Evidence-Based Interventions that Promote Resident Wellness from the Council of Emergency Residency Directors

Parsons, Melissa; Bailitz, John; Chung, Arlene S.; Mannix, Alexandra; Battaglioli, Nicole; Clinton, Michelle; Gottlieb, Michael

doi:10.5811/westjem.2019.11.42961

Cited by 38 publications

(64 citation statements)

References 120 publications

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“…One such study described that achieving resident wellness is a signi cant challenge, and to implement effective strategies resident-led continuous feedback and leadership cooperation is a must (21). A collection of ample literature on wellness depicted strategies for identifying the problem in the program and individual system-level interventions have shown improvement in resident wellness (22). The promotion of resident wellness requires a multi-level approach involving the residents and the leadership, with systematic support to wholly address burnout and enhance well-being, which became the framework of our TOC model (23).…”

Section: Literature Review/frameworkmentioning

confidence: 99%

A Systemic Approach to Trainee Physician Wellness: Using the Theory of Change to Restructure a Pediatric Residency Program

Raza¹,

Aj²,

Humayun³

et al. 2021

Preprint

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Background: Resident well-being leads to better patient care practices, but a systematic approach is needed to achieve the wellness agenda. The Theory of Change was used for developing an interventional model for wellness in our study, after identifying the causes of burnout and attrition in a pediatric residency program. Methods: This was a quality improvement project where residents were asked about their main stressors in an anonymous open-ended feedback form. Workload (n=63, 37.5%) was identified as the main source of dissatisfaction. A database of 43 residents who quit in the past ten years was examined to find 40.0% of residents left after the first year of training and the main cause was marriage and/or family concerns (28.9%). Then literature was reviewed to build a wellness intervention's framework. Finally, the Theory of Change was applied focusing on restructuring the residency core, accountability and communication, and stress management. The final theory of the change model included the assumptions that the program needed restructuring because of high attrition, low first pass exam rate, and decreased patient satisfaction. The goal was to increase resident wellness and performance, while keeping patient care at the core. Results: The short-term outcomes were drop in attrition rate from an average of 8.67% to 1.75%, decrease in FCPS exam attempt from 3.3 to almost 1, and an increase in patient satisfaction. Conclusion: Using the Theory of Change, it was possible to address residents’ concerns, increase their retention and improve patient satisfaction by reconstructing the wellness program.

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Section: Literature Review/frameworkmentioning

confidence: 99%

A Systemic Approach to Trainee Physician Wellness: Using the Theory of Change to Restructure a Pediatric Residency Program

Raza¹,

Aj²,

Humayun³

et al. 2021

Preprint

View full text Add to dashboard Cite

show abstract

“…5 Parsons et al endorse including mindfulness training into residency programs (Level 1B, Grade B recommendation). 6 To assist in accessing this resource, our department and university have kept a list of local resources that individual members can access to start, or continue, their own meditation practice.…”

Section: Mindfulness Meditationmentioning

confidence: 99%

Beyond survival: Practical wellness tips during the 2019 coronavirus disease pandemic

Maniuk

Mok

Schouela

et al. 2020

CJEM

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“…Burnout in healthcare exists across medicine, is higher than non‐healthcare roles, and can be identified early in medical training 1–4 . Burnout negatively impacts the individual physician and affects patients and the healthcare system through medical errors, poor patient satisfaction, reduced productivity, increased cost, physician attrition, and ultimately physician suicide 1–12 . Physicians have a higher risk for suicide than the general population, and burnout has been labeled a known “occupational hazard.” 9,12 …”

Section: Introductionmentioning

confidence: 99%

“…Emergency medicine (EM) physicians are consistently ranked high in burnout, and the field has been referred to as a “center” 6 of burnout 1,3,12 . Studies have demonstrated that burnout and emotional exhaustion begin early and persist across medical students and resident physicians in training 4,6,8–10 .…”

Section: Introductionmentioning

confidence: 99%

“…Studies have demonstrated that burnout and emotional exhaustion begin early and persist across medical students and resident physicians in training 4,6,8–10 . Across specialties resident trainees experience high rates of burnout as compared to students and faculty 1 . Studies classically have focused on measuring burnout, depression, and exhaustion, yet a gap persists in understanding the conceptual foundations and perspectives of what defines well‐being for EM resident trainees as they navigate their early clinical experiences and training 13 …”

Section: Introductionmentioning

confidence: 99%

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

Deutsch

Sangha

Spadaro

et al. 2021

AEM Education and Training

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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.

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Evidence-Based Interventions that Promote Resident Wellness from the Council of Emergency Residency Directors

Cited by 38 publications

References 120 publications

A Systemic Approach to Trainee Physician Wellness: Using the Theory of Change to Restructure a Pediatric Residency Program

A Systemic Approach to Trainee Physician Wellness: Using the Theory of Change to Restructure a Pediatric Residency Program

Beyond survival: Practical wellness tips during the 2019 coronavirus disease pandemic

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

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