Defining well‐being: A case‐study among emergency medicine residents at an academic center: A qualitative study

Abstract

Background Healthcare‐associated burnout is linked to reduced quality of care, decreased patient experience, and higher cost. The National Academy of Medicine has emphasized the importance of supporting clinician well‐being across healthcare; however, well‐being is poorly defined, especially early in emergency medicine training. Objectives The primary objective of this study was to explore and understand the attitudes, beliefs, and perspectives of emergency medicine (EM) resident physicians surrounding well‐being. A secondary objective was to identify priority areas of focus to promote a culture of well‐being for EM trainees. Approach We conducted semi‐structured focus groups of EM resident physicians at an urban, academic institution with a 4‐year training curriculum. Focus group interviews were transcribed and constructivist aggregated themes were identified using content analysis with a constant comparative coding approach. Results Seventeen EM residents participated in semi‐structured qualitative focus groups (PGY1 = 6, PGY2 = 6, PGY3 = 2, PGY4 = 3). Six key themes related to well‐being emerged spanning clinical and nonclinical areas: (1) a focus on basic needs being met, (2) on‐shift operational structure, (3) individual feedback, (4) feeling valued for clinical contributions, (5) a sense of community within the clinical environment, and (6) a sense of personal ownership over time. Conclusions Shifting the focus for medical trainees away from mitigating burnout and toward proactively promoting well‐being is important. Understanding the perspectives and key themes in how EM residents define well‐being can help support trainees early in their careers. Using qualitative methods, this study identified six key themes that can guide trainees, educational leaders, and academic hospital systems as they work toward building a culture of well‐being early in graduate medical education.

Medical Students’ Perceptions on Identifying and Addressing Emotional Responses in Emergency Medicine: Pilot Investigation

“…This study found that, regardless of whether students had already witnessed the care of a critically ill patient, most students did not feel prepared to identify or address the emotional impact associated with these situations. This highlights the need to train students early and normalize the emotional impact of working in medicine [19,20]. The stigma associated with mental health in health care has pervaded the classroom and hospitals, and to build structures to prevent burnout, we must begin early to help trainees identify feelings of anxiety, depression, or stress as they experience them [13,[21][22][23].…”

Educator's blueprint: A how‐to guide for survey design

“…Alternatively, a study examining different types of stressors in a simulated clinical environment may use heart rate variability to assess objective physiologic response to stressors and a survey instrument to assess trainees' subjective perceptions of stress 2 . Additionally, qualitative methodologies are often ideally suited to deeply explore poorly understood or poorly defined concepts, such as physician shame 3 . Ultimately, the prospective survey designer should carefully consider the strengths and limitations of using a survey as a research tool.…”

“…2 Additionally, qualitative methodologies are often ideally suited to deeply explore poorly understood or poorly defined concepts, such as physician shame. 3 Ultimately, the prospective survey designer should carefully consider the strengths and limitations of using a survey as a research tool.…”

“…developing content in a rigorous way,(2) writing and formatting survey items with clarity,(3) collecting evidence to support the validity of the survey results,(4) administering the survey to maximize response rate, and (5) clearly communicating the results of the survey in the medical literature.In this first paper, we have focused on the first two steps of this process. By first explicating the goals of the survey and the constructs being investigated, designers can determine the content of survey items.…”