Burnt Out, Now What? General Surgery Residents Experience With Burnout and Implementation of Department Sponsored Wellness Program
Chelsey Ciambella, Kenneth Lynch, Daryl Appleton, Tareq Kheirbek, David Harrington, Thomas Miner, William G. Cioffi
General Surgery, Brown University, Providence, Rhode Island, United States
Objectives: The physical, psychological, & professional stresses of surgical residency may contribute to high rates of burnout, depression & suicide among practicing physicians. We investigated if a multifaceted wellness program results in decreased burnout among general surgery residents. Design: Retrospective review of de-identified longitudinal survey data including the Maslach Burnout Inventory (MBI) from 2020-2021. Setting: General surgery residents at an academic level 1 trauma center in the northeast Participants: Preliminary & categorical general surgery residents, rotators from other programs were excluded. Interventions: Department funded multifaceted Residency Wellness Program including oversight & coordination by a chief surgical resident (wellness chief) & the hiring of a departmental wellness coach. Wellness chief responsibilities included coordination of structured, faculty led mentorship dinners, regularly scheduled social events, & availability of healthy snacks in call rooms throughout the academic year. The departmental wellness coach was fully integrated into the resident academic calendar, providing 3 solution-based resident lectures (Intro to Wellness, Managing Up & Across, Stress Interventions), 1 on 1 resident coaching, & mandatory twice yearly meetings for first year residents. Main Outcomes: The MBI is a validated psychological assessment instrument comprising 22 symptom items pertaining to occupational burnout. This survey was administered to all residents prior to the formal wellness program in Fall 2020 & then again after, in Spring 2021. Burnout was defined as a high score on emotional exhaustion & depersonalization. Cutoffs for each tertile of burnout were empirically determined based upon previously validated, normative MBI-HSS data for healthcare workers (Low EE ≤18, Moderate EE 19-26, High EE ≥27; Low DP ≤5, Moderate DP 6-9, High DP ≥10; Low PA ≥34, Moderate PA 29-33, High PA ≤28) Results: The MBI pre-survey had a 100% response rate. 14 of 49 (29%) respondents were at high risk for burn-out. During 2020-2021 there were 48 total 1:1 coaching sessions, averaging 44 minutes in length. Participant breakdown was PGY1: 100%, PGY2: 33.3%, PGY3: 14.3%, PGY4: 14.3%, PGY5: 57.2%. MBI post-survey had 98% response rate & 11 of 48 (23%) were at high risk for burn-out. Conclusions: To ensure a healthy resident population & support best outcomes for patients, the medical education community must not only identify those at risk for burnout but also implement effective strategies for wellness promotion. A department sponsored wellness program, including chief resident oversight, combined with a dedicated wellness coach, can help mitigate burnout, which has been shown to increase work satisfaction & improve validated metrics related to wellness & success. Continued analysis of this data long-term is needed to further delineate the beneficial effect a program such as this can have on overall resident wellness.
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