Improving burnout and well-being among medicine residents: Impact of a grassroots intervention compared to a formal program curriculum

Amy J Sheer; Irene M Estores; Rachel Nickels; Nila Radhakrishnan; Dianne L Goede; Lazarus K Mramba; Margaret C Lo

doi:10.4103/jehp.jehp_1378_20

Improving burnout and well-being among medicine residents: Impact of a grassroots intervention compared to a formal program curriculum

J Educ Health Promot. 2021 Jul 30:10:250. doi: 10.4103/jehp.jehp_1378_20. eCollection 2021.

Authors

Amy J Sheer¹, Irene M Estores¹, Rachel Nickels², Nila Radhakrishnan³, Dianne L Goede¹, Lazarus K Mramba⁴, Margaret C Lo¹

Affiliations

¹ Department of Medicine, Division of General Internal Medicine, University of Florida College of Medicine, FL, USA.
² Department of Medicine, Hospital Staff Physician, Malcolm Randal Veteran Affairs Medical Center, FL, USA.
³ Department of Medicine, Division of Hospital Medicine, University of Florida College of Medicine, Gainesville, FL, USA.
⁴ Department of Biostatistics and Data Science, University of Kansas Medical Center, Kansas City, Kansas, USA.

Abstract

Background: With growing resident burnout, Accreditation Council for Graduate Medical Education issued new requirements for program interventions to optimize resident well-being. Little evidence exists on how to best teach resiliency to residents. This study assesses the impact of both 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 Internal Medicine Residency Program participated in grassroots wellness interventions from the resident-led Gator Council in Gainesville, FL USA. From August 2017 to June 2018, residents participated in a formal program-driven resiliency curriculum. Wellness interventions included monthly morning reports, bimonthly workshops, and biannual noon conferences. Pre- and postintervention Maslach Burnout Inventory (MBI) and Physician Well-Being Index (PWBI) assessed the effect of both interventions on resident burnout and well-being. Statistical analyses used Student's t-test, Fisher's exact tests, and linear regression model.

Results: One hundred and twenty-two residents participated in grassroots interventions. One hundred and seventeen (87 residents, 35 students) participated in formal curriculum. Mean MBI scores for all three sections did not differ between pre -and postgrassroots intervention (emotional exhaustion [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 scored higher burnout levels compared to residents in EE (P = 0.001) and PA (P = 0.02). Pre- versus postcurriculum PWBI scores did not differ among residents (P = 0.20), while PWBI scores improved among students (P = 0.01).

Conclusions: This study found no improvement in resident burnout or well-being from a bottom-up and top-down approach. Our results imply the need for an early wellness curriculum to improve student well-being given their higher level of burnout. System-wide efforts are vital to combat physician burnout.

Keywords: Burnout; curriculum; medical residency; resident burnout; resilience.