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Health Disparities

Pandemic-Driven Posttraumatic Growth for Organizations and Individuals

Educational Objective
To understand how organizations and individuals can manage pandemic-driven posttraumatic growth

1 Credit CME

JAMA

Published Online: October 8, 2020

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Article Information and Disclosures

Kristine Olson, MD, MSc^1,2;

Tait Shanafelt, MD³;

Steve Southwick, MD^1,4

Author Affiliations

¹Yale School of Medicine, New Haven, Connecticut
²Yale New Haven Health, New Haven, Connecticut
³Stanford University School of Medicine, Stanford, California
⁴Icahn School of Medicine at Mount Sinai, New York, New York

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Many physicians and other health care workers have been experiencing enormous levels of stress and uncertainty while providing care for patients with coronavirus disease 2019 (COVID-19). Those who work in epicenters of the virus may care for high numbers of critically ill patients and experience psychological trauma related to exposure to many deaths in a short period of time or threat of death for themselves, colleagues, or loved ones. These clinicians may have encountered various challenges, such as not having enough personal protective equipment, being assigned to practice in areas outside their expertise, dealing with a lack of known therapeutics, making difficult decisions about rationing or prioritizing care, and facing disruptions affecting many aspects of health care and daily life. This acute stress among health care professionals is superimposed on preexisting high levels of occupationally related psychological and occupational stress.¹

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Article Information

Corresponding Author: Kristine Olson, MD, MSc, Yale School of Medicine, 20 York St, New Haven, CT 06510 (kristine.olson@yale.edu).

Published Online: October 8, 2020. doi:10.1001/jama.2020.20275

Conflict of Interest Disclosures: Dr Shanafelt reported receiving royalties for the book Mayo Clinic Strategies to Reduce Burnout: 12 Actions to Create the Ideal Workplace, being co-inventor of Well-being Index instruments and the Participatory Management Leadership Index, and at times receiving honoraria for providing grand rounds/keynote lectures and advising for health care organizations. Dr Southwick reported receiving royalties for the book Resilience: The Science of Mastering Life’s Greatest Challenges. No other disclosures were reported.

References

Shanafelt TD , West CP , Sinsky C , et al. Changes in burnout and satisfaction with work-life integration in physicians and the general US working population between 2011 and 2017. Mayo Clin Proc. 2019;94(9):1681-1694. doi:10.1016/j.mayocp.2018.10.023 PubMed Google Scholar Crossref

Shanafelt T , Ripp J , Trockel M . Understanding and addressing sources of anxiety among health care professionals during the COVID-19 pandemic. JAMA. 2020;323(21):2133-2134. doi:10.1001/jama.2020.5893 PubMed Google Scholar Crossref

Tedeschi RG , Calhoun LG . Target article: posttraumatic growth. Psychol Inq. 2004;15(1):1-18. doi:10.1207/s15327965pli1501_01 Google Scholar Crossref

Janoff-Bulman R . Shattering Assumptions: Toward a New Psychology of Trauma. Free Press; 1992.

Maitlis S . Post traumatic growth at work. Annu Rev Organ Psychol Organ Behav. 2019;7:395-419. doi:10.1146/annurev-orgpsych-012119-044932 Google Scholar Crossref

Ochoa Arnedo C , Sánchez N , Sumalla EC , Casellas-Grau A . Stress and growth in cancer: mechanisms and psychotherapeutic interventions to facilitate a constructive balance. Front Psychol. 2019;10:177. doi:10.3389/fpsyg.2019.00177 PubMed Google Scholar Crossref

Dale CR , Welling L , Clearfield C . Crisis management: how one Seattle health system is managing the COVID-19 crisis. Harvard Business Review. Accessed October 1, 2020. https://hbr.org/2020/04/how-one-seattle-health-system-is-managing-the-covid-19-crisis

Sebelius K . How post-Katrina New Orleans transformed its health care system. Boston Globe. Published August 28, 2015. Accessed October 1, 2020. https://www.bostonglobe.com/opinion/2015/08/28/how-post-katrina-new-orleans-transformed-its-health-care-system/5yoAmcLDa2OSSjM405tW0J/story.html

Tsai J , Mota NP , Southwick SM , Pietrzak RH . What doesn’t kill you makes you stronger: a national study of US military veterans. J Affect Disord. 2016;189:269-271. doi:10.1016/j.jad.2015.08.076 PubMed Google Scholar Crossref

Olson KD . Physician burnout: a leading indicator of health system performance? Mayo Clin Proc. 2017;92(11):1608-1611. doi:10.1016/j.mayocp.2017.09.008 PubMed Google Scholar Crossref

AMA CME Accreditation Information

Credit Designation Statement: The American Medical Association designates this Journal-based CME activity activity for a maximum of 1.00  AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Successful completion of this CME activity, which includes participation in the evaluation component, enables the participant to earn up to:

1.00 Medical Knowledge MOC points in the American Board of Internal Medicine's (ABIM) Maintenance of Certification (MOC) program;;
1.00 Self-Assessment points in the American Board of Otolaryngology – Head and Neck Surgery’s (ABOHNS) Continuing Certification program;
1.00 MOC points in the American Board of Pediatrics’ (ABP) Maintenance of Certification (MOC) program;
1.00 Lifelong Learning points in the American Board of Pathology’s (ABPath) Continuing Certification program; and
1.00 credit toward the CME [and Self-Assessment requirements] of the American Board of Surgery’s Continuous Certification program

It is the CME activity provider's responsibility to submit participant completion information to ACCME for the purpose of granting MOC credit.