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  • drnicoladepaul

Integrating well-being into medical education

Updated: Aug 23, 2022

I recently talked with Dr. Liz Dykhouse, a clinical psychologist and family medicine residency faculty member. We discussed how to integrate well-being into medical residency education and considered systemic challenges that can make it tough for clinicians to manage their self-care and personal wellness. I am excited to share our conversation!

In addition to celebrating Menders’ 20th episode, talking with Liz led me to reflect on my roles as a mentor, trainer, and supervisor. Working with trainees and early career clinicians has always been among the most meaningful and rewarding parts of my work as a psychologist. Playing these roles is good for my well-being because it keeps me connected with my purpose and lights up my brain cells in new ways with every interaction. I hope that my trainees and mentees benefit as much as I do from our work together.

I had a chance to sit down with a group of trainees new to my healthcare system a couple of weeks ago. We decided on picnic table supervision with a beverage of choice, my favorite kind, to be sure! I opted for a sparkling cardamom lemonade from Reno’s Pangolin Café (delicious!) as it was just a titch too early for my favorite sour beer from Local Beer Works right next door.

Our conversation was focused on how to deal with microaggressions in supervisory relationships. Admittedly, a heavy topic to kick off the training year. Unfortunately, the group had already encountered challenging staff interactions in their first few weeks at the medical center. And everyone had a story about a past supervisory relationship gone sour or sprinkled with unsavory or thoughtless comments about their race, sexual identity, or gender.

Hearing these stories always makes me cringe.

But I was grateful to have the opportunity to hold space for this conversation and to walk the trainees through a self-advocacy process that may help them feel better equipped to deal with the next microaggression or unwanted sexual comment.

Sometimes just showing up, creating space for painful conversations, and allowing another person to be fully seen, heard, and valued is an act of systemic advocacy.

Take a moment to consider what you can do:

- When was the last time you sat down and invited your team to dig into a tough conversation?

- How can you create space for open communication and connection with your team, even in imperfect circumstances?

- What can you do to model systemic advocacy and well-being for your colleagues, your team, or the next generation of clinicians?

What’s new on Menders?

Menders episode 20 is gracing the airwaves!

Dr. Liz Dykhouse highlights the differences between wellness and well-being in this episode. Liz shares how she and her team have integrated well-being into the core curriculum of their family medicine residency. And she shares her experiences developing a behavioral medicine curriculum for family medicine residents in Liberia. So exciting!

Liz and I also reflect on strategies that allow clinical supervisors and healthcare leaders to foster a culture of safety in which learners become comfortable acknowledging their challenges and reaching out to their supervisors and community for support. Finally, Liz provides a framework for how well-being naturally leads to systemic advocacy in healthcare and makes a case for why we need to focus on well-being and systemic advocacy for our future.

Listen to find out:

· Why (& when) she trains her residents to move away from a problem-solving approach!

· Why she believes that focusing on well-being now will create a foundation for long-term sustainability within our healthcare system.

· And how she balances her workload to maximize meaning and promote her sustainability in healthcare and medical education.

Here are a couple of my favorite quotable moments from this episode:

“We have to live within the system to promote change.”

- Dr. Liz Dykhouse (Menders, episode 20)

“I felt better today, but that didn’t solve the problems…I want [residents] to feel empowered to advocate for change…I also want them to know how to care for themselves individually!”

- Dr. Liz Dykhouse (Menders, episode 20)

“The thing that I have found most helpful working within the system myself and working collaboratively with leaders in a variety of different settings within the traditional method is the willingness of leaders to have the conversation, being willing to acknowledge:

‘This is hard, I’m asking you to do something challenging, and I don’t have a better answer. Can we be creative? How can I support you in caring for yourself while you’re here?’

That’s not a perfect solution, but those seem to be the leaders with the best relationships with their staff.”

- Me! (Dr. Nicola De Paul)

I hope this episode inspires you to consider what you can do to care for yourself at this moment while you take one tiny action to advocate for systemic transformation.


Wednesday, September 21st, I will be hosting a brand-new FREE LIVE MASTERCLASS!

Masterclass: How to Use a Road Map to Transform a Toxic Employee Culture into a Culture of Connection, Hope, and Well-being in 2023

During This Live Masterclass, You Will Learn:

1. Wellness vs. Well-Being, wait, there’s a difference?

2. How to get your team on the same page & on your side!

3. How to shut your mouth and open your ears, institutionally speaking.

4. How to identify meaningful and responsive strategies (that are under your control) to address employee complaints and satisfy your people!

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