Measuring Flourishing Among Internal Medicine and Psychiatry Residents

Abstract

Background Many residents experience burnout, prompting national attention to well-being; however, well-being is not merely the absence of burnout. A recently developed measure of flourishing may provide insight on this important topic. Objective We investigated flourishing in a sample of medical residents. Methods Internal medicine residents and psychiatry residents at 2 residency programs responded to a cross-sectional online survey (December 2017–February 2018), which focused on the Flourish Index (FI) and Secure Flourish Index (SFI). Both measures generate scores ranging from a low of 0 to a high of 10. Participants were queried about quality of life, burnout, work-life balance, empathic concern, and sociodemographic characteristics. Simple and multiple linear regressions were performed to examine the relationship between FI/SFI and other variables. Results The response rate was 92% (92 of 101). Participants were found to have a mean FI score of 6.8 (SD = 1.6) and mean SFI score of 6.9 (SD = 1.6). Low quality of life, low work-life balance satisfaction, high emotional exhaustion, lower empathic concern, and having a pet were all significantly associated with lower FI scores (R2 = 0.59; F[14, 69] = 7.10; P < .0001), indicating lesser flourishing, controlling for other variables. Similarly, low quality of life, high emotional exhaustion, lower empathic concern, and having a pet were all significantly associated with lower SFI scores (R2 = 0.55; F[14, 69] = 6.06; P < .0001), controlling for other variables. Conclusions In this sample, the flourishing indices were associated with well-being and burnout metrics.

Flourishing in Healthcare Trainees: Psychological Well-Being and the Conserved Transcriptional Response to Adversity

“…Incorporating positive psychological measurements and approaches into healthcare trainee programs is a common mandate and point of emphasis [ 85 , 112 , 113 , 114 , 115 ], and our findings point to socio-demographic factors and behavioral associations that can help identify and refine impactful and feasible programming to bolster healthcare trainee flourishing. Our findings indicate that facilitating the behaviors associated with flourishing is especially critical among primary caregivers to improve well-being and reduce loneliness and stress.…”

“…These data were collected from the subset of trainees who chose to participate in a larger study that evaluated a mindfulness intervention, and it is possible that self-selection biases influenced our dataset such that the symptoms, well-being, and physiology of our sample is not representative of the larger population. Here, we used the MHC-SF to quantify flourishing, but other flourishing measures have been used in the context of physician residents [ 112 ]. Interestingly, to our knowledge, the only other study to examine flourishing using an alternative measure found results that are discrepant with those found here and with the other studies that used the MHC-SF.…”

“…Specifically, this study and the previous two that used the MHC-SF found higher rates of flourishing among residents than has been found in a general adult population [ 73 , 85 ]. However, the study that used VanderWeele’s flourishing measure found lower flourishing scores, prompting the interpretation that medical residents have lower rates of flourishing than community samples [ 112 ]. More research using multiple measures is crucial to characterize rates of flourishing among healthcare trainees and providers, to identify factors associated with flourishing, and to evaluate the long-term impact of flourishing on provider health and performance outcomes.…”

Perceived procedural justice and psychological flourishing among mental health professionals in Macao: a moderated mediation model

“…Among the limited literature on mental health professionals’ positive wellbeing, only one cross-sectional study measured psychological flourishing among mental health professionals (i.e., psychiatrists residing in a hospital setting), and its findings showed that high quality of life, high work-life balance satisfaction, and low emotional exhaustion were significantly associated with psychological flourishing (Kelly-Hedrick et al, 2020 ). However, organizational factors were not included and so the degree to which distal factors in the workplace are related to mental health professionals’ psychological flourishing remains unknown.…”

“…To our best knowledge, three studies thus far have been conducted to test the relationship between emotional exhaustion and psychological flourishing. Although these studies were limited due to their cross-sectional design, they consistently showed that those employees who were more emotionally exhausted scored lower on psychological flourishing in samples of teachers, internists, and psychiatrists residing in hospitals, as well as gynecologic cancer specialists (Freire et al, 2020 ; Kelly-Hedrick et al, 2020 ; Vetter et al, 2018 ). The various stressors, including negative emotional experiences, encountered by emotionally exhausted individuals leave them with impaired psychosocial functioning and poorer work performance (Cropanzano et al, 2003 ; Tuithof et al, 2017 ); therefore, they retain insufficient capacity for psychological flourishing.…”