Resident Well-Being Before and During the COVID-19 Pandemic

ABSTRACT Background Preliminary studies reveal challenges posed by the COVID-19 pandemic to the well-being of health care workers. Little is known about the effects of the pandemic on the well-being of graduate medical education (GME) residents or about protective factors and post-traumatic growth. Through deeper examination of resident well-being during this unique crisis, we can identify trends and associated lessons to apply broadly to resident well-being. Objective To characterize resident burnout, resilience, and loneliness before and during the COVID-19 pandemic. Methods All residents in any specialty at a single institution were anonymously surveyed semiannually for 2 years (2019–2020), including the time period of the COVID-19 pandemic. Surveys included demographics, the 10-item Connor-Davidson Resilience Scale, the Maslach Burnout Inventory, and the UCLA Loneliness Scale. Results Overall response rates were 53% (508 of 964) in spring 2019, 55% (538 of 982) in fall 2019, 51% (498 of 984) in spring 2020, and 57% (563 of 985) in fall 2020. The overall rates of burnout were stable across all time periods and did not change during the COVID-19 pandemic. Among frontline residents, burnout rates were higher than other resident populations in both the pre- and post-COVID-19 pandemic time periods. Resilience and loneliness measures were similar for frontline and non-frontline residents and remained stable during the pandemic. Conclusions Initial data from this single institution survey of all GME residents in the first 8 months of the COVID-19 pandemic demonstrated burnout and loneliness did not increase and resilience was preserved.

A Positive Depression Screen Is Associated with Emergency Medicine Resident Burnout and Is not Affected by the Implementation of a Wellness Curriculum

Introduction: While burnout is occupation-specific, depression affects individuals comprehensively. Research on interventions for depression in emergency medicine (EM) residents is limited. Objectives: We sought to obtain longitudinal data on positive depression screens in EM residents, assess their association with burnout, and determine whether implementation of a wellness curriculum affected the rate of positive screens. Methods: In February 2017, we administered the Maslach Burnout Inventory and the Primary Care Evaluation of Mental Disorders Patient Health Questionnaire two-question depression screen at 10 EM residencies. At five intervention sites, a year-long wellness curriculum was then introduced while five control sites agreed not to introduce new wellness initiatives during the study period. Study instruments were re-administered in August 2017 and February 2018. Results: Of 382 residents, 285 participated in February 2017; 40% screened positive for depression. In August 2017, 247/386 residents participated; 27.9% screened positive for depression. In February 2018, 228/386 residents participated; 36.2% screened positive. A positive depression screen was associated with higher burnout. There were similar rates of positive screens at the intervention and control sites. Conclusion: Rates of positive depression screens in EM residents ranged between 27.9% and 40%. Residents with a positive screen reported higher levels of burnout. Rates of a positive screen were unaffected by introduction of a wellness curriculum.

Burnout and Empathy: A Cross-Sectional Study among Resident Physicians in Public Sector Hospitals of a Developing Country

The main objective of our study was to determine the prevalence of burnout and to identify various socio-demographic factors which are associated with resident burnout. As a secondary objective, we aimed to assess levels of empathy among the residents. A descriptive cross-sectional study was performed among residents working in Holy Family Hospital, Benazir Bhutto Hospital, and District Headquarter Hospital, all of which are situated in district Rawalpindi of Punjab, Pakistan. Data were collected from January 2019 to April 2019 using a convenient sampling technique. The participants were requested to complete Maslach Burnout Inventory to measure burnout and Jefferson Scale of Physician Empathy to measure empathy from January 2019 to April 2019. For data analysis IBM SPSS © version 25.0 was used. Descriptive statistics were used to summarize the quantitative variables. Chi-square test was used to determine the association between burnout and categorical variables. Then, those independent variables with p-value < 0.05 were subjected to binary logistic regression to identify predictors of burnout. A P-value of < 0.05 was used as the criterion for statistical significance and OR with 95% confidence interval was used to indicate the strength of association. Independent sample t-test was used to assess empathy among the groups. The prevalence of burnout in our sample was 78%. The average burnout score of the sample was 81±13.45. Weekly working hours (p-value < 0.05) and the type of specialty (p-value < 0.05) were significantly associated with resident burnout. Residents working more than 80 hours were more prone to develop burnout [AOR 2.700(1.42-5.120)]. Medical residents were found to be at a higher risk of developing burnout as compared to surgical residents [(AOR 2.097(1.16-3.78)]. Residents working less than 80 hours per week had more empathy scores as compared to residents working more than 80 hours and this result was statistically significant (p-value < 0.05). However, no significant difference in empathy was found for age, gender, marital status, and posts. Therefore, weekly working hours should be reduced to diminish burnout and increase empathy, thereby, promoting the quality of care being delivered to the patient. Moreover, efforts should be made to reduce burnout in medicine residents so that we may promote the doctor-patient relationship.