At Sunnybrook Health Sciences Centre, Registered Nurse Marley Gimblett was set to be in charge of the Emergency Department (ED) that weekend. Marley worked with colleagues on Sunnybrook’s Emergency Preparedness team to run through every potential scenario that could arise, part of the hospital’s ongoing imperative to be ready for any emergency event. However, as the weekend approached, there was a sense of unease among ED staff.

“In the ED, we’re ready for anything,” Marley says. “But for this, staff said they felt underprepared, especially to respond to large numbers of patients coming in who may be teargassed or pepper sprayed, and how they would protect staff and other patients from being exposed.”

Though a large-scale emergency in Toronto never materialized, Marley seized the opportunity to enhance emergency preparedness training in the Sunnybrook ED to help staff feel more confident and prepared in making critical decisions during a mass emergency – and to ensure proper procedures are in place to protect patients and staff from dangerous contaminants.

In September 2023, Marley enrolled in Sunnybrook’s Practice-Based Research and Innovation (PBRI) TAHSN fellowship, specifically to focus on improving preparedness among ED staff responding to chemical, biological, radiological, nuclear and explosive (CBRNE) events. The fellowship provides point-of-care health professionals such as Marley the opportunity to lead practice-based quality improvement projects that enhance patient care.

“My motivation for pursuing this came out of wanting to be a resource for staff, and wanting to have more knowledge about this topic,” Marley says. “When you’re getting involved in a fellowship project like this, you have to love your topic.”

Since completing the initial fellowship, Marley is now the inaugural PBRI advanced fellow at Sunnybrook, allowing her to continue her work. As an advanced fellow, Marley will support the implementation of a formal CBRNE response procedure, with a focus on training and education for clinical staff in the ED.

Among the initial training topics that Marley put together, and inspired by the convoy in Ottawa, was decontamination procedures for patients arriving in the ED with injuries or exposure to pepper spray and teargas.

“The focus was on Registered Nurses, as they’re typically the most hands-on in the ED,” Marley explains. “We trained staff on basic principles on CBRNE response and how to set up the decontamination room to prevent further staff and patient exposure to chemical substances like teargas and pepper spray,” adding that this protocol could be applied to other CBRNE exposures.

“For biological threats, that might be like having a patient with Ebola come in. For radiological or nuclear, it might be if someone has radiation poisoning or if there was an event at a nearby nuclear plant. Responding to explosives would be similar to a trauma, but on a different scale.”

Surveys following the training showed significant improvement in how confident and prepared ED staff felt about responding to CBRNE events.

Through the advanced fellowship, the project will continue and expand to support the implementation of dedicated CBRNE response training for Registered Nurses and Charge Nurses in the ED. Marley’s goal is to keep working with the Emergency Preparedness team to educate ED staff and have more ongoing training sessions. She says that would include further CBRNE preparedness education, proper personal protective equipment training, running a CBRNE simulation and further evaluating preparedness across the hospital as possible outcomes of her work.

The post Practice-Based Education Boosts Emergency Preparedness Training in the ED appeared first on Your Health Matters.

Dr. Lesley Gotlib Conn

As a medical anthropologist working at one of Canada’s busiest hospitals, Dr. Lesley Gotlib Conn examines important aspects of health care delivery like communication and care transitions, and uses theories and methods from her anthropological training to improve care experiences and outcomes for patients, families, and health-care providers. She also examines the experiences and perceptions of trainees.

“We recently published the results of a study examining North American surgical residents’ attitudes toward the educational value of caring for injured older adults,” says Dr. Gotlib Conn, an associate scientist in the Tory Trauma Research Program at Sunnybrook Research Institute and Associate Director of SHARE. “A major finding of the research was that trainees reported less interest in learning about geriatric trauma care as they progressed through their training. This has important implications for the future of surgical training and care, since surgeons will be increasingly needed to treat the growing population of injured older adults.”

Dr. Gotlib Conn first became interested in education research while working on her PhD which explored the social construction of gender and sexuality in a psychiatric teaching clinic. Her research explored, in part, how learners and trainees in the clinic were socialized to think about gender and sexuality in medical ways. “The study of doctors’ and health professionals’ socialization has a long history in anthropology and sociology and that is what drew me into the field of education research,” says Dr. Gotlib Conn.

Now in her tenth year as a scientist at Sunnybrook, Dr. Gotlib Conn is proud to be advancing education research with SHARE. “At Sunnybrook we are fortunate to have a diverse and highly collaborative group of education researchers who are focused on understanding and improving learning, teaching and clinical training across many health professions. Every year I am more and more impressed by the caliber of the education research that is proposed to our grant competition and presented during rounds and at our annual symposium.” 

Dr. Giovanna Sirianni

As a family physician with a focused practice in palliative care, empathy is a core competency for Dr. Giovanna Sirianni.

Among her many education research interests, she is particularly focused on developing communication skills and the provision of compassionate care, which is in part why she co-created the About Empathy podcast, a healthCARE podcast that focuses on patient, caregiver and health-care provider stories.

“Podcast guests discuss their personal stories, while myself and my co-hosts reflect on those stories to help enable and support empathic interactions in the health-care community,” says Dr. Sirianni. “Our team has undertaken a qualitative exploration of the podcast’s role in education from the perspective of medical students, residents and faculty members.”

The podcast’s role in medical education is just one of many projects Dr. Sirianni is working on at any given time. “Whenever I’m developing a new curricular intervention, assessment method or project, I try to approach each initiative through a scholarly lens to help question, evaluate and eventually disseminate,” says Dr. Sirianni, who is also an Assistant Professor and Enhanced Skills Residency Program Director in the Department of Family and Community Medicine in the Temerty Faculty of Medicine at the University of Toronto.

Her passion for education research is inspired by many of the physicians, teachers and scientists she’s had the opportunity to work with throughout her career. “They modeled the importance of asking provocative questions about our approach to medical education and not accepting the status quo,” says Dr. Sirianni. “They also helped demystify the world of academia and made it accessible for me to feel like I had a place in education research too.”

Dr. Sirianni says that spirit is supported at Sunnybrook, in particular through Sunnybrook’s Education Advisory Council, via their yearly grant program that funds education research projects. “This is a tangible and practical way that we recognize and move forward the work of educators, scholars and researchers.”

The post Get to know SHARE: Meet two Sunnybrook education researchers appeared first on Your Health Matters.

Dr. Tinmouth, Amal Ga’al, Dr. Norris, Sophie Weiss, Dr. Daneman

Dr. Mireille Norris knows firsthand about the unique disadvantages Black and Indigenous students experience while pursuing careers in medicine.

“I struggled as a Black woman who navigated the medical system,” she says, citing isolation due to the lack of Black representation in the field as well as racism and its resulting sense of unworthiness as just a couple reasons for her challenging path. “I’ve been shouldering a lot more than many of my peers throughout my career, and that has affected my academic productivity.”

With just over *2 per cent of Canadian physicians identifying as Black and less than **1 per cent of physicians identifying as Indigenous, similar issues continue to manifest in the newer generation of aspiring Black and Indigenous physicians.

“They really struggled with mentorship, representation, access to research and experiencing discrimination,” says the geriatrician, speaking of the Black medical students she’s encountered in recent years. Reflecting on their circumstances, she says, “I felt that I really needed to build the pipeline.”

Introducing SPARK

After brainstorming with her colleagues and friends Dr. Jill Tinmouth and Dr. Nick Daneman, and after expedited planning and approvals, the Sunnybrook Program to Access Research Knowledge for Black and Indigenous Medical Students — also known as SPARK — was born.

“The idea driving SPARK is to provide various opportunities,” explains Dr. Tinmouth. “We identified strong mentors and research projects, and another key element was to provide financial support throughout the program.”

SPARK, which is in the midst of its pilot year, is providing four Black and Indigenous medical students with an opportunity to engage in meaningful and fairly-paid research externships at Sunnybrook.

Dr. Norris explains this is a unique opportunity that many Black and Indigenous students typically would not be able to access.

“Residency is very competitive. There’s a disproportionate weight given to research experience. If you have a research opportunity, it reflects well on your resume. The students more likely to access these externships are those with parents and other connections in the medical community, which is not always the case for students who are Black and Indigenous,” says Dr. Norris of medical residency applications.

She adds, students are likely to face financial strain as research externships are often unpaid positions, leaving them with the difficult decision of choosing between an unpaid or low-paying research position and a part-time job to support their education.

In addition to addressing disparities in research access and its accompanying financial barriers, SPARK also equips students with networking opportunities by providing participants with three individualized mentors, including a Black or Indigenous physician who will help the student navigate being under-represented in the field.

Mentorship, allyship and embracing the students

“Many of the challenges that may go unnoticed to other people can be shared and discussed between myself and an Indigenous physician,” says Sophie Weiss, an Indigenous SPARK participant, of the benefits of having an Indigenous mentor. “It just creates the opportunity to ask questions from another person that’s in a similar position, but who is ahead of you in terms of their career. It can really provide that guidance.”

Passionate about geriatric medicine, Sophie, who is one of just two Indigenous students in her second-year medicine class at the University of Toronto, is working with Dr. Norris and Dr. Barbara Liu to understand how the COVID-19 pandemic has impacted the geriatric fall prevention program.

“I feel very in control of my own project, which is really, really exciting,” says Sophie. She notes that one of SPARK’s goals is to support students as leaders in their research projects, which may lead to additional opportunities such as becoming co-authors of a manuscript, thus strengthening their residency applications.

Of her supervisors allowing her to have autonomy over her work, she says, “I felt like they wanted me there, rather than me really hoping they would accept me.”

Amal Ga’al, a fellow SPARK participant who is working with Dr. Daneman on the COVID-19 expansion to outpatients project (COVIDEO), shares the same sentiments as Sophie when reflecting on her project and research mentor.

When prospective SPARK supervisors applied to take part in the program, they had to submit a statement of intent, sharing their personal stories and reasons for wanting to be involved.

For example, in his submission, Dr. Daneman discussed how racial equality was always important to him. He was born in South Africa during the apartheid, but was brought to Canada by his parents as an infant so that he could be raised in a more just society. He grew up idolizing Nelson Mandela and says he’s excited to be a part of SPARK, something that will help contribute to “true, equal opportunity for justice, education, health and happiness.”

“Being able to have supervisors and physicians actually share of themselves and explain why they were excited about the program sets you up with a feeling of not just being accepted, but very much embraced and brought into the fold,” says Amal.

This sense of mutual respect and collaboration, versus the typical supervisor-to-student power imbalance you might find in other research environments, is an intentional part of this innovative program.

“There is an injury that comes from being racialized,” says Dr. Norris. “When you have faculty who say, ‘I see you, I know you, I feel for your struggle,’ it helps bridge that experience and heal the wound.”

Amal, who is a member of U of T’s Black Medical Students Association, says that with the rise of conversations surrounding anti-Black and anti-Indigenous racism, some engagement can seem performative and disingenuous. But both she and Sophie agree that the efforts made by SPARK to enhance their communities have been genuine, self-reflective and welcoming — qualities that Dr. Norris is proud to see in both racialized SPARK supervisors and allies who’ve supported the program.

Dr. Tinmouth echoes this, specifically giving kudos to all those who enthusiastically helped financially.

“We could not have pulled this without the quick support of the organization, the Sunnybrook Department of Medicine and the Sunnybrook Research Institute,” she says. “It was remarkable, and we were able to start the program this summer.”

“I think it’s really fantastic the way the Sunnybrook community answered the call,” says Dr. Norris.

The long-term impacts

While SPARK is aimed at helping students elevate their educational opportunities and medical careers, its impact will be felt beyond the program, through the work that students will go on to do in the community.

“I have a very large interest in Indigenous health, and I plan to do lots of outreach and really form my future practice around that,” says Sophie.

She also notes that Indigenous people are highly represented in the Toronto patient population but very poorly represented in the physician population — characteristics that she wants to change.

“Representation is so important,” she says. “I know that I can make an impact.”

Amal says she’s still figuring out what her medical career will look like, but she’s grateful that SPARK has exposed her to physicians with all kinds of different paths.

Regardless of where her medical career goes, Amal says, “I’m really interested in inequality — how do you address that, and why does poverty exist in society? Why are certain people marginalized?” Looking forward, she says, “I want to be involved in addressing and alleviating some of those issues.”

While Amal and Sophie move toward those goals, they will continue working on their SPARK research projects, transitioning from full-time summer hours to part-time hours throughout the school year.

As for Dr. Norris, Dr. Tinmouth, Dr. Daneman and the rest of the SPARK team, they will continue advocating for Black and Indigenous medical students by seeking to secure the support and funding to allow SPARK to continue and grow beyond this pilot year.

“My hope for SPARK is that other hospitals will follow Sunnybrook’s footsteps,” says Dr. Norris. “SPARK exemplifies transformational actions from the hospital’s leadership team that will bolster the future of Black and Indigenous learners for success in medicine, which will lead to greater representation, fairer opportunities and better care for all.”

*Black physician stats: https://www.utoronto.ca/news/we-need-ensure-cultural-shift-u-t-s-onye-nnorom-why-canada-needs-more-black-physicians 
**Indigenous physician stats: https://globalnews.ca/news/4769750/access-aboriginal-doctors-struggle-indigenous-population/

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There are some cases that stick with you when you’re a police officer.

For Constable Paul Breeze, it was the horrific collision last summer involving a young woman who was in the passenger seat of an SUV. Unconscious, she was rushed to the Tory Regional Trauma Centre at Sunnybrook and Constable Breeze was there to share important details with the team.

Paramedics were able to identify the woman quickly, allowing Constable Breeze to contact her family right away and then bring in Victim Services Toronto, a community-based agency that works with the Toronto Police Service (TPS) to provide free, immediate response and support for families of victims in crisis situations.

Discharged from Sunnybrook in December, the young woman is now well on her way to recovery. Constable Breeze, who works in the Traffic Services division of the TPS, recalls how well the two teams worked together that day, something that he and Sunnybrook have been working on to make their collaboration even better.

“So many things went right that day,” he recalls. “Everyone worked together perfectly.”A former combat medic with the British Armed Forces, Constable Breeze is familiar with Emergency Department (ED) and trauma bay terminology and procedures – vital experience that has made him the division’s go-to guy for crisis scenarios.

He has been working with Sharon Ramagnano, manager of Trauma Services at Sunnybrook, on an orientation program that shares his trauma knowledge and know-how with police officers, so they will know what to do and how to behave in a trauma setting.

“Often, younger officers have never been in a hospital trauma unit before. They don’t know who’s who and what their role is, and it can be overwhelming,” Ramagnano points out. “The program guides them to the right people in the trauma unit.”

Called “A Police Officer’s Guide to the Trauma Room,” the program offers an in-class session with videos featuring trauma protocol and procedure. It clarifies the role of the police, hospital policies and appropriate conduct in the trauma area.

The program was a collaboration between Constable Breeze and Ramagnano, alongside Agnes Ryzynski, manager of simulation and curriculum development at Sunnybrook’s Canadian Simulation Centre and was based on trauma bay experiences and case studies. Last September it was presented for the first time at the Toronto Police College.

“[For the videos], we filmed scenarios the right way and then the wrong way, showing, [for example], a police officer standing too close to the patient care area and not getting names right for paperwork,” says Ramagnano.

Educating police on trauma bay policies has had a side benefit of enlightening the hospital’s trauma team, too. When an abbreviated version of the police presentation was shared with Sunnybrook, team members gained a better understanding of why visiting police officers are in the Emergency Department’s trauma unit and what they might need from hospital staff.

“The videos showed missed opportunities for evidence,” says Ramagnano, “such as staff throwing out an article of clothing that may seem insignificant to them but has importance to the police investigation.”

The program has helped both sides understand the role each plays in the care of the patient and in support of the patient’s family, resulting in improved communication and collaboration between police and the trauma team.

The program has been so successful that Sunnybrook received a community award from Toronto Police Traffic Services.

“It’s an award for community partners working together with us, and recognizes the teamwork that went into the development of this program, between Traffic Services, the Trauma Centre and the Simulation Centre. We felt it was important to recognize these efforts,” says Constable Breeze.

“Now that we’ve started delivering this [program to the TPS], officers are trained on what to expect – and the trauma team staff knows what we need to do our job,” says Constable Breeze. “It benefits all concerned.”

The post Working together in the trauma unit: police and ED staff appeared first on Your Health Matters.

It was a stressful situation for a new nurse in Sunnybrook’s Neonatal Intensive Care Unit (NICU): A father, upset over a change in the care plan for his premature baby, was becoming increasingly emotional and the nurse – who had been on the job for about six months – was struggling over how to handle the situation.

Enter registered nurse Jo-Ann Alfred, a nurse educator whose advanced education and clinical training gave her the tools she needed to calm the nurse down and help her deal with a potentially confrontational situation.

“The father was emotional, and at the time the nurse wasn’t sure how to properly explain the change in the plan without getting the father more upset,” says Alfred, an 18-year veteran nurse who has been working in the NICU since 2014. “I told her the biggest thing to do in this situation is to use kindness and understanding, and listen, because [for the most part] they just want to be heard.”

The work of Alfred and other nursing mentors is part of Sunnybrook’s emphasis on continuing education, which is proving to be more important as health-care workers adapt to new challenges of increasingly complex hospital settings, an aging population, complex medical conditions and technological advances such as mobile devices and electronic medical records.

“This is about ensuring that we are providing the best care we can for patients and families in a constantly evolving world,” says Elizabeth McLaney, Sunnybrook’s director of Interprofessional Education. “And at the same time, ensuring we can continue to provide that care for future generations.”

In the nursing education department, improving the patient experience comes in many forms – but it all starts with making sure newly hired nurses are comfortable and confident in their roles. Critical to this is mentoring. Following an orientation period, each new nurse is teamed with an experienced colleague, says Beverly Waite, a nursing education leader at Sunnybrook.

As well as benefiting from mentoring initiatives, many of Sunnybrook’s registered nurses pursue a master’s degree and even a PhD, qualifying them for advanced-practice nursing positions (such as nurse practitioner and clinical nurse specialist) and other clinical roles, as well as research, teaching and leadership positions.

So who are these Sunnybrook nurses embracing the never-stop-learning culture? Below are just a few.

Lauren Cosolo

Part-time registered nurse (RN) in the trauma unit and clinical instructor for University of Toronto (U of T) nursing students.

Lauren Cosolo knows through her own experience the value of having a mentor.

“When starting out as a new nurse, you’re not confident in yourself or your skills, but having somebody there to help you through that is so valuable,” says Cosolo, 27. “In the trauma unit, we get people who’ve been seriously hurt from motor vehicle collisions to gunshots and have traumatic brain injuries – they’re complex traumas that involve lots of different systems.”

For the past couple of years, while working part time in the unit, Cosolo has pursued a master’s degree in nursing. By doing so she hopes to become a nurse educator, to teach other nurses in “evidence-based practice” – that is, caring for patients using the best knowledge possible, based on both scientific findings and what has been shown to work in practice.

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“I really enjoy nursing education and being that support system: helping new nurses and nursing students develop skills and confidence.”

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When patients arrive in the trauma unit, she says, “usually they’re from the Intensive Care Unit (ICU) and they’re acutely ill. A newly hired nurse in the ICU may struggle at first with addressing the concerns and fears of distraught families of these patients. But the mentor helps by giving valuable advice and recommending resources to help the new nurse deal with the needs of the patients’ loved ones.”

Under the early guidance of her mentor Melanie Santos at Sunnybrook, Cosolo learned to hone her nursing skills. “Melanie was very much the one who would give me confidence. She was always there for support when I needed her, but also pushed me to be independent, which is important,” Cosolo says.

After taking a nurse preceptor workshop (which educates nurses on how to guide and work with students), Cosolo mentored her first student last year and takes pride in seeing her now working in the trauma unit.

“I really enjoy nursing education and being that support system: helping new nurses and nursing students develop skills and confidence, handle a full patient load and practise confidently, ethically and safely,” Cosolo adds.

Craig Dale

Advanced-practice nurse (APN) in the ICU and assistant professor at the Lawrence S. Bloomberg Faculty of Nursing at U of T

Craig Dale has seen his career as a nurse go through quite an evolution over his 22-year tenure at Sunnybrook; through it all, he’s constantly reminded of the importance of learning from the patient experience.

Dale, 51, has been an APN in the ICU for the past decade, with specialties in qualitative health research and critical-care nursing. He has been an assistant professor at the University of Toronto since January 2015, two years after earning his PhD in nursing.

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“A lot of people entering the profession don’t realize that you can have a rich career that advances patient care from more than one vantage.”

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“One thing I didn’t realize at the start of my career,” he says, “is, you can become a scientist at the same time as being a nurse clinician. A lot of people entering the profession don’t realize that you can have a rich career that advances patient care from more than one vantage. In my case, I’ve done this through my clinical role, my academic work, my research and as a mentor to other nurses at Sunnybrook.”

Dale’s research focuses on improving hygiene practices for intubated and mechanically ventilated adult patients. For his doctorate, he studied the practical challenges of providing oral care and how to improve it. It’s an essential life-saving skill; for instance, he discovered that pneumonia starts with bacteria in the mouth.

He believes nurses play a crucial role in the health-care system internationally, including in leadership positions, “because they understand what’s happening at the point of care: they know how things work and how they break down. They’ve also been trained to communicate with people in distress which is one of the most important skills clinicians can bring to the patient-family encounter.”

One young trauma patient, who suffered extensive orthopaedic and facial fractures in addition to a life-threatening pneumonia, was particularly memorable for Dale.

“He couldn’t speak while on the ventilator and his eyes wouldn’t open because of his facial swelling,” he says. “Assuming he was able to hear and understand me, I guided him during his care and offered encouraging details about his recovery. Many months later he walked into the ICU to thank me. He didn’t know what I looked like but said he could recognize my voice.

“Despite the high-tech focus of ICU life-support, I have learned how patient survival is undeniably conditioned by empathetic support and communication.”

Desiree and Drew Lewis

Staff RNs, Neonatal Intensive Care Unit (NICU)

Born several weeks early, it seemed fraternal twins Desiree and Drew Lewis’s destiny that they would end up working with other premature babies. They have been doing just that in Sunnybrook’s NICU since September 2015.

The sisters, who turned 26 in May, say their experiences in the NICU after getting nursing degrees have been “amazing,” in large part because they weren’t just thrown into the nursing pool to sink or swim.

Drew, the older twin by five minutes, always wanted to be a nurse. Desiree earned an accounting diploma before realizing she, too, would rather work in health care.

After graduating last year, they joined the NICU staff and entered an orientation program with in-class learning for two weeks, then received one-on-one training by nurse preceptors over a three-month period.

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“I am lucky that I can come to work every day and feel inspired by all those around me.”

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Their own background as premature twins helps fire their enthusiasm for their work in the NICU. “I am inspired by [preterm babies’] strength, resilience and fight, and by how strong and hopeful their families are,” says Desiree, who says these young patients motivate her every day to want to learn as much as possible about her profession.

“I am lucky that I can come to work every day and feel inspired by all those around me,” she says, adding she wants to further her education and inspire future nurses “the way I was inspired by many throughout my journey.”

Desiree says she and her sister continually experience what it means to be part of a teaching hospital. They’re grateful they can collaborate with other nurses, doctors, pharmacists, dietitians, social workers and other professionals who are passionate about their jobs and enthused to teach and “clarify their piece of the patient puzzle,” while trying to return that to their colleagues at Sunnybrook.

Although she’s not certain what her career future holds, Drew says she, too, will one day pursue additional education, and her experience at Sunnybrook will prepare her.

“I will be ready for the journey.”

All photography by Doug Nicholson

The post The importance of a never-stop-learning nursing culture appeared first on Your Health Matters.

“Am I going to be the worst resident in the history of residents?” Tiffany said as she started out her residency in Sunnybrook’s family practice unit.

Tiffany was one of the 4,000 students who come to Sunnybrook to learn each year. She let us join in her journey. Throughout the year, Tiffany met with videographer Monica Matys to document her story.

Now, as she starts her tenure as chief medical resident of the family practice unit, we say goodbye to Tiffany. (Though, maybe she will check in with us here and there, we hope!)

Tiffany says she learned a lot in the past year.

“I’ve learned so much about myself, and about patients and people in general,” she said. “I’ve learned it’s OK to feel something for your patients. It’s OK to connect with them, to not be a stone-faced person around them.”

She said she’s enjoyed being part of the web series to allow others to see what being a resident is like.

“I really hope you’ve all been able to see what it’s been like going through this process. And thank you for going through this process with me. I’ve learned that I’m doing what I love.”

Have a look at Tiffany’s final webisode below.

What do you think? Did you learn from Tiffany? What major lesson did you learn in your first year of residency?

The post Day in the Life of Medical Resident: Final webisode appeared first on Your Health Matters.

1. Is my stress level is normal?

We all experience stress from time to time, but this stress does not necessarily impact on our day-to-day functioning. This is normal stress. When stress starts to get in the way of our lives (e.g., work, school, relationships, daily responsibilities, social life, etc) or it occurs at level that we find too distressing, that is when we begin to classify the stress as being “maladaptive”. When it comes to the way in which our stress or anxiety affects our performance on various tasks, research shows that having some anxiety can actually be beneficial.

Having some anxiety about how you will perform on a test will likely lead to you studying and taking the time you need to prepare for the test. But, having too little or too much anxiety may actually hinder performance.

2.       What can I do to reduce my stress level?

There are many things that we can do to help manage our stress levels. General self-care is very important when we are experiencing stress. Things like getting enough sleep, exercise, balanced and healthy eating, and social engagement can all help modulate our stress levels. It is also important to make sure that we get a good balance of engaging in activities that make us feel productive (e.g. doing work, paying our bills, chores, etc) and activities that we find pleasurable and fun (e.g. hobbies we like, being with family/friends, playing sports, etc). If you’ve tried these strategies and it feels as though your stress level may still be difficult to manage, it can be helpful to speak to a professional who may be able to provide you with additional strategies to help manage your stress.  We have proven effective psychological and medical treatments for those experiencing more clinically significant stress.

3.       My mom says I should do yoga or take some deep breaths – will that help me feel less stress?

Yoga and deep breathing can be quite helpful for stress. Deep breathing is one type of relaxation strategy that involves taking deep breathes through your diaphragm. Research shows this type of breathing can reduce feelings of anxiety. There are other relaxation strategies that can be helpful as well, such as progressive muscle relaxation. This exercise requires you to tense and relax various muscle groups throughout your body and train yourself to notice the difference between the tensed and relaxed states.

4.       Does exercise help?

Yes, there is research to suggest regular exercise of at least a moderate intensity is associated with improvements in anxiety and depression. To achieve health benefits, Canada’s physical activity guidelines recommend that adults aged 18-64 engage in at least 150 minutes of moderate-to-vigorous aerobic physical activity (i.e. exercise that makes you sweat) per week.

5.       Are there any foods or drinks that might make me feel better or worse?

Eating a balanced and healthy diet can be helpful for managing stress. It is also important to limit use of alcohol and caffeine. Beverages that include alcohol and caffeine can affect our sleep and impact our body’s stress response.

The post When the going gets tough – Tips for dealing with stress appeared first on Your Health Matters.

Take a moment today to say thank you. Whether it’s a preceptor, colleague, supervisor, instructor, mentor, or your care provider — let your them know you appreciate how much they have helped you to learn and grow.

Send them an e-apple of thanks via this link.

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But getting great at these intricate skills, like anything, takes practice, especially when the heart is moving. (In my own simple way, I liken this to trying to mend a hole in my son’s jeans while he’s wearing them and running around). That’s why a new model of the heart at Sunnybrook, called a beating heart simulator, is getting a lot of attention. It’s a perfect replica of a heart in motion, allowing surgeons in training to hone their skills in a safe and supervised environment. Mistakes can be made, and moves replicated over and over, with no harmful consequences to the learner or patient.

If you view my video, you can see the amazing resemblance this simulator has to the real human heart. This truly cool technology is the latest addition to the recently expanded Sunnybrook Canadian Simulation Centre. It’s a head-turning space, outfitted with mock patients (who breath, scream and bleed), and various body parts that look incredibly close to the real thing. You can even practice birthing a baby! Thousands of students have been trained in this space, and now even more can come in for more specialized skills training. The hope is that more practice now helps make perfect later on.

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