An Evidence-based, Longitudinal Curriculum for Resident Physician Wellness: The 2017 Resident Wellness Consensus Summit

Abstract

IntroductionPhysicians are at much higher risk for burnout, depression, and suicide than their non-medical peers. One of the working groups from the May 2017 Resident Wellness Consensus Summit (RWCS) addressed this issue through the development of a longitudinal residency curriculum to address resident wellness and burnout.MethodsA 30-person (27 residents, three attending physicians) Wellness Curriculum Development workgroup developed the curriculum in two phases. In the first phase, the workgroup worked asynchronously in the Wellness Think Tank – an online resident community – conducting a literature review to identify 10 core topics. In the second phase, the workgroup expanded to include residents outside the Wellness Think Tank at the live RWCS event to identify gaps in the curriculum. This resulted in an additional seven core topics.ResultsSeventeen foundational topics served as the framework for the longitudinal resident wellness curriculum. The curriculum includes a two-module introduction to wellness; a seven-module “Self-Care Series” focusing on the appropriate structure of wellness activities and everyday necessities that promote physician wellness; a two-module section on physician suicide and self-help; a four-module “Clinical Care Series” focusing on delivering bad news, navigating difficult patient encounters, dealing with difficult consultants and staff members, and debriefing traumatic events in the emergency department; wellness in the workplace; and dealing with medical errors and shame.ConclusionThe resident wellness curriculum, derived from an evidence-based approach and input of residents from the Wellness Think Tank and the RWCS event, provides a guiding framework for residency programs in emergency medicine and potentially other specialties to improve physician wellness and promote a culture of wellness.

A Comprehensive Residency Wellness Curriculum

“…We propose the adoption of a curriculum that mirrors the topics we presented above. Particularly, we recommend covering general subject areas including stress management, sleep hygiene, nutrition and fitness, financial wellness, mindfulness, and coping with difficult outcomes or interactions [15][16][17][18][19][20][21][22]30].…”

“…Others have proposed an exercise and dietary improvement program and a financial management curriculum for surgical residents [20,21]. In 2017, the Resident Wellness Consensus Summit published the outline of a proposed comprehensive wellness curriculum for emergency medicine residency programs [22,23]. Another group implemented a corporate-based wellness curriculum in their emergency medicine residency program, which received negative feedback from participants [24].…”

The Implementation of a National Multifaceted Emergency Medicine Resident Wellness Curriculum Is Not Associated With Changes in Burnout

“…In the years since our curriculum was developed, academic leaders in EM, internal medicine, and pediatrics have recognized the need for a more comprehensive approach to creating and distributing well‐being resources. The 2017 Emergency Medicine Resident Wellness Consensus Summit used a learning network of residents and attending physicians to create a 17 module resident wellness curriculum, educator toolkit resources, resident needs assessment, and program‐level planning tool as well as a wellness‐targeted technology database . The Collaborative for Healing and Renewal in Medicine (CHARM), supported by the Alliance for Academic Internal Medicine (AAIM) is a clearinghouse for learner wellness resources and scholarly activity .…”

Can We Actually Improve Resident Wellness? Pilot Data from a Longitudinal Wellness Curriculum for Emergency Medicine Residents

“…The wellness curriculum piloted in this study was exclusively designed by and for emergency medicine residents and was created over a one-year time period by the Wellness Think Tank, a working group overseen by Academic Life in Emergency Medicine (ALiEM) [16]. The Wellness Think Tank is comprised of resident members from all over the United States, with oversight by faculty members at various institutions nationally.…”

“…The aim of this study is to examine the effect of implementation of an evidence-based, longitudinal curriculum for residency physician wellness on selfreported resident wellness at three Detroit emergency medicine residency programs [16]. This curriculum was designed explicitly for EM residents with the support of the Wellness Think Tank, a wellness initiative sponsored by Academic Life in EM (ALiEM).…”