Emergency Medicine Shift Factors Causing the Most Stress Among Emergency Medicine Residents

Abstract

Introduction: Past studies demonstrate that stress and anxiety affect emergency medicine physicians, but the causal factors identified are usually from sources outside the work shift. We attempt to show the relationship between intrinsic factors of a work shift and anxiety perceived by residents, while also examining differing gender responses. Methods: In 2018, a cross-sectional survey of emergency medicine residents in the United States was distributed anonymously through the Emergency Medicine Residents Association. The survey consisted of demographic questions, novel questions identifying intrinsic factors, and the Generalized Anxiety Disorder 7-item (GAD-7) scale. Spearman correlation, independent t-test, and multivariate analysis of variance were performed. Results: Data from 573 residents found several stressful factors: working with a nurse perceived to be inefficient, working with no inpatient beds available, and working with a colleague perceived to be inefficient. The majority of respondents reported some general anxiety on the GAD-7 assessment. There was no difference on anxiety level as a function of year of residency (p > .05). There was a significant gender difference on anxiety level, t(571) = -4.8689, p < .05, where male residents reported lower anxiety levels (mean=5.15) as compared to female residents (mean=7.02). Lastly, post-hoc analyses revealed that male and female respondents reported differing levels of stress in response to several intrinsic stress factors. Conclusion: We identified several intrinsic factors during a shift that contribute to resident anxiety and analyzed differing gender responses to these factors; this may provide a framework for residency programs to minimize stressors in the future.