Cognitive flow in health care settings: A systematic review

• Published in: Medical education 2021-07, Vol.55 (7), p.782-794
• Main Authors: McQueen, Sydney, Jiang, Stephanie, McParland, Aidan, Hammond Mobilio, Melanie, Moulton, Carol‐anne
• Format: Article
• Language: English
• Subjects: Medical education; Systematic review
• ISSN: 0308-0110; 1365-2923
• DOI: 10.1111/medu.14435

Introduction The state of cognitive flow, colloquially known as being ‘in the zone’, has been linked with enhanced performance, happiness, career satisfaction and decreased burnout. However, the concept has not been adopted strongly in health care training, continuing professional development, or daily practice. A systematic review with a narrative synthesis was undertaken to map the evidence for flow in health care. Methods A search was conducted in MEDLINE, PsycInfo, and EMBASE in July 2019 and updated in October 2020 for manuscripts discussing flow in all health care disciplines. Articles published between 1806 and 13 October 2020 were included. Two authors independently reviewed titles and s (and subsequently full texts where necessary) for inclusion. Disagreements were resolved by consensus. Data were extracted on location, manuscript type, population and context, measures, and key findings. Results A total of 4923 unique s were initially retrieved, and 15 articles were included in the final review. We report on the experience, benefits and strategies to support flow in health care. Flow may benefit providers by enhancing career enjoyment, wellness and performance, while mitigating exhaustion, burnout, and stress. Although research from other domains has focused on supporting flow through individualised training, our results highlight the importance of system and environmental factors. Conclusions Supporting professional and trainee flow in health care requires a holistic approach, including individual training and system‐level interventions. Promoting healthcare professional and trainee flow through individual and system‐level interventions may enhance wellness and career enjoyment, while protecting against exhaustion, burnout, and stress.