Grit Does Not Predict Burnout among First-Year Internal Medicine Residents

Abstract Objectives We implemented a curriculum using self-directed learning plans (SDLPs) based on clinical questions arising from the residents' practice, and we report on perceptions and attitudes from residents in internal medicine regarding the use of SDLPs conceived at point of care. Methods Internal medicine residents at a single community hospital in the Midwest were surveyed in 2006 regarding SDLPs. We report their perceived effectiveness in identifying knowledge gaps, the processes used to fill those gaps, and the resident outcomes using descriptive statistics. Results A total of 26 out of 37 residents (70%) responded. Most (24 of 26; 92%) perceived SDLPs helped them to identify and fill knowledge gaps and that their skills in framing questions (23 of 26; 88%), identifying resources (21 of 26; 81%), and critically appraising the evidence (20 of 26; 77%) improved through regular use. They also felt these plans led to a meaningful change in their practice or provided further direction for learning (17 of 26; 65%). Most (21 of 26; 81%) reported their intent to include point-of-care learning in their continuing education after residency. We found no significant differences in the responses of first-year compared with second- or third-year residents. Conclusions Questions arising during patient care are strong motivators for physician self-directed learning. The residents' responses indicated that they accepted the SDLPs and intend to use them in practice. Embedding the discussion of the SDLPs in preclinic conferences has ensured sustainability during the past 5 years and has enabled us to demonstrate teaching of practice-based learning and improvement.

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The Effect of Burnout on Medical Errors and Professionalism in First-Year Internal Medicine Residents

Journal of Graduate Medical Education ◽

10.4300/jgme-d-15-00457.1 ◽

2016 ◽

Vol 8 (4) ◽

pp. 597-600 ◽

Cited By ~ 15

Author(s):

Jason Kwah ◽

Jennifer Weintraub ◽

Robert Fallar ◽

Jonathan Ripp

Keyword(s):

Internal Medicine ◽

Emotional Exhaustion ◽

Medical Errors ◽

Maslach Burnout Inventory ◽

Personal Accomplishment ◽

First Year ◽

Medication Prescription ◽

Internal Medicine Residents ◽

Laboratory Test Results ◽

Discharge Summaries

ABSTRACT Background Burnout is a common issue in internal medicine residents, and its impact on medical errors and professionalism is an important subject of investigation. Objective To evaluate differences in medical errors and professionalism in internal medicine residents with and without burnout. Methods A single institution observational cohort study was conducted between June 2011 and July 2012. Burnout was measured using the Maslach Burnout Inventory to generate subscores for the following 3 domains: emotional exhaustion, depersonalization, and sense of personal accomplishment. By convention, burnout was defined as a high emotional exhaustion or depersonalization subscore. Medication prescription error rate was the chosen measure of medical errors. Professionalism was measured cumulatively through examining discharge summaries completed within 48 hours, outpatient charts completed within 72 hours, and the average time to review outpatient laboratory tests. Results Of a total of 54 eligible first-year residents, 53 (98%) and 32 (59%) completed the initial and follow-up surveys, respectively. Residents with year-end burnout had a lower rate of medication prescription errors (0.553 versus 0.780, P = .007). Discharge summaries completed within 48 hours of discharge (83.8% versus 84.0%, P = .93), outpatient charts completed within 72 hours of encounter (93.7% versus 94.3%, P = .31), and time (minutes) to review outpatient laboratory test results (72.3 versus 26.9, P = .28) were similar between residents with and without year-end burnout. Conclusions This study found a small decrease in medical errors in residents with year-end burnout compared to burnout-free residents and no difference in selected measures of professionalism.

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The Relationship Between Communication Scores From the USMLE Step 2 Clinical Skills Examination and Communication Ratings for First-Year Internal Medicine Residents

Academic Medicine ◽

10.1097/acm.0b013e31828b2df1 ◽

2013 ◽

Vol 88 (5) ◽

pp. 693-698 ◽

Cited By ~ 16

Author(s):

Marcia L. Winward ◽

Rebecca S. Lipner ◽

Mary M. Johnston ◽

Monica M. Cuddy ◽

Brian E. Clauser

Keyword(s):

Internal Medicine ◽

Clinical Skills ◽

First Year ◽

Internal Medicine Residents ◽

Usmle Step ◽

The Relationship

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The Incidence and Predictors of Job Burnout in First-Year Internal Medicine Residents: A Five-Institution Study

Academic Medicine ◽

10.1097/acm.0b013e31822c1236 ◽

2011 ◽

Vol 86 (10) ◽

pp. 1304-1310 ◽

Cited By ~ 68

Author(s):

Jonathan Ripp ◽

Mark Babyatsky ◽

Robert Fallar ◽

Hasan Bazari ◽

Lisa Bellini ◽

...

Keyword(s):

Internal Medicine ◽

Job Burnout ◽

First Year ◽

Internal Medicine Residents

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Assessment of Inpatient Time Allocation Among First-Year Internal Medicine Residents Using Time-Motion Observations

JAMA Internal Medicine ◽

10.1001/jamainternmed.2019.0095 ◽

2019 ◽

Vol 179 (6) ◽

pp. 760 ◽

Cited By ~ 19

Author(s):

Krisda H. Chaiyachati ◽

Judy A. Shea ◽

David A. Asch ◽

Manqing Liu ◽

Lisa M. Bellini ◽

...

Keyword(s):

Internal Medicine ◽

Time Allocation ◽

First Year ◽

Time Motion ◽

Internal Medicine Residents

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Reliability of focused cardiac ultrasound performed by first-year internal medicine residents at a community hospital after a short training

Journal of Community Hospital Internal Medicine Perspectives ◽

10.1080/20009666.2019.1659666 ◽

2019 ◽

Vol 9 (5) ◽

pp. 373-376

Author(s):

Sireesha Upadhrasta ◽

Mohamed Hussien Raafat ◽

Ricardo A.S. Conti

Keyword(s):

Internal Medicine ◽

Community Hospital ◽

First Year ◽

Cardiac Ultrasound ◽

Focused Cardiac Ultrasound ◽

Internal Medicine Residents

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First year internal medicine residents’ self-report point-of-care ultrasound knowledge and skills: what (Little) difference three years make

BMC Medical Education ◽

10.1186/s12909-021-02915-1 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Tanner Chahley ◽

Ada W Lam ◽

Samantha Halman ◽

Kathryn Watson ◽

Irene WY Ma

Keyword(s):

Internal Medicine ◽

Point Of Care ◽

Internal Medicine Residency ◽

Self Report ◽

First Year ◽

Learning Needs ◽

Point Of Care Ultrasound ◽

Internal Medicine Residents ◽

Study Support ◽

B Lines

Abstract Background With increasing availability of point-of-care ultrasound (POCUS) education in medical schools, it is unclear whether or not learning needs of junior medical residents have evolved over time. Methods We invited all postgraduate year (PGY)-1 residents at three Canadian internal medicine residency training programs in 2019 to complete a survey previously completed by 47 Canadian Internal Medicine PGY-1 s in 2016. Using a five-point Likert scale, participants rated perceived applicability of POCUS to the practice of internal medicine and self-reported skills in 15 diagnostic POCUS applications and 9 procedures. Results Of the 97 invited residents, 58 (60 %) completed the survey in 2019. Participants reported high applicability but low skills across all POCUS applications and procedures. The 2019 cohort reported higher skills in assessing pulmonary B lines than the 2016 cohort (2.3 ± SD 1.0 vs. 1.5 ± SD 0.7, adjusted p-value = 0.01). No other differences were noted. Conclusions POCUS educational needs continue to be high in Canadian internal medicine learners. The results of this needs assessment study support ongoing inclusion of basic POCUS elements in the current internal medicine residency curriculum.

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Quality of discharge summaries prepared by first year internal medicine residents

BMC Medical Education ◽

10.1186/1472-6920-12-77 ◽

2012 ◽

Vol 12 (1) ◽

Cited By ~ 20

Author(s):

Kimberly Legault ◽

Jacqueline Ostro ◽

Zahira Khalid ◽

Parveen Wasi ◽

John J You

Keyword(s):

Internal Medicine ◽

First Year ◽

Internal Medicine Residents ◽

Discharge Summaries

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Confidence in palliative care issues by medical students and internal medicine residents

BMJ Supportive & Palliative Care ◽

10.1136/bmjspcare-2017-001341 ◽

2017 ◽

Vol 9 (1) ◽

pp. e1-e1 ◽

Cited By ~ 7

Author(s):

Ana Carolina Montouro Storarri ◽

Giovana Dalmedico de Castro ◽

Lilian Castiglioni ◽

Patricia Maluf Cury

Keyword(s):

Internal Medicine ◽

Palliative Care ◽

Medical Students ◽

Medical School ◽

Medical Practice ◽

Terminal Illness ◽

First Year ◽

School Students ◽

Internal Medicine Residents ◽

Second Year

BackgroundPalliative care (PC) is a relatively new field in Brazil, but this knowledge is of great importance in medical practice.ObjectiveTo evaluate the degree of confidence among medical students and first-year and second-year internal medicine residents in addressing issues of death and terminal illness with patients and their families.MethodA modified version of the Self-Efficacy in Palliative Care Scale was applied to 293 students in their first year to sixth year at the School of Medicine of São José do Rio Preto and to 43 residents in their first year or second year of medical practice at the same institution in Brazil, in 2015. The questionnaire evaluated students' opinions on the need to include theoretical and practical classes on PC in the medical school.ResultsStudents in their fifth year of medical school were more confident than the students in their first, second, third and fourth years; there were no statistically significant differences between fifth-year students, sixth-year students and the internal medicine residents.ConclusionResidents were more confident than all of the medical school students except those in their fifth year (P<0.05) because they have more contact with terminally ill patients than other students do; fifth-year medical students are likely overestimating their abilities.

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Entrustability levels of general internal medicine residents

BMC Medical Education ◽

10.1186/s12909-021-02624-9 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Mostafa Dehghani Poudeh ◽

Aeen Mohammadi ◽

Rita Mojtahedzadeh ◽

Nikoo Yamani

Keyword(s):

Internal Medicine ◽

Health Professional ◽

First Year ◽

Direct Supervision ◽

Residency Programs ◽

Professional Activities ◽

General Internal ◽

Internal Medicine Residents ◽

Wide Range ◽

Indirect Supervision

Abstract Background Entrustable professional activities (EPAs) are those activities that a health professional can perform without direct supervision in a defined environment. Bridging the gap between competencies and learning objectives, EPAs have made assessing the performances of health professional more realistic. The main objective of the present study was developing and customizing EPAs for Iranian Internal Medicine Residency Programs. Results After reviewing the publications, residency curricula and logbooks, and collecting experts’ ideas, the initial list of EPAs was developed. Then, in a focus group, the list was refined, the entrustability level of each residency year was determined, and finally, the EPA-competency cross-tab was established, and in the next step, through a one- round Delphi, the results were validated. Twenty-eight EPAs were developed. Some of them were definitely suitable for the higher levels of residency, such that they had to be accomplished under direct supervision until the end of the program. On the other hand, some of EPAs were those that residents, even from the first year, are expected to perform independently or under indirect supervision. Most of the EPAs cover a wide range of competencies. Conclusion Determining the entrustability level of each residency year in each EPA as well as the competency- EPA matrix has crucial effect on the quality of the graduates. It seems that our findings are applicable in developing countries like Iran.

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