Addressing burnout at the resident physician level requires understanding its causes and its scope. An effective measure for doing that is the residency wellness survey.
Baylor Scott & White Health in Dallas began such a survey five years ago. Two of the leaders of that project, done in conjunction with the AMA, offered insight on the reasons behind the survey and how it drove changes in the program during a recent episode of “AMA Update.”
Need for assessment
Baylor Scott & White had traditionally done broad surveys of residents and fellows. In 2018, they noticed more respondents were mentioning stress and fatigue. From there, the program decided to get proactive.
“The experience of burnout is such a personal experience that people often define it in a subjective way,” said Emily Kaus, the graduate medical education wellness program manager at Baylor Scott & White. “You could ask two physicians, ‘Are you burnt out?’ and both may say yes but both, may have very different definitions. So we really need to rely on more standardized methods of measuring burnout to get a more objective picture.
“You can't really know the impact of your well-being efforts without measuring that change over time as well,” Kaus added. “So we've really benefited from seeing those data points over time, assessing what happened between data points and where we can focus our attention on our well-being efforts.”
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An open dialogue
“Part of assessing and managing well-being is that we keep that line of communication really open,” Kaus said. “It's not just the surveys that we're hearing about what residents want or what they expect would impact their well-being, what they see as either the pebble in their shoe or what they think would help. So we keep that line of communication open. We welcome feedback in that way all year round.
“And then something specifically that we initiated during the height of COVID, especially when we couldn't meet in person as much—it was harder to provide some of our services—our team developed an internal well-being website that our residents and, really, any physician in the system can log on to. It has a lot of different educational resources, support resources, anything folks may need to help assess and learn more about mental health and well-being.”
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One-on-one guidance
Residents at Baylor Scott & White work in a teaching hospital setting. The educational responsibilities that come with that for residents, who themselves are still training, can stretch them thin, survey data found. Offering some direction on time management proved helpful.
“I do work one-on-one with residents and fellows,” said Julie Higginbotham, resident education and development specialist at Baylor Scott & White. “Program directors will reach out and say: Hey, this resident is really struggling with time management or study skills.”
The one-on-one direction Higginbotham provides extends to learning strategies for residents.
“If they don't do very well on an in-training exam, I will meet with them and talk to them about test-taking strategies, and we'll practice test questions. Those two things are the big challenges we've found. And so those are the things that I incorporate into my education … helping them increase their medical knowledge the best I can and also giving them those ways to make teaching easier for them.”
“AMA Update” covers health care topics affecting the lives of physicians and patients. Hear from physicians and experts on public health, advocacy issues, scope of practice and more—because who’s doing the talking matters. You can catch every episode by subscribing to the AMA’s YouTube channel or the audio-only podcast version, which also features educational presentations and in-depth discussions.
