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

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.

Residency Training and Continuing Medical Education in School Health

PEDIATRICS ◽  
1993 ◽  
Vol 92 (3) ◽  
pp. 495-496
Author(s):  
Keyword(s):  
Medical Education ◽  
American Academy ◽  
Graduate Medical Education ◽  
Continuing Medical Education ◽  
School Health ◽  
Task Force ◽  
Well Being ◽  
Pediatric Practice ◽  
Graduate Medical ◽  
American Academy Of Pediatrics

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.

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

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.

scholarly journals Promotion of Wellness and Mental Health Awareness Among Physicians in Training: Perspective of a National, Multispecialty Panel of Residents and Fellows

2015 ◽  
Vol 7 (1) ◽  
pp. 143-147 ◽  
Author(s):  
Timothy J. Daskivich ◽  
Dinchen A. Jardine ◽  
Jennifer Tseng ◽  
Ricardo Correa ◽  
Brian C. Stagg ◽  
...  
Keyword(s):  
Mental Health ◽  
Medical Education ◽  
Learning Environment ◽  
Graduate Medical Education ◽  
Health Awareness ◽  
Graduate Medical ◽  
Mental Health Awareness ◽  
Education Community ◽  
Resident Wellness ◽  
The Ideal

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.

scholarly journals Well-Being in Graduate Medical Education

2017 ◽  
Vol 92 (7) ◽  
pp. 914-917 ◽  
Author(s):  
Jonathan A. Ripp ◽  
Michael R. Privitera ◽  
Colin P. West ◽  
Richard Leiter ◽  
Lia Logio ◽  
...  
Keyword(s):  
Medical Education ◽  
Graduate Medical Education ◽  
Well Being ◽  
Graduate Medical

scholarly journals Are residents learners or workers? A historical perspective in Japan

2021 ◽  
Vol 6 (1) ◽  
pp. 122-124
Author(s):  
Hirohisa Fujikawa ◽  
Daisuke Son ◽  
Masato Eto
Keyword(s):  
Medical Education ◽  
Graduate Medical Education ◽  
Postgraduate Medical Education ◽  
Working Hours ◽  
The United States ◽  
Accreditation Council ◽  
Graduate Medical ◽  
Resident Wellness ◽  
Aged Society ◽  
Near Future

Many countries enforce limits on the number of hours that medical residents work. For example, in the United States, regulations about duty hours were instituted by the Accreditation Council of Graduate Medical Education as early as in 2003, reinforcing those limits in 2011 and again in 2017 (Accreditation Council for Graduate Medical Education, 2017). These reforms triggered discussion in medical education literature about their wide-ranging effects on resident education, resident wellness, and patient care (Bolster & Rourke, 2015). In Japan, restrictions on working hours will be implemented for physicians in April 2024 (Shibuya & Unno, 2019). Because of its rapidly shifting demographics to being a super-aged society with a low birth rate, Japan is now facing issues with residents’ learning and working that other countries will need to confront in the near future as their populations shift as well (as of late 2020). Here we report on the history and current situation of postgraduate medical education in Japan, which are highly relevant to re-evaluating postgraduate training in other countries.

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

2012 ◽  
Vol 4 (1) ◽  
pp. 76-82 ◽  
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.

scholarly journals A cross-sectional study of United States family medicine residency programme director burnout: implications for mitigation efforts and future research

2020 ◽  
Vol 37 (6) ◽  
pp. 772-778
Author(s):  
Tamatha M Psenka ◽  
John R Freedy ◽  
Lisa D Mims ◽  
Alec O DeCastro ◽  
Carole R Berini ◽  
...  
Keyword(s):  
Medical Education ◽  
Depressive Symptoms ◽  
Family Medicine ◽  
Graduate Medical Education ◽  
Emotional Exhaustion ◽  
Future Research ◽  
Programme Director ◽  
Family Medicine Residency ◽  
Graduate Medical ◽  
Residency Programme

Abstract Background Academic physician burnout is concerning. Too little is known about factors associated with residency programme director burnout. Continued uncertainty risks adverse outcomes including graduate medical education leadership turnover and negative impact on recruiting and retaining under-represented minority residency programme directors. Objective This study assessed symptoms of burnout (emotional exhaustion, depersonalization) and depression along with evidence-based individual and environmental risk factors in a U.S. sample of family medicine residency programme directors. Methods The omnibus 2018 Council of Academic Family Medicine Education Research Alliance survey was used to contact programme directors at all Accreditation Council for Graduate Medical Education accredited U.S. family medicine residency programmes via email. Descriptive data included programme director and programme characteristics, Areas of Worklife (workload, values and control), loneliness (lack companionship, feel left out and feel isolated), burnout (emotional exhaustion, depersonalization) and depressive symptoms. Chi-square tests contrasted descriptive variables with burnout and depressive symptoms. Logistic regression (LR) modelled associations between significant descriptive variables and burnout and depressive symptoms. Results The survey response rate was 45.2% (268/590). Programme directors reported: emotional exhaustion (25.0%), depersonalization (10.3%) and depressive symptoms (25.3%). LR models found significant associations with emotional exhaustion (Workload: lacking time and other work-related resources); lack of companionship, depersonalization (North West Central residency region; Workload and lack of companionship) and depressive symptoms (Black/African American ethnicity). Conclusions One-quarter of U.S. programme directors report burnout or depressive symptoms. Future research should consider associated variables as possible intervention targets to reduce programme director distress and turnover.

scholarly journals Resident Wellness in US Ophthalmic Graduate Medical Education

2018 ◽  
Vol 136 (6) ◽  
pp. 695 ◽  
Author(s):  
Elaine M. Tran ◽  
Ingrid U. Scott ◽  
Melissa A. Clark ◽  
Paul B. Greenberg
Keyword(s):  
Medical Education ◽  
Graduate Medical Education ◽  
Graduate Medical ◽  
Resident Wellness

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

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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