The Resilient Resident: A Resiliency Curriculum on Physical Medicine and Rehabilitation Resident Burnout
DOI:
https://doi.org/10.5195/ijms.2023.3000Keywords:
Resiliency, • Education, Medical [I02.358.399], Curriculum, Burnout, PhysicianAbstract
Background: Physical Medicine and Rehabilitation (PM&R) physicians are among those most affected by burnout. Following the 2017 Revision of ACGME (Accreditation Council for Graduate Medical Education) Requirements, programs and institutions were encouraged to emphasize physician well-being and recognition and strategies to mitigate burnout. As an at-risk specialty, we desired to develop and implement a facilitated resilience curriculum for Resident Physicians (RPs).
Methods: Resilience Series workshop curriculum was put into action during the 2018-2019 academic year at a Rehabilitation Hospital. The leader of each workshop previously underwent formal resilience training in integrative health coaching and organizational leadership. In part with all RP’s, a four-part workshop series was conducted using four guiding questions: (1) “Who am I and who are we?”, (2) “What contributes to resilience?”, (3) “What challenges our resilience?”, and (4) “How can we combat challenges to resilience?”. Pilot data on curriculum usability was collected via an End of Curriculum Assessment (ECA) administered to all RPs. Data did not require specific statistical analysis computation.
Results: Key RP ECA themes highlighted that (1) RPs were highly engaged in the process, (2) all RPs reported the Resilience Curriculum was helpful, (3) strategies learned in times of stress were firmly adopted, (4) RPs endorsed increased comfort discussing personal struggles with peers and more control over work schedules.
Conclusions: Our resilience curriculum is a pilot program that provides an example curriculum to address RP burnout in the workplace and can be used to meet ACGME residency program requirements.
References
Maslach C, Jackson SE, Leiter MP. Maslach Burnout Inventory: 3rd ed. Consulting Psychology Press. 1986.
Shanafelt TD, Boone S, Litjen T, Dyrbye LN, Sotile W, Satele D, et al. Burnout and Satisfaction with Work-life Balance Among US Physicians Relative to the General US Population. Arch Intern Med. 2012;172(18):1377-85. doi: doi:10.1001/archinternmed.2012.3199
Shanafelt TD, Hasan O, Dyrbye LN, Sinsky C, Satele D, Sloan J, 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;90(12):1600-13. doi: 10.1016/j.mayocp.2015.08.023
Medscape. Medscape National Physician Burnout and Suicide report 2020. Available from: https://www.medscape.com/slideshow/2020-lifestyle-burnout-6012460; updated 2020 Jan 15.
Medscape. ‘Death by 1000 Cuts’: Medscape National Physician Burnout and Suicide Report 2021. Available from: https://www.medscape.com/slideshow/2021-lifestyle-burnout-6013456; updated 2021 Jan 22.
Shanafelt TD, West CP, Sinsky C, Trockel M, Tutty M, Satele DV, et al. Changes in Burnout and Satisfaction with Work-Life Integration in Physicians and the General US Working Population Between 2011 and 2017. Mayo Clin Proc. 2019;94(9):1681-1694. doi: 10.1016/j.mayocp.2018.10.023
Dyrbye LN, Burke SE, Hardeman RR, Herrin J, Wittlin NM, Yeazel M, et al. Association of Clinical Specialty with Symptoms of Burnout and Career Choice Regret Among US Resident Physicians. JAMA. 2018;320(11):1114-1130. doi:10.1001/jama.2018.12615
Bean AC, Schroeder AN, McKernan GP, Mesoros M, Silver JK, Verduzco-Gutierrez Monica, et al. Factors Associated with Burnout in Physical Medicine and Rehabilitation Residents in the United States, Am Journ of Phys Med & Rehab: 2022;101(7)674-684. doi: 10.1097/PHM.0000000000001886
Duke Health. Duke Health and Well-Being Coach Training. Available from: https://dhwprograms.dukehealth.org/health-wellbeing-coach-training/; updated 2024.
Silver JK, Bhatnagar S. Physician Burnout in Physical Medicine and Rehabilitation (PM&R): Should We Focus More on Physiatrists' Mission? Am J Phys Med Rehabil. 2017 Aug;96(8): e159-e161. doi: 0.1097/PHM.0000000000000674.
Rath, T. Strengths Finder 2.0. New York, NY: Gallup Press; 2007.
Briggs, Katharine C. Myers-Briggs Type Indicator. Form G. Palo Alto, Calif.: Consulting Psychologists Press, 1987.
Kolbe Corp. KOLBE A™ INDEX. Available from: https://secure.kolbe.com/k2/show_takeIndex/indexType_A; updated 2021; cited 2024.
LaFontaine TP, DiLorenzo TM, Frensch PA, Stucky-Ropp RC, Bargman EP, McDonald DG. Aerobic Exercise and Mood. Sports Medicine. 1992 Mar;13(3):160–70. doi: 10.2165/00007256-199213030-00002
Accreditation Council for Graduate Medical Education. ACGME Common Program Requirements Section VI with Background and Intent; updated 2017 Feb
Atrium Health. Department of Physical Medicine and Rehabilitation. Well-Being Policy. updated June 2024.
Wake Forest University School of Medicine. Counseling and Well-Being Services. Available from: https://school.wakehealth.edu/about-the-school/health-and-wellness/counseling-and-well-being; updated 2024
Wake Forest University School of Medicine. Mindful Medicine. Available from: https://school.wakehealth.edu/education-and-training/certificate-programs/mindful-medicine; updated 2024
Wake Forest University School of Medicine. Active Resilience Training. Available from: https://school.wakehealth.edu/education-and-training/certificate-programs/active-resilience-training; updated 2024
Liaison Committee on Medical Education. Functions and Structure of a Medical School: Standards for Accreditation of Medical Education Programs Leading to the MD Degree. 2024 March.
Ogrinc G, Davies L, Goodman D, Batalden PB, Davidoff F, Stevens D. SQUIRE 2.0 (Standards for Quality Improvement Reporting Excellence): revised publication guidelines from a detailed consensus process. BMJ Quality & Safety 2016; 25:986-992.
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