I wonder how many of you are aware of“AWAR2E”? If you are not, you are missing out on one of the most ground-breaking projects at OVC this year: the AWAR2E group is applying rigorous methods of inquiry to unravel the root causes of anxiety, burnout and depression in the veterinary profession.
The ultimate goal of this work is to develop and share wellness training and support programs for both veterinary students and practicing veterinarians. Zoetis has demonstrated a very strong interest in promoting veterinary wellness, and has committed $130,000 over three years to help the OVC researchers in their work.
AWAR2E refers to Advancement of Wellness and Resilience via Research and Education, the name of a group of researchers that came together in spring 2015. It comprises the following persons: Colleen Best, post-doctoral Fellow; Joanne Hewson, Associate Professor, Department of Clinical Studies; Andria Jones-Bitton, Associate Professor, and Deep Khosa, Assistant Professor, both in the Department of Population Medicine; and Peter Conlon, Associate Dean, Students.
Noting growing anecdotal evidence that their veterinary colleagues were not doing so well in terms of wellness and resilience, the group wanted to apply epidemiological and qualitative research techniques to describe and better understand these disturbing trends in the veterinary population.
Last summer the AWAR2E group completed a survey of 400 veterinarians in Ontario, the first of its kind. Most respondents, 91 per cent, were clinical practitioners. Two-thirds of participants met the scale definition for some level of anxiety and one-quarter met the scale definition for some level of depression. The researchers also noted an unusually high prevalence of burnout (low personal accomplishment, high emotional exhaustion, high depersonalization) and compassion fatigue (low compassion satisfaction, high burnout and secondary traumatic stress). They also found lower resilience scores than the general population. This latter finding is particularly concerning given resilience helps protect against the effects of stress, and is protective against depression, anxiety, and other mental distress.
With support from Zoetis, they recently conducted a qualitative study involving face-to-face interviews of veterinarians to explore their lived experience of mental health and resilience, as well as perceived impacts on patient care, client communication, and health of practice. Perhaps indicative of the profound need for this kind of research, the researchers were overwhelmed by the number veterinarians who wanted to share their experiences.
Next the AWAR2E group plan a
Canada-wide veterinarian survey to investigate prevalence of perceived stress,
anxiety, depression, burnout, compassion fatigue, and resilience, and factors
associated with these outcomes. The data
to be collected, once analyzed, may shed light on why we are seeing a higher
prevalence of burnout and lower mental health in veterinarians than ever
before, and may perhaps lead to strategies that can be employed to reduce this
high prevalence.
The
AWAR2E group, from left:
Colleen Best, post-doctoral Fellow; Deep Khosa andAndria Jones-Bitton, both in the Department of
Population Medicine,
Peter Conlon, Associate Dean, Students, and Joanne Hewson, Department of Clinical Studies; .
The group is passionate about trying to support and prepare our students for veterinary practice with tools and skills to thrive. Those efforts include research and enhancements to our DVM curriculum.
Initial research related to student veterinarians is focusing on the Myers‐Briggs Type Indicator (MBTI) personality types of OVC students, and associations with gender, career interests at entry, grade-point averages, depression, and psychological capital. Epidemiology Masters student Monika Goetz, advised by Drs. Conlon and Jones-Bitton, recently presented preliminary findings at the Zoetis and VCA sponsored AAVMC Veterinary Wellness Summit in Fort Collins, Colorado. Monika was the only graduate student presenting at this conference, which suggests OVC has one of the most active research programs devoted to veterinary wellness.
Curricular enhancements focus on several domains of wellness (emotional, environmental, financial, social, physical, occupational, intellectual). In Phase 1 this translates into 13 hours of lectures and labs added to Art of Veterinary Medicine focusing on emotional, social, environmental and financial wellness domains. Pre- and post-training measurements will be used to evaluate the training impacts on mindfulness, self-compassion, quality of life, perceived stress, and resilience.
A one-week elective Wellness Rotation in Phase 4 will focus on seven domains of wellness to help promote effective self-management, wellness, and strengthen resilience. This will include mind-body techniques, self-care strategies, mental health literacy and first aid, and self-awareness exercises. Outcomes will include personal resilience plans to help manage challenges of veterinary careers. As with the Phase 1 curriculum changes, research will be conducted to evaluate the training with pre-training assessments of mental health, quality of life and resilience measures compared with assessments immediately post-training, several months later, and yearly thereafter for first three years of practice.
Wellness has been an important focus at OVC for some time. Wellness Wednesdays feature Zoetis-sponsored lunch-time talks on a variety of topics, including: study habits, stress management, mindfulness, boundary-setting, nutrition, communication, and more.
You have probably also spotted the Wellness Wagons in our midst. Located in the cafeteria and learning commons these contain games, cards, colouring, football/soccer/volleyballs, yoga mats, etc. to promote play and for students to use to decompress. And a new OVC Student Wellness Club, THRIVE, started by started by Shannon Finn, Phase 3 DVM student, debuted this fall.
To summarize, Dr. Conlon put it this way:
“If you can imagine a cliff, many programs currently serving veterinary
students and professionals seek to identify and help individuals who are truly
debilitated, akin to an ambulance at the bottom of the cliff. In contrast, the programs that the AWAR2E
group are developing will provide warnings and guardrails to help keep us a way
from the cliff edge, and maybe a trampoline halfway down to help us bounce back
if we slip a little over the edge.” Makes so much sense, right?
I am very proud of this team of researchers who are applying their research acumen in a non-traditional way to help solve one of the most worrying trends in our profession. I look forward to seeing further results of their impactful work.