Healthcare Professional Burnout and Resilience

Getting to Know 2017 AMS Phoenix Fellow Dr. Martimianakis

AMS would like to introduce our new 2017 Phoenix Fellow Dr. Maria Athina Martimianakis. Dr. Martimianakis is an Associate Professor and Director of Medical Education Scholarship in the Department of Paediatrics, University of Toronto and a Scientist and International Strategic Lead with the Wilson Centre.

Tina Martimianakis

How did you decide on your area of study for your AMS Phoenix Fellowship?

While I was pursuing my PhD I became immersed in health professions education through a fellowship at the Wilson Centre. I became fascinated by the ways in which physicians decided what knowledges were relevant to their clinical practice and how these decisions impacted their interactions with patients, other health professionals and scientists from different disciplines. Since then I have studied various dimensions of knowledge politics and their effects on the construction and performance of professional identity. For me, professional identities are in large part constructed through the acquisition of knowledge and the practice of expertise during the delivery of care.  In interdisciplinary contexts, the practice of expertise is complicated by hidden curriculum effects; tacit cultural and structural influences that socialize health professionals to what forms of knowledge are valued and not valued in specific contexts. My research has focused on making visible the unintended effects of organizational practices on the capacity of health professionals to access important information and/or share their expertise effectively in the delivery of care. One of the organizational practices I study is the implementation of organizational change.  What happens when workplaces change? How does professional identity change with it, and what impact do these changes have on patient experiences?

What was the catalyst for your interest in compassion in healthcare?

I believe that compassion is the starting point for the resolution of all equity problems, particularly those associated with the exchange of expertise and knowledge. Healthcare is at the centre of contemporary discourse of what counts as knowledge, what counts as expertise and how to bring knowledge and expertise to the resolutions of problems of immediate impact – the health and well-being of people. In recent years I have had several personal encounters with our health care system as both a patient and a family member of young and elderly patients. In the process, I have experienced the best of care and the worst of care. Through the AMS Phoenix project I have found a forum to reflect on these contradictory personal experiences and to consider how my research could contribute to meaningful health system reform.

What inspired you to apply for a Fellowship?

Working with clinical educators immersed in multiple competing organizational change mandates, I have witnessed and experienced first-hand the impact of work intensification. I saw an opportunity to contribute to the AMS phoenix project by focusing my research and educational practice on the topic of how organizational change manifests through identity issues, particularly issues that compromise the wellness of faculty and learners.

What value does being an AMS Fellow bring to you professionally?

The fellowship has allowed me to protect time and devote resources to exploring ways in which I can incorporate a compassionate gaze in the educational practices of my institution. The notice of the award is already drawing attention to the project, allowing me to identify local colleagues and trainees to collaborate with on this work.

Do you know other Phoenix Fellows? Have you been inspired by any of their work/projects in particular?

I have followed the work of all Phoenix Fellows with great interest. I am particularly excited to collaborate with Paula Rowland, Kathryn Parker and Marion Briggs who have experience navigating health care organization change mandates and have contributed through their Phoenix projects to the incorporation of compassionate perspectives at various operational levels of academic health science centres. They have graciously agreed to provide peer mentorship as I evolve this work.

What one little thing could we do to make our healthcare system more compassionate?

Thinking about the wellness of learners and teachers when engaging in curricular reform, particularly for education delivered in clinical settings.

What advice do you have for healthcare professionals to avoid/overcome compassion fatigue and burnout?

Compassion fatigue and burnout are not personal failures. They are in large part a product of systems issues which we can all play a role in resolving. We must turn our caring gaze on our colleagues and encourage them to do the same for us. Let’s make our organizations accountable for the well-being of all employees.

Would the advice be the same for medical school students?

Yes, medical students must learn early on to recognize symptoms of compassion fatigue and burnout in themselves, their peers and their teachers. Part of good clinical practice should be the regular assessment of working and learning conditions with an eye to identifying and reforming practices that compromise the wellness of staff and learners.

About the author

Tina Martimianakis

Maria Athina (Tina) Martimianakis is the Director of Medical Education Scholarship and an Assistant Professor at the Department of Paediatrics, University of Toronto.  She is also a Scientist and the Strategic Lead International at the Wilson Centre for research in health professions education.  Drawing on critical social science theories and Foucauldian discourse analysis, Tina studies the…

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