Current Wellness Practices among Otolaryngology Residencies

Abstract

Objectives To determine if and how resident emotional health is monitored among otolaryngology training programs and to determine what wellness resources are available to otolaryngology residents. Study Design Survey. Setting Tertiary academic medical centers. Subjects and Methods An anonymous 50-item survey sent via REDCap to the 107 allopathic American otolaryngology program directors (PDs). Results The response rate was 44%, of whom 47.7% regularly surveyed emotional health among their residents. A total of 33.3% used the Maslach Burnout Inventory, and 61.9% used another scale or did not know. Eighty-one percent of surveys were anonymous, and 45% surveyed yearly, which was mandatory in only 33.3% of programs. Whether surveys took place was not related to PD or program demographics. In total, 72.7% of programs utilized faculty mentors for their residents; 88.6% had a wellness lecture within the last year; and 74.5% had no-cost mental health resources with extended hours as required by the American Council of Graduate Medical Education. Within the last year, 31.8% had provided seminars in mindfulness or meditation. Seventy-five percent had financially supported social events for their residents; <15% supported athletic or mental wellness activities. Healthy foods were provided by 36.4%, and 67.4% of programs gave their residents days off in addition to vacation days for medical or dental appointments. Residents were allowed a mean 18.76 vacation days and 3.73 additional wellness days. Conclusion There is no standard practice for measuring and monitoring emotional health by otolaryngology programs. Programs struggle to offer interventions to prevent burnout, with 25% noncompliant with the wellness requirements mandated by the American Council of Graduate Medical Education.

Program Directors’ Opinions About Otolaryngology Resident Teaching Medical School Anatomy

“…The response rate was low but similar to previous studies of this group of PDs [17]. Our study looked only at PD attitudes, so the point of view of residents, students, and medical school administrators is not described.…”

Consequences of Medical Hierarchy on Medical Students, Residents, and Medical Education in Otolaryngology

“…33 Furthermore, residents in programs perceived to have significant hierarchical culture are less likely to engage in high-quality feedback from faculty. 34 Since mentoring and feedback have both been shown to promote resident well-being, 9,35,36 hindrance of these educational objectives amplifies rigid hierarchies’ negative impacts and further perpetuates them. Finally, hierarchical structure has been implicated as a hindrance to the creation of an inclusive workplace in health care organizations.…”

“…28 Several proposed interventions to increase trainee morale and minimize burnout include faculty mentorship programs, healthy food options during meetings, physical wellness programs, empathy training programs, professionalism forums, mistreatment programs, and mindfulness activities. 36,48,[66][67][68] Implications for Practice Our literature review highlights the ways in which dysfunction within hierarchy can undermine institutional values and trainee education. 7 These effects include creating moral distress, restricting voice, reducing trainee autonomy, perpetuating mistreatment, and worsening burnout.…”

Otolaryngology Resident Wellness, Training, and Education in the Early Phase of the COVID-19 Pandemic

“…Otolaryngology programs should continue their efforts to promote resident wellness. 50 Mindfulness practices have been implemented at many medical centers and are effective in sustainably reducing burnout. 51,52 During the COVID-19 pandemic, mindfulness training may offer a promising avenue for improving wellness, as it could easily be incorporated into existing online lecture series that are attended virtually by many residents.…”