Dataset Information

Six Steps to Achieve Meaning, Wellness, and Avoid Burnout in a Residency Program.

ABSTRACT: Burnout has become an increasingly recognized problem in higher medical education and is particularly prevalent within the field of Neurology and its training programs. Many previously reported wellness initiatives in other residencies focused mainly on community/team building. We developed a comprehensive Wellness Curriculum (WC) and established a new role of Resident Wellness Liaison in order to facilitate wellness across the department and training program. Here we present a 6-step outline of our WC which can easily be adapted to the needs of other programs. The steps include creating a Wellness Committee with a Resident Wellness Liaison, identification and optimization of institutional resources, identifying and troubleshooting barriers to wellness, providing education and reflection on wellness, showing appreciation to each other, and assessing the impact of the implemented strategies. In order to measure the impact of our WC and to perform a needs assessment for future directions, we posed questions-grounded in the theory of drivers of burnout and engagement-to our residents (N?=?24) at a noon conference in the summer of 2020. Interventions implemented at our institution have been very well received by residents, as evidenced by their comments and feedback. Themes that were highlighted by residents include enjoying flexibility, having a welcoming social support system at work, and being able to find meaning in the day-to-day work. The creation of a comprehensive WC is a feasible and meaningful intervention for addressing resident wellness in a Neurology training program and could be adapted to other programs.

SUBMITTER: Stamm B

PROVIDER: S-EPMC7724401 | biostudies-literature | 2020 Jan-Dec

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

Six Steps to Achieve Meaning, Wellness, and Avoid Burnout in a Residency Program.

Stamm Brian B Yu Margaret M Lineback Christina M CM Bega Danny D

Journal of medical education and curricular development 20200101

Burnout has become an increasingly recognized problem in higher medical education and is particularly prevalent within the field of Neurology and its training programs. Many previously reported wellness initiatives in other residencies focused mainly on community/team building. We developed a comprehensive Wellness Curriculum (WC) and established a new role of Resident Wellness Liaison in order to facilitate wellness across the department and training program. Here we present a 6-step outline of ...[more]

PMID: 33335990

Similar Datasets

Project description:The competence centre for Residency Training in Family Medicine Bavaria (CCRTB) was established to improve the quality of postgraduate medical education by offering training and mentoring programmes for residents, and by providing train-the-trainer and mentoring courses for supervisors. Beyond that, regional Residency Training Networks (RTN) on avoluntary basis were developed to facilitate structured and efficient clinical rotation programs. Primary aim was to investigate the burden of burnout and the development of professionalism among CCRTB-residencies within a cross-sectional study. Secondary aim was to evaluate differences between CCRTB-residents with and without participation in aregional RTN. Burnout was determined with the Maslach Burnout Inventory (MBI), comprising the scales emotional exhaustion, depersonalization, and personal accomplishment. Ambulatory professionalization was evaluated using the German Professional Scale (Pro-D), comprising the scales professionalism towards the patient, towards other professionals, towards society, and towards oneself. Statistical significance of group differences was calculated by nonparametric tests. Multivariable linear regression modelling was performed to estimate the independent impact of professionalization and RTN participation on burnout scores. 347 CRRTB residents in ambulatory postgraduate training were invited, 212 (61.1%) participated, and 197 (92.9%) were included in our analyses. Lower emotional exhaustion and depersonalization, and increased personal accomplishment was associated with increased professionalisation, which was significant for nearly all Pro-D scales (p ≤ 0.05). RTN residents showed higher professionalism towards the patient (p = 0.031), other professionals (p = 0.012), and towards the society (p = 0.007) than residents of unstructured programs, and higher levels of personal accomplishment (p < 0.05). Early and efficient professionalization might be akey to reduce burnout and to establish asatisfying career in family medicine. Train-the-trainer and mentoring concepts should be implemented regularly for the training of residents. Thus, increased engagement in medical didactics should be aprerequisite for accreditation as atraining practice for residents.

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:BACKGROUND:Physicians, particularly trainees and those in surgical subspecialties, are at risk for burnout. Mistreatment (i.e., discrimination, verbal or physical abuse, and sexual harassment) may contribute to burnout and suicidal thoughts. METHODS:A cross-sectional national survey of general surgery residents administered with the 2018 American Board of Surgery In-Training Examination assessed mistreatment, burnout (evaluated with the use of the modified Maslach Burnout Inventory), and suicidal thoughts during the past year. We used multivariable logistic-regression models to assess the association of mistreatment with burnout and suicidal thoughts. The survey asked residents to report their gender. RESULTS:Among 7409 residents (99.3% of the eligible residents) from all 262 surgical residency programs, 31.9% reported discrimination based on their self-identified gender, 16.6% reported racial discrimination, 30.3% reported verbal or physical abuse (or both), and 10.3% reported sexual harassment. Rates of all mistreatment measures were higher among women; 65.1% of the women reported gender discrimination and 19.9% reported sexual harassment. Patients and patients' families were the most frequent sources of gender discrimination (as reported by 43.6% of residents) and racial discrimination (47.4%), whereas attending surgeons were the most frequent sources of sexual harassment (27.2%) and abuse (51.9%). Proportion of residents reporting mistreatment varied considerably among residency programs (e.g., ranging from 0 to 66.7% for verbal abuse). Weekly burnout symptoms were reported by 38.5% of residents, and 4.5% reported having had suicidal thoughts during the past year. Residents who reported exposure to discrimination, abuse, or harassment at least a few times per month were more likely than residents with no reported mistreatment exposures to have symptoms of burnout (odds ratio, 2.94; 95% confidence interval [CI], 2.58 to 3.36) and suicidal thoughts (odds ratio, 3.07; 95% CI, 2.25 to 4.19). Although models that were not adjusted for mistreatment showed that women were more likely than men to report burnout symptoms (42.4% vs. 35.9%; odds ratio, 1.33; 95% CI, 1.20 to 1.48), the difference was no longer evident after the models were adjusted for mistreatment (odds ratio, 0.90; 95% CI, 0.80 to 1.00). CONCLUSIONS:Mistreatment occurs frequently among general surgery residents, especially women, and is associated with burnout and suicidal thoughts.

Project description:Abstract A multi-center, two arm, parallel group, randomized controlled trial: study participants were screened, assessed for risk factors and randomized (control or intervention) based on the SPPB score at baseline. High-risk participants (SPPB less or equal 6) were given a home-based exercise program up to 12 sessions (3 times per week) that specifically targets and modifies impairments that interfere with engaging in exercise in a group setting. When the high-risk participants attained SPPB > 6, they transitioned to a community-based group exercise program and continued until the end of active intervention phase. Low-to-moderate risk patients (SPPB > 6) were directly enrolled into an evidence-based one-hour group exercise program, which was offered up to 24 sessions with free transportation (2 times a week). The primary outcome measure was the number of fallers at the end of the nine-month study period. All analyses performed were on an intention-to-treat basis. Between December 2012 and July 2014, 354 patients who were at least 65 years old and visited the Emergency Department for falls or fall-related injuries were recruited (177 participants in each group). At the end of the nine-month follow-up period, 37.9% of the control group and 30.5% of the intervention group fell at least once. The intervention program significantly reduced the number of fallers adjusting for critical comorbidities (odds ratio 0.33 [0.15 – 0.74], p=0.004). We also observed that the intervention group had a lower proportion of individuals with injurious falls and significantly less reduction in physical performance by SPPB. No adverse events were reported during the study period. The SAFE study showed that screening, risk modification and intensive, consistent and progressive physical therapy can effectively reduce the number of fallers and injurious falls. This study is registered with the U.S. Clinical Trials Registry, number NCT01713543 and was funded by Ministry of Health Singapore under its Health Services Research Competitive Research Grant (Grant Number: HSRG10MAY002).

Project description:IntroductionRecent research demonstrates burnout prevalence rates as high as 76% in emergency medicine (EM) residents. In 2017 the Accreditation Council for Graduate Medical Education (ACGME) required that all training programs provide dedicated wellness education for their trainees as a requirement for accreditation. We aimed to conduct a systematic review of published wellness interventions conducted in EM residency programs following the implementation of the 2017 ACGME Common Program Requirements change in order to characterized published intervention and evaluate their effectiveness.MethodsWe applied a published approach to conducting systematic reviews of the medical education literature. We performed a search of the literature from January 1, 2017-February 1, 2020. Studies were included for final review if they described a specific intervention and reported outcomes with the primary goal of improving EM resident wellness. Outcomes were characterized using the Kirkpatrick training evaluation model.ResultsEight of 35 identified studies met inclusion criteria. Most described small convenience samples of EM residents from single training programs and used the satisfaction rates of participants as primary outcome data. Only quantitative assessment methods were used. Studies addressed only a limited number of factors affecting resident wellness. The majority of interventions focused on personal factors, although a few also included sociocultural factors and the learning and practice environment.ConclusionThere is a relative dearth of literature in the area of research focused on interventions designed to improve EM resident wellness. Furthermore, the studies we identified are narrow in scope, involve relatively few participants, and describe programmatic changes of limited variety. Future directions include an increase and emphasis on multi-institutional studies, randomized controlled trials, qualitative methodology, and opportunities for funded research.

Dataset Information

Six Steps to Achieve Meaning, Wellness, and Avoid Burnout in a Residency Program.

Publications

Six Steps to Achieve Meaning, Wellness, and Avoid Burnout in a Residency Program.

Similar Datasets

OmicsDI is part of the ELIXIR infrastructure

Tweets