A national assessment of residency wellness initiatives in emergency medicine

A Positive Depression Screen Is Associated with Emergency Medicine Resident Burnout and Is not Affected by the Implementation of a Wellness Curriculum

Western Journal of Emergency Medicine ◽

10.5811/westjem.2021.9.52016 ◽

2021 ◽

Vol 22 (6) ◽

pp. 1341-1346

Author(s):

Kelly Williamson ◽

Patrick Lank ◽

Adriana Olson ◽

Navneet Cheema ◽

Elise Lovell

Keyword(s):

Emergency Medicine ◽

Maslach Burnout Inventory ◽

Positive Screen ◽

Emergency Medicine Resident ◽

Medicine Resident ◽

Patient Health ◽

Resident Burnout ◽

And Control ◽

Wellness Curriculum ◽

Wellness Initiatives

Introduction: While burnout is occupation-specific, depression affects individuals comprehensively. Research on interventions for depression in emergency medicine (EM) residents is limited. Objectives: We sought to obtain longitudinal data on positive depression screens in EM residents, assess their association with burnout, and determine whether implementation of a wellness curriculum affected the rate of positive screens. Methods: In February 2017, we administered the Maslach Burnout Inventory and the Primary Care Evaluation of Mental Disorders Patient Health Questionnaire two-question depression screen at 10 EM residencies. At five intervention sites, a year-long wellness curriculum was then introduced while five control sites agreed not to introduce new wellness initiatives during the study period. Study instruments were re-administered in August 2017 and February 2018. Results: Of 382 residents, 285 participated in February 2017; 40% screened positive for depression. In August 2017, 247/386 residents participated; 27.9% screened positive for depression. In February 2018, 228/386 residents participated; 36.2% screened positive. A positive depression screen was associated with higher burnout. There were similar rates of positive screens at the intervention and control sites. Conclusion: Rates of positive depression screens in EM residents ranged between 27.9% and 40%. Residents with a positive screen reported higher levels of burnout. Rates of a positive screen were unaffected by introduction of a wellness curriculum.

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MP17: Evaluation of a national competency-based assessment system in emergency medicine: A CanDREAM study

CJEM ◽

10.1017/cem.2020.165 ◽

2020 ◽

Vol 22 (S1) ◽

pp. S48-S48

Author(s):

B. Thoma ◽

A. Hall ◽

K. Clark ◽

N. Meshkat ◽

W. Cheung ◽

...

Keyword(s):

Emergency Medicine ◽

Outcome Evaluation ◽

Assessment System ◽

Professional Activity ◽

National Guidelines ◽

National Assessment ◽

Competency Based Medical Education ◽

Level Data ◽

Starting Point ◽

Competency Based

Introduction: In 2018, Canadian postgraduate specialist Emergency Medicine (EM) programs began implementing a competency-based medical education (CBME) assessment system. To support improvement of this assessment program, we sought to evaluate its short-term educational outcomes nationally and within individual programs. Methods: Program-level data from the 2018 resident cohort were amalgamated and analyzed. The number of Entrustable Professional Activity (EPA) assessments (overall and for each EPA) and the timing of resident promotion through program stages was compared between programs and to the guidelines provided by the national EM specialty committee. Total EPA observations from each program were correlated with the number of EM and pediatric EM rotations. Results: Data from 15 of 17 (88.2%) EM programs containing 9,842 EPA observations from 68 of the 77 (88.3%) Canadian EM specialist residents in the 2018 cohort were analyzed. The average number of EPAs observed per resident in each program varied from 92.5 to 229.6 and correlated strongly with the number of blocks spent on EM and pediatric EM (r = 0.83, p < 0.001). Relative to the guidelines outlined by the specialty committee, residents were promoted later than expected and with fewer EPA observations than suggested. Conclusion: We present a new approach to the amalgamation of national and program-level assessment data. There was demonstrable variation in both EPA-based assessment numbers and promotion timelines between programs and with national guidelines. This evaluation data will inform the revision of local programs and national guidelines and serve as a starting point for further reaching outcome evaluation. This process could be replicated by other national assessment programs.

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P095: Wellness, sleep and exercise in emergency medicine residents: an observational study

CJEM ◽

10.1017/cem.2017.297 ◽

2017 ◽

Vol 19 (S1) ◽

pp. S110

Author(s):

Z. Poonja ◽

P.S. O’Brien ◽

E. Cross ◽

C. Desrochers ◽

P.K. Jaggi ◽

...

Keyword(s):

Emergency Medicine ◽

Statistical Power ◽

Step Count ◽

Daily Step ◽

Data Set ◽

Sleep Quantity ◽

Metabolic Equivalents ◽

Perceived Wellness ◽

Daily Step Count ◽

Wellness Initiatives

Introduction: Burnout is well documented in residents and emergency physicians. Wellness initiatives are becoming increasingly prevalent, but there is a lack of data supporting their efficacy. In some populations, a relationship between sleep, exercise and wellness has been documented, but this relationship has not been established in emergency medicine (EM) residents or physicians. We aim to determine whether exercise and sleep quality and quantity as measured by a Fitbit are associated with greater perceived wellness in EM residents. Methods: Fifteen EM residents from two training sites wore a Fitbit during a 4-week EM rotation. The Fitbit recorded data on sleep quantity (minutes sleeping)/quality (sleep disruptions) and exercise quantity (daily step count)/quality (daily active minutes performing activity of 3-6 and >6 metabolic equivalents). Participants completed an end-of-rotation Perceived Wellness Survey (PWS) which provided information on six domains of personal wellness (psychological, emotional, social, physical, spiritual and intellectual). Associations between PWS scores and the Fitbit markers were evaluated using a Mann-Whitney-U statistical analysis. Results: Preliminary results indicate that residents who scored ≥50th percentile for sleep quantity had significantly higher PWS scores than those who scored ≤50th percentile (median PWS 17.0 vs 13.0 respectively, p=0.04). There was no significant correlation between PWS scores, sleep interruptions, daily step count and average daily active minutes. Postgraduate Year PGY1 and PGY2-5 report median PWS scores of 13.9 and 17.2 respectively. Conclusion: To our knowledge, this is the first study to objectively measure the quality and quantity of sleep as well as exercise habits of EM residents using a Fitbit device. Our data indicates a significant relationship between better sleep quantity and higher wellness scores in this population. We aim to enroll 30 residents in order to obtain a more robust data set. A larger sample size will increase statistical power and allow us to more extensively evaluate the use of exercise and sleep monitoring devices in the efficacy assessment of wellness initiatives.

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