Medicine and Health Sciences Commons^™

Wellness Review 2023, Part 1, Brian A. Ferguson, Martin Huecker

Journal of Wellness

Introduction: The 2023 Part 1 summary reviews research on wellness in healthcare professionals published outside of JWellness from January 1, 2023 to June 30, 2023.

Methods: Editors conducted a Boolean search of titles and abstracts in PubMed utilizing keyword identifiers pairing healthcare personnel (providers, nurses, and other staff) with a well-being metric. Of 416 relevant articles, an intriguing and innovative 30 were selected for inclusion, with two additional articles manually curated.

Literature in Review: This sample of the recent literature into healthcare professional wellness included multiple targeted interventions and studies of resilience. Main themes that emerged include: positive systematic healthcare …

Sexual Well-Being Among Medical Residents At A Community-Based Academic Institution, Fiore Casale, Hinduja Nallamala, Todd Foster, Christine Alicea, Laurel Fick

Journal of Wellness

Introduction: Medical residency training is demanding, with challenging workloads, long hours, and excessive stress that impact residents’ physical, mental, and emotional health. Although the concept of health and wellness in residency has become more widespread across programs, few studies have explored the sexual health of medical residents during training.

Methods: To better understand the current state of sexual health and well-being of resident physicians, physicians in training across Internal Medicine, Pediatrics, Family Medicine, OB/GYN, Transitional Year, and General Surgery completed anonymous surveys that incorporated validated questionnaires, including the International Index of Erectile Function (IIEF) and the Index of Premature Ejaculation …

Burnout As Chronic Disease, Benjamin Doolittle

Journal of Wellness

Burnout is endemic. The prevalence of burnout (~50%) among healthcare providers has been stable over the past 20 years. Acknowledging variability from year to year, burnout is pervasive, with no signs of abating. Despite increased awareness of mental health issues, the rise of Chief Wellness Officers, and the expansion of Employee Assistance Programs, there has not been much improvement. We are even burned out from burnout. Survey responses are low and often do not result in action. Longitudinal intervention trials are often small and of short duration. We need a new paradigm to manage physician burnout. A chronic care management …

Enhancing Adherence To Best Practice Guidelines Related To Pressure Injury Prevention In The Operating Room At A Children's Hospital During Comprehensive Dental Procedures., Alyce Bailey Seaver

Doctor of Nursing Practice Papers

Background: 1,600,000 patients develop a hospital-acquired pressure injury every year, and 23% of these originate during surgery. Research has demonstrated that the incidence of hospital-acquired pressure injuries developing during surgery has risen over the past 5 years. This rise has been attributed to nurse circulators exhibiting poor knowledge regarding best practices for intraoperative patient positioning and intraoperative documentation that does not follow standards of care.

Purpose: This quality improvement project aimed to enhance circulator knowledge on best practices for intraoperative patient positioning and improve documentation of intraoperative patient positioning in the electronic medical record to comply with standards of …

Barriers And Facilitators To Achieving Well-Being In Pediatric Providers, Whitney Marvin, Jillian Harvey, Natasha Ruth

Journal of Wellness

Introduction: Physician well-being has become increasingly important for health systems across the country due to the strong ties between quality, safety, and overall patient outcomes. Burnout has increased steadily and has been exacerbated by the COVID-19 pandemic. This study seeks to successfully identify factors that both enhance and detract from well-being in a cohort of pediatric faculty and advanced practice providers (APPs).

Methods: This study utilized a multimethod approach including surveys and a total of 8 semi-structured, virtual focus groups of pediatricians and advanced practice providers (orchestrated through Microsoft Teams) to understand perspectives on burnout and well-being. Each …

Incorporating Sexual And Gender Minority Patient Care Competencies: A Case Based Curriculum For Caring For Gender Diverse Youth, Eileen Cichoskikelly, Suzanne Kingery, Susan Sawning

Faculty Scholarship

There is a gap in medical education training content specifically focused on the care of Sexual and Gender Minority (SGM) people and people with Differences in Sex Development (DSD). Inadequate training contributes to suboptimal health care access, utilization, and experiences among SGM-DSD people. Improving medical education training can be challenging as many clinician educators received sparse instruction themselves in these areas and there are limited teaching resources that expand beyond didactic instruction. In 2014 the Association of American Medical Colleges (AAMC) Advisory Committee on Sexual Orientation, Gender Identity, and Sex Development published a landmark document identifying 30 specifiers of competence …

Emergency Medicine In-Training Examination Scores Are Not Associated With Burnout And Not Affected By The Introduction Of A Wellness Curriculum, Kelly Williamson Md, Patrick M. Lank, Nicholas Hartman, Nathan Olson, Elise O. Lovell

Journal of Wellness

Introduction: There is little research examining the relationship between burnout and medical knowledge. Study Objectives: The authors sought to determine if emergency medicine (EM) resident performance on the In-Training Examination (EM-ITE) is associated with burnout and if EM-ITE scores are affected by the implementation of a wellness curriculum.

Methods: As part of a multi-institution prospective education intervention trial, the Maslach Burnout Inventory, a valuable tool in the assessment of physician burnout, was administered at 10 EM residencies in February 2017. Then, five intervention sites introduced a year-long wellness curriculum. The MBI was re-administered at all sites in August 2017 and …

Survey Of Nutrition Education Among Medical Students, Michael P. Duggan, Anahita T. Kodali, Zach A. Panton, Shannon M. Smith, Grant J. Riew, Jack F. Donaghue, Gregory A. Leya, Logan G. Briggs

Journal of Wellness

Introduction: The current literature regarding both specific interventions and the current level of nutrition education in the United States is scarce. The purpose of this paper is to provide medical student perspectives on both the degree and necessity of nutrition education during medical school.

Methods: Medicine in Motion (MM) is a non-profit student-run organization founded in 2018 that aims to address burnout in medicine through physical activity, community service, and philanthropy. MM issued a survey to nine of its chapters in January 2021 to assess a range of topics including burnout, physical activity, and nutrition education.

Results: Of 5500 invited …

Does Positive Psychology Coaching Improve Trainee Well-Being? Evidence From A Longitudinal Professional Development Coaching Program In A Cohort Of Pediatric Trainees, Benjamin Nelson, Jacqueline T. Chu, Michael G. Healy, Yoon Soo Park, Kerri Palamara Md

Journal of Wellness

Introduction: Trainee burnout is common and evidence supporting the effectiveness of well-being interventions for this population is limited. We studied the effect of a longitudinal coaching program grounded in positive psychology on measures of pediatric trainee well-being.

Methods: Pediatric interns and fellows (n = 67) were enrolled in a positive psychology coaching program in 2017-2019. Pediatric faculty (n = 23) underwent training and were paired with trainees outside their field of interest. Trainees were surveyed at the beginning and end of the program to assess burnout and well-being, and key skills necessary to achieve well-being.

Results: Thirty-one …

Variable Shift Lengths Negatively Affect Emergency Medicine Resident Wellness, Marcus Fazzari, Joseph Longobardi, Joseph Mccarthy, Matthew Hysell, Sidney Hann

Journal of Wellness

Introduction: Burnout is very common in emergency medicine and there has been extensive research evaluating factors that contribute to burnout. We sought to examine the contributions of post-graduate year (PGY), shifts worked per month, patients seen per shift, and length of shifts to emergency medicine resident burnout.

Methods: All emergency medicine residents were surveyed with regards to their PGY, shifts worked per month, patients seen per shift, and length of shifts. They were administered the Stanford Wellness Survey and asked to globally rate their degree of burnout. We then modeled whether consideration of the surveyed factors increased the …

Anatomy Lab, Brian R. Smith

Journal of Wellness

No abstract provided.

Assessing The Efficacy Of A Meditation Intervention On Dispositional Mindfulness Among Medical Students And Resident Physicians, Kelsey Stefan, Michael Villeneuve, Varun Konanki, Erica Rarity, Rahul Mhaskar, Liwei Chen, Amelia Phillips

Journal of Wellness

Introduction: Dispositional mindfulness is the act of paying attention to one’s thoughts and feelings with an open and non-judgemental attitude. Medical students and resident physicians are under immense pressure and stress daily, and they need effective tools to help increase their dispositional mindfulness. This project examined the impact of a meditation intervention on medical students’ dispositional mindfulness.

Methods: In 2020, medical students and resident physicians at the University of South Florida were given the option to practice daily meditation for thirty days; time spent on the practice varied depending on comfort with the practice. Dispositional mindfulness levels were assessed using …

Who Leads The Emergency Department Debrief?, Allison D. Lane, Ethan Bryce, Marcy R. Milbrandt, Lisa R. Stoneking

Journal of Wellness

No abstract provided.

Development And Use Of A Survey Tool To Prioritize And Catalyze Change Surrounding Faculty Wellness In A Department Of Pediatrics, Sarah Rhoads, Alison Riese, Mohammed Faizan, Lloyd Feit, Shuba Kamath, Albert Ross, Katherine Mason

Journal of Wellness

Introduction: Physician wellness is an important factor in the delivery of safe, effective and humanistic patient care. There is compelling data describing the widespread prevalence of physician burnout and its subsequent adverse impact on patient care, healthcare costs, and relationships. Initiatives to improve wellness are necessary to maintain the healthcare work force as well as to ensure high-quality care. This project investigated faculty physicians’ attitudes and priorities regarding physician wellness within the department of Pediatrics at a single-center academic institution.

Methods: A survey was created and distributed via e-mail to all faculty physicians employed within the Department of Pediatrics in …

No Longer Beholden – Moving On From Elaborate Chart Notes, Jeffrey H. Millstein

Journal of Wellness

Despite recent changes in Medicare billing documentation guidelines, physician chart notes remain far lengthier and more detailed than is required. This is worrisome, as documentation burden is a major contributor to physician burnout. Elements of medical culture which have contributed to the elaborate chart note standard may be used to transform notes, reduce charting burden and improve physician well-being.

Associations Between Faculty Vitality And Burnout In The Covid-19 Era: The Experience Of One Institution, Megan Ferriby Ferber, Tina H. Chen, Patrice L. Vallot, Jane Mchowat, Cindy C. Bitter

Journal of Wellness

Introduction: Faculty vitality is the ideal synergy between engaged faculty and mission-driven institutions that generates a fruitful environment for academic productivity, career satisfaction, and fulfillment of shared goals. The COVID-19 pandemic has introduced unprecedented disruptions to faculty vitality, with profound perturbations to individual and institutional support networks. However, the extent of this impact is unclear, as are strategies to mitigate loss of faculty vitality and prevent burnout.

Methods: We developed a survey instrument to evaluate the impact of COVID-19 on faculty vitality and burnout at a mid-sized, Midwestern academic institution affiliated with a university hospital. Survey items focused on individual …

More Work, Less Reward: The Minority Tax On Us Medical Students, Marija Kamceva, Baffour Kyerematen, Sabina Spigner, Samuel Bunting, Simiao Li-Sauerwine, Jane Yee, Michael Gisondi

Journal of Wellness

Introduction: Minority tax is defined as the burden of time and resources placed on minority persons to represent and advocate for their communities. We determined whether medical students underrepresented in medicine (URM) or from historically excluded (HE) populations experience a minority tax and characterized its effects.

Methods: This cross-sectional survey of US medical students occurred November 2020 - June 2021. We used Mann-Whitney U tests to compare metrics between URM and HE participants and their peers. The primary outcome was time invested in activism/diversity initiatives versus other work. Secondary outcomes included measures of microaggressions, discrimination, institutional culture, anxiety/depression, …

Lgbtq+ Microaggressions In Clinical Skills Training., Andrew Givens, Gita Jaikumar, Hayden Norris, Jacqueline Tran, Elisha Vanzant, Bhawana Yadav, Emily Noonan, Linda Fuselier, Laura Weingartner

Undergraduate Research Events

BACKGROUND

Lesbian, gay, bisexual, transgender, and queer (LGBTQ+) people experience health disparities. Implicit bias and mistreatment by healthcare providers can also lead LGTBQ+ people to delay care or avoid it entirely. Clinical skills training in the care of LGBTQ+ patients is therefore critical to health equity. Standardized patient (SP) encounters allow medical students to be assessed as providers in a mock clinical setting.

METHODS

The study population was rising third-year medical students at the University of Louisville School of Medicine in 2022. Out of 149 total encounters, coders reviewed all encounters with gender diverse SPs (n=86) and coded microaggressions, which …

Multicomponent Approach To Delirium Prevention In The Acute Care Setting: An Evidence-Based Quality Improvement Project., Kelley James

Doctor of Nursing Practice Papers

Background: Acutely ill, hospitalized individuals are at an increased likelihood of developing delirium. Between 30-35% of those patients admitted to the hospital will develop delirium, and as a result, these individuals will face an increased risk of mortality, adverse medical events, restraint usage, and incur a more extended hospitalization. The literature supports early screening utilizing the Confusion Assessment Method (CAM) tool and nurse-driven, multicomponent interventions to aid in preventing its development.

Environment: This project was implemented in a long-term, acute care facility specializing in patients requiring long-term mechanical ventilation, advanced wound care, pulmonary and respiratory care, and the rehabilitation of …

A Geographically Targeted Approach For A Preceptor Tax Incentive Using Primary Care Health Professional Shortage Areas (Hpsas), Julia Mattingly, Sarah Belcher, Samuel C. Kessler

Commonwealth Policy Papers

Years before the COVID-19 pandemic brought on a health care shortage in Kentucky, its rural areas were already struggling to obtain and attract primary care medical practitioners. Even though the number of medical school graduates in the U.S. has steadily increased throughout the years, there is a general disinterest in rural or small-town practice, and legislators throughout the country have pondered ways to address this issue plaguing communities. Versions of Preceptor Tax Incentive legislation in Kentucky have been proposed in the General Assembly to address care shortages in the state, however, all have been unsuccessful at truly targeting rural areas …

Ideas To Action: Using Curriculum Design To Develop A “Roadmap To Wellness” Curriculum, Christine R. Stehman, Kelly Williamson, Erin Dehon, Al'ai Alvarez, Manish Garg, Michelle D. Lall

Journal of Wellness

Introduction: Physician burnout, well-being, and professional fulfillment are deeply intertwined topics that are increasingly recognized as affecting the lives of physicians, health care workers, and patients alike. The Accreditation Council for Graduate Medical Education (ACGME) mandates that all residencies address wellness within the context of residency training without providing much guidance on how to do so. Emergency Medicine organizations such as the American College of Emergency Physicians, the American Academy of Emergency Physicians, the Society for Academic Emergency Medicine, and the Council of Residency Directors of Emergency Medicine (CORD) suggest that one method to address wellness is in the …

Implementation Of A Drive-Through Covid-19 Mass Vaccination Site: Experiences From Louvax–Broadbent In Louisville, Kentucky, Ruth Carrico, Sarah Beth Hartlage, Valenchia Brown Msn, Aprn, Fnp-C, Sarah M. Bishop, Luanne Didelot, William Hayden, Beverly Williams Coleman, Sarah Tan, Delanor Manson, Kellie Kane, Dawn Balcom, Paul Kern

The University of Louisville Journal of Respiratory Infections

Background: Response to the COVID-19 pandemic has required innovative approaches to vaccination, including methods to rapidly and safely immunize communities. A major challenge to such a response involved access to untapped healthcare worker resources. The Louisville, Kentucky, response involved the use of a large volunteer workforce to supplement local public health employees in planning and implementing a large-scale drive-through vaccination event. The objective of this manuscript was to outline processes involved in training a mass immunization workforce and implementating a large-scale COVID-19 community vaccination.

Approach: Competency-based and standardized training was provided for every volunteer before working their shift. Volunteers worked …

Feasibility Of A “Network Of Champions” In Implementing A Program To Address Physician Well-Being, Kerri Palamara, Sara Poplau, Cheryl Rusten, Maria L. Walter, Cynthia D. Smith, Clare Sipler, Susan Hingle, Mark Linzer

Journal of Wellness

Introduction: Healthcare leaders have been challenged to mitigate burnout and foster well-being among physicians. Professional societies are beginning to address this in a systematic manner.

Methods: In 2014, the American College of Physicians (ACP) endeavored to improve well-being for its 160,000 members of internists and trainees through a Well-being Champion (WBC) program based in the majority of its 85 national and international chapters. The program was supported by an evidence-based curriculum, chapter volunteers who served as champions, and in-person and virtual trainings. Training included a 1-2 day program in 2018 and 2019, focused on educating champions on causes …

Resident-Led Physical Wellness Initiative Linked To Less Burnout For Emergency Physicians During Covid-19 Pandemic, Camila A. Calderón, Adeola A. Kosoko, Salil K. Bhandari, Jason A. Lesnick, Derek R. Herkes, Ryan M. Huebinger

Journal of Wellness

Introduction: The COVID-19 pandemic has taken a significant toll on societal, physical, and psychological health. Emergency physicians (EPs) are susceptible to burnout under ordinary circumstances and may be particularly vulnerable during the pandemic. To reduce pandemic-related burnout, we implemented a residency-led physical wellness initiative and evaluated the effect on burnout among EPs.

Methods: In the spring of 2020, we invited all resident and attending EPs in our department to participate in a four-week physical wellness initiative as part of a prospective study. After completing or opting out of this wellness initiative, EPs responded to an online survey comprised …

Comparing Medical Student Nonverbal Behavior With Cisgender And Transgender Standardized Patients, Meghan M. Schneider, Emily J. Noonan, Laura Weingartner

The Cardinal Edge

It is essential for medical students to effectively communicate with patients of all gender identities. Evaluating nonverbal behavior is one way to assess the quality of patient care – examining providers’ behaviors while working with cisgender and transgender patients can identify potential biases linked to patient identity. To evaluate nonverbal behavior, the authors analyzed video-recorded training sessions with medical students interviewing standardized patients who identified as cisgender or transgender women. All students identified as cisgender men or cisgender women. The authors rated ten nonverbal behaviors from 1-7 and noted whether these behaviors were perceived to detract from the encounter. Average …

Improvement Cycles In Medical Education: From Quality Improvement To Patient Care And Clinical Research, Julio A. Ramirez

The University of Louisville Journal of Respiratory Infections

No abstract provided.

Reducing “Treble” With Performance Focused Music Programs In Medical School: A Student Driven Needs Assessment To Clarify Participation Barriers Amongst Undergraduate Medical Students, Alexander Tu, Tiffany Truong, Kristy J. Carlson, Matthew J. Brooks, Jayme R. Dowdall

Journal of Wellness

Introduction: The beneficial impact of performing arts involvement within undergraduate medical education, such as music, has been studied, but support for the arts varies significantly by institution. Research has suggested that medical student involvement in the arts can help develop their identities as physicians and may reduce stress and burnout, an increasingly difficult problem within the medical student community.

Methods: We used a mixed-method cross-sectional study design, using a questionnaire and semi-structured interview designed amongst a team of music professionals and healthcare providers with music backgrounds. Out of 511 enrolled medical students, 93 students participated in the study for a …

Medical Schools Ignore The Nature Of Consciousness At Great Cost, Anoop Kumar

Journal of Wellness

The essential question of the relationship between consciousness and matter is ignored in medical school curricula, leading to a machine-like view of the human being that contributes to physician burnout and intellectual dissatisfaction. The evidence suggesting that the brain may not be the seat of consciousness is generally ignored to preserve the worldview of the primacy of matter. By investigating new frameworks detailing the nature of consciousness at different levels of hierarchy, we can bring intellectual rigor to a once opaque subject that supports a fundamental reality about our experience: We are human beings, not only human bodies.

Anxiety And Self-Efficacy Related To Learning Neuroanatomy In An Integrated Medical Curriculum., Jessica S. Bergden

Electronic Theses and Dissertations

Medical student anxiety towards learning neuroanatomy — neurophobia, a key obstacle in medical education, is influencing medical student success and potentially swaying medical students away from neurology careers. This is particularly concerning with condensed neuroanatomy instructional hours from curriculum integration and the concurrent shortage of neurologists, combined with the rising prevalence of neurological disease, and medical students choosing neurological specialties at lower rates. Neuroanatomy education is one factor described in the literature as contributing toneurophobia, yet specific ways in which neuroanatomy education could be improved have not yet been explained. In this present work, we demonstrate four specific domains, namely …

Language Medical Students Use To Comfort Patients Through Difficult Discussions, Zayna H. Qaissi, Emily J. Noonan, Laura A. Weingartner

Undergraduate Arts and Research Showcase

MERA Abstract

Language medical students use to comfort patients through difficult discussions.

AUTHORS

Zayna Qaissi, BA Candidate; Emily J Noonan, PhD, MA; Laura A. Weingartner, PhD, MS

BACKGROUND

Comforting communication supports patient satisfaction. Examining how medical students approach potentially sensitive topics can help educators identify strategies that improve the quality of care. The purpose of this study was to examine verbal approaches that student-physicians use to put patients at ease.

METHODS

Seventy-five medical students were observed in standardized patient encounters. We assessed how students provided comfort by transcribing interview recordings and observing how students addressed the patients’ mental health, sexual …