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Using Insights From Sports Psychology to Improve Recently Qualified Doctors' Self-Efficacy While Managing Acutely Unwell Patients.

Authors
  • Church, Helen R1
  • Murdoch-Eaton, Deborah2
  • Sandars, John3
  • 1 H.R. Church is clinical assistant professor, University of Nottingham, Nottingham, United Kingdom. At the time this work was produced, she was a PhD student, University of Sheffield, Sheffield, United Kingdom; ORCID: http://orcid.org/0000-0003-0455-9576. , (United Kingdom)
  • 2 D. Murdoch-Eaton is dean of medical education and head, Academic Unit, Medical Education, University of Sheffield, Sheffield, United Kingdom; ORCID: https://orcid.org/0000-0002-2246-8785. , (United Kingdom)
  • 3 J. Sandars is professor, Medical Education, Faculty of Health, Social Care, and Medicine, Edge Hill University, Ormskirk, United Kingdom; ORCID: http://orcid.org/0000-0003-3930-387X. , (United Kingdom)
Type
Published Article
Journal
Academic medicine : journal of the Association of American Medical Colleges
Publication Date
May 01, 2021
Volume
96
Issue
5
Pages
695–700
Identifiers
DOI: 10.1097/ACM.0000000000003809
PMID: 33086231
Source
Medline
Language
English
License
Unknown

Abstract

Doctors experience a range of negative reactions when managing acutely unwell patients. These may manifest as emotions or behaviors. Without appropriate coping strategies, these emotions and behaviors can impede optimal clinical performance, which directly affects patient care. Athletes use performance enhancing routines (PERs) to minimize the effect of their negative emotions and behaviors on competitive performance. The authors investigated whether PERs could similarly improve recently qualified doctors' emotional and behavioral control while managing acutely unwell patients and whether the doctors perceived any effect on clinical performance. Twelve doctors within 2 years of graduation from medical school recruited from 2 sites in Sheffield and Chesterfield, United Kingdom, implemented PERs using the PERFORM (Performance Enhancing Routines For Optimization of Readiness using Metacognition) model over a 4-month period between April and December 2017. The doctors' perceptions of PERFORM's effect on their ability to manage patients was evaluated using self-reported mixed-methods data, including think-aloud commentaries, semistructured interviews, and self-efficacy scores. Doctors reported that PERFORM improved their ability to control negative emotions or behaviors during an acutely unwell patient in situ simulation, showing a statistically significant improvement in self-efficacy scores (P = .003, effect size = 0.89). Qualitative data revealed perceived improvement in aspects of clinical performance such as enhanced knowledge recall and decision making. These performance attributes appeared to positively impact interprofessional relationships and patient care. Doctors individualized their PERs and supported the wider implementation of PERFORM in health care education. This is the first study to employ individualized PERs based on sports psychology in a medical context. The PERFORM model could be introduced into existing acute patient management courses to provide emotional regulation coaching alongside clinical skills training. Further research might investigate PERFORM's effect in other environments where emotional and behavioral control is paramount, such as surgery. Copyright © 2020 by the Association of American Medical Colleges.

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