Developing a Novel Resilience Curriculum for Internal Medicine Interns Using a Survey-Based Needs Assessment
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Survey questions were organized into four domains (selfperceptions of wellness, coping mechanisms, professional identity, and organizational culture). Questions with the greatest change in distribution from pre- to post-survey were tested statistically using Fisher’s exact test.
INTRODUCTION
The highest rates of burnout syndrome, defined as emotional exhaustion, depersonalization, and reduced personal accomplishment, are found in residents and fellows, and burnout may lead to increased medical errors.1,2 Internal medicine residents with burnout are more likely to report providing suboptimal care to patients when compared with nonburnout peers.3 Although there have been campaigns to create residency curricula that promote resilience,4,5 improvement of burnout metrics with curricular interventions has not been strongly demonstrated. We hypothesized that resident resilience metrics would improve with implementation of a tailored resilience curriculum based on a needs assessment of internal medicine interns.
METHODS
We enrolled all internal medicine and medicine-pediatric interns at the University of Colorado School of Medicine during the 2017–2018 academic year. An anonymous survey-based needs assessment was administered to all interns at the beginning of the academic year. The needs assessment included 5point Likert scale questions on personal and professional stress management, burnout, and perceptions of program support of housestaff. Based on the needs assessment survey results, a five-part resilience curriculum was designed by chief residents and vetted by resident and faculty members of the residency wellness committee. Each 30‐minute curriculum session, facilitated by senior residents and faculty, was executed during consecutive educational half-days from November 2017 to May 2018. A post-intervention survey with the same questions as the initial needs assessment was administered to all interns at the conclusion of the curriculum. Data were analyzed using SAS Enterprise Guide 7.1 (SAS Institute, Inc., Cary, NC).
Previous Presentations The descriptive statistics in this dataset were presented as a poster at the Education Scholarship & Innovation Symposium at the University of Colorado Anschutz Medical Campus on May 13, 2019. Received March 5, 2020 Accepted April 22, 2020
RESULTS
Of 80 total interns, 58 completed the pre-survey (72.5%) and 52 completed the post-survey (65%). The survey results are displayed in Table 1. In the self-perceptions of wellness domain, greater than 70% of interns indicated they felt burnout; this value did not significantly change between the pre- and post-surveys. There was a statistically significant increase in the coping mechanisms domain of having an outlet in the residency program to discuss professional stress, which increased from 59 to 87% (p = 0.0014). In the professional identity domain, there was a significant increase in feeling camaraderie with fellow residents (86 to 98%, p = 0.0340) and a near-significant increase in perception that burnout management skills are be
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