Dataset Information

Resident Wellness: An Intervention to Decrease Burnout and Increase Resiliency and Happiness.

ABSTRACT:

Introduction

Despite the national focus on trainee burnout, effective wellness programs that can easily be incorporated into training curriculums are lacking. Strategies such as mindfulness and positive psychology, linked with deep breathing, have been shown to increase resiliency. We hypothesized that education about the neuroscience literature, coupled with teaching about well-being using short, easy-to-practice evidence-based exercises, would increase acceptance of this curriculum among residents and that providing protected time to practice these exercises would help trainees incorporate them into their daily lives.

Methods

Residents were asked to attend a 60-minute didactic featuring both the concepts and science behind well-being. Residents then attended 15-minute booster sessions during protected didactic time each week for a 12-week curriculum. The booster sessions were peer-led by wellness champions. Additionally, there were monthly competitions using free phone apps to promote physical fitness through steps and flights challenges.

Results

The 12-week curriculum was offered to 272 residents across five subspecialties of internal medicine, general surgery, anesthesiology, psychiatry, and physical medicine and rehabilitation. A total of 188 residents (69%) participated in the initial didactic component. The curriculum was positively received, with four of the five residency programs participating in weekly sessions. Residents in four participating departments then chose to continue the weekly sessions on a voluntary basis after the initial 12-week curriculum.

Discussion

It is feasible to implement a low-cost, peer-led wellness curriculum to educate residents and foster an environment during residency training where mindfulness, optimism, gratitude, and social connectedness are the norm.

SUBMITTER: Aggarwal R

PROVIDER: S-EPMC6338253 | biostudies-literature | 2017 Nov

REPOSITORIES: biostudies-literature

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Publications

Resident Wellness: An Intervention to Decrease Burnout and Increase Resiliency and Happiness.

Aggarwal Rashi R Deutsch Jill K JK Medina Jose J Kothari Neil N

MedEdPORTAL : the journal of teaching and learning resources 20171106

<h4>Introduction</h4>Despite the national focus on trainee burnout, effective wellness programs that can easily be incorporated into training curriculums are lacking. Strategies such as mindfulness and positive psychology, linked with deep breathing, have been shown to increase resiliency. We hypothesized that education about the neuroscience literature, coupled with teaching about well-being using short, easy-to-practice evidence-based exercises, would increase acceptance of this curriculum amo ...[more]

PMID: 30800852

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Project description:BACKGROUND:Professional burnout among medical trainees has been identified as a national concern in need of attention. A significant challenge for residency programs is designing and implementing effective strategies to promote resident wellness and reduce burnout. Emerging evidence highlights the importance of developing organizational changes targeting physician burnout. METHODS:To address this critical need, Harvard South Shore (HSS) Psychiatry Residency Training Program aimed to assess burnout among residents, identify areas for wellness-related growth, and implement strategies for organizational change to reduce burnout and increase wellness. We aligned closely to the Standards for Quality Improvement Reporting Excellence (SQUIRE) 2.0 guidelines to systematically approach planning, conducting, and evaluating this quality improvement effort. We developed a wellness action team and assessed burnout using the Copenhagen Burnout Inventory (CBI). We also conducted a survey to investigate high opportunity areas for wellness-related growth and using this data we designed and implemented four organizational initiatives to (i) improve residents' on-call experience, (ii) increase social activities, (iii) support preventative care, and (iv) promote wellness education. We then re-assessed burnout 1?year after implementation and performed two-sample t-tests to compare CBI scores. We additionally gathered and analyzed feedback from residents on the implemented organizational initiatives' relevance to wellness and their well-being. RESULTS:There was an overall clinically meaningful reduction in burnout averaged among all residents that participated. Participants indicated that fitness-oriented activities were most likely to lead to change in wellness habits. CONCLUSION:Our implemented wellness program was resident-led and involved continuous feedback from both residents and leadership. Given that there may be multiple factors that affect resident burnout, future studies involving a control group could help reveal whether our intervention contributed to the change in burnout scores we observed.

Project description:ImportanceBurnout is a work-related syndrome of depersonalization (DP), emotional exhaustion (EE), and low personal achievement (PA) that is prevalent among internal medicine resident trainees. Prior interventions have had modest effects on resident burnout. The association of a new 4 + 4 block schedule (4 inpatient weeks plus 4 outpatient weeks) with resident burnout has not previously been evaluated.ObjectiveTo evaluate the association of a 4 + 4 block schedule, compared with a 4 + 1 schedule, with burnout, wellness, and self-reported professional engagement and clinical preparedness among resident physicians.Design, setting, and participantsThis nonrandomized preintervention and postintervention survey study was conducted in a single academic-based internal medicine residency program from June 2019 to June 2021. The study included residents in the categorical, hospitalist, and primary care tracks in postgraduate years 1 and 2 (PGY1 and PGY2). Data analysis was conducted from October to December 2022.InterventionIn the 4 + 4 structure, resident schedules alternated between 4-week inpatient call-based rotations and 4-week ambulatory non-call-based rotations.Main outcomes and measuresThe primary outcome was burnout, assessed using the Maslach Burnout Inventory subcategories of EE (range, 0-54), DP (range, 0-30), and PA (range, 0-48), adjusted for sex and PGY. Secondary outcomes included In-Training Examination (ITE) scores and a questionnaire on professional, educational, and health outcomes. Multivariable logistic regression was used to assess the primary outcome, 1-way analysis of variance was used to compare ITE percentiles, and a Bonferroni-adjusted Kruskal Wallis test was used for the remaining secondary outcomes. The findings were reexamined with several sensitivity analyses, and Cohen's D was used to estimate standardized mean differences (SMDs).ResultsOf the 313 eligible residents, 216 completed the surveys. A total of 107 respondents (49.5%) were women and 109 (50.5%) were men; 119 (55.1%) were PGY1 residents. The survey response rates were 78.0% (85 of 109) in the preintervention cohort and 60.6% (63 of 104) and 68.0% (68 of 100) in the 2 postintervention cohorts. The PGY1 residents had higher response rates than the PGY2 residents (119 of 152 [78.2%] vs 97 of 161 [60.2%]; P < .001). Adjusted EE scores (mean difference [MD], -6.78 [95% CI, -9.24 to -4.32]) and adjusted DP scores (MD, -3.81 [95% CI, -5.29 to -2.34]) were lower in the combined postintervention cohort. The change in PA scores was not statistically significant (MD, 1.4 [95% CI, -0.49 to 3.29]). Of the 15 items exploring professional, educational, and health outcomes, a large positive association was observed for 11 items (SMDs >1.0). No statistically significant change in ITE percentile ranks was noted.Conclusions and relevanceIn this survey study of internal medicine resident physicians, a positive association was observed between a 4 + 4 block training schedule and internal medicine resident burnout scores and improved self-reported professional, educational, and health outcomes. These results suggest that specific 4 + 4 block combinations may better improve resident burnout than a 4 + 1 combination used previously.

Dataset Information

Resident Wellness: An Intervention to Decrease Burnout and Increase Resiliency and Happiness.

Introduction

Methods

Results

Discussion

Publications

Resident Wellness: An Intervention to Decrease Burnout and Increase Resiliency and Happiness.

Similar Datasets

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