Medicine and Health Sciences Commons^™

Assessment Of General Surgery Resident Wellness From The Perspectives Of Family, Friends, And Loved Ones, Dana Unninayar, Benjamin Sc Fung, Gordon Best, Isabelle Raiche

Journal of Wellness

Introduction: Surgical trainees have high rates of burnout compared to residents from other specialties. However, burnout is underreported by trainees, limiting potential interventions to improve wellness. Loved ones are an underused resource for assessing wellness and detecting burnout among residents. The purpose of this study is to assess the perceptions and concerns regarding resident wellness and burnout, as well as strategies to improve wellness, from the perspective of loved ones.

Methods: This cross-sectional survey study was conducted in 2022 at an urban academic center after ethics board approval. An anonymous 18-question survey to assess resident burnout, wellness, and …

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 …

Virtual Delivery Of Stress Management And Resiliency Training (Smart) During The Covid-19 Pandemic To Hematology/Oncology Fellows: A Pilot Study, Colt Williams, Sherry Chesak, Deirdre R. Pachman, Ross Dierkhising, Laura Rhee, Konstantinos Leventakos

Journal of Wellness

Introduction: Medical trainees experience a high degree of stress that predisposes them to burnout. This pilot study tested a scalable approach to deliver a validated resilience program (Stress Management and Resiliency Training (SMART)) among Hematology/Oncology fellows at an academic medical center.

Methods: This was a mixed-methods, prospective, single-arm clinical trial involving Hematology/Oncology fellows at Mayo Clinic in Rochester, MN, USA. Four one-hour training sessions were conducted virtually with 26 fellows. Stress, burnout, and emotional resilience were measured at baseline, three months, and six months post-intervention using the Perceived Stress Scale (PSS-10), Maslach Burnout Inventory (MBI-HSS), and Connor-Davidson Resilience …

Exploration Of Burnout, Emotional Thriving, And Emotional Recovery In An Academic Medical Center: A Mixed Methods Quality Improvement Project, Roxana Naderi, Katherine T. Morrison, Zuzanna Czernik, James E. Carter Jr, Katherine N. Dickerman, Alexandra Gallant, Lara Kirkbride-Romeo, Lauren Mcbeth, Angela Keniston, Kristin M. Jensen

Journal of Wellness

Introduction: Healthcare provider burnout, an indicator of wellbeing, impacts patient safety, provider distress, and employee turnover. In this mixed methods, multi-site quality improvement study conductedpandemic, we assessed employee wellbeing in a large clinical department.

Methods: Wellbeing surveys were sent electronically to Department of Medicine clinicians, researchers, administrators, and staff from August-September 2019 assessing perceptions of Burnout, Emotional Thriving (ET), and Emotional Recovery (ER). Qualitative responses were reviewed for themes using mixed inductive-deductive analysis. The initial coding was done by small teams with consensus obtained through large group discussions. This study was IRB-approved as non-human subjects research.

Results: Of the 671 …

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 …

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 …

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 …

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 …

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

Journal of Wellness

No abstract provided.

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.

A Resident Retreat With Emergency Medicine Specific Mindfulness Training Significantly Reduces Burnout And Perceived Stress, James O'Shea, Mark Dannenfelser, Melissa White, Anwar Osborne, Timothy P. Moran, Michelle D. Lall

Journal of Wellness

Introduction: We hypothesize that a resident retreat with mindfulness training tailored for Emergency Medicine (EM) physicians can significantly reduce levels of burnout and perceived stress in EM residents.

Methods: We conducted an intervention study of 60 EM residents undergoing an annual resident retreat with a 2.5-hour mindfulness training. The retreat was a department-funded 2-day off-site experience with a wellness theme. The training was developed and delivered by an EM physician (JO'S) who is a Mindfulness-Based Stress Reduction (MBSR) teacher trainee, and a certified MBSR teacher (MD). The training focused on techniques that can be used on shift, such as mindful …

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 …

Emergency Medicine Shift Factors Causing The Most Stress Among Emergency Medicine Residents, Mohamad Moussa, Kristen Hayden, Chia-Hao Shih, Sadik Khuder, Zayd Safadi, Connor Parsell

Journal of Wellness

Introduction: Past studies demonstrate that stress and anxiety affect emergency medicine physicians, but the causal factors identified are usually from sources outside the work shift. We attempt to show the relationship between intrinsic factors of a work shift and anxiety perceived by residents, while also examining differing gender responses.

Methods: In 2018, a cross-sectional survey of emergency medicine residents in the United States was distributed anonymously through the Emergency Medicine Residents Association. The survey consisted of demographic questions, novel questions identifying intrinsic factors, and the Generalized Anxiety Disorder 7-item (GAD-7) scale. Spearman correlation, independent t-test, and multivariate analysis of variance …

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.

The Complicated Path To Wellness, Jennifer Reese, Martin Huecker

Journal of Wellness

No abstract provided.

Physician Trading Cards As A Tool To Improve Resident Joy In Medicine While Improving Patient Satisfaction, Lindsay Weiss, Mary Edmond, Sarah Varghese, Anthony Cooley

Journal of Wellness

Introduction: To combat resident physician burnout, wellness programming should include approaches that foster joy to work as a physician. Photograph trading cards have been used to improve patient satisfaction but have not been explored as a way to improve physician work satisfaction. We aimed to use trading cards to improve resident physician identification by patients’ families, as well as measure their effect on the hospital experience for patients and residents.

Methods: For a one-month period in 2019, trading cards were piloted with the nine residents assigned to the inpatient pediatrics service. Employing five-point Likert scales, surveys were administered to residents …

Optimizing Wellness In Academic Emergency Medicine, Kristen E. Nordenholz, Al'ai Alvarez, Michelle D. Lall, Christine Stehman, Cindy C. Bitter, Emily L. Hirsh, Rita Manfredi, Rosanna D. Sikora, Dave W. Lu, Leon D. Sanchez, Matthew L. Wong, Steven Bird, Andra L. Blomkalns

Journal of Wellness

Introduction

Academic Emergency Physicians (EPs) face additional unique challenges in optimizing wellness compared to community EPs.

Objective

Our objective was to explore specific individual and systems challenges that academic EPs encounter that affect their wellbeing and professional fulfillment in emergency medicine (EM).

Methods

An expert group of academic EPs convened in 2019 at the annual meeting of the Society of Academic Emergency Medicine to investigate the overall causes of burnout in healthcare providers, the effects of burnout on the healthcare system, specific causes of burnout in EM, and the distinct challenges facing academic emergency physicians.

Results

We outline specific causes …

Promoting Resident Emotional Health Meaningful Connections: An Evaluation Of A Wellness Game, Bruce St. Amour, William B. Dehart

Journal of Wellness

Introduction

Physician wellness is a topic of significant national interest. Physician burnout is at its highest point during residency and is linked to many negative outcomes. The Core Emotional Needs are a useful framework to guide thinking toward wellness in residents: connection and acceptance, healthy autonomy and performance, reasonable limits, and healthy responsibility and standards. We examined the efficacy of a game (“Well, For Me…”) designed to improve social connection and acceptance among residents to reduce social isolation. We hypothesized that this activity would be viewed positively by the residents as an intervention to improve resident wellness.

Methods

Participants …

Factor Structure And Measurement Invariance Of The Maslach Burnout Inventory In Emergency Medicine Residents, Tim P. Moran, Nicole Battaglioli, Simiao Li-Sauerwine

Journal of Wellness

Introduction: Emergency medicine residents suffer from high rates of occupational burnout. Recent research has focused on identifying risk and protective factors for burnout as well as targets for intervention. This research has primarily employed the Maslach Burnout Inventory to evaluate burnout in this population. Factor analytic work has identified three underlying factors measured by the Maslach Burnout Inventory: Emotional Exhaustion, Depersonalization, and Personal Accomplishment. However, this three-factor structure has not been evaluated in emergency medicine residents. Furthermore, its structural equivalence has not been demonstrated across commonly-studied risk factors, such as gender and year of post-graduate training. In the present study, …

Perspective: Responding To The Well-Being Of Health Care Workers And Learners In Academic Medicine During The Covid-19 Pandemic, Cherie C. Hill, Paula G. Gomes, Alayna H. Feng, Cricket C. Gullickson, Carla I. Haack, Sheryl L. Heron

Journal of Wellness

No abstract provided.

Burnout Among Emergency Physicians Working At A Large Tertiary Centre In Ontario, Rushika Perera, Kristine Van Aarsen, Laura Foxcroft, Rodrick Lim

Journal of Wellness

BACKGROUND: Emergency medicine (EM) is a high-stress specialty. Work related stress and burnout have been reported to negatively impact physician-patient interactions, overall physician mental and physical health, and most importantly, patient outcomes. We assessed the rates of burnout among emergency physicians (EPs) at our centre.

METHODS: A local cross-sectional study to assess burnout among adult and pediatric EPs, fellows and residents was conducted at three Emergency Departments (EDs) at a single institution in Canada. The anonymous online survey encompassed demographics, the validated MBI tool (Maslach Burnout Inventory) and additional questions aimed at identifying determinants of EP burnout. Each respondent’s three …

They Shouldn't Get To Hurt You, Diann M. Krywko

Journal of Wellness

No abstract provided.

The Make ‘Em Well Project -Rewards And Recognition Phase, Diann M. Krywko

Journal of Wellness

The Make ‘EM Well Project- Rewards and Recognition

Background: Physicians report high burnout levels and difficulty finding joy in work, causing a healthcare system crisis. Our institution assessed burnout by administering the Areas of Work-life (AWS) and Maslach Burnout Inventory™ (MBI) Surveys. Emergency Medicine (EM) results were alarming. Effectively rewarding and recognizing employees requires understanding different appreciation languages. Administrators should understand what enhances and detracts from joy in the workplace. This study describes the “Make ‘EM Well Project” and its focus on Rewards and Recognition (RR).

Methods: Two surveys were sent to EM providers including faculty, residents, fellows, and advanced …