Promoting Intern Resilience: Individual Chief Wellness Check-ins

Fischer, Jason B.; Alpert, Aviva; Rao, Priyanka

doi:10.15766/mep_2374-8265.10848

Cited by 15 publications

(8 citation statements)

References 21 publications

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“…However, little is known about the extent to which interns' well-being can be influenced by support provided by their senior residents, and what peer support processes may be most effective for enhancing well-being. Promisingly, one recent study suggested that regular well-being check-ins with chief residents may normalize the intern experience and help interns manage stress 14 . To better understand the specific experience of interns, we conducted a qualitative study to elucidate contributors to emotional distress and ways that peer support from senior residents may impact intern well-being in our institution's internal medicine residency program.…”

Section: Introductionmentioning

confidence: 99%

“I Wish They Had Asked”: a Qualitative Study of Emotional Distress and Peer Support During Internship

2020

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BACKGROUND: Interns are vulnerable to emotional distress and burnout. Little is known about the extent to which interns' well-being can be influenced by peer support provided by their senior residents. OBJECTIVE: To elucidate contributors to interns' emotional distress and ways that peer support from senior residents may impact intern well-being. DESIGN: Qualitative study using semi-structured interviews conducted December 2017-March 2018. PARTICIPANTS: Second year residents (n = 11) in internal medicine at a major academic medical center during the data collection period. APPROACH: Constructivist grounded theory approach in which transcripts were analyzed in an iterative fashion using constant comparison to identify themes and to create a conceptual model. KEY RESULTS: The investigators identified three themes around emotional distress and two themes around resident peer support. Distress was a pervasive experience among participants, caused by a combination of contextual factors that decreased emotional resilience (e.g., sleep deprivation) and acute triggers (e.g., patient death) that led to an abrupt increase in distress. Participants grappled with identity reconciliation throughout internship. Reaching clinical competency reinforced self-efficacy for participants. With regard to peer support, participants recalled that resident support was ad hoc, primarily involving task support and debriefing traumatic events. Participants reflected that their intern experiences shaped their supervisory support style once they became senior residents; they did not perceive any formalized, systematic approach to supporting interns. CONCLUSIONS: We propose a model illustrating key points at which near-peers can make an impact in reducing interns' distress and suggest strategies they can use. Given the substantial role peer learning plays in intern development, senior residents can impact their interns by normalizing emotions, allowing vulnerability, and highlighting the importance of self-care. A formalized peer support skill-building curriculum for senior residents may empower them to provide more effective support as part of their supervisory efforts.

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Section: Introductionmentioning

confidence: 99%

“I Wish They Had Asked”: a Qualitative Study of Emotional Distress and Peer Support During Internship

2020

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“…Regular fortnightly 'check-in' sessions were conducted to elicit concerns, obtain feedback, and ensure continual wellbeing. This channel of communication was well received by interns: they appreciated faculty's concerns, had the autonomy of being able to input and contribute to the care of patients, the opportunity to air grievances confidentially and importantly, had closure on concerns they have raised regarding their rotations and training (Fischer et al, 2019). The enhanced collegiality between interns, support from seniors and improved cooperation among healthcare workers during this time of crisis naturally also contributed to reduced burnout levels, a finding well established in literature.…”

Section: Discussionmentioning

confidence: 99%

The COVID-19 pandemic: Impact on interns in a paediatric rotation

Tan

Lee

et al. 2021

TAPS

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Introduction: The coronavirus disease 2019 (COVID-19) pandemic has brought about additional challenges beyond the usual transitional stresses faced by a newly qualified doctor. We aimed to evaluate the impact of COVID-19 on interns’ stress, burnout, emotions, and implications on their training, while exploring their coping mechanisms and resilience levels. Methods: Newly graduated doctors interning in a Paediatric department in Singapore, who experienced escalation of the pandemic from January to April 2020, were invited to participate. Participants completed the Perceived Stress Scale (PSS), Maslach’s Burnout Inventory (MBI), and Connor Davidson Resilience Scale 25-item (CD-RISC 25) pre-pandemic and 4 months into COVID-19. Group interviews were conducted to supplement the quantitative responses to achieve study aims. Results: Response rate was 100% (n=10) for post-exposure questionnaires and group interviews. Despite working through the pandemic, interns’ stress levels were not increased, burnout remained low, while resilience remained high. Four themes emerged from the group interviews – the impacts of the pandemic on their psychology, duties, training, as well as protective mechanisms. Their responses, particularly the institutional mechanisms and individual coping strategies, enabled us to understand their unexpected low burnout and high resilience despite the pandemic. Conclusion: This study demonstrated that it is possible to mitigate stress, burnout and preserve resilience of vulnerable healthcare workers such as interns amidst a pandemic. The study also validated a multifaceted approach that targets institutional, faculty as well as individual levels, can ensure the continued wellbeing of healthcare workers even in challenging times.

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“…Several initiatives have been designed to address detachment and combat burnout by promoting social connection. Examples include reflection groups, structured social events, individual wellness check-ins by chief residents, resilience workshops, and sharing stories about patient care [6,7,8,9,10,11,12,13,14,15]. Many of these initiatives, while anecdotally beneficial, require considerable institutional resources and trainee time.…”

Section: Finding Meaning and Communitymentioning

confidence: 99%

Humanistic Stories About the Workplace and Resident Wellness: a Missing Connection?

2020

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Burnout is common among residents. A 2018 nation-wide survey of 50 medical schools found that 45% of residents experienced at least one major symptom of burnout, or a sense of detachment, emotional exhaustion and a blunted sense of accomplishment [1,2,3]. A 2019 systematic review revealed a 33.7% prevalence of burnout specifically among psychiatry residents [4]. Many factors contribute to burnout including patient complexity; volumes and workload; various and increasing tasks associated with patient care that may be perceived as "non-physician tasks"; large and complex hospitals; and institutional, interpersonal, and cultural detachment from the learning environment [5].During the course of a decade at one academic hospital-based psychiatry residency training program, trainees exhibited evidence of higher than expected rates of burnout as measured by the Accreditation Council for Graduate Medical Education (ACGME) survey as well as through internal observations and measures. Though most survey responses were comparable to other Graduate Medical Education (GME) programs' responses, psychiatry trainees reported a lower "sense of belonging" than other GME trainees. After reviewing survey results, consulting the literature, and obtaining feedback from residents, we hypothesized that psychiatry trainees in our large and complex hospital system may experience feelings of contextual detachment, which we define as feelings of separation from one's institutional, interpersonal, and cultural environment. Finding Meaning and CommunitySeveral initiatives have been designed to address detachment and combat burnout by promoting social connection. Examples include reflection groups, structured social events, individual wellness check-ins by chief residents, resilience workshops, and sharing stories about patient care [6,7,8,9,10,11,12,13,14,15]. Many of these initiatives, while anecdotally beneficial, require considerable institutional resources and trainee time. Furthermore, no study to date has explored story sharing on the institutional, interpersonal, Terms of use and reuse: academic research for non-commercial purposes, see here for full terms. http://www.springer.com/gb/openaccess/authors-rights/aam-terms-v1

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Promoting Intern Resilience: Individual Chief Wellness Check-ins

Cited by 15 publications

References 21 publications

“I Wish They Had Asked”: a Qualitative Study of Emotional Distress and Peer Support During Internship

“I Wish They Had Asked”: a Qualitative Study of Emotional Distress and Peer Support During Internship

The COVID-19 pandemic: Impact on interns in a paediatric rotation

Humanistic Stories About the Workplace and Resident Wellness: a Missing Connection?

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