How do resident physicians prefer to seek help from burnout? A best-worst scaling survey of internal medicine resident physicians examining rank-ordered factors for help-seeking and barriers to utilizing mental health supports (Preprint)

2021 ◽  
Author(s):  
Andrew Wu ◽  
Varsha Radhakrishnan ◽  
Elizabeth Targan ◽  
Timothy P Scarella ◽  
John Torous ◽  
...  
Keyword(s):  
Internal Medicine ◽  
Peer Support ◽  
Help Seeking ◽  
Latent Class ◽  
Internal Medicine Resident ◽  
Wellness Programs ◽  
Specific Information ◽  
Medicine Resident ◽  
Resident Physicians ◽  
Best Worst Scaling

BACKGROUND Burnout interventions are limited by low utilization. Understanding resident physician preferences for burnout interventions may increase utilization and improve assessment of interventions. OBJECTIVE An econometric best-worst scaling (BWS) framework was used to survey internal medicine resident physicians to establish help-seeking preferences for burnout and barriers to utilizing wellness supports. METHODS Internal medicine resident physicians at our institution completed an anonymous online BWS survey during the 2020-2021 academic year. This cross-sectional study was analyzed with multinomial logistic regression and latent class modeling to determine relative rank-ordering of factors for seeking support for burnout and barriers to utilizing wellness supports. ANOVA with post-hoc Tukey HSD was used to analyze differences in mean utility scores representing choice for barriers and support options. RESULTS 77 residents completed the survey (47% response rate). Top-ranking factors for seeking wellness supports were seeking informal peer support (best: 71%/worst: 0.6%) and support from friends and family (best: 70%/worst: 1.6%). Top-ranking barriers to seeking counseling were time (best: 75%/worst: 5%) and money (best: 35%/worst: 21%). Latent class analysis identified two segments, a Formal Help-Seeking group (n=6) that preferred seeking therapy as their 2nd-ranking factor (best: 63%/worst: 0%), and an Open to Isolating group (n=20) that preferred to not seek support from others as their 3rd ranking factor (best: 14%/worst: 18%). CONCLUSIONS Overall, resident physicians reported high preference for informal peer support, though there exists a segment that prefer counseling services and a segment that prefers not to seek help at all. Time and cost are more significant barriers compared to stigma against utilizing wellness supports. Using BWS-informed studies are a promising and easy-to-administer methodology for clinician wellness programs to gather specific information on clinician preferences to determine best practices for wellness programs. CLINICALTRIAL N/A

What gets resident physicians stressed and how would they prefer to be supported? A best–worst scaling study

2021 ◽  
pp. postgradmedj-2021-140719
Author(s):  
Andrew Wu ◽  
Ritika S Parris ◽  
Timothy M Scarella ◽  
Carrie D Tibbles ◽  
John Torous ◽  
...  
Keyword(s):  
Internal Medicine ◽  
Emergency Medicine ◽  
Peer Support ◽  
Well Being ◽  
Specific Information ◽  
Choice Modelling ◽  
Work Stressors ◽  
Cross Sectional ◽  
Academic Medical Centre ◽  
Best Worst Scaling

IntroductionPhysician burnout has severe consequences on clinician well-being. Residents face numerous work-stressors that can contribute to burnout; however, given specialty variation in work-stress, it is difficult to identify systemic stressors and implement effective burnout interventions on an institutional level. Assessing resident preferences by specialty for common wellness interventions could also contribute to improved efficacy.MethodsThis cross-sectional study used best–worst scaling (BWS), a type of discrete choice modelling, to explore how 267 residents across nine specialties (anaesthesiology, emergency medicine, internal medicine, neurology, obstetrics and gynaecology, pathology, psychiatry, radiology and surgery) prioritised 16 work-stressors and 4 wellness interventions at a large academic medical centre during the COVID-19 pandemic (December 2020).ResultsTop-ranked stressors were work-life integration and electronic health record documentation. Therapy (63%, selected as ‘would realistically consider intervention’) and coaching (58%) were the most preferred wellness supports in comparison to group-based peer support (20%) and individual peer support (22%). Pathology, psychiatry and OBGYN specialties were most willing to consider all intervention options, with emergency medicine and internal medicine specialties least willing to consider intervention options.ConclusionBWS can identify relative differences in surveyed stressors, allowing for the generation of specialty-specific stressor rankings and preferences for specific wellness interventions that can be used to drive institution-wide changes to improve clinician wellness. BWS surveys are a potential methodology for clinician wellness programmes to gather specific information on preferences to determine best practices for resident wellness.

A low-fidelity simulation curriculum addresses needs identified by faculty and improves the comfort level of senior internal medicine resident physicians with inhospital resuscitation*

2010 ◽  
Vol 38 (9) ◽  
pp. 1899-1903 ◽  
Author(s):  
Andrew Healey ◽  
Jonathan Sherbino ◽  
Jerome Fan ◽  
Mark Mensour ◽  
Suneel Upadhye ◽  
...  
Keyword(s):  
Internal Medicine ◽  
Internal Medicine Resident ◽  
Comfort Level ◽  
Medicine Resident ◽  
Resident Physicians

Performance on Preventive Cancer Screening Tests in the Ambulatory Setting by Internal Medicine Resident Physicians

2010 ◽  
Vol 22 (1) ◽  
pp. 45-49 ◽  
Author(s):  
Perry G. An ◽  
Jeffrey M. Ashburner ◽  
Blair W. Fosburgh ◽  
Steven J. Atlas
Keyword(s):  
Internal Medicine ◽  
Cancer Screening ◽  
Internal Medicine Resident ◽  
Screening Tests ◽  
Ambulatory Setting ◽  
Medicine Resident ◽  
Resident Physicians ◽  
Cancer Screening Tests

Pharmacogenomics education and perceptions: is there a gap between internal medicine resident and attending physicians?

2021 ◽  
Author(s):  
Carolyn R Rohrer Vitek ◽  
Jyothsna Giri ◽  
Pedro J Caraballo ◽  
Timothy B Curry ◽  
Wayne T Nicholson
Keyword(s):  
Internal Medicine ◽  
Point Of Care ◽  
Internal Medicine Resident ◽  
Current Clinical Practice ◽  
Medicine Resident ◽  
Resident Physicians ◽  
Internal Medicine Residents ◽  
Care Gaps ◽  
Attending Physicians ◽  
Do So

Aim: To determine if differences in self-reported pharmacogenomics knowledge, skills and perceptions exist between internal medicine residents and attending physicians. Materials & methods: Forty-six internal medicine residents and 54 attending physicians completed surveys. Thirteen participated in focus groups to explore themes emerging from the surveys. Results: Resident physicians reported a greater amount of pharmacogenomics training compared with attending physicians (48 vs 13%, p < 0.00012). No differences were found in self-reported knowledge, skills and perceptions. Conclusion: Both groups expressed pharmacogenomics was relevant to their current clinical practice; they should be able to provide information to patients and use to guide prescribing, but lacked sufficient education to be able to do so effectively. Practical approaches are needed to teach pharmacogenomics concepts and address point-of-care gaps.

Telehealth for the internal medicine resident: A 3-year longitudinal curriculum

2019 ◽  
pp. 1357633X1989668 ◽  
Author(s):  
Elizabeth Barnhardt Kirkland ◽  
Ragan DuBose-Morris ◽  
Ashley Duckett
Keyword(s):  
Internal Medicine ◽  
Healthcare System ◽  
Patient Monitoring ◽  
Internal Medicine Resident ◽  
System Level ◽  
Remote Patient Monitoring ◽  
Medicine Resident ◽  
Resident Physicians ◽  
Internal Medicine Residents ◽  
Remote Patient

Aims Across the United States of America, patients are increasingly receiving healthcare using innovative telehealth technologies. As healthcare continues to shift away from traditional office-based visits, providers face new challenges. Telehealth champions are needed to adapt technologies to meet the needs of patients, providers and communities, especially within the realm of primary care specialties. Given these challenges, this intervention aimed to incorporate telemedicine into internal medicine resident training across multiple training years to prepare them for practice in the current and changing healthcare system. Methods Education and telehealth leaders at the Medical University of South Carolina identified key topics relevant to telehealth and the provision of general internal medicine services. With this as a framework, we developed a 3-year longitudinal telehealth curriculum for internal medicine resident physicians, consisting of an introduction to telemedicine equipment in the first year, didactic learning through in-person education and online modules in the second year and experiential learning through remote monitoring of chronic disease in the third year. Participants included approximately 100 internal medicine residents per year (2016–2019). Self-perceived knowledge, comfort and ability to provide telehealth services was assessed via a survey completed before and after participation in the curriculum. Results Resident physicians’ self-reported knowledge of telehealth history, access to care, contributions of telehealth applications and quality of care and communication each improved after completion of the online curriculum. There were also significant improvements in resident comfort and perceived ability to provide telehealth services after participation in the curriculum, as assessed via a survey. Overall, 41% of residents felt their ability to utilize telehealth as part of their current or future practice was greater than average after completion of the online modules compared to only 2% at baseline ( p<0.01). Results also show residents accurately identify barriers to telehealth adoption at the healthcare system level, including the lack of clinical time to implement services (67% post- vs 47% pre-curriculum, p = 0.02), unfamiliarity with concepts (65% post- vs 21% pre-curriculum, p<−0.01) and concerns about consistent provider reimbursement (74% post- vs 39% pre-curriculum, p < 0.01). Conclusion Telemedicine and remote patient monitoring are an increasingly prevalent form of healthcare delivery. Internal medicine residents must be adept in caring for patients utilizing this technology. This curriculum was effective in improving resident comfort and self-efficacy in providing care through telehealth and provided residents with hands-on opportunities through supervised inclusion in remote patient-monitoring services. This curriculum model could be employed and evaluated within other internal medicine residency programmes to determine the feasibility at institutions with and without advanced telehealth centres.

scholarly journals Teaching Internal Medicine Resident Physicians About Alcoholics Anonymous

2006 ◽  
Vol 27 (3) ◽  
pp. 5-11 ◽  
Author(s):  
Adam J. Rose ◽  
Melissa R. Stein ◽  
Julia H. Arnsten ◽  
Richard Saitz
Keyword(s):  
Internal Medicine ◽  
Alcoholics Anonymous ◽  
Internal Medicine Resident ◽  
Medicine Resident ◽  
Resident Physicians

scholarly journals Impact of Pocket Insulin Dosing Guide on Utilization of Basal/Bolus Insulin by Internal Medicine Resident Physicians

Cureus ◽  
2018 ◽  
Author(s):  
Chaitanya K Mamillapalli ◽  
Edward Rico ◽  
Deepika Nallala ◽  
Owaise Mansuri ◽  
Michael G Jakoby
Keyword(s):  
Internal Medicine ◽  
Internal Medicine Resident ◽  
Medicine Resident ◽  
Resident Physicians ◽  
Bolus Insulin ◽  
Basal Bolus

scholarly journals Semantic competency as a marker of clinical reasoning performance

MedEdPublish ◽  
2022 ◽  
Vol 12 ◽  
pp. 1
Author(s):  
Michael Berge ◽  
Michael Soh ◽  
Fahlsing Christopher ◽  
Rene McKinnon ◽  
Berish Wetstein ◽  
...  
Keyword(s):  
Internal Medicine ◽  
Clinical Reasoning ◽  
Future Study ◽  
Internal Medicine Resident ◽  
Semantic Competence ◽  
Medicine Resident ◽  
Think Alouds ◽  
Resident Physicians ◽  
Attending Physicians ◽  
The Relationship

Background: This study sought to explore the relationship between semantic competence (or dyscompetence) displayed during “think-alouds” performed by resident and attending physicians and clinical reasoning performance. Methods: Internal medicine resident physicians and practicing internists participated in think-alouds performed after watching videos of typical presentations of common diseases in internal medicine. The think-alouds were evaluated for the presence of semantic competence and dyscompetence and these results were correlated with clinical reasoning performance.  Results: We found that the length of think-aloud was negatively correlated with clinical reasoning performance. Beyond this finding, however, we did not find any other significant correlations between semantic competence or dyscompetence and clinical reasoning performance. Conclusions: While this study did not produce the previously hypothesized findings of correlation between semantic competence and clinical reasoning performance, we discuss the possible implications and areas of future study regarding the relationship between semantic competency and clinical reasoning performance.

scholarly journals Burnout and Physical Activity in Minnesota Internal Medicine Resident Physicians

2014 ◽  
Vol 6 (4) ◽  
pp. 669-674 ◽  
Author(s):  
Shawn M. Olson ◽  
Nnaemeka U. Odo ◽  
Alisa M. Duran ◽  
Anne G. Pereira ◽  
Jeffrey H. Mandel
Keyword(s):  
Internal Medicine ◽  
Physical Activity ◽  
Human Services ◽  
Medical Training ◽  
Internal Medicine Resident ◽  
Maslach Burnout Inventory ◽  
Physical Activity Guidelines ◽  
Medicine Resident ◽  
Resident Physicians ◽  
National Physical Activity

Abstract Background Regular physical activity plays an important role in the amelioration of several mental health disorders; however, its relationship with burnout has not yet been clarified. Objective To determine the association between achievement of national physical activity guidelines and burnout in internal medicine resident physicians. Methods A Web-based survey of internal medicine resident physicians at the University of Minnesota and Hennepin County Medical Center was conducted from September to October 2012. Survey measures included the Maslach Burnout Inventory-Human Services Survey and the International Physical Activity Questionnaire. Results Of 149 eligible residents, 76 (51.0%) completed surveys, which were used in the analysis. Burnout prevalence, determined by the Maslach Burnout Inventory, was 53.9% (41 of 76). Prevalence of failure to achieve US Department of Health and Human Services physical activity guidelines was 40.8% (31 of 76), and 78.9% (60 of 76) of residents reported that their level of physical activity has decreased since they began medical training. Residents who were able to meet physical activity guidelines were less likely to be burned out than their fellow residents (OR, 0.38, 95% CI 0.147–0.99). Conclusions Among internal medicine resident physicians, achievement of national physical activity guidelines appears to be inversely associated with burnout. Given the high national prevalence of burnout and inactivity, additional investigation of this relationship appears warranted.

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