Poster3-02: RESILIENCE COACHING THROUGH POSITIVE PSYCHOLOGY: A NOVEL WELL-BEING INITIATIVE FOR SURGICAL INTERNS
Robert A Swendiman, MD, MPP1, Yun Song, MD1, Samuel Torres Landa, MD2, Faisal Kahn, EMTM, MAPP3, David F Sigmon, MD1, Robert Caskey, MD1, Ari D Brooks, MD, MS1, Noel N Williams, MD1, Kristoffel R Dumon, MD1, Cary B Aarons, MD1; 1University of Pennsylvania Health System, 2Oregon Health Sciences University, 3University of Pennsylvania
Background: Medical students experience high rates of burnout, which can be worsened by the demanding transition to surgical training. However, there remains uncertainty in the appropriate intervention(s). We developed a well-being coaching intervention informed by the science of positive psychology to help interns increase resilience, engagement at work, and reduce burnout.
Methods: We initiated a new wellness and resilience curriculum starting in July 2018. Baseline surveys, including the Maslach Burnout Inventory for Medical Personnel (MBI), Physician Well-Being Index, and the Perceived Stress Scale, were administered to the entire residency program. The abbreviated Maslach Inventory (AMI), the Brief Resilience Scale, the Scale of Positive and Negative Experience (SPANE), and Value in Action Inventory of Strengths (VIA) were also administered to the incoming interns in General, Vascular, Cardiac, Plastic, and Urologic surgery for assessment prior to starting residency. Incoming interns receive year-long resilience and positive psychology coaching through an outside consulting firm. Mid-year semi-structured interviews will assess ongoing needs. Post-intervention surveys will evaluate program impact.
Results: The MBI identified 47% of the incoming interns at high risk of burnout. Most reported depersonalization (41%) with lower levels of emotional exhaustion (12%) and low personal accomplishment (12%). In contrast, 57% of current residents met criteria for high risk of burnout, which peaked in the third clinical year. Pre-intervention assessments among interns revealed potential differences by gender in emotional exhaustion on the AMI (men 7.06; women 9.38, p = 0.21), in the Brief Resilience Scale (men 4.05; women 3.37, p = 0.05), and in the SPANE negative affect (men 14; women 17.3, p = 0.09). VIA surveys demonstrated high levels of overlapping character strengths in honesty, judgement, love of learning, and kindness among new interns, but also suggested differences in creativity, kindness, leadership and prudence by gender.
Conclusions: Almost half of incoming interns demonstrated high risk for burnout, even prior to beginning their surgical training. Closer formative program evaluation highlights increased risk of burnout among junior residents and a potential gender disparity, which will require strategic interventions. Wellness initiatives should match housestaff needs in each program to maximize efficacy.