Wellness Interventions in Emergency Medicine Residency Programs: Review of the Literature Since 2017

Chung, Arlene S.; Mott, Sarah; Rebillot, Katie; Li‐Sauerwine, Simiao; Shah, Sneha; Coates, Wendy C.; Yarris, Lalena M.

doi:10.5811/westjem.2020.11.48884

Cited by 8 publications

(18 citation statements)

References 20 publications

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“…The majority of interventions targeting external factors fulfill at least one of the 10 recommendations which comprise the well‐being section of the Common Program Requirements. While almost every residency program described the existence of wellness interventions, few reach publication 11 . Because of the relative dearth of literature describing outcomes‐level data for wellness programming, a rigorous examination of the efficacy of these interventions would further the field with respect to understanding “what works.”…”

Section: Discussionmentioning

confidence: 99%

“…A recently published systematic review of wellness interventions for resident physicians across all specialties recommends that interventions are grounded in educational theory, using validated wellness instruments 10 . Within EM residency programs, existing publications of wellness interventions spotlight a few programs with modest impact 11 . To date, there has not been a national assessment of existing interventions intended to improve resident wellness in emergency medicine and gaps therein.…”

Section: Introductionmentioning

confidence: 99%

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Moving beyond personal factors: A national study of wellness interventions in emergency medicine residency programs

Li‐Sauerwine

Rebillot

Chung

et al. 2021

AEM Education and Training

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Background In 2017, the Accreditation Council for Graduate Medical Education (ACGME) revised its Common Program Requirements to support trainees and faculty by mandating programs to provide dedicated wellness resources and education. Emergency medicine may benefit from this change due to high burnout rates within the specialty. However, the current state of wellness interventions in emergency medicine (EM) residency programs has not yet been well described. Understanding current practices is necessary to assess unmet needs and inform the development and evaluation of future interventions that aim to improve trainee wellness. Objectives The goal of this study was to describe currently implemented wellness interventions in EM residency programs. Methods This descriptive study surveyed 250 ACGME‐accredited EM residency programs between March 1 and June 1, 2020, regarding wellness interventions. The survey included demographic questions; structured multiple‐choice questions about cost, frequency, and champions; and free‐text response options to briefly describe interventions. Respondents were also asked to classify the interventions according to the seven factors described in the National Academy of Medicine Model of Clinician Well‐Being and Resilience. Results Ninety of 250 (36% response rate) residency programs participated, describing 162 unique wellness interventions. Respondents classified the majority of interventions (n = 136) as targeting personal factors according to the National Academy of Medicine model. Qualitative analysis revealed five major themes describing the interventions: program culture, program factors, environmental and clinical factors, wellness activities and practices, and wellness resources. Conclusions Results of this survey may help to inform a national needs assessment addressing the current state of wellness interventions in EM residency programs. Our results highlight the need for more interventions targeting external factors impacting resident wellness.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Moving beyond personal factors: A national study of wellness interventions in emergency medicine residency programs

Li‐Sauerwine

Rebillot

Chung

et al. 2021

AEM Education and Training

Self Cite

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“…It is a novel intervention that can teach habits of self-monitoring and self-reflection. 5,6 This implementation requires budget support, clear goals, and finding an appropriate…”

Section: Lessons Learnedmentioning

confidence: 99%

“…Implementation of an emergency medicine residency social worker/coach is feasible. It is a novel intervention that can teach habits of self‐monitoring and self‐reflection 5,6 . This implementation requires budget support, clear goals, and finding an appropriate individual to provide services.…”

Section: Lessons Learnedmentioning

confidence: 99%

Implementation of dedicated social worker coaching for emergency medicine residents ‐ Lessons learned

Buchanan,

Meadows,

Whitehead

et al. 2023

JACEP Open

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Emergency medicine training is associated with high levels of stress and burnout, which were exacerbated by the COVID‐19 pandemic. The pandemic further exposed a mismatch between trainees' mental health needs and timely support services; therefore, the objective of our innovation was to create an opportunity for residents to access a social worker who could provide consistent coaching. The residency leadership team partnered with our graduate medical education (GME) office to identify a clinical social worker and professionally‐trained coach to lead sessions. The project was budgeted at an initial cost of $15,000 over 1 year. Residents participated in 49 group and 73 individual sessions. Post implementation in 2021, we compared this intervention to all other wellness initiatives. Resident response rate was 80.88% (n = 55/68) and median interquartile range (IQR) score of the initiative was 2 (1 = detrimental and 4 = beneficial) versus 3.79 (3.69–3.88) the median IQR of all wellness initiatives. A notable number, 22%, rated the program as detrimental, which could be related to summary comments regarding ability to attend sessions, lack of session structure, loss of personal/educational time, and capacity of the social worker to relate with them. Summary comments also revealed the innovation was useful, with individual sessions preferred to group sessions. Application of a social worker coaching program in an emergency medicine residency program appears to be a feasible novel intervention. Lessons learned after implementation include the importance of recruiting someone with emergency department/GME experience, orienting them to culture before implementation and framing coaching as an integrated residency resource.

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“…[59][60][61][62][63][64][65] In contrast, interventions designed to address individual factors, including self-care workshops, mindfulness training, support groups, and wellness curricula have had a small or negligible effect on reducing resident burnout. 59,[66][67][68] Further research is needed to develop optimal strategies to mitigate burnout in residents.…”

Section: Possible Solutions and Future Directionsmentioning

confidence: 99%

Factors Associated With Burnout in Physical Medicine and Rehabilitation Residents in the United States

Bean

Schroeder

McKernan

et al. 2021

Am J Phys Med Rehabil

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ObjectivesThe aims of the study were to determine the prevalence of burnout in physical medicine and rehabilitation residents in the United States and to identify the personal- and program-specific characteristics most strongly associated with residents reporting burnout.DesignThis was a cross-sectional survey of US physical medicine and rehabilitation residents. Emotional exhaustion, depersonalization, and burnout were assessed using two validated items from the Maslach Burnout Inventory. Associations of burnout with demographics and personal factors, residency program characteristics, perceived program support, and work/life balance were evaluated.ResultsThe survey was completed by 296 residents (22.8%), with 35.8% of residents meeting the criteria for burnout. Residents’ perception of not having adequate time for personal/family life was the factor most strongly associated with burnout (χ2 = 93.769, P < 0.001). Residents who reported inappropriate clerical burden and working more than 50 hrs/wk on inpatient rotations were most likely to report that they did not have adequate time for personal/family life. Faculty support (χ2 = 41.599, P < 0.001) and performing activities that led residents to choose physical medicine and rehabilitation as a specialty (χ2 = 93.082, P < 0.001) were protective against burnout.ConclusionsResidents reporting having inadequate time for their personal/family life was most strongly associated with physical medicine and rehabilitation resident burnout, although many personal and program characteristics were associated with burnout.

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Wellness Interventions in Emergency Medicine Residency Programs: Review of the Literature Since 2017

Cited by 8 publications

References 20 publications

Moving beyond personal factors: A national study of wellness interventions in emergency medicine residency programs

Moving beyond personal factors: A national study of wellness interventions in emergency medicine residency programs

Implementation of dedicated social worker coaching for emergency medicine residents ‐ Lessons learned

Factors Associated With Burnout in Physical Medicine and Rehabilitation Residents in the United States

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