Document Type : Original Article
Authors
- . Amy J. Sheer
- . Irene M. Estores
- . Rachel Nickels 1
- . Nila Radhakrishnan 2
- . Dianne L. Goede
- . Lazarus K. Mramba 3
- . Margaret C. Lo
1 Department of Medicine, Hospital Staff Physician, Malcolm Randal Veteran Affairs Medical Center, FL, USA
2 Department of Medicine, Division of Hospital Medicine, University of Florida College of Medicine, Gainesville, FL, USA
3 Department of Biostatistics and Data Science, University of Kansas Medical Center, Kansas City, Kansas, USA
Abstract
BACKGROUND: With growing resident burnout, Accreditation Council for Graduate Medical
Education issued new requirements for program interventions to optimize resident well‑being. Little
evidence exists on how to best teach resiliency to residents. This study assesses the impact of
both a grassroots intervention and formal resiliency curriculum on resident burnout and well‑being.
MATERIALS AND METHODS: From November 2016 to August 2017, residents in a large Internal
Medicine Residency Program participated in grassroots wellness interventions from the resident‑led
Gator Council in Gainesville, FL USA. From August 2017 to June 2018, residents participated in
a formal program‑driven resiliency curriculum. Wellness interventions included monthly morning
reports, bimonthly workshops, and biannual noon conferences. Pre‑ and postintervention Maslach
Burnout Inventory (MBI) and Physician Well‑Being Index (PWBI) assessed the effect of both
interventions on resident burnout and well‑being. Statistical analyses used Student’s t‑test, Fisher’s
exact tests, and linear regression model.
RESULTS: One hundred and twenty‑two residents participated in grassroots interventions. One
hundred and seventeen (87 residents, 35 students) participated in formal curriculum. Mean MBI
scores for all three sections did not differ between pre ‑and postgrassroots intervention (emotional
exhaustion [EE] P = 0.46; depersonalization [DP] P = 0.43; personal accomplishment [PA] P = 0.73])
or between pre‑ and postcurriculum (EE P = 0.20; DP P = 0.40; PA P = 0.51). Students scored
higher burnout levels compared to residents in EE (P = 0.001) and PA (P = 0.02). Pre‑ versus
postcurriculum PWBI scores did not differ among residents (P = 0.20), while PWBI scores improved
among students (P = 0.01).
CONCLUSIONS: This study found no improvement in resident burnout or well‑being from a
bottom‑up and top‑down approach. Our results imply the need for an early wellness curriculum
to improve student well‑being given their higher level of burnout. System‑wide efforts are vital to
combat physician burnout.
Keywords
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