Background Wellness initiatives implemented by graduate medical education programs can help mitigate burnout in resident physicians. Objective This systematic review seeks to identify factors that impact the effectiveness of resident wellness interventions and to provide a conceptual framework to guide future interventions. Methods Using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, 6 electronic databases were searched in November 2019 using variations of the keywords “resident physicians,” “wellness,” and “intervention.” Peer-reviewed full-text English-language articles on controlled studies were considered for inclusion. The quality of the studies was assessed using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) guidelines. Results The initial search disclosed 1196 articles, of which 18 studies enrolling 666 resident physicians met inclusion criteria for qualitative review. Interventions using peer support and individual meditation enhanced well-being. Effective wellness interventions also used educational theory to guide program development, surveyed participants to guide intervention design, incorporated programming into existing didactic curricula, and recruited voluntary participants. The quality of most of the included studies was poor (13 of 18, 72%) and could be improved by using standardized wellness assessments supported by validity evidence. Conclusions This systematic review suggests that future resident wellness initiatives should focus on grounding interventions in educational theory, forging consensus on wellness instruments with validity evidence, and examining the impact of initiatives on patient outcomes. A logic model can provide a framework for designing and implementing effective wellness interventions.

Objective Assess caregivers’ knowledge about juice and sugar-sweetened beverages (SSBs) and identify factors that contribute to their early introduction. Methods One hundred forty-four parents of young infants completed a 45-item questionnaire focused on infant nutrition. Results Seventy-two percent of parents plan to give juice to their babies starting in the first year of life; only 16% plan to introduce SSBs. Parents with some college education or more were significantly less likely to report an intention to introduce juice ( P < .0001) and SSBs ( P < .001) in their children’s diets. Education level was significantly associated with knowledge about juice and SSBs ( P < .001). Parents with higher knowledge were significantly less likely to plan on introducing juice ( P < .001) and SSBs ( P < .001). Conclusion Parents of young infants lack enough knowledge about the detrimental effects of juice and sugary drinks. These knowledge gaps give pediatric providers a unique opportunity to provide anticipatory guidance starting in early infancy on the adverse health effects of juice and SSBs.

Purpose: To investigate the prevalence of preoperative cataract surgery testing and consultation at a single United States teaching hospital. Setting: Academic-affiliated Veterans Affairs Medical Center. Design: Retrospective chart review. Methods: This study included patients who received cataract surgery from 2014 to 2018. For patients with bilateral cataracts, the second surgery was excluded to ensure independent selection. Charlson Comorbidity Index (CCI) scores and heart disease status were recorded. The outcomes of interest were preoperative testing, such as complete blood count, chemistry panel, and echocardiography, and consultation (office visits to non-ophthalmologists) during the period between the date the decision was made to proceed with surgery and the cataract surgery date. Results: For this study 1320 charts were reviewed; 1257 (95.2%) patients met the study criteria. The mean CCI score was 1.7; 42.0% (528/1257) had heart disease. The prevalence of preoperative testing was 0.08% (1/1257). The prevalence of preoperative consultation was 4.2% (53/1257); 86.8% (46/53) of patients received cardiology consultation; 17.0% (9/53) pulmonology; and 15.1% (8/53) primary care. Of the patients who received cardiac consultation, 63.0% (29/46) had heart disease; the remaining had an electrocardiogram abnormality. Conclusions: There was a low prevalence of preoperative testing and consultation for cataract surgery at this teaching hospital. Further studies using medical record data are needed to assess the current rates and the role of preoperative testing and consultation for cataract surgery patients.