Kathleen E Padilla1, Emily M Silver2, Laura E Flores3, Roshell Muir4, Manisha Salinas5, Edward R Mariano6. 1. School of Criminology and Criminal Justice, Arizona State University; Phoenix, AZ, USA. Electronic address: kepadil1@asu.edu. 2. Department of Psychology, University of Chicago, Chicago, IL, USA. Electronic address: esilver3@uchicago.edu. 3. College of Medicine, University of Nebraska Medical Center, Omaha, NE, USA. Electronic address: laura.flores@unmc.edu. 4. Department of Medicine, Division of Infectious Diseases and HIV Medicine, Drexel University College of Medicine, Philadelphia, PA, USA. Electronic address: rrm65@drexel.edu. 5. Department of Hematology and Oncology, Mayo Clinic, Jacksonville, FL, USA. Electronic address: salinas.manisha@mayo.edu. 6. Department of Anesthesiology, Perioperative and Pain Medicine, Stanford University School of Medicine, Stanford, CA, USA; Anesthesiology and Perioperative Care Service, Veterans Affairs Palo Alto Health Care System, Palo Alto, CA, USA. Electronic address: emariano@stanford.edu.
To the Editor:We were very interested to read the article by Jung et al. describing the impact of a parent-child interactive anesthesiology educational program (IAEP) on parental wellness, job fulfillment, and child knowledge of parental occupational duties [1]. The authors utilized a four-part, four-hour program that provided lessons and hands-on experience for children, aged 5 through 18, on topics such as general anesthesia and surgery, pediatric anesthesia and surgery, neuroanesthesia and surgery, and airway and ultrasound procedures. The program was overwhelmingly well-received. After the conclusion of the program, physician and nurse anesthetist respondents indicated that the program itself was worthwhile, satisfying, and fulfilling. They also said that their children reported a better understanding of their parents' occupational duties. Physician and nurse anesthetist participants themselves felt more fulfilled in their occupational roles after participation. We applaud Jung and colleagues for taking the initiative to address a critical component of burnout – personal accomplishment [2] – through a program designed specifically to increase job fulfillment.During the ongoing COVID-19 pandemic, there has been an increasing emphasis on physician well-being. We wish to highlight the importance of this study's intervention on decreasing child distress and increasing child well-being which have also been impacted by COVID-19 in a variety of ways such as school and park closure, shelter in place orders, and other public health measures. From a social-ecological perspective [3], children are embedded within a set of systems – including peers, family, neighborhoods, culture, and time. Due to the proximity of parental occupation, it is likely that children are greatly impacted by their parents' occupational duties. This consequence is especially true given the hazardous work of anesthesia professionals in the context of COVID-19 and the real dangers of bringing a highly transmissible disease home. It is important to appreciate the bidirectional impact of this program: helping children feel more supported thereby reduces stress in their caregivers who also happen to be providing critical healthcare services. Additionally, the inclusion of a parenting class, where caregivers who participate in the IAEP program could connect with one another and provide further sources of social support, may be a powerful way to reduce stress and increase participants' perceived connection to their occupation, resulting in increased levels of job fulfillment.While we enthusiastically support the work of Jung and colleagues, we do wish to share potential opportunities for improvement, particularly in the methodology, that will undoubtedly serve to increase the measured effect and potential reach of a program such as this. The utilization of validated post-event surveys is certainly critical for emerging programs such as the IAEP, but it will be difficult to truly measure the efficacy without baseline pre-intervention data in a cohort study (Fig. 1
) or alternatively by designing a randomized controlled trial. Related to the above-mentioned discussion on child burnout and wellness, we would like to have seen separate age- and developmentally-appropriate survey instruments employed. The resulting data from the childparticipants themselves would have added another dimension of program evaluation. Ascertaining baseline levels of child wellness and understanding of their parents' occupational duties (as stated as an overarching goal of the program), would provide guidance for program improvement and implementation to better meet the needs of this population. Integration of these additional tools would provide program administrators with information to identify the most effective portions of the program as well as determine if the program itself is responsible for the increase in child understanding of parental occupational duties rather than simply time with the parent.
Fig. 1
Proposed interactive anesthesiology educational program (IAEP) implementation with added social support parenting class.
Proposed interactive anesthesiology educational program (IAEP) implementation with added social support parenting class.As Jung et al. suggest, it has become critical to focus research and scholarly attention towards physician burnout and wellness, particularly among women physicians and physicians with children [4] who often face disparate levels of burnout. This crisis of healthcare worker burnout has become more pronounced amidst the COVID-19 pandemic. During this time, the professional careers of women in general, and women physicians in particular, have been disproportionately affected primarily due to caregiver responsibilities [5]. Moving forward, it becomes imperative to better understand the social ecology in which physicians and their children are embedded and to accept that the well-being of children and other immediate family members is a prerequisite to improved feelings of job fulfillment and the overall wellness of physicians.
Declaration of Competing Interest
No author has any conflicts of interest to disclose.
Fig. 1