Identifying institutional factors in general surgery resident wellness and burnout

Foote, Darci C.; Donkersloot, John N.; Sandhu, Gurjit; Ziegler, Kerstin; Lau, James N.

doi:10.1016/j.amjsurg.2021.07.014

Cited by 16 publications

(6 citation statements)

References 29 publications

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“…Voice and agency are critical to employee engagement and well-being across work environments . They are prerequisites for the assertion of autonomy, a key element of physician wellness . Bongiovanni et al, in a qualitative study of residents who left general surgery, identified lack of voice as a major reason for attrition.…”

Section: Discussionmentioning

confidence: 99%

Experiences With Unionization Among General Surgery Resident Physicians, Faculty, and Staff

Foote,

Rosenblatt,

Amortegui

et al. 2024

JAMA Netw Open

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ImportanceLabor unions are a mechanism for employee advocacy, but their role in surgery resident wellness is poorly characterized.ObjectiveTo understand experiences with unionization among general surgery residents and residency program faculty and staff.Design, Setting, and ParticipantsThis exploratory qualitative study included data from the Surgical Education Culture Optimization Through Targeted Interventions Based on National Comparative Data (SECOND) trial. In the exploratory phase of the SECOND trial (from March 6, 2019, to March 12, 2020), semistructured interviews about wellness were conducted with residents, faculty (attending physicians), and staff (program administrators) at 15 general surgery residency programs. Unionization was identified as an emergent theme in the interviews. Data analysis was performed from March 2019 to May 2023.Main Outcomes and MeasuresThe main outcome was resident and faculty experience with resident labor unions. In the qualitative analysis, lexical searches of interview transcripts identified content regarding resident labor unions. A codebook was developed inductively. Transcripts were coded by dyads, using a constant comparative approach, with differences reconciled by consensus.ResultsA total of 22 interview transcripts were identified with relevant content. Of these, 19 were individual interviews conducted with residents (n = 10), faculty (n = 4), administrative staff (n = 1), a program director (n = 1), a department chair (n = 1), and designated institutional officials (n = 2), and 3 were from resident focus groups. Residents from all postgraduate year levels, including professional development (ie, research) years, were represented. Interviewees discussed resident unions at 2 programs (1 recently unionized and 1 with a decades-long history). Interviewees described the lack of voice and the lack of agency as drivers of unionization (“Residents…are trying to take control of their well-being”). Increased salary stipends and/or housing stipends were the most concretely identified union benefits. Unanticipated consequences of unionization were described by both residents and faculty, including (1) irrelevance of union-negotiated benefits to surgical residents, (2) paradoxical losses of surgery department–provided benefits, and (3) framing of resident-faculty relationships as adversarial. Union executives were noted to be nonphysician administrators whose participation in discussions about clinical education progression may increase the time and effort to remediate a resident and/or reduce educators’ will to meaningfully intervene. Active surgical resident participation within the union allows for an understanding of surgical trainees’ unique needs and reduced conflict.Conclusions and RelevanceIn this qualitative study, unionization was a mechanism for resident voice and agency; the desire to unionize likely highlighted the lack of other such mechanisms in the training environment. However, these findings suggest that unionization may have had unintended consequences on benefits, flexibility, and teaching. Effective advocacy, whether within or outside the context of a union, was facilitated by participation from surgical residents. Future research should expand on this exploratory study by including a greater number of institutions and investigating the evolution of themes over time.

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Section: Discussionmentioning

confidence: 99%

Experiences With Unionization Among General Surgery Resident Physicians, Faculty, and Staff

Foote,

Rosenblatt,

Amortegui

et al. 2024

JAMA Netw Open

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“…Estudos revelam que pacientes atendidos por profissionais com alto nível de Burnout têm piores desfechos de saúde, incluindo maiores taxas de complicações e hospitalizações mais longas (Bitran et al, 2019;Foote et al, 2022). A redução da qualidade do cuidado devido ao Burnout pode levar a um ciclo vicioso, onde o aumento dos erros e a diminuição da satisfação dos pacientes aumentam ainda mais o estresse e o desgaste dos profissionais de saúde (West et al, 2018).…”

Section: Impacto Na Qualidade Do Atendimento Ao Pacienteunclassified

Fatores De Risco E Intervenções Eficazes Para a Síndrome De Burnout Entre Profissionais De Saúde: Uma Revisão Bibliográfica

Da Silva Júnior,

Muzzi Barcelos,

Sousa Gonçalves

et al. 2024

RECIMA21

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A síndrome de Burnout, caracterizada por esgotamento físico, emocional e mental, é prevalente entre profissionais de saúde devido às altas demandas e exposição contínua ao sofrimento alheio. Compreender os fatores de risco e intervenções eficazes é crucial para mitigar seus impactos negativos. Objetivo: A revisão bibliográfica realizada neste estudo visa abordar evidências recentes sobre os principais fatores de risco e as intervenções eficazes na síndrome de burnout em profissionais da saúde. Métodos: Realizou-se uma busca sistemática na literatura científica publicada entre 2009 e 2024 nas bases de dados PubMed, Web of Science, Scopus e Google Scholar. Foram identificados 690 estudos, dos quais 33 preencheram todos os critérios de inclusão e foram analisados detalhadamente. Resultados e Discussão: A revisão revelou alta prevalência de Burnout entre profissionais de saúde, com fatores de risco organizacionais (sobrecarga de trabalho, falta de apoio institucional) e individuais (perfeccionismo, baixa resiliência) significativos. Intervenções eficazes incluem reestruturação de turnos, programas de reconhecimento, técnicas de mindfulness e suporte psicológico. A implementação de estratégias de suporte social e uso de tecnologias de saúde mental também se mostraram promissoras. A integração de intervenções organizacionais e individuais é essencial para reduzir os efeitos do Burnout. Conclusão: A prevenção e o manejo do Burnout requerem intervenções multifacetadas que abordem tanto o ambiente de trabalho quanto as necessidades pessoais dos profissionais de saúde. A implementação de políticas de saúde pública e programas de apoio contínuos é fundamental para garantir a saúde mental dos profissionais de saúde e a qualidade do atendimento ao paciente.

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“…In addition, leaders need to build belief that the plans will be successful in promoting wellness by addressing the existing gap in the clinical learning environment and/or trainee experience. Studies demonstrating effective workplace interventions to promote wellness have been limited, so finding ways to communicate the personal impact of proposed changes may be more successful [ 2 , 3 , 19 – 21 ].…”

Section: Case Examplementioning

confidence: 99%

Teaming beyond the clinical environment – building collective commitment across graduate medical education

Laughlin,

Griffeth,

Bush

et al. 2023

BMC Med Educ

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Identifying institutional factors in general surgery resident wellness and burnout

Cited by 16 publications

References 29 publications

Experiences With Unionization Among General Surgery Resident Physicians, Faculty, and Staff

Experiences With Unionization Among General Surgery Resident Physicians, Faculty, and Staff

Fatores De Risco E Intervenções Eficazes Para a Síndrome De Burnout Entre Profissionais De Saúde: Uma Revisão Bibliográfica

Teaming beyond the clinical environment – building collective commitment across graduate medical education

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