DEVELOPING A RESIDENCY WELLNESS CURRICULUM UTILIZING SELF-CARE PLANS
BACKGROUND: The ACGME has placed an emphasis on implementing wellness guidelines, including processes to assess burnout and mechanisms to intervene if a resident is at risk. Our study aims to evaluate and improve resident understanding of wellness and burnout, and to develop a self-care plan in an effort to reinforce compliance and effect change in individual wellness behaviors.
METHODS: Residents and faculty from Internal Medicine, Med-Peds and Pediatrics were included in the study. A pre-survey was distributed to obtain baseline information regarding burnout, perceptions of wellness and reflections of the individual's state of wellness. An educational intervention was conducted as a five-hour workshop emphasizing signs of burnout and promoting self-reflection. Each resident and faculty member were educated and encouraged to create a self-care plan that included two wellness goals. Following the workshop, a post-survey assessed knowledge of burnout, wellness and self-care wellness plan initiation. After 3 months, participants were surveyed again to assess retention of knowledge about burnout and wellness, as well as the ability to follow through with a self-care plan.
Results: A total of 48 respondents completed the pre-seminar survey. Of those 48 respondents, 26 (54.17%) also completed the post-seminar survey. The three-month follow up survey had a total of 22 (45.83%) responses. Frequent self-care domains chosen by participants included diet, physical exercise, and mindfulness/meditation. Prior to the five-hour workshop, 30.77% of respondents felt confident in their knowledge of resources for addressing burnout; this increased to 88.46% after the workshop, which was statistically significant (p-value = 0.0468). Although not statistically significant, at 3-months 63.64% of respondents were knowledgeable in regards to resources when experiencing burnout. On the pre-workshop survey and the 3-month follow up survey, 81.82% of respondents were personally satisfied with their work and 86.36% were happy with their career choice. Of those individuals that completed a self-care plan, there was increased awareness of the signs of burnout in themselves (66.67% vs 100%), signs in others (50% vs 100%) and resources available (50% vs 80%).
DISCUSSION: Although there has been a focus on physician burnout in the last few years, there are few studies that assess educational interventions to improve understanding of burnout and wellness. Our study demonstrates the continued need for a wellness workshop that focuses on diet, physical exercise and mindfulness/meditation. The workshop was successful in educating attendees on the resources available to address burnout. In addition, there have been no studies that have utilized self-care plans as part of a wellness educational intervention. Our results did not demonstrate a statistical significance for the impact of an individual's self-care plan on their perception of wellness due to sample size. However, there was a noted trend toward improved awareness of signs and resources. For future workshops, by providing time to create self-care plans, we anticipate that self-care plans will be efficacious in the future. Finally, although not formally assessed, individual self-care plans provide a guide of the domains and areas of need for the Wellness Committee to focus on interventions.