User:Aapro24/sandbox

Evaluating Content

 * Is everything in the article relevant to the article topic? Is there anything that distracted you?
 * The sentence describing Freud’s berger’s paper was distracting because it seems out of context considering it is not mentioned again throughout the article. Also, the last sentence in the introduction is just thrown in and assumes the reader knows Maslach’s work. It’s not until the “Diagnosis” section that Maslach is properly introduced. Lastly, I think the fact burn-out is included as an ICD-10 should have been further elaborated on.
 * Is any information out of date? Is anything missing that could be added?
 * Maslach’s work is cited and referred to within the text several times however her most recent piece is from 2001 which is out-dated considering it was 18 years ago. It would be better if there was more studies researched and described to validate the treatment and prevention methods.
 * What else could be improved?
 * I would also improve the organization of the article. There is little flow from one section to another. Likewise, I would like to have seen treatment and prevention presented as separate sections instead of being grouped together.

Evaluating Tone

 * Is the article neutral? Are there any claims that appear heavily biased toward a particular position?
 * The diagnosis portion of the article heavily links burn-out to depression and does little to differentiate between the two since an individual suffering from burn-out is not necessarily depressed. Most of the sources in this section simply seek to validate how the two can be indistinguishable.
 * Are there viewpoints that are overrepresented, or underrepresented?
 * As previously stated, the viewpoint seeking to prove that burn-out is almost synonymous to depression is over-represented while the impact of environmental factors when contributing to burn-out is underrepresented.

Evaluating Sources

 * Check a few citations. Do the links work? Does the source support the claims in the article?
 * The citations links work. There is little support for the claim that the true way to prevent burn-out is at the organizational level.
 * Is each fact referenced with an appropriate, reliable reference? Where does the information come from? Are these neutral sources? If biased, is that bias noted?
 * The article references a source for each fact but relies heavily upon the works of Maslach and Bianchi seeing as the two authors make up nearly half of the references. Relying so much on the work of two individuals predisposes the article to include the biases of these authors. However, the bias is never noted within the wiki piece itself.

Checking the Talk Page

 * What kinds of conversations, if any, are going on behind the scenes about how to represent this topic?
 * There are a couple conversations discussing how the information provided in the article comes primarily from a psychological background and how there is still a need for it to be more thorough overall.
 * How is the article rated? Is it a part of any WikiProjects?
 * It is rated as a start-class for WikiProjects Occupational Safety and Health, Occupations, Physiology, and Psychology. This low rating means that the article is quite incomplete and does not provide substantial source support. This kind of article is in its beginning phases and still needs to be further developed and revised.
 * How does the way Wikipedia discusses this topic differ from the way we've talked about it in class?
 * We have not mentioned this topic in class; however, other courses that have discussed burn-out often take into consideration all the factors that might influences it and address those variables as preventative measures to be taken. Wikipedia only mentioned a few of these and did very little research to support the claims it made for prevention of burn-out.

~Aapro24

Choosing a topic - New Article - Physician Burnout
Since the only relevant article I found in relation to my literary review covered occupational burnout as a whole as opposed to physician burnout, I'd like to create an article on Physician Burnout independently since I think there is so much to cover that doesn't exist on Wikipedia yet.

Physician Burnout
Physician burnout has been classified as a psychological syndrome that can be expressed as a prolonged response to due chronic occupational stressors. In the practice of medicine, it has been known to affect a wide variety of individuals from medical students through practicing physicians although its impact reaches far beyond that. Because of the toll taken on the healthcare industry, various treatment and prevention strategies have been developed at individual, team, and organizational levels in hopes to seek the best method of addressing this epidemic.

Prevalence
While occupational burnout has existed all throughout time, current literature suggests the prevalence of physician burnout now exceeds 50%. This refers to not only physicians currently practicing medicine, but also those in training. Signs of burnout have even been traced back to medical students who have experienced disconnect between taught professional behaviors and those witnessed in practice.

Signs
Burnout has been referred to as a compilation of cynicism, depersonalization, and a low sense of accomplishment. Other symptoms included feelings of emotional exhaustion, inadequacy, and detachment. This is thought to be due to imbalances whether that be in regards to workload, personal values, incentive, justice, and a sense of community. Factors such as time pressure, chaotic work environments and a lack of alignment between physicians and executives have been known to exacerbate this burden. These elements can cause clinicians to become frustrated and overwhelmed. Moreover, the correlation between lack of control and burnout has been explored and shows that an increased sense of lack of control has been linked to a greater risk of being affected by burnout.

Models
Likewise, burnout has been analyzed utilizing differing conceptual models. One strategy examined burnout as a product of three stages. Stage one consists of exhaustion at work that progresses into detachment and negative feelings at work that later starts to affect patients and coworkers in stage two. Lastly, stage three is composed of feelings of inadequacy and failure. However, a more recent approach sought to choose three stages that served as a bridge between said stages and imbalances. The first groups together all job stressors such as imbalances caused by work demands while the second solely addressed individual strain in the form of anxiety and exhaustion. Lastly, the third described changes in mood and behavior as defensive coping that could be closely linked to cynicism.

Physicians
The progression of physician burnout takes a toll on the individual whether it be a medical student or practicing clinician mainly through adverse psychological affects that have lasting consequences. A concept known as asymmetrical rewards speaks of how physicians are rarely recognized for what they do well, yet there is much attention surrounding medical malpractice suits ready to capitalize on a physician’s errors. In addition, clinicians become desensitized to patients and medicine resulting a perspective shift towards viewing patient care as a chore more than a desire to heal. However, the affects of burnout extend past the physicians themselves to ultimately affect anyone in contact with them.

Colleagues
Friends and family often feel the burden when interacting with burned-out clinicians since most of these individuals will be disengaged and can exhibit symptoms of major depressive disorder. Coworkers are also likely to be impacted. For example, burnout initiated by a chaotic, unsupportive work environment results in higher rates of miscommunication and unresolved conflicts. It has also been shown that a workforce afflicted by burnout contributes to an overall greater hostile atmosphere.

Health Industry
Other impacted populations include the patients and healthcare industry seeing as burnout results in decreased quality of care. Research has generated evidence supporting an inverse correlation between burnout and productivity. Thus the shift in decreased productivity sometimes ends in decreased physician retention due to low job satisfaction and decreased mental health. Since successful medical interactions are based on trust between providers and patients, this constant staff turnover can go on to reflect poorly upon the institution.

Individual-approach
Treatment strategies first focused on addressing the individual. Physician-oriented approaches ranged from cognitive behavioral techniques (CBT) such as mediation and coping strategies to professional coaching which aimed at reinforcing individual resilience. Professional coaching involves the implementation of mentors that would aid in guiding physicians using their previous experiences with patients. Gazelle, Liebschutz, and Riess discussed the benefits of professional coaching as being able to cater to each provider using his or her own previous experiences therefore personalizing the intervention as opposed to CBT which delivers treatment in a standardized manner. On the other hand, Dr. Kelly speaks of how altering perception of patients from chores and potential litigation sources to opportunities to heal is key to the reversal of burnout.

Organizational-approach
However, some research suggests that a combination of individual, team, and organization approaches is the only way to address all levels of burnout and successfully put an end to this epidemic. Generally, organizational approaches have shown much promise as successful treatment options by reducing workloads and distributing more flexible schedules among employees. A shift to realign goals between physicians and executive administrators could also contribute to reducing the risk of burnout. A systematic review analyzing individual and organizational strategies found that organization-oriented approaches were more effective. Other examples of team approaches are the implementation of honest discussions between caregivers to emphasize compassion as well as organization-wide events to enhance workforce well-being. While Gazelle and Panagioti concluded that organizational approaches were superior to individualized interventions, the final verdict has not yet been reached as Wuest’s combined intervention addressing burnout at the individual, team, and organizational levels might be the key.