scholarly journals Two Novel Approaches to Improve Otolaryngology Resident Wellness: The ACGME Back to Bedside Initiative

2018 ◽  
Vol 158 (6) ◽  
pp. 979-980 ◽  
Author(s):  
Emily C. Ambrose ◽  
Jenna Devare ◽  
Carl M. Truesdale ◽  
Ellen Ricker ◽  
Janice Firn ◽  
...  

Rates of burnout, mental illness, and suicide are disproportionately elevated among physicians, and surgical specialists, including otolaryngologists, are at even higher risk for professional burnout. These trends have been identified at both the trainee and attending level. To combat resident burnout, the Accreditation Council for Graduate Medical Education (ACGME) Council of Review Committee Residents (CRCR) designed the Back to Bedside Initiative, the goals of which are to foster meaning in the learning environment and to help trainees to engage more deeply with patients. Two funded Back to Bedside proposals involve otolaryngology training programs. Herein, we discuss these 2 approaches in an effort to foster additional novel resident wellness initiatives and awareness thereof across our subspecialty.

2015 ◽  
Vol 7 (1) ◽  
pp. 143-147 ◽  
Author(s):  
Timothy J. Daskivich ◽  
Dinchen A. Jardine ◽  
Jennifer Tseng ◽  
Ricardo Correa ◽  
Brian C. Stagg ◽  
...  

Abstract Background Physicians in training are at high risk for depression, and physicians in practice have a substantially elevated risk of suicide compared to the general population. The graduate medical education community is currently mobilizing efforts to improve resident wellness. Objective We sought to provide a trainee perspective on current resources to support resident wellness and resources that need to be developed to ensure an optimal learning environment. Methods The ACGME Council of Review Committee Residents, a 29-member multispecialty group of residents and fellows, conducted an appreciative inquiry exercise to (1) identify existing resources to address resident wellness; (2) envision the ideal learning environment to promote wellness; and (3) determine how the existing infrastructure could be modified to approach the ideal. The information was aggregated to identify consensus themes from group discussion. Results National policy on resident wellness should (1) increase awareness of the stress of residency and destigmatize depression in trainees; (2) develop systems to identify and treat depression in trainees in a confidential way to reduce barriers to accessing help; (3) enhance mentoring by senior peers and faculty; (4) promote a supportive culture; and (5) encourage additional study of the problem to deepen our understanding of the issue. Conclusions A multispecialty, national panel of trainees identified actionable goals to broaden efforts in programs and sponsoring institutions to promote resident wellness and mental health awareness. Engagement of all stakeholders within the graduate medical education community will be critical to developing a comprehensive solution to this important issue.


2021 ◽  
pp. 014556132110091
Author(s):  
Joseph R. Acevedo ◽  
Jamie A. Schlacter ◽  
Tamara N. Chambers ◽  
Lia K. Jacobson ◽  
Ronica Yalamanchili ◽  
...  

Objective: Investigate the effect of a targeted wellness program on burnout in Otolaryngology residents. Methods: Residents and faculty collaboratively developed a program aimed at improving resident wellness. Program implementation began in July of 2018 and after 1 year, residents evaluated the program’s effects on burnout. We used the Maslach Burnout Inventory (MBI) and a Likert scale to evaluate the effects of the program. Results: After 1 year of the resident wellness program, the MBI results showed an increase in the number of residents in the “engaged” category and a decrease in those rated as “burnout.” Residents rated favorably initiatives grouped into the following themes: time away from work, faculty engaging with residents outside of the hospital environment, efforts to enhance residents’ self-efficacy, fostering a positive culture among residents, and providing easy access to physical activity. The majority of initiatives were targeted to the “culture of wellness” domain, as defined by the Stanford Well MD framework. Our program targeted to a lesser extent the other 2 domains, “efficiency of practice” and “personal resilience.” Conclusion: After 1 year, the wellness program resulted in a trend toward improving burnout. Future efforts should be focused on targeting the multidimensional drivers of burnout as defined by established wellness frameworks. Realizing new stressors brought on by the COVID-19 pandemic will also be an area of active effort and research.


2007 ◽  
Vol 30 (4) ◽  
pp. 63 ◽  
Author(s):  
S. Edwards ◽  
S. Verma ◽  
R. Zulla

Prevalence of stress-related mental health problems in residents is equal to, or greater than, the general population. Medical training has been identified as the most significant negative influence on resident mental health. At the same time, residents possess inadequate stress management and general wellness skills and poor help-seeking behaviours. Unique barriers prevent residents from self-identifying and seeking assistance. Stress management programs in medical education have been shown to decrease subjective distress and increase wellness and coping skills. The University of Toronto operates the largest postgraduate medical training program in the country. The Director of Resident Wellness position was created in the Postgraduate Medical Education Office to develop a systemic approach to resident wellness that facilitates early detection and intervention of significant stress related problems and promote professionalism. Phase One of this new initiative has been to highlight its presence to residents and program directors by speaking to resident wellness issues at educational events. Resources on stress management, professional services, mental health, and financial management have been identified and posted on the postgraduate medical education website and circulated to program directors. Partnerships have been established with physician health professionals, the University of Toronto, and the Professional Association of Residents and Internes of Ontario. Research opportunities for determining prevalence and effective management strategies for stress related problems are being identified and ultimately programs/resources will be implemented to ensure that resident have readily accessible resources. The establishment of a Resident Wellness Strategy from its embryonic stags and the challenges faced are presented as a template for implementing similar programs at other medical schools. Earle L, Kelly L. Coping Strategies, Depression and Anxiety among Ontario Family Medicine Residents. Canadian Family Physician 2005; 51:242-3. Cohen J, Patten S. Well-being in residency training: a survey examining resident physician satisfaction both within and outside of residency training and mental health in Alberta. BMC Medical Education; 5(21). Levey RE. Sources of stress for residents and recommendations for programs to assist them. Academic Med 2001; 70(2):142-150.


2007 ◽  
Vol 30 (4) ◽  
pp. 56
Author(s):  
I. Rigby ◽  
I. Walker ◽  
T. Donnon ◽  
D. Howes ◽  
J. Lord

We sought to assess the impact of procedural skills simulation training on residents’ competence in performing critical resuscitation skills. Our study was a prospective, cross-sectional study of residents from three residency training programs (Family Medicine, Emergency Medicine and Internal Medicine) at the University of Calgary. Participants completed a survey measuring competence in the performance of the procedural skills required to manage hemodynamic instability. The study intervention was an 8 hour simulation based training program focused on resuscitation procedure psychomotor skill acquisition. Competence was criterion validated at the Right Internal Jugular Central Venous Catheter Insertion station by an expert observer using a standardized checklist (Observed Structured Clinical Examination (OSCE) format). At the completion of the simulation course participants repeated the self-assessment survey. Descriptive Statistics, Cronbach’s alpha, Pearson’s correlation coefficient and Paired Sample t-test statistical tools were applied to the analyze the data. Thirty-five of 37 residents (9 FRCPC Emergency Medicine, 4 CCFP-Emergency Medicine, 17 CCFP, and 5 Internal Medicine) completed both survey instruments and the eight hour course. Seventy-two percent of participants were PGY-1 or 2. Mean age was 30.7 years of age. Cronbach’s alpha for the survey instrument was 0.944. Pearson’s Correlation Coefficient was 0.69 (p < 0.001) for relationship between Expert Assessment and Self-Assessment. The mean improvement in competence score pre- to post-intervention was 6.77 (p < 0.01, 95% CI 5.23-8.32). Residents from a variety of training programs (Internal Medicine, Emergency Medicine and Family Medicine) demonstrated a statistically significant improvement in competence with critical resuscitation procedural skills following an intensive simulation based training program. Self-assessment of competence was validated using correlation data based on expert assessments. Dawson S. Procedural simulation: a primer. J Vasc Interv Radiol. 2006; 17(2.1):205-13. Vozenilek J, Huff JS, Reznek M, Gordon JA. See one, do one, teach one: advanced technology in medical education. Acad Emerg Med. 2004; 11(11):1149-54. Ziv A, Wolpe PR, Small SD, Glick S. Simulation-based medical education: an ethical imperative. Acad Med. 2003; 78(8):783-8.


BJPsych Open ◽  
2021 ◽  
Vol 7 (S1) ◽  
pp. S125-S125
Author(s):  
Debakanta Behera ◽  
Ji Yen Ku

AimsThird year Medical students from the International Medical University, Malaysia were assessed regarding their commonly held attitudes and beliefs for the mental illness in general as well as with respect to psychiatry as a faculty through a survey monkey based survey,BackgroundCommonly held perceptions and prejudices often can be overcame by education and early exposure to facts which also holds true with medical students and their attitude as well as expectations to psychiatry. Ever growing awareness regarding the Mental illness has helped but is unable to complete address the stigma and prejudices associated with it. Also Early exposure to psychiatry in medical education can provide a positive experience to medical students including germinating an interest in psychiatry as a career choice among the students.Method42 students of 3rd and 4th year medical school from International Medical University, Malaysia, some without any exposure to psychiatry, were participated in a survey created on a cloud based online survey link and responded to a questionnaire about the attitude and belief towards mental Illness as well as Psychiatry as a career choice. The results were analysed and data interpreted.ResultMost students (85%) though agreed that psychiatry is a rapidly expanding frontier of medicine sadly only 20% stated that it would be one of the top three career choice. Just under the 50% of the students stated that the psychiatric patients are more likely to harm others. About 95% felt that psychiatric consultations of patients with medical and surgical health problems would be helpful and 90% students shared that they would not feel embarrassed about someone from their family if diagnosed with mental illness.ConclusionPsychiatric exposure in medical education has been recognised as inadequate in general and often exposing medical students to psychiatry early helps improving the stigma and prejudices associated with mental illness. It will also give them sufficient exposure to assess the illness holistically keeping mental health in mind while treating physically ill people and also may inspire them to choose psychiatry as a career choice in a rapidly developing and conservative country such as Malaysia where mental health services are largely inadequate and is the second biggest health issue.


PEDIATRICS ◽  
2000 ◽  
Vol 105 (Supplement_3) ◽  
pp. 984-988
Author(s):  
Joel J. Alpert ◽  
Suzette M. Levenson ◽  
Cindy J. Osman ◽  
Sabin James

Objective. Many organizations make efforts to identify future pediatric leaders, often focusing on chief residents (CRs). Identifying future leaders is an issue of great importance not only to the ultimate success of the organization but also to the profession. Because little is known regarding whether completing a CR predicts future leadership in medicine, we sought to determine if former pediatric CRs when compared with pediatric residents who were not CRs reported more often that they were leaders in their profession. Design/Methods. Twenty-four pediatric training programs stratified by resident size (&lt;18, 18–36, and &gt;36) and geography (East, South, Midwest, and West) were selected randomly from the Graduate Medical Education Directory(American Medical Association, Chicago, IL). Program directors were contacted by mail and telephone and asked to provide their housestaff rosters from 1965–1985. The resulting resident sample was surveyed by questionnaire in 1995. Results. Fifteen of 17 program directors (88%) who possessed the requested data provided 1965–1985 rosters yielding a sample of 963 residents. Fifty-five percent of the resident sample (533) responded. Fifty-eight of the respondents had not completed a pediatric residency, leaving a survey sample of 475. Thirty-four percent (163) were CRs. The sample had a mean age of 47, 67% were male and 87% married. Fellowships were completed by 51%. More former CRs compared with non-CRs (75% vs 64%), more former fellows than non-fellows (75% vs 60%) and more males than females (74% vs 55%) reported they were professional leaders. These associations persisted in a logistic regression that controlled for CR status, gender, marital status, and fellowship status as leadership predictors. Former CRs, former fellows, and men were, respectively, 1.8, 2.3, and 2.3 times more likely to report professional leadership. Conclusions. Pediatric residents who were former CRs and/or fellows, and males were more likely to report professional leadership. Although men were more likely to report professional leadership, with more women entering pediatrics the reported gender differences will likely disappear over time.


Author(s):  
Tiffany A. Koszalka ◽  
Bradley Olson

A major issue facing medical education training programs across the USA is the recent advent of universal mandatory duty hour limitations and the time pressure it places on formal face-to-face educational sessions. In response to these mandates and associated issues many medical education programs are exploring the use of online instruction to address issues of accessibility. This chapter describes the instructional development process followed to transform a classroom-based pediatrics residency lecture series into an on-demand, video-enhanced, online instructional environment. An overview of the learning principles and instructional sciences that guided the design process is provided. The phases of the designed solution are then described in the context of enhancing the lecture series as it was transformed into online instruction. Implementation logistics are described followed by an overview of the benefits, barriers, and initial project outcomes. Plans for future enhancements and research projects are also discussed.


2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Paul L. P. Brand ◽  
H. Jeroen Rosingh ◽  
Maarten A. C. Meijssen ◽  
Ingrid M. Nijholt ◽  
Saskia Dünnwald ◽  
...  

Abstract Background Even in anonymous evaluations of a postgraduate medical education (PGME) program, residents may be reluctant to provide an honest evaluation of their PGME program, because they fear embarrassment or repercussions from their supervisors if their anonymity as a respondent is endangered. This study was set up to test the hypothesis that current residents in a PGME program provide more positive evaluations of their PGME program than residents having completed it. We therefore compared PGME learning environment evaluations of current residents in the program to leaving residents having completed it. Methods This observational study used data gathered routinely in the quality cycle of PGME programs at two Dutch teaching hospitals to test our hypothesis. At both hospitals, all current PGME residents are requested to complete the Scan of Postgraduate Education Environment Domains (SPEED) annually. Residents leaving the hospital after completion of the PGME program are also asked to complete the SPEED after an exit interview with the hospital’s independent residency coordinator. All SPEED evaluations are collected and analysed anonymously. We compared the residents’ grades (on a continuous scale ranging from 0 (poor) to 10 (excellent)) on the three SPEED domains (content, atmosphere, and organization of the program) and their mean (overall department grade) between current and leaving residents. Results Mean (SD) overall SPEED department grades were 8.00 (0.52) for 287 current residents in 39 PGME programs and 8.07 (0.48) for 170 leaving residents in 39 programs. Neither the overall SPEED department grades (t test, p = 0.53, 95% CI for difference − 0.16 to 0.31) nor the department SPEED domain grades (MANOVA, F(3, 62) = 0.79, p = 0.51) were significantly different between current and leaving residents. Conclusions Residents leaving the program did not provide more critical evaluations of their PGME learning environment than current residents in the program. This suggests that current residents’ evaluations of their postgraduate learning environment were not affected by social desirability bias or fear of repercussions from faculty.


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