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 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 Residentsʼ Perspectives on the Learning Environment: Data From the Accreditation Council for Graduate Medical Education Resident Survey

2010 ◽  
Vol 85 (3) ◽  
pp. 512-518 ◽  
Author(s):  
Kathleen D. Holt ◽  
Rebecca S. Miller ◽  
Ingrid Philibert ◽  
Jeanne K. Heard ◽  
Thomas J. Nasca
Keyword(s):  
Medical Education ◽  
Learning Environment ◽  
Graduate Medical Education ◽  
Accreditation Council ◽  
Graduate Medical

scholarly journals Preliminary Evidence Supporting a Novel 10-Item Clinical Learning Environment Quick Survey (CLEQS)

2021 ◽  
Vol 13 (4) ◽  
pp. 553-560
Author(s):  
Deborah Simpson ◽  
Matthew McDiarmid ◽  
Tricia La Fratta ◽  
Nicole Salvo ◽  
Jacob L. Bidwell ◽  
...  
Keyword(s):  
Health Care ◽  
Medical Education ◽  
Learning Environment ◽  
Graduate Medical Education ◽  
Validity Evidence ◽  
Clinical Learning ◽  
Clinical Learning Environment ◽  
Good Reliability ◽  
Team Members ◽  
Graduate Medical

ABSTRACT Background The clinical learning environment (CLE) is a priority focus in medical education. The Accreditation Council for Graduate Medical Education Clinical Learning Environment Review's (CLER) recent addition of teaming and health care systems obligates educators to monitor these areas. Tools to evaluate the CLE would ideally be: (1) appropriate for all health care team members on a specific unit/project; (2) informed by contemporary learning environment frameworks; and (3) feasible/quick to complete. No existing CLE evaluation tool meets these criteria. Objective This report describes the creation and preliminary validity evidence for a Clinical Learning Environment Quick Survey (CLEQS). Methods Survey items were identified from the literature and other data sources, sorted into 1 of 4 learning environment domains (personal, social, organizational, material) and reviewed by multiple stakeholders and experts. Leaders from 6 interprofessional graduate medical education quality improvement/patient safety teams distributed this voluntary survey to their clinical team members (November 2019–mid-January 2021) using electronic or paper formats. Validity evidence for this instrument was based on the content, response process, internal structure, reliability, relations to other variables, and consequences. Results Two hundred one CLEQS responses were obtained, taking 1.5 minutes on average to complete with good reliability (Cronbach's α ≥ 0.83). The Cronbach alpha for each CE domain with the overall item ranged from 0.50 for personal to 0.79 for social. There were strong associations with other measures and clarity about improvement targets. Conclusions CLEQS meets the 3 criteria for evaluating CLEs. Reliability data supports its internal consistency, and initial validity evidence is promising.

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 Success of a Resident-Led Safety Council: A Model for Satisfying CLER Pathways to Excellence Patient Safety Goals

2019 ◽  
Vol 11 (2) ◽  
pp. 226-230 ◽  
Author(s):  
Sarah P. Cohen ◽  
Jonathan H. Pelletier ◽  
Jennifer M. Ladd ◽  
Colby Feeney ◽  
Victoria Parente ◽  
...  
Keyword(s):  
Medical Education ◽  
Patient Safety ◽  
Learning Environment ◽  
Graduate Medical Education ◽  
Safety Data ◽  
Clinical Learning Environment ◽  
Safety Attitudes ◽  
Graduate Medical ◽  
Safety Report ◽  
Safety Event

ABSTRACT Background  The Accreditation Council for Graduate Medical Education (ACGME) Clinical Learning Environment Review (CLER) program focuses on aspects of the graduate medical education learning environment, such as patient safety. Data from CLER site visits reveal that many resident physicians do not receive adequate training on patient safety. Objective  We evaluated a pediatric resident-led safety council as a method to meet CLER Pathways to Excellence patient safety objectives. Methods  The Duke Pediatric Residency Safety Council (PRSC) created an infrastructure for residents to participate in department safety efforts, review safety events, and act as leaders for safety initiatives. Annual surveys were distributed to graduate medical education trainees through the institution's patient safety center and the PRSC. Survey results of safety attitudes were compared over time within the pediatrics program and between pediatrics and nonpediatrics trainees at the institution. Resident-submitted safety reports were tracked through an institutional safety event repository. Results  From 2013 to 2017, the percentage of residents who strongly agreed that they could submit a safety report doubled (from 35% [6 of 17] to 73% [22 of 30], P = .011). The average number of safety reports submitted by a pediatrics resident per year did not significantly change during this period (from 3.0 to 3.8, P = .11). In 2017, 90% of pediatrics residents (27 of 30) agreed or strongly agreed that their concerns would be addressed if they entered a safety report. Conclusions  The council addressed 5 of the 7 CLER Pathways to Excellence in patient safety.

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 Characteristics of Designated Institutional Officials and Sponsoring Institutions of ACGME-Accredited Training Programs

2020 ◽  
Vol 13 (1) ◽  
pp. 70-75
Author(s):  
Ryan S. D'Souza ◽  
Brendan Langford ◽  
Shawn D'Souza ◽  
Steven Rose ◽  
Timothy Long
Keyword(s):  
Medical Education ◽  
Graduate Medical Education ◽  
Training Programs ◽  
Female Gender ◽  
Academic Rank ◽  
Leadership Positions ◽  
Accreditation Council ◽  
Graduate Medical ◽  
Education Community ◽  
Status Number

ABSTRACT Background Since the Accreditation Council for Graduate Medical Education (ACGME) established the designated institutional official (DIO) role in 1998, there have been major changes in sponsoring institutions (SIs) and DIO responsibilities. Yet there remains a large gap in our knowledge regarding baseline SI and DIO characteristics as well as a need for institutions wanting to increase diversity in the DIO role and other leadership positions within the medical education community. Objective We sought to characterize demographics of DIOs and the SIs they oversee. Methods We identified SIs and DIOs on the ACGME website on February 15, 2020. Reviewed data included SI accreditation status, number of programs and resident/fellow positions, and DIO characteristics. Results We identified 831 SIs. SIs with continued accreditation sponsored more programs (median 4.0) than SIs with initial accreditation (median 1.0, P < .001). DIO age ranged from 29–81 years (median 57 years). Two-hundred eighty-three of 831 (34%) DIOs were women. Of 576 DIOs with known academic rank, 356 (62%) DIOs held senior academic rank. A higher proportion of male DIOs had senior academic rank (68% vs 52%; OR 1.90 [95% CI 1.34–2.70]; P < .001) and professor rank (39% vs 24%; OR 2.01 [95% CI 1.38–2.94]; P < .001) compared to female DIOs. Female gender was associated with a greater number of ACGME-accredited programs and filled resident/fellow positions per SI (P < .001 for both). Conclusions This study describes characteristics of DIOs and SIs and offers insights for those pursuing a DIO position.

scholarly journals Psychological Safety and Support: Assessing Resident Perceptions of the Clinical Learning Environment

2018 ◽  
Vol 10 (6) ◽  
pp. 651-656 ◽  
Author(s):  
Nital P. Appelbaum ◽  
Sally A. Santen ◽  
Brian M. Aboff ◽  
Ryan Vega ◽  
Jose L. Munoz ◽  
...  
Keyword(s):  
Medical Education ◽  
Program Evaluation ◽  
Learning Environment ◽  
Graduate Medical Education ◽  
Organizational Support ◽  
Perceived Organizational Support ◽  
Psychological Safety ◽  
Clinical Learning ◽  
Clinical Learning Environment ◽  
Graduate Medical

ABSTRACT Background Assessments of the clinical learning environment could allow early interventions to improve graduate medical education. To date, measurement tools for this have not been identified. Objective We established the concurrent validity of 2 instruments that assess cultural facets of the clinical learning environment by correlating them with external program evaluation data. Methods In 2017 we surveyed residents across 19 training programs on their perceptions of organizational support by using the Short Survey of Perceived Organizational Support (SPOS), and psychological safety by using the Psychological Safety Scale (PSS). Data were aggregated to the program level and correlated with results from the Accreditation Council for Graduate Medical Education (ACGME) Resident Survey. Results Of 511 residents, 322 (63%) completed the survey, and 496 of 516 residents (96%) completed the ACGME Resident Survey. Perceived organizational support correlated positively with overall program evaluation score (r = 0.75, P < .001); faculty (r = 0.72, P < .001); evaluation (r = 0.73, P < .001); educational content (r = 0.52, P = .022); and resources domains (r = 0.55, P =  .014). Psychological safety had a positive correlation with overall program evaluation (r = 0.57, P = .011); faculty (r = 0.50, P = .028); and evaluation (r = 0.62, P < .005). Conclusions The SPOS and PSS correlated with key ACGME Resident Survey domains. Programs showing greater support of residents were likely to show more positive ratings on program evaluation metrics. Teaching institutions may benefit from actively monitoring and improving aspects of their learning environment through internal assessments.

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.

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