BACKGROUND: Burnout continues to erode the physician workforce, and there are few effective intervention studies to guide educators. OBJECTIVE: We explored residents' experience in a model environment emphasizing resident wellness, safety, and interpersonal skills. METHODS: As 1 of 14 participants in the national Preparing the Personal Physician for Practice (P4) project, the family medicine residency at Lehigh Valley Health Network implemented a series of curricular changes designed to transform the culture of education. This mixed-methods case study utilizes the results from 3 quantitative self-report instruments for well-being, along with content analysis of transcripts from 20 focus groups and 33 resident advising sessions to describe experiences of the residents enrolled between July 2007 and June 2012. RESULTS: In the intervention, we found no statistically significant quantitative differences in the well-being of residents compared with the family medicine faculty and staff. Deductive (a priori and template) analysis and inductive thematic analysis of the residents' articulations of their experiences revealed 6 recurrent themes: naming/articulation of emotions, relationships, attitudes about self-care, self-reflection, delivery of learning experiences, and availability of resources. CONCLUSIONS: Quantitative measures of well-being did not capture the experiential value of the curricular innovations implemented by the residency program, while qualitative analysis highlighted themes important to residents. While not all residents in the intervention expressed support for the changes, repeated references to the nurturing educational environment indicate recognition of, and favorable responses to, the creation of an emotionally intelligent learning community.
BACKGROUND: Burnout continues to erode the physician workforce, and there are few effective intervention studies to guide educators. OBJECTIVE: We explored residents' experience in a model environment emphasizing resident wellness, safety, and interpersonal skills. METHODS: As 1 of 14 participants in the national Preparing the Personal Physician for Practice (P4) project, the family medicine residency at Lehigh Valley Health Network implemented a series of curricular changes designed to transform the culture of education. This mixed-methods case study utilizes the results from 3 quantitative self-report instruments for well-being, along with content analysis of transcripts from 20 focus groups and 33 resident advising sessions to describe experiences of the residents enrolled between July 2007 and June 2012. RESULTS: In the intervention, we found no statistically significant quantitative differences in the well-being of residents compared with the family medicine faculty and staff. Deductive (a priori and template) analysis and inductive thematic analysis of the residents' articulations of their experiences revealed 6 recurrent themes: naming/articulation of emotions, relationships, attitudes about self-care, self-reflection, delivery of learning experiences, and availability of resources. CONCLUSIONS: Quantitative measures of well-being did not capture the experiential value of the curricular innovations implemented by the residency program, while qualitative analysis highlighted themes important to residents. While not all residents in the intervention expressed support for the changes, repeated references to the nurturing educational environment indicate recognition of, and favorable responses to, the creation of an emotionally intelligent learning community.
Authors: Tait D Shanafelt; Sonja Boone; Litjen Tan; Lotte N Dyrbye; Wayne Sotile; Daniel Satele; Colin P West; Jeff Sloan; Michael R Oreskovich Journal: Arch Intern Med Date: 2012-10-08