| OCR Text |
Show What Do FM Residents Want For Burnout Prevention? Time. Jordan Knox MD, Katherine Fortenberry PhD, Sonja Van Hala MD MPH FAAFP Family Medicine Residency Program, Department of Family and Preventive Medicine, University of Utah Introduction • Burnout in medical trainees is high and impacted by many factors; recent changes to ACGME guidelines increase focus on resident wellness "What else could our residency program do to support wellness?" Efficiency 24% • Challenging for programs to address these factors with finite resources • University of Utah Family Medicine Residency Program has longitudinal wellness curriculum: o protected support group o established policies for physical/mental health appointments o structured wellness check-ins o structured peer support o structured faculty support Basic Needs 8% Protected Time 42% Sample Requests -Half day per week for administrative tasks -Half to third day per month protected for self-care appointments -Build in registry work to schedules Structured Events - promoting wellness beyond basic needs -Support Group for each class -Required weekly group fitness -Periodic debriefing for challenging rotations Schedule Efficiency - Reducing inefficiencies or needless burdens in schedules • Yet, our residents still report burnout/depression symptoms at higher rates than we would like. -Consolidate documentation -Cluster work responsibilities to minimize impact on weekends -Rotate holiday coverage Basics - Meeting residents' basic needs - Provide snacks at clinics -Provide residents with lists of medical/mental health/dental providers Methods Results • During one didactic session, we asked residents the question, "What else could our residency program do to support wellness?" • Time is of the essence - by priority and popularity 42% of votes favor time for personal and professional needs o Self-care: dental visits, exercise, adequate sleep o Patient care: complete notes/charting, patient panel outreach, read up on challenging cases • The authors independently coded these suggestions into themes • Our residents overwhelmingly prioritize time o Personal / self-care o Professional / patient-care • Data from single residency, but likely translates across residencies and settings. Structured Events 26% Theme Protect Time - allowing residents more unscheduled or protected time • Using nominal group technique, residents: o Provided any/all answers, #nofilter o Took turns providing suggestions until all ideas exhausted o Voted for top 8, weighted (8 = top priority, 1 = low priority) Discussion • Structured events 26% favored implementing activities for wellness • Reducing redundancy and improving efficiency, as well as "basic needs" (snacks, suggested health care providers) were less heavily favored by this voting. • Difficult to implement other strategies (mindfulness, healthy eating, medical appointments) without this. o Baseline needs: adequate sleep, self-care o Without this, capacity for self-care is severely limited. • Strained, moment-to-moment mentality impairs: o introspection o processing of emotions o learning from challenging patient encounters o possible leading factor in dissatisfaction leading to burnout • We have a system of training that normalizes overcommitment. It is time to open a conversation about redesigning medical training to reflect what we really need as people - time for work, and time for life. References Accreditation Council for Graduate Medical Education. ACGME Common Program Requirements Section VI with Background and Intent. 2017. Accessed 4/17/17 Ripp, Jonathan A., et al. "Well-being in graduate medical education: a call for action." Academic Medicine 92.7 (2017): 914-917. DEPARTMENT OF FAMILY AND PREVENTIVE MEDICINE |
