Resident Wellness Initiative to Reduce Burnout and Mitigate Stress

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BACKGROUND:Burnout during residency training has gained significant attention over the past several years. High-rates of burnout, depression and anxiety have been documented in residents throughout their training and a call has been made to develop programs to help mitigate the stress of residency training. We undertook a comprehensive resident wellness initiative to assess burnout and offer residents potential interventions and coping strategies to decrease burnout and reduce stress.METHODS:An interventional trial was developed where we incrementally introduced multiple wellness initiatives from September 2012 through June 2016 in an OB/GYN residency program in a large urban university medical center. The wellness initiatives included increased access to program and department leadership for ongoing program improvements, formalized mindful practice training with an emphasis on stress-reduction techniques, confidential, free access to psychotherapy, group conflict mediation and peer and faculty engagement in a mentorship program. Prior to the start of the program and annually, the residents were assessed with the Maslach Burnout Inventory (MBI) and the Perceived Stress Scale. Additionally, we tracked resident satisfaction with the program through an annual online survey review of the training program.RESULTS:Forty-nine residents participated in the program over 3 years. At the beginning of the wellness initiative, 64% of the residents exhibited signs of burn-out as defined by two or more high-risk scores in the MBI subcategories. Perceived stress was above normative values in 61% of the residents. Within the first year the number with burn-out signs began to stabilize (62%) and improve in year 2 (51%; P<.05). This trend has been maintained through year 3 (49%). Additionally, there was a decrease in the number of residents with perceived stress scores above the norm (49%; P<.05), suggesting an improvement in coping mechanisms with additional exposure to the wellness curriculum. We saw no difference in overall number of residents reporting a “very positive” residency experience (72%, range 65%–79%) over the course of the wellness initiative.DISCUSSION:A comprehensive resident wellness initiative can offer a significant improvement in preventing burnout, reducing stress burdens, and potentially improve resiliency in residency through the development of useful coping mechanisms.

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