Well-Being Intervention in General Surgery: Multicenter Study of Program Director and Resident Perspectives

Abstract

BACKGROUND: Physician well-being is critical for optimal care, but rates of psychological distress among surgical trainees are rising. Although numerous efforts have been made, the perceived efficacy of well-being interventions is not well understood. STUDY DESIGN: This qualitative thematic study included online questionnaires to Program Directors (PDs) and residents at 16 ACGME-accredited General Surgery residency programs. PDs reported active well-being interventions for surgical residents or those under consideration at their institutions. Residents shared perspectives of available well-being interventions through open-ended responses. Conventional content analysis was used to analyze responses. RESULTS: Fifteen PDs, or their proxies (94% response rate), responded. Responses revealed that a majority of available well-being interventions are focused on changing the individual experience rather than the underlying workplace. PD decision-making around well-being interventions is often not based on objective data. Three hundred residents (34% response rate) responded. Of available interventions, those that increase control (eg advanced and flexible scheduling), increase support (eg mentorship), and decrease demand (eg work hour limits) were consistently identified as beneficial, but interventions perceived to increase demand (eg held during unprotected time) were consistently identified as not beneficial. Group social activities, cognitive skills training, and well-being committees were variably seen as beneficial (increasing support) or not (increasing demand). CONCLUSIONS: Our findings underscore the prevalence of individual-based well-being interventions and the paucity of system-level changes. This may explain, in part, the persistence of distress among residents despite abundant effort, highlighting the imperative for system-level transformation.

The Current State of Plastic Surgery Residency Wellness Programs: Benefits and Barriers

“…Mandatory attendance for wellness events reduces their benefit, as forced attendance is perceived as counterintuitive by adding on to existing responsibilities and schedules. 28,33 Mandated participation must be balanced with each resident's desire or need to access wellness resources. Half of programs publish wellness calendars and curriculum, which may represent one strategy for offering residents more flexibility in how they access wellness resources.…”

“…27 Despite attempts to address plastic surgery resident wellness, the structure of wellness programs and interventions in plastic surgery residency programs has not been described as in other surgical fields, such as general surgery, urology, otolaryngology (ENT), ophthalmology, and obstetrics and gynecology (OBGYN). [28][29][30][31][32] The purpose of this study was to catalog features of plastic surgery residency wellness programs and evaluate program directors' sentiments towards their wellness programs.…”

Belonging in Surgery

“…6 Importantly, high surgeon stress levels are associated with burnout, depression, and worse patient outcomes. 32,33 While there are traditional activities that can mitigate stress, such as mindfulness exercises, 34,35 they are often hard to coordinate within a typical surgeon's workload. These data suggest that stress reduction may be possible through increasing a sense of community among surgeons and surgical trainees by addressing Belonging in Surgery.…”