolation frequently occurred, which are known to be detrimental to health and well-being.(3) Despite the stressors brought on by the COVID-19 pandemic, this time has equipped individuals with adaptability and introspection, and on a larger scale growth for policy change to support mental health and well-being. Joy in the workplace has been reported to mitigate the risk of burnout and promote individual well-being.(4,5)

There are few intervention studies related to joy in the workplace among healthcare settings. A study of physicians who participated in a 6-month reflective, shared experience demonstrated improved burnout, depressive symptoms, and job satisfaction.(6)

The authors describe how a shared experience with a cases and conundrums conference promoted social connection and collaboration in the workplac...
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Well-being is a state that addresses physical, mental, and social dimensions of an individual’s life.(1) While healthcare providers have extensive training to diagnosis and treat physical and mental health conditions, social determinants of health continue to draw more attention. In particular, social connectedness has shifted during the COVID-19 pandemic in both personal and professional settings. It has been suggested that choosing the term “physical distancing” over “social distancing” may have been more tactful to encourage social connection, in what evolved into new formations, from the start of the COVID-19 pandemic.(2) As a result, loneliness and isolation frequently occurred, which are known to be detrimental to health and well-being.(3) Despite the stressors brought on by the COVID-19 pandemic, this time has equipped individuals with adaptability and introspection, and on a larger scale growth for policy change to support mental health and well-being. Joy in the workplace has been reported to mitigate the risk of burnout and promote individual well-being.(4,5)

There are few intervention studies related to joy in the workplace among healthcare settings. A study of physicians who participated in a 6-month reflective, shared experience demonstrated improved burnout, depressive symptoms, and job satisfaction.(6)

The authors describe how a shared experience with a cases and conundrums conference promoted social connection and collaboration in the workplace. Having a shared, relatable interest among healthcare providers can reduce the risk of burnout.

1. U.S. Department of Health and Human Services. Health People 2020 Framework. https://www.healthypeople.gov/sites/default/files/HP2020Framework.pdf. Published 2010. Accessed February 23, 2021.
2. On Being with Krista Tippett [Internet]; 2021 December 2, 2021. Podcast. Available from: https://onbeing.org/programs/vivek-murthy-and-richard-davidson-the-futur...
3. Banerjee D, Rai M. Social isolation in Covid-19: The impact of loneliness. Int J Soc Psychiatry. 2020;66(6):525-527.
4. Dyrbye LN, West CP, Kelsey EA, Gossard AA, Satele D, Shanafelt T. A national study of personal accomplishment, burnout, and satisfaction with work-life integration among advance practice nurses relative to other workers. J Am Assoc Nurse Pract. 2020.
5. West CP, Dyrbye LN, Rabatin JT, et al. Intervention to promote physician well-being, job satisfaction, and professionalism: a randomized clinical trial. JAMA Intern Med. 2014;174(4):527-533.
6. West CP, Dyrbye LN, Satele DV, Shanafelt TD. Colleagues Meeting to Promote and Sustain Satisfaction (COMPASS) Groups for Physician Well-Being: A Randomized Clinical Trial. Mayo Clin Proc. 2021;96(10):2606-2614.
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Competing Interests: None declared.
Published on: (13 December 2021)
Page navigation anchor for RE: Great work!
RE: Great work!
Danielle J O'Laughlin, Physician Assistant, Mayo Clinic
Cases and Conundrums is an excellent resource for new clinicians. Not only does it promote team bonding, networking and idea sharing but it improves medial knowledge, highlights strengths among clinicians and allows all to learn valuable lessons in medicine. Keep up the great work! This could benefit so many others if implemented across the medical institution (other areas of primary care, specialty areas, etc).

Competing Interests: None declared.
Published on: (6 December 2021)
Page navigation anchor for RE:
RE:
Luke T Hafdahl, Intneranl Medicine Physician, Mayo Clinic
I found the "Cases and Conundrums" conference a remarkable experience. Certainly, from a patient care perspective, the value of getting perspectives cannot be overstated. When you are deep in the diagnostic process, that momentum can carry you away and you can lose the ability to "step back" and re-appraise the situation (especially when things are not working out the way you would expect). However, the greater value of the conference is the normalization of how the diagnostic process is iterative and longitudinal is most important. The hidden curriculum so many leave residency with is that you are expected to "get it right" on the first evaluation of the patient, which is rarely the case. Having a forum where the diagnostic process and its cycle of testing, trialing and reappraising is discussed as the norm is so critical for healthy expectations on one's performance as a physician. Seeing other respected colleagues who do are going through the same challenges helps dispel unreasonable self-imposed expectations of diagnostic accuracy that, if left unchecked, could hasten burn out.

Competing Interests: None declared.
Published on: (21 November 2021)
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RE:
Brittany Strelow, Physician Assistant, Mayo Clinic
“Cases and Conundrums” was an excellent resource. I enjoyed the camaraderie that was offered. It was beneficial to hear those who come across so confident in the clinic that sometimes they are unsure like others. The program took away the hierarchy as mostly early-career clinicians. It didn’t matter if you were a physician, physician assistant, nurse practitioner; we were all working together to find answers to our cases. Many were at similar points in career/age, which made it easy to connect socially and break down barriers. We started to learn each other’s strengths and create avenues for someone to reach out to later.

Competing Interests: None declared.