Maintaining the Fire but Avoiding Burnout: Implementation and Evaluation of a Resident Well-Being Program - 26/03/18

Doi : 10.1016/j.jamcollsurg.2017.12.017

Taylor S. Riall, MD, PhD, FACS ^a,^⁎ , Joshua Teiman, MD ^a, Michelle Chang, MD ^a, Denzel Cole, MD ^a, Tambre Leighn, MA, CPC, PCC ^c, Hilary McClafferty, MD ^b, Valentine N. Nfonsam, MD ^a
^a Department of Surgery, University of Arizona, Tucson, Arizona
^b Center for Integrative Medicine, University of Arizona, Tucson, Arizona
^c Los Angeles, CA

^∗Correspondence address: Taylor S Riall, MD, PhD, FACS, Department of Surgery, University of Arizona, 1501 N Campbell Ave, Rm 4410, PO Box 245131, Tucson, AZ 85724.Department of SurgeryUniversity of Arizona1501 N Campbell AveRm 4410PO Box 245131TucsonAZ85724

Abstract

Background

There have been few programs designed to improve surgical resident well-being, and such efforts often lack formal evaluation.

Study Design

General surgery residents participated in the Energy Leadership Well-Being and Resiliency Program. They were assessed at baseline and 1 year after implementation using the Energy Leadership Index (measures emotional intelligence), Maslach Burnout Inventory General Survey, Perceived Stress Scale, the Beck Depression Inventory, and the annual required ACGME resident survey. Scores before and after implementation were compared using paired t-tests for continuous variables and chi-square tests for categorical variables.

Results

Forty-nine general surgery residents participate in the program. One year after implementation, resident score on the Energy Leadership Index improved (from 3.16 ± 0.24 to 3.24 ± 0.32; p = 0.03). Resident perceived stress decreased from baseline (Perceived Stress Scale score, from 17.0 ± 7.2 to 15.7 ± 6.2; p = 0.05). Scores on the emotional exhaustion scale of the Maslach Burnout Inventory decreased (from 16.8 ± 8.4 to 14.4 ± 8.5; p = 0.04). Resident-reported satisfaction improved in many areas; satisfaction with leadership skills, work relationships, communication skills, productivity, time management, personal freedom, and work-life balance, increased during the 1-year intervention (p = NS). On the annual ACGME resident survey, residents' evaluation of the program as positive or very positive increased from 80% to 96%.

Conclusions

This study demonstrates that formal implementation of a program to improve resident well-being positively impacted residents' perceived stress, emotional exhaustion, emotional intelligence, life satisfaction, and their perception of the residency program. Formal evaluation and reporting of such efforts allow for reproducibility and scalability, with the potential for widespread impact on resident well-being.

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Abbreviations and Acronyms : ARL, BDI, ELI, MBI, PSS, PWBI