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The COVID-19 pandemic caused hospitals to make changes to workflow that exacerbated emotional exhaustion and burnout among health care workers. This article examines one of those changes, restricted visitation, showing how it changed the social organization of work by upending established interactional patterns and relationships between health care workers, patients, and patients' families. Based on 40 interviews with intensive care unit (ICU) workers in units that were full of COVID-19 patients and had fully restricted visitation, study findings show that staff took on emotional support roles with patients that had typically been done by families at the bedside. They also faced increased anger, distrust, and misunderstandings from families who were not allowed to see their dying loved one. With each other, staff bonded together with dark humor and candid talk about the scale of deaths, constructing a shared understanding and solidarity amidst the tragedy of the pandemic.

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Publicly Available
Reconfiguring the Social Organization of Work in the Intensive Care Unit: Changed Relationships and New Roles During COVID-19
By
Rodriquez, Jason
Source:
Social Science & Medicine

This paper examines hospital competition and restrictions on physician-owned hospital; it proceeds as follows. Part I provides an overview of the seemingly inexorable trends towards further consolidation among healthcare providers and the related competition concerns this consolidation raises. Part II discusses the factors which position POHs well as potential market entrants. Part III describes how the accrual of market power by incumbent hospitals and health systems accentuates the incentives and importance of physicians to identify opportunities for market entry and innovation. Part IV describes the growth of POHs and the subsequent ban on further growth and expansion. Part V then discusses the effects of the POH ban on competition in healthcare markets, potential benefits of relaxing the ban, and more narrowly tailored policy options for addressing concerns associated with physician ownership short of an outright ban. Lastly, Part VI concludes the paper with our recommendation that Congress consider removing the ban on POHs or at least relaxing it.

This resource is found in our Actionable Strategies for Government: Aligning Values & Improving Diversity, Equity & Inclusion (Aligning Values).

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Reconsidering the Ban on Physician-Owned Hospitals to Combat Consolidation
By
Mandelberg, Matthew; Smith, Michael; Ehrenfeld, Jesse; Miller, Brian
Source:
N.Y.U Journal of Legislation and Public Policy

All surgical fields that lead to a career in Hand Surgery have a stark lack of diversity of sex/gender and race, at every level of the workforce, from trainees to practicing physicians. Despite consistent statistics in publications on lack of diversity in surgical fields, a guide to effective recruitment and retention is lacking. Although we recognize that a strategy cannot be applied in all practices, this article provides actionable items to consider in the commitment and work toward a more just and equitable practice of Hand Surgery.

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Recruiting, Supporting and Retaining Diversity in Hand Surgery
By
Sinclair, Micah K.; Chhabra, A. Bobby
Source:
Hand Clinics

Retention and burnout have always been a challenge for nurse leaders, but the pandemic brought these concerns to a whole new level. And now the Great Resignation is affecting health care. So how can nurse leaders at hospitals and health care systems create a supportive environment for staff during a public health emergency? Structured support groups are a viable option for emphasizing self-care and wellness. We explain why we decided to form a structured support group for our intensive care unit nurses and illustrate the results from our clinical research team. In addition, we share feedback we received from participating nurses and offer advice on forming a structured support group in acute care settings. This strategy resulted in a change in the participant's behaviors after attending the structured emotional support group. This finding aligns with the literature, which supports strategies to protect nurses' mental well-being and to take preventive measures in critical situations. Using this as a foundation, a structured emotional support group can change nurse engagement and involvement in their process and practice, during times of crisis. Many other benefits could be realized from this strategy such as improved nursing practice and processes, improved nurse satisfaction, and improved recruitment and retention.

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Reducing Staff Turnover and Clinician Burnout With a Structured Support Group During the COVID-19 Pandemic
By
Drexler, Diane; Cornell, Diane; Cherrie, Carrie; Consolo, Christina; Doonan, Ronda L.
Source:
Nursing Administration Quarterly

[This is an excerpt.] The healthcare landscape is evolving, generating new and unprecedented challenges for health systems to manage, such as fallout from a global pandemic, workforce and drug shortages, clinician burnout, and more. But The Joint Commission’s dedication to improving patient care remains steadfast. This means we must evolve, too, meeting the moment and partnering with stakeholders to drive optimal care and value – a top priority of Joint Commission President and Chief Executive Officer Dr. Jonathan Perlin. [To read more, click View Resource.]

This resource is found in our Actionable Strategies for Health Organizations: Aligning Values (Invest/Advocate for Patients, Communities, & Workers) AND Actionable Strategies for Professional Associations: Spotlights: Professional Associations Relational Strategies (Aligning Values).

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Reducing the Burden: Eliminating 168 Accreditation Requirements Is Just the Start
By
Petrovic, Kathryn
Source:
The Joint Commission

Accurately quantifying clinician time spent on electronic health record (EHR) activities outside the time scheduled with patients is critical for understanding occupational stress associated with ambulatory clinic environments. We make 3 recommendations regarding EHR workload measures that are intended to capture time working in the EHR outside time scheduled with patients, formally defined as work outside of work (WOW): (1) separate all time working in the EHR outside of time scheduled with patients from time working in the EHR during time scheduled with patients, (2) do not exclude any time before or after scheduled time with patients, and (3) encourage the EHR vendor and research communities to develop and standardize validated, vendor-agnostic methods for measuring active EHR use. Attributing all EHR work outside time scheduled with patients to WOW, regardless of when it occurs, will produce an objective and standardized measure better suited for use in efforts to reduce burnout, set policy, and facilitate research.

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Refining Vendor-Defined Measures to Accurately Quantify EHR Workload Outside Time Scheduled With Patients
By
Arndt, Brian G.; Micek, Mark A.; Rule, Adam; Shafer, Christina M.; Baltus, Jeffrey J.; Sinsky, Christine A.
Source:
The Annals of Family Medicine

[This is an excerpt.] Burnout, caused by chronic emotional and interpersonal stress at work, is a common experience among medical residents. Despite widespread acknowledgement of its existence, there are few successful interventions that reduce burnout. [To read more, click View Resource.]

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Reflecting on Reflection Rounds: Discovering and Analyzing Elements of an ICU Team Group Discussion That Improve Provider Wellness
By
Krumm, I.R.; Clair, B.; Almeida, J.; Wood, D.; Aitken, J.; Feemster, L.C.; Adamson, R.
Source:
B102. Advances in Medical Education in Pulmonary, Critical Care, and Sleep Medicine

Documentation burden, defined as the excessive effort expended on health care documentation, is associated with a number of adverse outcomes, including clinician burnout, reduced quality of medical care, and disruption of clinical data contained in the electronic health record. With the growing concern for the wellness of the clinical workforce, documentation burden is receiving national attention. The American Medical Informatics Association (AMIA) has taken the lead by establishing the 25 × 5 Task Force (“Task Force”) in December 2021, which aims to reduce clinician documentation burden to 25% of the current state in the coming 5 years. Aligned with the timing of the Task Force launch, the AMIA Clinical Informatics Conference (CIC) 2022 co-chairs, Rosemary Kennedy (Connect America) and Paul Fu (City of Hope), conceptualized an opening plenary panel in a “fireside chat” format focused on clinical documentation burden. In this editorial, the authors describe the panel discussion, identify key themes from the panel, and offer recommendations to address documentation burden. The proceedings of the AMIA CIC 2022 Fireside Chat serve as an opportunity to acknowledge those who are engaged and passionate about addressing documentation burden from the vantage point of different stakeholders and institutions.

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Reflections on the Documentation Burden Reduction AMIA Plenary Session Through the Lens of 25×5
By
Levy, Deborah R.; Sloss, Elizabeth A.; Chartash, David; Corley, Sarah T.; Mishuris, Rebecca G.; Rosenbloom, S. Trent; Tiase, Victoria L.
Source:
Applied Clinical Informatics

BACKGROUND: Few qualitative studies have focused on suicide and specific job-related problems associated with suicide in pharmacists. Greater knowledge of specific work-related stressors amongst pharmacists could inform suicide prevention strategies. OBJECTIVE: To identify job-related stressors associated with pharmacist suicides and compare stressors to those previously reported in physicians and nurses. METHODS: Free-text law enforcement and medical examiner data for pharmacist suicides were extracted from the National Violent Death Registry (NVDRS) for 2003–2019. Reflexive thematic analysis was deployed via a deductive approach utilizing codes and themes found in previous research on nurse and physician suicides. New codes were also identified through inductive coding. RESULTS: A total of 291,872 suicides occurred between 2003 and 2019, of which 392 were pharmacist deaths. Of these, 62 pharmacist suicides were coded with job-related problems. Almost all deductive themes/codes extracted from nurses and physicians were present in pharmacists. Common codes found in the pharmacist dataset that were also found previously in physicians and nurses were: history of mental health, substance use disorder, hopelessness impending or proceeding job loss, and access to lethal weapons and/or drugs. Novel codes were added through inductive content analysis. Codes novel to pharmacists were: verbalized suicidal ideation (SI) or intent, diversion for the purpose of suicide, and the fear of job loss. Disciplinary action at the institutional level was associated with the fear of job loss and cited as the event triggering suicide completion. CONCLUSION: Pharmacists have similar job-related stressors associated with suicide as physicians and nurses. Evaluating the process of disciplinary action is warranted. Future research is indicated to evaluate causal relationship between work-related stressors and mental health outcomes leading to suicide in pharmacists.

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Reflexive Thematic Analysis of Job-Related Problems Associated With Pharmacist Suicide, 2003–2019
By
Groner-Richardson, Marcus A.; Cotton, Shannon A.; Ali, Sarah; Davidson, Judy E.; Ye, Gordon Y.; Zisook, Sidney; Lee, Kelly C.
Source:
Research in Social and Administrative Pharmacy

AIM: To study the relation between burnout and resilience and to identify the profile of nurses presenting this quality. BACKGROUND AND INTRODUCTION: Healthcare professionals are subject to high rates of burnout. Resilience could be an important factor in preventing or alleviating this condition. METHODS: The PubMed, ProQuest, Scopus and ScienceDirect databases were consulted in February 2022 using the equation 'burnout AND resilience AND nurs*'. The inclusion criteria applied were that the texts should describe quantitative studies, be published in English or Spanish, in any year, and be directly related to the question considered. The meta-analysis was performed using StatsDirect statistical software. RESULTS: Analysis of the 29 studies shows that among the dimensions of burnout, nurses are especially prone to emotional exhaustion, and are less affected by depersonalisation and low personal accomplishment. Those who score highly for resilience tend to have longer service experience, acceptable salaries and less work overload. Meta-analysis reveals an inverse correlation between resilience and burnout (r = -0.41; n = 2750), exhaustion (r = -0.27; n = 6966) and depersonalisation (r = -0.23; n = 6115). CONCLUSION: Many nurses present low levels of resilience and suffer from burnout syndrome. The application of programmes to enhance their resilience would help prevent burnout and optimise the potential to provide quality health care. IMPLICATIONS FOR NURSING AND HEALTH POLICY: Resilience is inversely correlated with burnout, depersonalisation and emotional exhaustion. Accordingly, healthcare organisations should develop and implement evidence-based programmes to foster nurses' resilience and thus reduce their susceptibility to burnout.

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Relation and Effect of Resilience on Burnout in Nurses: A Literature Review and Meta-Analysis
By
Castillo-González, Andrea; Velando-Soriano, Almudena; De La Fuente-Solana, Emilia I.; Martos-Cabrera, Begoña M.; Membrive-Jiménez, María José; Lucía, Ramírez-Baena; Cañadas-De La Fuente, Guillermo A.
Source:
International Nursing Review

INTRODUCTION: Job satisfaction and retention of military and civilian nurses and physicians who work in military treatment facilities (MTFs) are critical to maintaining quality of care and operational readiness. Civilian nurses and physicians working in MTFs supplement staffing for active duty military nurses and physicians and support operational readiness when military nurses and physicians deploy in wartime crises or humanitarian efforts. Decreased retention of military and civilian nurses and physicians can negatively impact operational readiness and patient care outcomes. Although several factors (e.g., burnout, pay, and leadership) influence job satisfaction and retention among nurses and physicians in both military and civilian healthcare settings, high-quality communication and relationships between nurses and physicians are associated with better job satisfaction and retention. However, little is known about how high-quality communication and relationships affect job satisfaction and retention among nurses and physicians in MTFs. Relational coordination (RC) is a process of high-quality communication supported by relationships of shared knowledge, shared goals, and mutual respect among members of the healthcare team. By strengthening RC, hospital leaders can more effectively achieve desired outcomes. The purpose of this study was to explore how RC influences job satisfaction and intent to stay among nurses, residents, and physicians in an Army hospital, and whether job satisfaction mediated the relationship between RC and intent to stay. MATERIALS AND METHODS: We conducted an exploratory, cross-sectional study in a 138-bed MTF in the southeastern USA and invited a convenience sample of military and civilian nurses, residents, and physicians to complete a 47-item survey on RC, job satisfaction, and intent to stay. We used Pearson’s correlation to explore relationships between RC, job satisfaction, and intent to stay and then employed multiple regression to explore whether RC predicts job satisfaction and intent to stay, after controlling for professional role, demographic characteristics, and other covariates. Furthermore, we explored whether job satisfaction mediates the relationship between RC and intent to stay. RESULTS: Two hundred and eighty-nine participants completed the survey. Seventy percentage of respondents were civilian, were Caucasian (61%), and had a mean age of 40 years old. The RCs within roles (b = 0.76, P < .001) and between roles (b = 0.46, P < .001) were both positively associated with job satisfaction. RCs within roles was associated with higher intent to stay (b = 0.38, P = .005). Civilian nurses and physicians reported higher intent to stay, followed by officers and enlisted service members. Job satisfaction mediated the relationship between RC within roles and intent to stay. CONCLUSION: Our findings suggest that RC is a powerful workplace dynamic that influences job satisfaction and intent to stay, for nurses, residents, and physicians in MTFs. Specifically, we found that RC was positively associated with job satisfaction and intent to stay and that job satisfaction mediates the relationship between RC and intent to stay. We recommend that hospital leaders in MTFs explore interventions to strengthen RC among health professionals by including relational, work process and structural interventions as part of their strategy for retaining military healthcare professionals.

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Relational Coordination as a Predictor of Job Satisfaction and Intent to Stay Among Nurses and Physicians in the Military Health System
By
House, Sherita; Crandell, Jamie; Stucky, Christopher; Kitzmiller, Rebecca; Jones, Cheryl; Gittell, Jody Hoffer
Source:
Military Medicine

OBJECTIVE: To evaluate relationships between physician-reported workplace burnout and ratings of potential workplace stressors. METHODS: A voluntary survey on workplace burnout was conducted by physicians at a university-affiliated tertiary care medical center including the work-related domain of the Copenhagen Burnout Inventory, no/little burnout (considered non-burnout): <50 points and moderate-to-severe burnout: >50 points, General Self-Efficacy Scale: (0-40 points), Insomnia Severity Index (0-28), Perceived Stress Scale (0-40), and questionnaire of 19 potential workplace stressors by 5-point Likert scale from strongly negative to very positive. Analysis was performed with the χ2 and Student t-test. RESULTS: Ninety (78%) respondents completed all components. Workplace burnout occurred in 54 (60%) respondents. General Self-Efficacy Scale was lower in those with burnout (31.3 vs 33.5; P = .008), whereas Insomnia Severity Index and Perceived Stress Scale were higher (9.8 vs 5.7; P< .001, 21.9 vs 20.3; P = .024, respectively). Electronic medical records (EMRs), billing, and delays were viewed as negative stressors for all-comers (burnout vs non-burnout): EMR (81% vs 64%; P = .19), billing (61% vs 47%; P = .25), and delays (86% vs 76%; P = .32), respectively. The ability to complete work was also a negative stressor but significantly more prevalent with concomitant burnout (55% vs 22%; P = .005). Positive factors identified by both groups included clinical decision-making (80% vs 83%; P = .053) and patient interaction (57% vs 69%; P = .06). Staff/peer relationships (P = .029) and team communication (P = .014) were viewed as positive factors by both, but significantly more in those without burnout (Table). Both groups rated clinical work volume (P = .40), adequate staff (P = .66), hospital mandates (P = .75), and insurers (P = .82) in top 5 workplace stressors. CONCLUSIONS: Physicians possess high self-efficacy. Still, workplace burnout is common and associated with higher stress levels, sleep dissatisfaction, and lower self-efficacy. Billing, delays, EMR, support staff, and hospital mandates are negative stressors regardless of burnout status. Physician perception regarding inability to complete work may indicate progression toward burnout. Otherwise, burnout is characterized by subtle loss of positivity particularly relationships and communication rather than overt pessimism and may go unrecognized. This underscores the need for early detection and intervention to prevent burnout and promote physician well-being.

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Relationship Between Physician Burnout and Workplace Specific Stressors: The Loss of Positive Perception
By
Potter, Helen A.; O'Brien-Irr, Monica S.; Henninger, Matthew W.; Flanagan-Priore, Catherine; Winkelstein, Peter; Harris, Linda M.
Source:
Journal of Vascular Surgery

OBJECTIVE: To explore the relationship of electronic health record (EHR)–based audit log data with physician burnout and clinical practice process measures. METHODS: From September 4 to October 7, 2019, we surveyed physicians in a larger academic medical department and matched responses to August 1 through October 31, 2019, EHR-based audit log data. Multivariable regression analysis evaluated the relationship between log data and burnout and the interrelationship between log data and turnaround time for In Basket messages and percentage of encounters closed within 24 hours. RESULTS: Of the 537 physicians surveyed, 413 (77%) responded. On multivariable analysis, number of In Basket messages received per day (each additional message: odds ratio, 1.04 [95% CI, 1.02 to 1.07]; P<.001) and time spent in the EHR outside scheduled patient care (each additional hour: odds ratio, 1.01 [95% CI, 1.00 to 1.02]; P=.04) were associated with burnout. Time spent doing In Basket work (each additional minute: parameter estimate, −0.11 [95% CI, −0.19 to −0.03]; P=.01) and in the EHR outside scheduled patient care (each additional hour: parameter estimate, 0.04 [95% CI, 0.01 to 0.06]; P=.002) were associated with turnaround time (days per message) for In Basket messages. None of the variables explored were independently associated with percentage of encounters closed within 24 hours. CONCLUSION: Electronic health record–based audit log data of workload relate to odds of burnout and responsiveness to patient-related inquiries and results. Further study is needed to determine whether interventions that reduce the number of and time spent doing In Basket messages or time spent in the EHR outside scheduled patient care reduce physician burnout and improve clinical practice process measures.

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Relationships Between EHR-Based Audit Log Data and Physician Burnout and Clinical Practice Process Measures
By
Dyrbye, Liselotte N.; Gordon, Joel; O’Horo, John; Belford, Sylvia M.; Wright, Michael; Satele, Daniel V.; West, Colin P.
Source:
Mayo Clinic Proceedings

Hospital-based chaplains receive specialized training to provide spiritual support to patients and healthcare staff during difficult health transitions. However, the impact of perceived chaplain importance on healthcare staff’s emotional and professional well-being is unclear. Healthcare staff (n = 1471) caring for patients in an acute care setting within a large health system answered demographic and emotional health questions in Research Electronic Data Capture (REDCap). Findings suggest that as perceived levels of chaplain importance increase, burnout may decrease and compassion satisfaction may improve. Chaplain presence in the hospital setting may support healthcare staff emotional and professional well-being following occupational stressors including COVID-19-related surges.

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Relationships Between Perceived Importance of Chaplain Presence and Health Professionals’ Emotional Well-Being in the United States
By
Gaines, Adam F.; Rangel, Teresa L.; Freedberg, Rachel; Doucette, Sheila; Stengem, Danell; Timmerman, Rosemary; Roney, Jamie; Arenivar, Patrick; Patterson, Angela; Long, JoAnn; Sumner, Sarah; Bock, Dawn; Mendelson, Sherri; Saul, Trisha; West, AnneMarie; Leavitt, Robert E.; Colorafi, Karen
Source:
Journal of Religion and Health

BACKGROUND: The COVID-19 pandemic has been an unusually comprehensive crisis that has taken a toll on people in their roles both at work and at home, giving rise to a new normal. PURPOSE: Relational coordination theory shows how communicating and relating for the purpose of task integration drives positive outcomes for workers, their clients, and their employers. The ecological theory of work–family spillover shows how relational dynamics from work spillover into family life, and vice versa. We build upon these two theories to understand how relationships at work impact work–life balance and worker well-being, especially in times of crisis. METHODOLOGY: This study was based on surveys of clinicians affiliated with a large California health system during the COVID-19 pandemic. Mediation and multilevel logistic regression models were used to assess how relational coordination among colleagues impacts well-being (job satisfaction and lack of burnout) through its effects on work–life balance (schedule control and personal time). RESULTS: A 1-point increase in relational coordination tripled clinician odds of having schedule control (OR = 3.33, p < .001) and nearly doubled the odds of having adequate personal time (OR = 1.83, p < .001). A 1-point increase in relational coordination nearly quadrupled odds of being satisfied with their job (OR = 3.92, p < .001) and decreased odds of burnout by 64% (OR = 0.36, p < .001). The impact of relational coordination on worker well-being was mediated by greater schedule control and personal time. CONCLUSION: Relational coordination among colleagues impacts worker well-being by enabling greater control over one’s schedule and more personal time, thus creating a positive spillover from work to home in times of crisis. PRACTICE IMPLICATIONSs: In times of crisis, leaders should prioritize relational coordination among colleagues in order to support their resilience both at work and at home.

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Relationships and Resilience at Work and at Home: Impact of Relational Coordination on Clinician Work–Life Balance and Well-Being in Times of Crisis
By
Ali, Hebatallah Naim; Gittell, Jody Hoffer; Deng, Sien; Stults, Cheryl D.; Martinez, Meghan; Pertsch, Suzanne; Weger, Lauren; Dillon, Ellis C.
Source:
Health Care Management Review

OBJECTIVE: Work-related pain is a known risk factor for vascular surgeon burnout. It risks early attrition from our workforce and is a recognized threat to the specialty. Our study aimed to understand whether work-related pain similarly contributed to vascular surgery trainee well-being. METHODS: A confidential, voluntary survey was administered after the 2022 VSITE to trainees in all ACGME-accredited vascular surgery programs. Burnout was measured by a modified, abbreviated Maslach Burnout Inventory; pain after a full day of work was measured using a 10-point Likert scale and then dichotomized as “no to mild pain” (0-2) vs “moderate to severe pain” (3-9). Univariable analyses and multivariable regression assessed associations of pain with well-being indicators (e.g., burnout, thoughts of attrition, and thoughts of career change). Pain management strategies were included as additional covariables in our study. RESULTS: 527 trainees completed the survey (82.2% response rate). 38% reported moderate to severe pain after a full day of work of whom 73.6% reported using ergonomic adjustments and 67.0% used over-the-counter medications. Significantly more women reported moderate to severe pain than men (44.3% vs 34.5%, p<0.01). After adjusting for gender, training level, race/ethnicity, mistreatment, and dissatisfaction with operative autonomy, moderate-to-severe pain (OR 2.52, 95% CI 1.48-4.26) and using physiotherapy as pain management (OR 3.06, 95% CI 1.02-9.14) were risk factors for burnout. Moderate to severe pain was not a risk factor for thoughts of attrition or career change following adjustment. CONCLUSION: Physical pain is prevalent among vascular surgery trainees and represents a risk factor for trainee burnout. Programs should provide ergonomic education and adjuncts, such as posture awareness and microbreaks during surgery, early and throughout training.

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Reported Pain at Work Is a Risk Factor for Vascular Surgery Trainee Burnout
By
Pillado, Eric B.; Li, Ruojia Debbie; Chia, Matthew; Eng, Joshua; DiLosa, Kathryn L.; Conway, Allan; Escobar, Guillermo A.; Shaw, Palma; Sheahan, Malachi; Bilimoria, Karl; Hu, Yue-Yung; Coleman, Dawn M.
Source:
Journal of Vascular Surgery

OBJECTIVE: This study was designed to assess the effects of the coronavirus disease pandemic on job satisfaction (JS) and burnout among surgical sub-specialty residents. DESIGN: This is a retrospective, observational, survey-based study. We administered a web-based questionnaire to surgical sub-specialty residents, and results were compared to a prior study in 2016. The questionnaire included elements on demographics, JS, burnout, and self-care habits. Basic statistical analyses were used to compare data from 2020 and 2016. SETTING: This study takes place at Robert Wood Johnson University Hospital, a single mid-sized New Jersey-based academic institution. PARTICIPANTS: This survey was sent to all obstetrics and gynecology and general surgery residents from every postgraduate year based out of our institution. The survey was sent to a total of 50 residents across the 2 programs. Forty total residents responded to the survey, with a response rate of 80%. RESULTS: JS was significantly higher in 2020 than 2016 (p < 0.001). There were no differences between postgraduate years for 2020 or 2016 in emotional exhaustion (p = 0.29, p = 0.75), personal accomplishment (p = 0.88, p = 0.26), or depersonalization (p = 0.14, p = 0.59) burnout scores. A total of 0% of residents in 2020 worked fewer than 61 hours per week. Residents in 2020 exercised more (40.0% vs 21.6%), had similar alcohol usage (60%), and had similar diets to residents in 2016. Residents in 2020 were less likely to regret their specialty (7.5% vs 21.6%), consider changing residencies (30.0% vs 37.8%), or consider a career change (15.0% vs 45.9%). CONCLUSIONS: JS scores were significantly higher during the coronavirus disease pandemic. The cancellation of elective surgeries led to a lighter workload for surgical residents. Residents were uncertain of their role during the pandemic, however, new stressors encouraged residents to seek alternative methods for personal wellness.

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Resident Burnout Trends During COVID19: A Retrospective Observational Study
By
Elwood, Adam D; Patel, Nell Maloney; Hutchinson-Colas, Juana
Source:
Journal of Surgical Education

OBJECTIVE: Resident physician wellness has been a highly contentious topic in graduate medical education over the past 2 decades. Physicians, including residents and attending physicians, are more likely than other professionals to work through illness and delay necessary healthcare screening appointments. Potential reasons for underutilization of health care include–unpredictable work hours, limited time, concerns about confidentiality, poor support from training programs, and apprehension about the impact on their peers. The goal of this study was to evaluate access to health care amongst resident physicians within a large military training facility. DESIGN: This is an observational study using Department of Defense approved software to distribute an anonymous ten question survey on routine health care practices of residents. The survey was distributed to a total of 240 active-duty military resident physicians at a large tertiary military medical center. RESULTS: One hundred seventy-eight residents completed the survey with a 74% response rate. Residents from 15 specialty areas responded. Compared to male counterparts’, female residents were more likely to miss routine scheduled health care appointments to include, behavioral health appointments (54.2% vs 28%, p < 0.01). Female residents were more likely to report that attitudes toward missing clinical duties for health care appointments impacted their decision to start or add to their family more than male coresidents (32.3% vs 18.3%, p = 0.03). Surgical residents are also more likely to miss routine screening appointments or scheduled follow ups than residents in nonsurgical training programs; (84.0-88% compared to 52.4%-62.8%) respectively. CONCLUSIONS: Resident health and wellness have long been an issue, with resident physical and mental health being negatively impacted during residency. Our study notes that residents in the military system also face barriers accessing routine health care. Female surgical residents being the demographic most significantly impacted. Our survey highlights cultural attitudes in military graduate medical education regarding the prioritization of personal health, and the negative impact that can have on residents’ utilization of care. Our survey also raises concerns particularly amongst female surgical residents, that these attitudes may impact career advancement, as well as influence their decision to start or add to their families.

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Resident Trainee Access and Barriers to Routine Health Services in the Military Health System
By
Munisteri, Meghan; Wong, Rebecca; Loza, Lina; Scott, Laura L.F.; Keyser, Erin A.; Gonzalez-Brown, Veronica
Source:
Journal of Surgical Education

BACKGROUND: In graduate medical education, teaching is a required subcompetency largely fulfilled via clinical teaching, journal clubs, and grand rounds. Evidence shows that when moving to undergraduate teaching, residents often face a steep learning curve. We aimed to assess residents’ perspective of the experience of teaching medical students. METHODS: Psychiatry residents taught small group sections of bioethics to first- and second-year medical students in December 2018. We conducted two 1-hour focus group interviews with four residents on their perspectives on the teaching experience. RESULTS: Resident-teachers described receiving certain benefits from teaching, such as meeting their altruistic desire to give back to the profession. Nonetheless, some participants felt frustrated by students’ varying engagement and respect, while also feeling insecure and intimidated. Resident-teachers experienced some of the medical students as disrespectful and limited in their appreciation for diversity and the profession of medicine and perceived the students’ disengagement and lessened professionalism. CONCLUSION: As residency programs seek to implement initiatives to improve teaching skills of residents, resident experiences should be considered when implementing these initiatives.

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Resident-Teaching of Ethics in Undergraduate Medical Education: A Grounded Theory Analysis
By
Schmidt, Cindy; Ashraf, Nauman; Stevens, Kristine A.
Source:
Baylor University Medical Center Proceedings

BACKGROUND: Nationwide nursing shortages have spurred nursing research on burnout and resiliency to better understand the emotional health of nurses and allied staff to retain talent. Our institution implemented resilience rooms in the neuroscience units of our hospital. The goal of this study was to evaluate the effects of resilience room use on emotional distress among staff. METHODS: Resilience rooms opened to staff in the neuroscience tower in January 2021. Entrances were electronically captured via badge readers. Upon exit, staff completed a survey containing items on demographics, burnout, and emotional distress. RESULTS: Resilience rooms were used 1988 times, and 396 surveys were completed. Rooms were most used by intensive care unit nurses (40.1% of entrances), followed by nurse leaders (28.8%). Staff with >10 years of experience accounted for 50.8% of uses. One-third reported moderate burnout, and 15.9% reported heavy or extreme burnout. Overall, emotional distress decreased by 49.4% from entrance to exit. The greatest decreases in distress were recorded by those with the lowest levels of burnout (72.5% decrease). CONCLUSION: Resilience room use was associated with significant decreases in emotional distress. The greatest decreases occurred with the lowest levels of burnout, suggesting that early engagement with resilience rooms is most beneficial.

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Resilience Room Use and Its Effect on Distress Among Nurses and Allied Staff
By
Prendergast, Virginia; Elmasry, Sandra; Juhl, Natasha A.; Chapple, Kristina M.
Source:
Journal of Neuroscience Nursing