Well-being in Residency: Impact of an Online Physician Well-being Course on Resiliency and Burnout in Incoming Residents

Combating Burnout Amongst Residents Through Fostering Resilience: A Systematic Review

BackgroundBurnout, marked by emotional exhaustion, depersonalization and depletion of professional efficacy, is rampant among residents. With deleterious effects on productivity, conduct and patient care, resident programs have increasingly emphasized resilience training to combat burnout. However, the personalized nature of burnout complicates the effective design of such programs. Premised on recent works that identify burnout as a result of shifting personhood, this study utilizes the Ring Theory of Personhood to guide the conceptualization of resilience training programs that address changes in the belief systems shaping one's self-concept.MethodsA systematic scoping review to explore how resilience is addressed and assessed amongst medical residents was conducted. Guided by the PRISMA-compliant Systematic Evidence-Based Approach (SEBA), searches for relevant articles published between 1st January 2000 and 4th November 2024 on PubMed, Embase, Scopus, ERIC and PsycINFO were performed. The SEBA methodology facilitated the integration of the themes and categories identified using thematic and content analyses.ResultsOf 15 953 abstracts screened, 666 articles were reviewed and 69 full-text articles were included. Three domains were identified: guiding theories; methods of teaching resilience; and assessment.ConclusionThe reliance on individual or societal theories has constrained the understanding, design and assessment of resilience programs. Current approaches, including mindfulness workshops, self-care initiatives and organization-led resilience training, are neither timely nor focused on the needs of each resident. To mitigate burnout, personalized, longitudinal and timely support is essential. Mentoring offers a more suitable alternative, providing culturally sensitive, resource-appropriate, sustainable and clinically relevant support to build resilience effectively.

Residency Wellness: A Historical Narrative Review

INTRODUCTION

The structure of medical residency in the United States has experienced significant changes, paralleling advances in medical science and education. While these changes have enhanced medical training, they have introduced challenges, particularly in resident wellness. The well-being of residents is critical for patient care and the healthcare system. This review aims to provide an overview of the historical trends in medical residency, focusing on the evolution of resident wellness and its associated challenges.

METHODS

A narrative review was conducted, examining the evolution and challenges of medical residency with an emphasis on resident wellness. An exhaustive literature search on January 25, 2024 was conducted across PubMed, Web of Science, and Google Scholar. The search utilized keywords related to medical residency, wellness, and educational reforms. Articles were selected based on relevance and robust evidence, and information was organized into thematic categories for narrative synthesis.

RESULTS

The search yielded 57 publications that met the inclusion criteria. Historical trends revealed a shift from an apprenticeship model to formalized training programs, with each phase bringing unique challenges to resident wellness. The Flexner Report's influence on standardizing medical education, the rise of modern residency programs, and the recognition of burnout as a significant issue were key developments. Policy changes, technological impacts, and the COVID-19 pandemic have further shaped residency training and wellness. Studies highlight the need for interventions addressing burnout and promoting wellness, with varied approaches across specialties and institutions.

CONCLUSION

Residency burnout has been a growing concern since the 1970s, exacerbated by advancements in medicine, technology, and recent global events like the COVID-19 pandemic. Although awareness has increased, the need remains to address burnout and promote wellness during residency. Further research is warranted to develop effective interventions and adapt training to meet the evolving needs of residents.

Online Mindfulness-Based Interventions for Healthcare Professionals: A Scoping Review

BACKGROUND

Healthcare professionals work in challenging environments with extended working hours and excessive workloads to provide high-quality care. However, they hardly get the time to care for themselves. Online mindfulness-based interventions-which are not restricted by time or location-can be a powerful strategy to help healthcare professionals.

OBJECTIVES

This scoping review aims to explore the current evidence about online mindfulness-based interventions for healthcare professionals.

DESIGN

A scoping review was conducted.

METHODS

A literature search was conducted to retrieve articles published between October 2016 and March 2023 in seven databases, including backward and forward citation tracking from the included articles. Among 1,278 articles retrieved, 33 met the criteria for review.

RESULTS

Two-thirds of the studies utilized commercialized mindfulness programs (n = 22). Duration of the mindfulness interventions varied from 1 week to 4 months, and half of the studies used audio-guided programs. Online mindfulness-based intervention studies were targeted to reduce burnout (n = 26), and the majority reported reduction in burnout (n = 18).

CONCLUSION

Most studies used individual audio-guided programs that warrant the use of diverse delivery methods such as video media, simulation, and virtual reality for interactions in the future. Although the literature has accumulated evidence for commercialized online mindfulness-based interventions, further studies are needed to develop and test tailored interventions for healthcare professionals.