1. Center for Professional Health CPH Reflections, Self-Awareness, and Discovery The Professional Health and Wellness of the Medical Student: Reflections, Self-Awareness, and Discovery Charlene M. Dewey, M.D., M.Ed., FACP William H. Swiggart, M.S., L.P.C./ MHSP Co-Directors, Center for Professional Health 1107 Oxford House Nashville, TN 37232-4300

2. Center for Professional Health CPH Goal This session will encourage learners to reflect on several factors within their lives that will influence their professional health and wellness and how these factors and their self-awareness can help maintain professional wellness and professional boundaries.

3. Center for Professional Health CPH Objectives Learners will: 1.Reflect on their personal characteristics and family of origin and how these influence their specialty selection. 2.Share their specialty choices and discuss how their personal characteristics will influence their behaviors in that career choice. 3.Interpret/value how professional health and wellness influences boundary and professionalism lapses. 4.Identify their stress triggers and how they respond in stressful situations. 5.Recognize the behaviors associated with flooding and select appropriate means for handling flooded colleagues, teammates, and family members.

4. Center for Professional Health CPH Agenda 1.Introduction 2.Small Group Session #1 –Self-awareness & personality inventories –Family roles –Specialty choices & hidden curriculum 3. Professional Health & Wellness (large group) 4. Small Group Session #2 –Professional health and wellness –Dealing with the flooded colleague/team member –Emotional intelligence 5.Summary & evaluations

5. Center for Professional Health CPH Survey Results N=53 (44%) Age: 17.5 (ave); 15 (mode);,5-26 (range) 49 comments; 30(61%) = “help people” 23% = reason changed over time; 76.5% no change

6. Center for Professional Health CPH Survey Results Specialty: 23% ped sub 23% other 12.5% IM sub 11 of 16 personality types I:E ratio is 1:2 (36%=I and 64%=E) 22.6% = ENFJ 37% = divided into: ESFJ, ISTJ & INTJ (13%, 13%, 11%)

7. Center for Professional Health CPH Personality & Careers How old were you? A personal story

8. Center for Professional Health CPH Self-Awareness Key to emotional intelligence Leads to self-control

9. Center for Professional Health CPH Personality Types The Sixteen Types US Population Breakdown The table organizing the sixteen types was created by Isabel Myers (an INFP). ISTJ ISTJ 11–14% ISFJ ISFJ 9–14% INFJ INFJ 1–3% INTJ INTJ 2–4% ISTP ISTP 4–6% ISFP ISFP 5–9% INFP INFP 4–5% INTP INTP 3–5% ESTP ESTP 4–5% ESFP ESFP 4–9% ENFP ENFP 6–8% ENTP ENTP 2–5% ESTJ ESTJ 8–12% ESFJ ESFJ 9–13% ENFJ ENFJ 2–5% ENTJ ENTJ 2–5% Estimated percentages of the 16 types in the population. [32] [32] http://en.wikipedia.org/wiki/Myers-Briggs_Type_Indicatorhttp://en.wikipedia.org/wiki/Myers-Briggs_Type_Indicator (Table copied May 1, 2011)

10. Center for Professional Health CPH Family Job Description Family roles  Family Hero  Caretaker/People Pleaser  Scapegoat  Lost Child  Mascot/Clown Job title Job description

11. Center for Professional Health CPH Hidden Curriculum Not part of any printed curriculum Messages we learn Contributor or change agent? Part of the problem or part of the solution?

12. Center for Professional Health CPH Group 1 Dewey, Charlene Adams, Carmen Michelle Andrade, Gabriela Barnett, Brian Scott Blanco, Marissa Bourne, Sarah Burjek, Nicholas Edward Chi, Michael Dhulipala, Sravan Choudary Eshaghian, Daniel Friedlander, David Fallon Gregg, L. Parker Hames, Nicole Angele Lio, Elizabeth Group 2 Swiggart, William Aisagbonhi, Omonigho Augustina Ayers, Katie Bergman, Mica Yael Choxi, Ankeet Cooperstein, Emily Eby, Kathryn Grace Eskind, David Fritz, Ryan Maston, Emily Elizabeth McConnaughey, Shannon Marie Poon, Sabrina Schulte, Rachael Rae Chase Wright, Danielle Group 3 Rodgers, Scott Andresen, Jennifer Michelle Binka, Edem Chiaghana, Chuks Edwards, Kimberly Ann Fuchs, Christian Jan Hanif, Rimal Hsu, Emory Knowlton, Peter Marcovitz, David Musee, Joel Ovalle, Fernando Ruiz, Rachel Sullivan, Billy Group 4 Lomis, Kim Allen, Amil Apple, Rachel Price Deery, Sarah Furman, Adrian Arthur Gebre-Amlak, Kassatihun Gregg, Justin Hawley, Catherine Hipp, Dustin Michael Kohorst, Kelly Louise Mariotti, Jolene Myler, Conrad Spencer Powers, Albert Russell, III Wegner, Adam Michael Small Groups 1-4

13. Center for Professional Health CPH Group 5 Cutrer, William B Logan, Carol Rozear Moore, Ryan Davis Pai, Anita Kochikar Powers, Albert Russell, III Real, Joe Schmidt, Alexandra Shpigel, Adam Arnold Sopfe, Jenna Toaz, Erin Tustin, Aaron Wayne Vucovich, Megan Weiner, Ashley Wilburn, clayton Woo, Kel Vin Group 6 Rush, Charles Grayson, Britney Kirlew, Christine Lorraine Kutaka, Julia Jeanne Lominadze, Zurabi Meenderink, Leslie Michelle Nathan, Niraj O'Brien, Nathan Michael Patrawala, Samit Atul Saboori, Mazeyar Sathiyakumar, Asmitha Kathleen Smith, Jason Stallings, Shannon Torossian, Artour Zackoff, Matthew Group 7 Clark, Nathaniel Koehler, Daniel Lewallen, James Bradford Mistry, Akshitkumar Maheshbhai Opara, Rejoice Ngozi Bless Parikh, Ravi Pennington, Joseph Daniel Perdigoto, Ana Robinson, Jamie Shih, Grace Chia-huei Steer, Jonathan Thurman, Alex Tourjee, Stephen Mankata Wolf, Michael Seth Group 8 Fleming, Amy E Ark, Jacob Tyler Durrani, Alia Gartland, Matthew Grady Hooper, William Blake Hungwe, Tendeukai Jermakowicz, Walter John, III Knadler, Joseph Martin, Allison McHugh, Julia Sandler, Carla Walls, Morgan Breon Wurster, Victoria Zuckerman, Scott Lawrence Small Groups 5-8

14. Center for Professional Health CPH Small Group Activities Small groups assigned Facilitator role Participant role 10 minute break Large group

15. Center for Professional Health CPH Professional Health & Wellness

16. Center for Professional Health CPH Maintain Health & Wellness

17. Center for Professional Health CPH Vanderbilt Center for Professional Health Continuing Medical Education Courses Prescribing Controlled Drugs © Maintaining Proper Boundaries © Program for Distressed Physicians © www.mc.vanderbilt.edu/cph

18. Center for Professional Health CPH Course Demographics CoursesNAve AgeSex Distressed764812% F88% M Boundaries504415% F95% M Prescribing6615011% F88% M Total1241 DistressedBoundariesPrescribing IM subspecialties*IM/FPIM/FM Psychiatry OB/GYNSurgery OB/GYNER *(interventionalists)

19. Center for Professional Health CPH Flooding* “This means you feel so stressed that you become emotionally and physically overwhelmed…” “Pounding heart, sweaty hands, and shallow breathing.” “When you’re in this state of mind…you are not capable of hearing new information or accepting influence.” *John M. Gottman, Ph.D. The Relationship Cure, Crown Publishers, New York, 2001, 74-78.

20. Center for Professional Health CPH

21. Center for Professional Health CPH Which person is flooded?

22. Center for Professional Health CPH DRAN

23. Center for Professional Health CPH Describe Describe the other person’s behavior objectively Use concrete terms Describe a specified time, place & frequency of action Describe the action, not the “motive”

24. Center for Professional Health CPH Reinforce Recognize the other person’s past efforts

25. Center for Professional Health CPH Assert Directly & Specifically Express your feelings Express them calmly State feelings in a positive manner Direct yourself to the offending behavior, not the entire person’s character Ask explicitly for change in the other person’s behavior

26. Center for Professional Health CPH Negotiate: Work Towards A Compromise That is Reasonable Request a small change at first Take into account whether the person can meet your needs or goals Specify behaviors you are willing to change Make consequences explicit Reward positive changes

27. Center for Professional Health CPH Emotional Intelligence Five components of emotional intelligence: 1.Self-awareness 2.Self-regulation 3.Motivation 4.Empathy 5.Social skill

28. Center for Professional Health CPH Summary Reflection Self-awareness Discovery