Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2022;1(1):12.
doi: 10.1007/s44186-022-00014-3. Epub 2022 Mar 31.

Flourishing as a guide to intervention: a national multicenter study of general surgery residents

Anya L Greenberg  1 , Christy Boscardin  2 , Carter C Lebares  1 ; General Surgery Research Collaborative on Resident Wellbeing
Collaborators, Affiliations

Flourishing as a guide to intervention: a national multicenter study of general surgery residents

Anya L Greenberg et al. Global Surg Educ. 2022.

Abstract

Purpose: Physician wellbeing is critical to maximize patient experience, quality of care, and healthcare value. Objective measures to guide and assess efficacy of interventions in terms of enhanced thriving (as opposed to just decreased pathology) have been limited. Here we provide early data on modifiable targets, potential interventions, and comparative impact.

Methods: In this cross-sectional survey-based study of mixed-level residents at 16 academic General Surgery training programs, gender-identity, race, post-graduate year, and gap years were self-reported. Correlation between our primary outcome variable, flourishing, and measures of resilience (mindfulness, personal accomplishment [PA], workplace support, workplace control) and risk (depression, emotional exhaustion, depersonalization, perceived stress, anxiety, workplace demand) were assessed.

Results: Of 891 recipients, 300 responded (60% non-male, 41% non-white). Flourishing was significantly positively correlated with all measured resilience factors and negatively correlated with all measured risk factors. In multivariable modelling, mindfulness, PA, and workplace support were positively and significantly associated with flourishing, with PA having the strongest resilience effect. Depression and anxiety were negatively and significantly associated with flourishing, with depression having the strongest risk effect.

Conclusions: Our results suggest that interventions that increase mindfulness, workplace support, and PA, as well as those that decrease depression and anxiety may particularly impact flourishing (i.e., global wellbeing) in surgical trainees. These findings provide preliminary guidance on allocation of resources toward wellbeing interventions. In particular, cognitive (i.e., mindfulness) training is a feasible intervention with modest but significant association with flourishing, and potential indirect effects through influence on PA, anxiety and depression.

Supplementary information: The online version contains supplementary material available at 10.1007/s44186-022-00014-3.

Keywords: Distress; Flourishing; Job strain; Mindfulness for surgeons; Surgical education; Surgical resident wellbeing.

PubMed Disclaimer

Conflict of interest statement

Conflict of interestThe authors declare no competing interests.

References

    1. Aaronson AL, Backes K, Agarwal G, Goldstein JL, Anzia J. Mental health during residency training: assessing the barriers to seeking care. Acad Psychiatry. 2018;42(4):469–72. 10.1007/s40596-017-0881-3. - PubMed
    1. Accreditations Council for Graduate Medical Education (2017) ACGME Common Program Requirements: section VI with background intent. 20.
    1. Accreditations Council for Graduate Medical Education, Brigham, T., Barden, C., American Association of Critical Care Nurses, Legreid Dopp, A., American Society of Health System Pharmacists, Hengerer, A., Federation of State Medical Boards, Kaplan, J., American College of Emergency Physicians, Malone, B., National League for Nursing, Martin, C., American Society of Health System Pharmacists, McHugh, M., University of Pennsylvania School of Nursing, Nora, L. M., & American Board of Medical Specialties. A journey to construct an all-encompassing conceptual model of factors affecting clinician well-being and resilience. NAM Perspect. 2018. 10.31478/201801b
    1. Addolorato G, Ancona C, Capristo E, Graziosetto R, Di Rienzo L, Maurizi M, Gasbarrini G. State and trait anxiety in women affected by allergic and vasomotor rhinitis. J Psychosom Res. 1999;46(3):283–9. 10.1016/S0022-3999(98)00109-3. - PubMed
    1. Aggarwal R, Kim K, O’Donohoe J, Kleinschmit K. Implementing organizational strategies for resident well-being: practical tips. Acad Psychiatry. 2019;43(4):400–4. 10.1007/s40596-019-01045-7. - PubMed

LinkOut - more resources