Impact of Implementing a Daily Learning Conversation on the Mental Well-being of Anesthesiology Teachers and Trainees

A recent report by the Royal College of Anaesthetists (UK) reveals that one in four qualified anesthetists is considering leaving the NHS in the next five years, resulting in over one million procedures being postponed yearly. This is a public health issue. Among the main reasons cited by these anesthetists is the negative impact they attribute to their profession on their mental health. Regarding trainee anesthetists, another report by the Royal College of Anaesthetists highlights burn-out symptoms in 85% of interns. Meanwhile, a survey of members of the European Society of Anaesthesiology and Intensive Care highlighted this year the fact that over 50% of anesthetists suffer from "imposter syndrome", first described in 1978 as the inability to internalize success and the tendency to attribute success to external causes such as luck, error or knowing the right people. This "syndrome" is more common among physicians than in the general population. It is statistically associated with burnout, anxiety, and depression.

The survey revealed that women and young anesthetists are particularly at-risk sub-groups who may preferentially benefit from targeted interventions aimed at improving their well-being. Further research is needed to explore the nature and effectiveness of such interventions.

As part of their anesthesia training, future anesthetists receive teacher feedback. This feedback, defined as communication consisting of an opportunity to comment on actions to obtain a modification or reinforcement of those actions, is not delivered in the same way by all anesthesia teachers due to a lack of training on the part of the latter, but also to a lack of standardization of practices. Yet these conversations constitute complex interpersonal exchanges in which the teacher's lack of training and the absence of a shared model between teacher and learner can be deleterious, particularly to the psychological well-being of the various parties involved.

The literature reports that trainees can sometimes perceive that the institutional culture within universities prevents honest, two-way feedback, negatively impacting the specialty's working environment and learning objectives. How relationships with faculty might influence the quality and impact of feedback delivered in future anesthetists' training is yet to be fully explored.

A learning conversation model based on the advocacy-inquiry method has been described to foster productive conversation. This methodology is adopted in the sphere of medical simulation as part of debriefing with good judgment, an approach designed to encourage open dialogue, reflection, and accurate assessment of the learner's thought process.