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A presentation for medical students, junior doctors and physicians.

By Kate Jurd, Learning Technologist, Toowoomba Hospital QLD Australia
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Wellness and performance

Published on Jan 01, 2018

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Wellness & Performance

A presentation for medical students, junior doctors and physicians.

By Kate Jurd, Learning Technologist, Toowoomba Hospital QLD Australia
Photo by Hudson Hintze

Depression and suicide

Why wellness?

Student and physician suicide is increasing – and these tragic events devastate the medical profession and our community.

A 2013 Australian, Beyondblue survey found one in 10 doctors and one in five medical students had experienced suicidal thoughts in the previous year.

A study published in the Journal of the American Medical Association reviewed 200 previous studies looking at the mental health of 129,000 medical students from 47 countries.

It found that 27 per cent of medical students had experienced depression, while 11 per cent reported suicidal ideation during medical school, and only 16 per cent sought treatment.

Photo by GoatLegSF

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Wellness = Professionalism = Performance


We tend to place a huge amount of emphasis on knowledge and technical skills and tend to ignore the non-technical or soft skills, (empathy, kindness, compassion, reliability) however these go hand in hand, and you need knowledge and the soft skills to be a good doctor and you need both to be an effective and perform well in the clinical setting
Photo by Yuya Tamai

Kind  Attentive Caring Respectful

 Empathetic  Courteous   Focused   Listens  Reliable
These are the characteristics of a good doctor
These attributes focus on professional qualities and a professional attitude (Professionalism) Wellness forms the basis of professionalism

Attributes of professionalism
Reliability, punctuality,
Good communicator
Self motivated
Willing to work in a team
Caring attitude to patients

The more well you are...

Physical wellness, emotional wellness, mental wellness, spiritual wellness

The more well you are… the better state of mind, body and spirit and the more effective you are as you interact with other health professionals and how you care for your patients. Wellness is key

Better communication

The more well you are the better you communicate with your patients

Better team work

The more well you are the better you are at working in a team

Better performance

The more well you are...the better you will perform

Wellness buckets
Vitality | Connections | Contribution

If we look at wellness in terms of 3 buckets-
Vitality, Connections and Contribution.

Concept taken from Jonathan Fields, Good Life Project

The first bucket is about caring for your mind and body.

The second bucket is your relationships – family, friends, peers, work, community.

The third bucket is about your purpose and contributing to the world – this is believing in yourself and feeling good about what you do.

Keeping these buckets filled is the way to stay well, be professional and perform well


Optimum state of mind and body
Vitality = is the state of your body and mindset - mental and physical wellbeing. If your vitality bucket is full then you are more:

• Energized
• Fit, strong
• Aware of and capable of being in the moment
• Optimistic about the future and what it holds
• Peaceful and calm, able to dissipate stress
• Able to bounce back from adversity
• Immersed in a process of growth
• Having gratitude
• Fueled by a sense of meaning
• Happy
Photo by Dylan Siebel


 Belonging  | Looking after one another 
This is about Nourishing relationships – family, friends, work colleagues, patients
– being part of a community
– belonging – when this bucket if full you have good relationships and have a sense of belonging in the health profession and your community
Photo by rawpixel.com


Contribution – contributing to the world, to the medical profession; to patient wellbeing, a sence of calling; purpose

It’s about feeling like you’re accessing your full potential, your strengths, your gifts, the deepest parts of your humanity, leaving nothing unrealized or untapped.

finding meaning in what you do – believing in yourself, having self compassion
Photo by Alex Hockett

Wellness habits

Ways to keep the buckets full
Strategies to keep the buckets full

Wellness logbook

Wellness logbook - set wellness goals and reflect regularly on how you are going.
Photo by Jan Kahánek

Sleep                 diet                exercise

Importance of sleeping well, eating well and exercise

Quality sleep

Quality sleep is essential for health and wellbeing. Lack of sleep can impair attention, working memory and reaction time.

Ways to improve sleep is to improve your sleep environment.

Beds are for sleeping not working.

Keep the bedroom quiet, dark and cool. Put up blockout curtains and use an eye mask, particularly if you are on shift work and need to sleep during the day.

Avoid screens (blue light) at least an hour before you go to bed.

If you have difficulty getting to sleep try breathing exercise or meditation before bed to calm the mind.

Melatonin, magnesium and herbal teas (chamomile, primrose) can assist sleep.

Have a warm shower before bed, this helps your core body temperature to cool down.
Photo by Tara Raye

Move more - exercise snacking

Schedule exercise activities into your weekly routine.

Include short exercise routines - high intensity interval training
- over 15 minute
- run or cycle fast for 1 minute, walk or cycle slowly for 1 minute, repeat.

Get an exercise buddy.
Photo by Luis Quintero

There are other ways to get the exercise you need

If you dont like going to the gym or playing sport there are other ways to get the excercise you need
Photo by mi..chael

Getting outdoors - into nature

At the weekend do something you enjoy:

Walk, hike, trail run...

Intern advice get outdoors, get some fresh air ...be in nature.

Dump the junk

Also vitality means eating well (and healthy)

Challenge yourself - give up one of your most unhealthy vices for your first rotation
such as drinking sugary drinks, ordering takeaways or eating too many sweet treats.

....and try and eat more healthy wholesome foods.

Plan what you eat, make a list and schedule your shopping and cooking - make batches and freeze

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Make healthier food choices
Fresh local produce is best - triple your vegetable intake

Reduce: sugar, processed food, starchy carbohydrates such as potatoes, white pasta, white rice.

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And sometimes all you need to do is hit the Pause button – STOP. REVIVE
Photo by Annie Roi

Learn to meditate

Start small, 5 minutes a day.

Steps to get started with a short daily practice:

Sit comfortably in an upright position.
Notice the sensations in your body, scan from head to feet, notice any tingling, notice the feel of your body on the chair.

Focus on your breath - notice where it enters the body and where it leaves the body.
Breath in to the count of 4 and breath out to the count of 5
Notice the sounds in the room, those that are close and those that are far away

If any thoughts enter your mind - just notice and let them go.

Continue with the breath, slowly in and out.
Photo by Jared Rice

Positive self talk

You can change the way your brain looks at things by using affirmations, developing a mantra or directive phrase.

The idea is to reframe the negative thoughts and develop new scripts. eg 'slow down, Ive been here before' or 'stop, focus' breathe. I can do this.


Journaling goals, both learning and personal on a daily basis is worthwhile reflective practice.

Acknowledging gratitude and positive accomplishments is a powerful tool for self growth.

At the end of the day write down 3 good things that happened and one thing you are grateful for.

Build peer network

Build peer network: join in on the activities, be involved with your peers, interns, residents etc you will learn and gain a lot from one another – nourish these relationships – they will be extremely beneficial as you move forward in your career.

Recognise signs of stress

These can range from Changes in sleep and appetite
Feeling down most of the time
Increased self criticism and irritability – getting angry in the workplace with colleagues – Lowered performance in the clinical setting

this is a sign of stress and not being well—affects professionalism and performance

Speak to someone early

You are not alone - ask for help - dont struggle on your own, we have been there too!
Photo by Marc Wathieu

Who can you lean on?

Support: Don’t forget to think about your support network – partners, siblings, parents – those you feel comfortable talking to and asking for advice – keep them in the loop.

Get a GP

Find a GP and see them. Have regular check ups.

Get a GP

Find a GP and see them. Have regular check ups.

Finacial advice

Seeking financial advice
Income protection.
Photo by Theen ...


Dr Shahina Braganza | Jonathan Fields
Acknowledgement to Dr Shahina Braganza
Emergency Physician Gold Coast Health
shahinabraganza.com (http://shahinabraganza.com) | @ShahinaBraganza

Shahina provided assistance with this presentation - concepts based on the wellness talk she gave at Gold Coast Health.

Plus reference to Jonathan Fields: the Good Life Project www.goodlifeproject.com
(wellness buckets)
Photo by Aaron Burden