Wellness behavior profiles of internal medicine and psychiatry residents
Main Article Content
Abstract
Background
The ACGME requires that residency training programs (RTP) establish interventions that facilitate resident well-being, promote resilience, and guard against burnout. There is, however, limited data characterizing residents’ engagement in wellness promoting behaviors during training to guide these initiatives.
Methods
We surveyed all internal medicine and psychiatry residents at our institution regarding sixteen self-care or wellness-promoting behaviors that could have been performed away from work over the preceding 30-days; they were divided into activities done alone and those involving others.
Results
101 residents were invited to share their behavioral profiles. Most residents completed the entirety of the survey (86%, n=87). Getting a good night’s sleep (sleeping >7 hours consecutively) was the most frequent behavior that did not require others (averaged 14 times in prior 30 days). The most frequent wellness activities involving others included “cuddling” with another adult (16 times), calling family members (13 times), and sharing a meal with friends or family (11 times). Most behaviors (13/16) were performed more frequently among residents compared to interns; two of these reaching statistical significance - sleeping >7 hours consecutively and attending a special event (both P < 0.05).
Discussion
This study offers a glimpse into the self-care activities of interns and residents in 2 training programs. The wellness behaviors that were most commonly endorsed involved trainees’ friends and family. These behavioral profiles of interns and residents may serve to inform the development of the program-specific wellness curricula that have been mandated by the ACGME.
Article Details
The Medical Research Archives grants authors the right to publish and reproduce the unrevised contribution in whole or in part at any time and in any form for any scholarly non-commercial purpose with the condition that all publications of the contribution include a full citation to the journal as published by the Medical Research Archives.
References
2. Dyrbye, LN et al. Burnout and suicidal ideation among US medical students. Ann Intern Med. 2008: 2;149(5):334-41.
3. Shanafelt, TD et al. Changes in burnout and satisfaction with work-life balance in physicians and the general US working population between 2011 and 2014. Mayo Clin Proc. 2015 Dec;90(12):1600-13. doi: 10.1016/j.mayocp.2015.08.023.
4. Lefebvre, DC. Perspective: Resident physician wellness: A New Hope. Acad Med. 2012;87(5):598-602. doi: 10.1097/ACM.0b013e31824d47ff.
5. Ripp, JA et al., “Well-being in graduate medical education: A call to action”. Acad Med. 2017 Jul;92(7):914-917. doi: 10.1097/ACM.0000000000001735.
6. Oreskovich, MR. The prevalence of substance use disorders in American physicians. Am J Addict. 2015 Jan;24(1):30-8. doi: 10.1111/ajad.12173.
7. Shanafelt TD et al. Relationship between increased personal well-being and enhanced empathy among internal medicine residents. J Gen Intern Med. 2005; 20(7): 559–564.
8. Kahneman D. The lazy controller. Thinking, Fast and Slow. New York, NY: Foarrar, Straus and Giroux; 2011.
9. ACGME Common Program Requirements, 2017. Accreditation Council for Graduate Medical Education.
10. Wright SM et al. Attributes of excellent attending-physician role models. N Eng J Med. 1998; 339: 1986-93.
11. Wright SM, Carrese JA. Which values do attending-physicians try to pass on to house officers? Medical Education. 2001; 35: 941-945.
12. Pang, Alex Soojung-Kim. Sleep. In: Rest: Why you get more done when you work less. New York, NY: Basic Books; 2016.
13. Frank E, Rothenberg R, Lewis C, Belodoff BF. Correlates of physicians’ prevention-related practices: findings from the Women Physicians’ Health Study. Arch Fam Med 2000;9(4):359-67.
14. Abramson S, Stein J, Schaufele M, Frates E, Rogan S. Personal exercise habits and counseling practices of primary care physicians: a national survey. Clin J Sport Med 2000;10(1):40-8.
15. Panagioti M et al. Controlled interventions to Reduce Burnout in Physicians: A Systematic Review and Meta-analysis. JAMA Intern Med. 2017; 177 (2): 195-205. Doi:10.1001/jamaInternmed.2016.7674.
16. Awa W, Plaumann M, Walter U. Burnout prevention: a review of intervention programs. Patient Educ Couns. 2010;78(2):184-190.
17. Ruotsalainen J, Verbeek J, Mariné A, Serra C. Preventing occupational stress in healthcare workers. Cochrane Database Syst Rev. 2015;(4):CD002892.
18. Lebensohn P et al. Resident wellness behaviors: relationship to stress, depression and burnout. Fam Med. 2013 Sep; 45(8): 541-9.
19. Dyrbye L, Shanafelt T. A narrative review on burnout experienced by medical students and residents. Med Educ. 2016 Jan; 50 (1): 132-49.
20. Desai SV, Feldman L, Brown L, er al. Effect of the 2011 vs 2003 duty hour regulation-compliant models on sleep duration, trainee education and continuity of patient care among internal medicine house staff: a randomized trial. JAMA Intern Med. 2013; 173 (8): 649-655. Doi:10.1001/jamainternalmed.2013.2973.
21. Williams D., Tricomi G, Gupta J, Janise A. Efficacy of burnout interventions in the medical education pipeline. Acad Psychiatry. 2015 Feb; 39 (1): 47-54.
22. Williams AS et al. Understanding the exercise habits of residents and attending physicians: a mixed methodology study. Fam Med. 2015 Debl 47 (2): 118-23.
23. Taylor T et al. Recovery of sleep or recovery of self? A grounded theory study of residents’ decision making regarding how to spend their nonclinical postcall time. Acad Med. 2016; 91:395-400.
24. Baldwin Jr., DC, Daugherty, SR, Ryan, PM, Yaghmour, NA. What do residents do when not working or sleeping? A multispecialty survey of 36 residency programs. Acad Med. 2012;87:395-402.
25. Khandelwal S, Zemore SE, Hemmerling A. Nutrition education in internal medicine residency programs and predictors of residents’ dietary counseling practices. J Med Educ Curric Dev. 2018 Mar 21.
26. American Medical Association. Preventing burnout in medical residents and fellows: 6 keys for wellness. January 20, 2016. Accessed online at https://www.ama-assn.org/residents-students/resident-student-health/preventing-burnout-medical-residents-and-fellows-6-keys.
27. Jauhar S., “The real problem with medical internships”. The New York Times. July 1, 2015.