Resident Physician Wellness Curriculum: A Study of Efficacy and Satisfaction

Abstract

Background Recent literature highlights the alarming prevalence of burnout, depression, and illness during residency training; a trend that is also linked to suboptimal patient care. Dedicated wellness curricula may be one solution to this concerning issue. Purpose To determine the effect of a multi-faceted wellness curriculum during emergency medicine residency training on wellness scores and to assess resident satisfaction with the program. Methods This study was conducted via a longitudinal survey. In 2009, a faculty-derived resident wellness curriculum (F-RWC) was initiated. This program was then bolstered with a parallel resident-derived curriculum (R-RWC) one year later, in 2010. Emergency medicine residents were surveyed in 2009, 2010, and 2011 to assess wellness at baseline, after one year of the F-RWC, and after one year of combined RWCs, respectively. Surveys included two validated assessment instruments (the Brief Resident Wellness Profile (BRWP) and the SF-8^TM Health Survey), a satisfaction Likert scale, and a demographics information sheet. Results The survey response rates were 89% (n=17), 100% (n=17), and 83% (n=24) from 2009, 2010, and 2011, respectively, for a total of 58 participants. From baseline in 2009, there was a significant improvement in resident wellness, with the addition of parallel RWC by 2011, as measured by the BRWP (p=0.024). The faces scale, a subset of the BRWP, showed a trend toward benefit but did not reach statistical significance (p=0.085). There was no evidence of a statistically significant change in SF-8^TM scores over time. Participants consistently reported positive satisfaction scores with RWC initiatives. Conclusions Dedicated RWC, with input from both faculty and resident physicians, improved wellness during residency training with a high degree of participant satisfaction. Such programs are needed to support resident physicians during their training.

Keywords: physician burnout; physician well-being; resident curriculum; resident training; resident wellness; wellness.

Figure 1. Wellness scores

A) Scores from the Brief Resident Wellness Profile (BRWP; error bars represent mean and 95% confidence interval for each year). There was a significant improvement over time from 2009 to 2011 (p=0.024); B) Scores from the SF-8 health survey, Physical Component Summary (PCS-8; p=0.174); C) Scores from the SF-8 health survey, Mental Component Summary (MCS-8; p=0.392).

Figure 2. Faces scores

Faces scores (range from most unhappy face =0, to happiest face =6). The Fisher exact test showed improvement from 3.765 to 4.417 (from 2009 to 2011) but did not reach statistical significance (p=0.084). Faces illustration from Keim et al. 2006 [18].

Figure 3. Resident satisfaction with the Resident-derived Resident Wellness Curriculum (R-RWC)