Improving burnout and well‑being among medicine residents: Impact of a grassroots intervention compared to a formal program curriculum
نویسندگان
1 Department of Medicine, Hospital Staff Physician, Malcolm Randal Veteran Affairs Medical Center, FL, USA
2 Department of Medicine, Division of Hospital Medicine, University of Florida College of Medicine, Gainesville, FL, USA
3
4
5 Department of Biostatistics and Data Science, University of Kansas Medical Center, Kansas City, Kansas, USA
6
7
doi
چکیده
BACKGROUND: With growing resident burnout, Accreditation Council for Graduate MedicalEducation issued new requirements for program interventions to optimize resident well‑being. Littleevidence exists on how to best teach resiliency to residents. This study assesses the impact ofboth a grassroots intervention and formal resiliency curriculum on resident burnout and well‑being.MATERIALS AND METHODS: From November 2016 to August 2017, residents in a large InternalMedicine Residency Program participated in grassroots wellness interventions from the resident‑ledGator Council in Gainesville, FL USA. From August 2017 to June 2018, residents participated ina formal program‑driven resiliency curriculum. Wellness interventions included monthly morningreports, bimonthly workshops, and biannual noon conferences. Pre‑ and postintervention MaslachBurnout Inventory (MBI) and Physician Well‑Being Index (PWBI) assessed the effect of bothinterventions on resident burnout and well‑being. Statistical analyses used Student’s t‑test, Fisher’sexact tests, and linear regression model.RESULTS: One hundred and twenty‑two residents participated in grassroots interventions. Onehundred and seventeen (87 residents, 35 students) participated in formal curriculum. Mean MBIscores for all three sections did not differ between pre ‑and postgrassroots intervention (emotionalexhaustion [EE] P = 0.46; depersonalization [DP] P = 0.43; personal accomplishment [PA] P = 0.73])or between pre‑ and postcurriculum (EE P = 0.20; DP P = 0.40; PA P = 0.51). Students scoredhigher burnout levels compared to residents in EE (P = 0.001) and PA (P = 0.02). Pre‑ versuspostcurriculum PWBI scores did not differ among residents (P = 0.20), while PWBI scores improvedamong students (P = 0.01).CONCLUSIONS: This study found no improvement in resident burnout or well‑being from abottom‑up and top‑down approach. Our results imply the need for an early wellness curriculumto improve student well‑being given their higher level of burnout. System‑wide efforts are vital tocombat physician burnout.
