Well-Being in Graduate Medical Education

Children between the ages of 5 and 18 spend a significant amount of their time in school. School health is a vital part of pediatric practice and an important concern for pediatric graduate medical education. There are few substantiated data, however, to suggest that residents entering pediatric practice or academic medicine are exposed to school health in a significant way. Many pediatricians, upon entering practice, find that they are consulted by school systems and parents whose children have problems related to school. Pediatricians find themselves unprepared for this new role and express the need for postgraduate education in school health.1-4 The American Academy of Pediatrics Task Force on Pediatric Education5 and the most recent report from the Pediatric Residency Review Committee have both underscored the appropriateness and importance of education in school health as an important part of the residency curriculum.6 The American Academy of Pediatrics believes that education in school health should be an important part of graduate medical education for pediatric residents and of continuing medical education for practicing pediatricians. Many advances in pediatrics that affect the well-being of the child relate directly to the school setting. Increased attention to federal legislation (Section 504 of PL 93-112, the Rehabilitation Act of 1973; parts B and H of PL 102-119, the Individuals with Disabilities Education Act), health education including education about the prevention of drug and alcohol abuse and acquired immunodeficiency syndrome, new approaches to screening and health services in the schools, immunization requirements, physical fitness, and knowledge about the school environment—all are important aspects of school health and areas in which many residents and/or pediatricians have had little or no training or experience.

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Graduate Medical Education on the Frontlines during the COVID-19 Pandemic in New York City- A Response to Promote Well-being

Journal of Wellness ◽

10.18297/jwellness/vol3/iss2/9 ◽

2021 ◽

Vol 3 (2) ◽

Keyword(s):

Mental Health ◽

Health Care ◽

Medical Education ◽

Graduate Medical Education ◽

Health Program ◽

Mental Health Program ◽

Well Being ◽

The United States ◽

Personal Factors ◽

Graduate Medical

Introduction: The COVID-19 pandemic has driven many health care institutions in the United States beyond their capacity. Physicians-in-training in graduate medical education programs have suffered the strain of providing patient care during this unprecedented time of crisis. The significant prevalence of pre-existing resident and fellow burnout and depression makes the need for action by institutions to support the well-being of residents and fellows even more urgent. We aim to describe innovative adaptations our Office of Graduate Medical Education implemented with the support of institutional leadership as responses to promote the well-being of residents and fellows on the frontlines during the COVID-19 pandemic. Methods: The Office of Graduate Medical Education (GME), in collaboration with the Office of Well-being and Resilience, developed a set of resources and interventions to support trainees during the pandemic based on four major categories: workplace culture, personal factors and health, mental health support, and workplace efficiency and function. Examination of the capacity of existing services and gaps that needed to be filled in the rapidly evolving early days of the COVID pandemic led to a robust growth in resources. For example, the already established Student and Trainee Mental Health program was able to expand and adapt its role to serve trainee needs more effectively. Results: We expanded resources to target trainee well-being across a broad array of domains within a short time frame. With investment in access to the Student and Trainee Mental Health program, utilization increased by 25.7%, with 1,231 more visits in 2020 compared to the number of visits in 2019, prior to the COVID-19 pandemic. The creation of Recharge Rooms had a positive impact on the well-being of health care workers. After a single fifteen-minute experience in the Recharge Room, an average 59.6% reduction in self-reported stress levels was noted by users. Other interventions were noted to be helpful in regular town hall meetings with trainees. Conclusion: Addressing trainee well-being is an essential aspect of a crisis response. The Mount Sinai Health System was able to care for the physical, mental, psychosocial, and safety needs of our trainees thanks to the collaborative effort of a pre-existing institutional well-being program and the GME Office. The ability to implement such a response was enabled by our well-being foundation, which allowed leadership at the highest institutional level and the Office of GME to provide support in response to this unprecedented crisis.

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Perfect Compliance: The 2018 Accreditation Council for Graduate Medical Education Well-Being Survey

Annals of Internal Medicine ◽

10.7326/m18-2302 ◽

2019 ◽

Vol 170 (4) ◽

pp. 257 ◽

Cited By ~ 1

Author(s):

Christina M. Yuan

Keyword(s):

Medical Education ◽

Graduate Medical Education ◽

Well Being ◽

Accreditation Council ◽

Graduate Medical

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Integrative Medicine in Residency Education: Developing Competency Through Online Curriculum Training

Journal of Graduate Medical Education ◽

10.4300/jgme-04-01-30 ◽

2012 ◽

Vol 4 (1) ◽

pp. 76-82 ◽

Cited By ~ 35

Author(s):

Patricia Lebensohn ◽

Benjamin Kligler ◽

Sally Dodds ◽

Craig Schneider ◽

Selma Sroka ◽

...

Keyword(s):

Medical Education ◽

Online Education ◽

Graduate Medical Education ◽

Integrative Medicine ◽

Medical Knowledge ◽

Well Being ◽

High Rate ◽

Complementary Alternative Medicine ◽

Graduate Medical ◽

Behavioral Assessments

Abstract Introduction The Integrative Medicine in Residency (IMR) program, a 200-hour Internet-based, collaborative educational initiative was implemented in 8 family medicine residency programs and has shown a potential to serve as a national model for incorporating training in integrative/complementary/alternative medicine in graduate medical education. Intervention The curriculum content was designed based on a needs assessment and a set of competencies for graduate medical education developed following the Accreditation Council for Graduate Medical Education outcome project guidelines. The content was delivered through distributed online learning and included onsite activities. A modular format allowed for a flexible implementation in different residency settings. Evaluation To assess the feasibility of implementing the curriculum, a multimodal evaluation was utilized, including: (1) residents' evaluation of the curriculum; (2) residents' competencies evaluation through medical knowledge testing, self-assessment, direct observations, and reflections; and (3) residents' wellness and well-being through behavioral assessments. Results The class of 2011 (n = 61) had a high rate of curriculum completion in the first and second year (98.7% and 84.2%) and course evaluations on meeting objectives, clinical utility, and functioning of the technology were highly rated. There was a statistically significant improvement in medical knowledge test scores for questions aligned with content for both the PGY-1 and PGY-2 courses. Conclusions The IMR program is an advance in the national effort to make training in integrative medicine available to physicians on a broad scale and is a success in terms of online education. Evaluation suggests that this program is feasible for implementation and acceptable to residents despite the many pressures of residency.

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The Impact of Coronavirus Disease 2019 (COVID-19) on Graduate Medical Education (GME): An Exploration of Behavioral Health Aspects

10.5772/intechopen.96764 ◽

2021 ◽

Author(s):

Jordan C. Holter ◽

Christine Marchionni ◽

James A. James III

Keyword(s):

United States ◽

Medical Education ◽

Behavioral Health ◽

Graduate Medical Education ◽

Well Being ◽

The United States ◽

Medical Community ◽

Physician Burnout ◽

Graduate Medical ◽

Policies And Procedures

The Coronavirus Disease 2019, regularly referred to as “COVID-19”, has had an unprecedented impact on not only the state of graduate medical education (GME) for post-doctoral trainees, but also their well-being and welfare. Trainees comprise approximately 14% of physicians in the United States. This crucial portion of personnel in healthcare has irrefutably represented the resilience that personifies the medical community. The prevalence of physical and emotional exertion by these trainees, necessitated by the pandemic, has precipitated behavioral health ailments like mood disorders including depression and anxiety, diminished satisfaction in their corresponding specialties and impaired their ability to achieve balance between professional and personal responsibilities. This excerpt examines the pervasiveness of the adverse psychosocial implications the COVID-19 pandemic has had on this susceptible practitioner population in addition to the examination of physical and emotional exhaustion that exacerbate physician burnout including the implementation of policies and procedures to address the emergent problem of physician burnout throughout the COVID-19 pandemic by the GME. Also, this excerpt examines the adaptation of GME, including the reformation and implementation of innovative policies and procedures that has incontestably created an imprint on medical education for descendants of ACGME residency and fellowship programs in the United States.

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The genealogy of teaching clinical reasoning and diagnostic skill: the GEL Study

Diagnosis ◽

10.1515/dx-2019-0107 ◽

2020 ◽

Vol 7 (3) ◽

pp. 197-203 ◽

Cited By ~ 2

Author(s):

Stephen W. Russell ◽

Sanjay V. Desai ◽

Paul O’Rourke ◽

Neera Ahuja ◽

Anand Patel ◽

...

Keyword(s):

Medical Education ◽

Graduate Medical Education ◽

Medical Training ◽

Clinical Skill ◽

Well Being ◽

Training Environment ◽

Graduate Medical ◽

Diagnostic Skills ◽

Professional Fulfillment ◽

Diagnostic Skill

AbstractThe genealogy of graduate medical education in America begins at the bedside. However, today’s graduate medical trainees work in a training environment that is vastly different from medical training a century ago. The goal of the Graduate Medical Education Laboratory (GEL) Study, supported by the American Medical Association’s (AMA) “Reimagining Residency” initiative, is to determine the factors in the training environment that most contribute to resident well-being and developing diagnostic skills. We believe that increasing time at the bedside will improve clinical skill, increase professional fulfillment, and reduce workplace burnout. Our graduate medical education laboratory will test these ideas to understand which interventions can be shared among all training programs. Through the GEL Study, we aim to ensure resident readiness for practice as we understand, then optimize, the learning environment for trainees and staff.

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Well-being in Residency: Impact of an Online Physician Well-being Course on Resiliency and Burnout in Incoming Residents

Family Medicine ◽

10.22454/fammed.2021.314886 ◽

2021 ◽

Vol 53 (2) ◽

pp. 123-128

Author(s):

Mari Ricker ◽

Audrey J. Brooks ◽

Sarah Bodine ◽

Patricia Lebensohn ◽

Victoria Maizes

Keyword(s):

Medical Education ◽

Graduate Medical Education ◽

Emotional Exhaustion ◽

Well Being ◽

Personal Accomplishment ◽

Graduate Medical ◽

Resident Wellness ◽

Mindfulness Practices ◽

Wellness Behavior ◽

Managing Stress

Background and Objectives: Wellness in residency has come to the forefront of national graduate medical education initiatives. Exponential growth in knowledge and skill development occurs under immense pressures, with physical, mental, and emotional stressors putting residents at burnout risk. The Accreditation Council for Graduate Medical Education requires programs to attend to resident wellness, providing the structure, environment, and resources to address burnout. This study’s purpose was to evaluate the Andrew Weil Center for Integrative Medicine online Physician Well-being Course (PWC) with incoming postgraduate year-1 (PGY-1) residents in multiple residencies across a single health care system. The PWC teaches the learner strategies for building resilience, managing stress, identifying signs of burnout, and mindfulness practices including a self-selected daily 10-minute resiliency activity (meditation, gratitude journaling, and finding meaning journaling) for 14 days. Methods: Incoming PGY-1 residents were enrolled in PWC 1 month prior to 2018 orientation. Validated measures of resiliency, burnout and gratitude were completed pre- and postcourse. We assessed pre/postcourse changes with paired t tests. We asked participants whether they incorporated any wellness behavior changes postcourse. Results: Almost two-thirds of the incoming trainees completed the course (n=53/87, 61%). We found significant improvements (P<.05) for resiliency and burnout (emotional exhaustion, depersonalization). Gratitude did not change. The personal accomplishment burnout scale declined. The most frequently reported wellness behaviors were in the area of sleep, exercise, and diet. Conclusions: Resiliency, emotional exhaustion, and depersonalization improved, personal accomplishment declined, while gratitude remained the same. This project demonstrates an accessible and scalable approach to teaching well-being to incoming residents.

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