PURPOSE: We aimed to test whether measures of resident well-being correlated with perceptions of program support and psychological safety. BACKGROUND: Trainee well-being is a crucial component of developing competent and skilled OB/GYN physicians. While there are several measures of well-being collected at the national-level, there is little insight in the role of individual programs to foster trainee well-being. Perceived organizational and psychological safety are two constructs that can help identify cultural aspects of the clinical learning environment that may relate to trainee well-being. METHODS: OBGYN residents in a training program were recruited to complete an IRB-approved survey through paper and electronic methods between May-June 2018. Measures included the Survey of Perceived Organizational Support (POS), Psychological Safety Scale (PS), Perceived Stress Scale (PSS), Wayne State Wellness Scale (RWS) and Physician Well-Being Index (PWBI); all demonstrate validity and reliability evidence to assess factors of well-being and cultural aspects of the training program. Results: 20 OBGYN residents completed our survey. Results indicated a strong relationship between perceived organizational support and wellness (r=.62, P<.01 for RWS, r=.50, P<.05 for PWB)., suggesting greater perceptions of support relate to better wellness. Similarly, psychological safety also had a strong relationship with wellness (r=.56, p<.05 for RWS; r=-.72, p<.01 for PWB). DISCUSSION: Our findings suggest that there is a strong relationship between trainee wellness and the cultural measures of support and safety, especially between psychological safety and negative indicators of well-being (e.g., feeling burnt out from work, feelings of irritation). Further research should include interventions to improve perceptions of support and safety.
At the completion of training in obstetrics and gynecology (Ob/Gyn), residents are expected to have comprehensive knowledge of the field. However, there is no comprehensive Ob/Gyn residency education curriculum. We hypothesize that there is a need for a standardized curriculum. A needs assessment survey was administered to determine the current state of resident didactic education, the perceptions that Ob/Gyn residents, program directors (PDs), and assistant program directors (APDs) have regarding centralization and standardization of education, and the need for a standardized Ob/Gyn residency education curriculum. In 2019, a web-based survey was distributed to Ob/Gyn residents and program leadership from three institutions. The main outcomes were measured on a 5-pt Likert scale. A total of 50 (3 PDs, 5 APDs, and 42 residents) participants completed the survey with a response rate of 68% (50/73). Almost all (94%) participants agreed or strongly agreed that residents nationwide should have equal access to high-quality Ob/Gyn educational resources. Further, 92% agreed or strongly agreed that core Ob/Gyn resources should be centrally located. A majority, 76%, agreed or strongly agreed that there is a need for a national curriculum. This study demonstrates a perceived need for a centrally located, standardized Ob/Gyn residency education curriculum.
ObjectivesTo develop physicians who can practice safely, we need better understanding of how the clinical learning environment affects trainee well-being. Two psychosocial constructs may help us understand the context: psychological safety (belief one can speak up without concerns) and perceived organizational support (degree to which members feel that their organization cares for them and values their contributions). The objective of this study is to test a moderated mediation model to determine how humiliation (X) impacts trainees’ well-being (Y) while taking into account psychological safety (mediator) and organizational support (moderator).MethodsBetween May and June 2018, a single health system recruited resident physicians across 19 programs to complete an anonymous electronic survey to assess facets of the clinical learning environment, well-being, and experiences of humiliation. In a moderated mediation analysis, mediation helps explain how a predictor variable (X) impacts an outcome variable (Y) through a mediating variable, whereas moderation helps explain under what conditions such a relationship exists.ResultsOf 428 residents, 303 responded (71%) to the survey across 19 training programs. The effects of humiliation on well-being were mitigated by psychological safety, which varied depending on the levels of perceived organizational support. Environments rated 1 SD below the mean on perceived organization support by residents had a stronger negative impact of public humiliation on psychological safety.ConclusionsThe findings suggest that humiliation is associated with well-being through the effects of psychological safety and influenced by organizational support. Further work might explore the relationship by investing resources (e.g., faculty development, mentorship) to increase psychological safety and reduce humiliation during training, especially within environments prone to be perceived as unsupportive of trainees.
INTRODUCTION: Pain with intrauterine device (IUD) insertion is identified as a barrier to compliance with this highly effective long acting reversible contraceptive. Several studies have assessed the efficacy of interventions to alleviate patient discomfort associated with IUD insertion, but no interventions have been clearly shown to improve procedural pain. The aim of this study was to determine if use of a cold compress on the abdomen during intrauterine device insertion improves pain. METHODS: This study is a prospective, randomized controlled trial comparing cold compression to no intervention during IUD device insertion. Study participants were women who desired IUD placement at Virginia Commonwealth University OB/GYN clinics. Subjects were randomized to control (n=40) versus cold compress (n=47) and they completed a pre- and post-procedural visual acuity scale for pain. Additional data was collected regarding gravidity, parity, history of cervical procedures and socioeconomic status as well as history related to chronic pain. RESULTS: There was no difference in pre and post-insertional pain in those who received a cold compress versus the control during insertion of intrauterine device (3.6 versus 2.8, P=0.223). The insertional pain was rated at 4.5 and 4.7 for patients who received the cold compress and the control group, respectively (P=0.724). CONCLUSION: While a cold compress is a simple, inexpensive and safe method of pain control this study shows no improvement in insertional pain for intrauterine device placement.
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