COVID-19 Exposure Risk, Burnout, and Shifts in Family Medicine Faculty's Efforts: A National Survey.

BACKGROUND AND OBJECTIVES: In response to the COVID-19 pandemic, academic family physicians had to change their clinical, teaching, research, and administrative efforts, while simultaneously balancing their home environment demands. It is unclear how the changes in effort affected physicians' personal well-being, particularly burnout. This study sought to identify changes in faculty's clinical, teaching, research, and administrative efforts during the COVID-19 pandemic and how effort shifts were associated with burnout. We also examined associations with important demographics and burnout. METHODS: We took data from the 2020 Council of Academic Family Medicine's Educational Research Alliance survey of family medicine educators and practicing physicians during November 2020 through December 2020. We analyzed self-report measures of demographics, effort (clinical, teaching, research, and administrative) before and during the pandemic, COVID-19 exposure level, and rates of burnout (emotional exhaustion and depersonalization) using logistic regressions. RESULTS: Most participants reported no change in efforts. If changes were reported, clinical (21.6%) and administrative (24.8%) efforts tended to increase from before to during the pandemic, while teaching tended to decrease (27.7%). Increases in teaching and clinical efforts were associated with higher rates of emotional exhaustion. Higher depersonalization was associated with increased clinical efforts. Being older and working in a rural setting was associated with lower burnout, while being female was associated with higher burnout. CONCLUSIONS: Shifts in effort across academic family physicians' multiple roles were associated with emotional exhaustion and, to a lesser degree, depersonalization. The high rates of burnout demand additional attention from directors and administrators, especially among female physicians.

Faculty Engagement and Productivity During the COVID-19 Pandemic.

BACKGROUND AND OBJECTIVES: COVID-19 has had an unprecedented effect on faculty of academic family medicine departments. We sought to characterize faculty's self-reported changes in engagement and productivity in clinical, education, and scholarly efforts during the COVID-19 pandemic, and to correlate the changes with age, gender, and level of COVID-19 exposure. We also sought to determine if differences in faculty engagement and productivity were related to departmental efforts to create virtual community, manage conflict, foster engagement with colleagues, and support faculty emotional well-being. METHODS: We surveyed family medicine department faculty nationally on the effects of the COVID-19 pandemic on their engagement and productivity in clinical care, teaching and research, and on the effect of departmental efforts on well-being. RESULTS: Most respondents reported decreased engagement and productivity across clinical, teaching, and research domains. Older age and male gender were associated with higher clinical engagement. Most respondents were satisfied with their departments' virtual community but reported that social distancing had a negative impact on departmental ability to problem-solve and on personal emotional well-being. Higher engagement and productivity in all three domains of effort (clinical, teaching, and research) were associated with respondents' well-being and with positive perceptions of their department's efforts. CONCLUSIONS: Clinical, teaching, and research engagement and productivity for academic family physicians decreased during the COVID-19 pandemic. Faculty well-being and departmental interventions lessened the impact of diminished productivity and research engagement.

Saint Louis University GWEP Pivots to Virtual Service Delivery: Lessons Learned

In response to the COVID-19 pandemic, Saint Louis University GWEP quickly pivoted service initiatives to online formats. Despite challenges of technology literacy and access, GWEP faculty, staff, and students creatively adapted in-person programming to online delivery and developed new virtually-delivered services. These service delivery adaptations provided opportunities for educating students, residents, faculty, community partners, and older adults and their caregivers to gain new knowledge and skills while continuing to participate in programming. This presentation will highlight innovations in the area of services to persons with dementia through Cognitive Stimulation Therapy, caregivers through education and support programs, older adults experiencing loneliness and social isolation through Circle of Friends, and older adults and caregivers through a virtual geriatric assessment clinic. We share highlights here of our efforts to pivot programming, access new funding streams, and, in some cases, create online delivery, including valuable lessons learned.

Adaptive Care and Remote Training: Models of Resilience for GWEPs During a Pandemic

Service and training are interconnected for GWEP’s, whose dual missions are to advance training as well as service delivery to improve the care of older adults. The COVID-19 pandemic has necessitated a pivoting from in-person to remote delivery of program content and services. As a result, older adults and their families require the continuity of services with their providers due to the barriers that the pandemic has created. Additionally, universities and organizations have adapted virtually to teach learners how to work with older adults around different health initiatives. The pandemic required these programs to develop immediate services that provided an alternative to remote delivery services. This collection of GWEP programs utilized students and trainees in their older adult services and initiatives. The goal of this symposium is to demonstrate new models of educational and program delivery to enhance and extend training and service to new audiences. The symposium centers on best practices including technological tools to promote GWEP aims and will allow a discussion of challenges and outcomes faced. The session will be comprised of presentations from five university-based, Geriatric Workforce Enhancement Programs (approximately 12 minutes each), a 20 minute discussion and sharing of best practices, and a 10 minute question/answer session. Individual presentations will address areas that include: 1.) group interventions for dementia and caregivers, 2.) teaching interdisciplinary interns in conducting telehealth visits, 3.) adapting geriatrics regional conferences to reach older adults virtually, and 4.) Developing new programs and services for underserved and underrepresented older adult populations.

Relational teletherapy experiences of couple and family therapy trainees: "Reading the room," exhaustion, and the comforts of home.

Couple and family therapists are increasingly using telehealth platforms to deliver services. Unfortunately, the literature on relational teletherapy is not well developed. This study sought to understand experiences of teletherapy with couples and families as it contrasts with individual clients and in-person therapy. We utilized a hermeneutic phenomenological approach to qualitative inquiry from data collected through open-ended questions on a web-based survey of graduate student trainees (n = 66) in COAMFTE-accredited couple and family therapy programs. Thematic analysis identified the body-of-the-therapist and client as they exist (and are obstructed) due to technology for creating barriers and opportunities in translating CFT intervention to telehealth platforms. Relational teletherapy cultivated therapist creativity and exhaustion. It also made plain the need for systemic interventions with children and adolescents that engages their parents and home environments. Implications for CFT practice, training, and intervention research are outlined.