Maintaining the Fire but Avoiding Burnout: Implementation and Evaluation of a Resident Well-Being Program
Abstract
BACKGROUND: There have been few programs designed to improve surgical resident well-being, and such efforts often lack formal evaluation. STUDY DESIGN: General surgery residents participated in the Energy Leadership Well-Being and Resiliency Program. They were assessed at baseline and 1 year after implementation using the Energy Leadership Index (measures emotional intelligence), Maslach Burnout Inventory General Survey, Perceived Stress Scale, the Beck Depression Inventory, and the annual required ACGME resident survey. Scores before and after implementation were compared using paired t-tests for continuous variables and chi-square tests for categorical variables. RESULTS: Forty-nine general surgery residents participate in the program. One year after implementation, resident score on the Energy Leadership Index improved (from 3.16 ± 0.24 to 3.24 ± 0.32; p = 0.03). Resident perceived stress decreased from baseline (Perceived Stress Scale score, from 17.0 ± 7.2 to 15.7 ± 6.2; p = 0.05). Scores on the emotional exhaustion scale of the Maslach Burnout Inventory decreased (from 16.8 ± 8.4 to 14.4 ± 8.5; p = 0.04). Resident-reported satisfaction improved in many areas; satisfaction with leadership skills, work relationships, communication skills, productivity, time management, personal freedom, and work-life balance, increased during the 1-year intervention (p = NS). On the annual ACGME resident survey, residents' evaluation of the program as positive or very positive increased from 80% to 96%. CONCLUSIONS: This study demonstrates that formal implementation of a program to improve resident well-being positively impacted residents' perceived stress, emotional exhaustion, emotional intelligence, life satisfaction, and their perception of the residency program. Formal evaluation and reporting of such efforts allow for reproducibility and scalability, with the potential for widespread impact on resident well-being.
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In the coaching intervention subgroup, emotional exhaustion (EE) was significantly reduced: Cohen's d SMD -0.24 (95% CI -0.40 to -0.07, p = 0.04, I2 = 41.6%).
“Subgroup analyses of coaching intervention [59–72, 74, 75] demonstrated a post-intervention Cohen’s d SMD in EE (-0.24, 95% CI -0.40 to -0.07, p = 0.04, I2 = 41.6%).”
From Individual and organizational interventions to reduce burnout in resident physicians: a systematic review and meta-analysis (2024) · cites this paper as [66]
Cites
An inventory for measuring depression
BECK, A. T. (1961) · Archives of General Psychiatry · doi:10.1001/archpsyc.1961.01710120031004 · Cited by 38,032 · see citing works
A Global Measure of Perceived Stress
Cohen, S., Kamarck, T., & Mermelstein, R. (1983) · Journal of Health and Social Behavior · doi:10.2307/2136404 · Cited by 32,807 · see citing works
(1996) · Consulting Psychologists Press eBooks · Cited by 7,863 · see citing works
Interventions to prevent and reduce physician burnout: a systematic review and meta-analysis
West, C. P., Dyrbye, L. N., Erwin, P. J., & Shanafelt, T. D. (2016) · The Lancet · doi:10.1016/s0140-6736(16)31279-x · Cited by 2,362 · see citing works
Dyrbye, L. N., West, C. P., Satele, D., Boone, S., Tan, L., Sloan, J., & Shanafelt, T. D. (2014) · Academic Medicine · doi:10.1097/acm.0000000000000134 · Cited by 2,040 · see citing works
Krasner, M. S. (2009) · JAMA · doi:10.1001/jama.2009.1384 · Cited by 1,650 · see citing works
Physician wellness: a missing quality indicator
Wallace, J. E., Lemaire, J. B., & Ghali, W. A. (2009) · The Lancet · doi:10.1016/s0140-6736(09)61424-0 · Cited by 1,608 · see citing works
Burnout and Career Satisfaction Among American Surgeons
Shanafelt, T. D., Balch, C. M., Bechamps, G. J., Russell, T., Dyrbye, L., Satele, D., Collicott, P., Novotny, P. J., Sloan, J., & Freischlag, J. A. (2009) · Annals of Surgery · doi:10.1097/sla.0b013e3181ac4dfd · Cited by 1,275 · see citing works
Burnout During Residency Training: A Literature Review
IsHak, W. W., Lederer, S., Mandili, C., Nikravesh, R., Seligman, L., Vasa, M., Ogunyemi, D., & Bernstein, C. A. (2009) · Journal of Graduate Medical Education · doi:10.4300/jgme-d-09-00054.1 · Cited by 643 · see citing works
National Survey of Burnout among US General Surgery Residents
Elmore, L. C., Jeffe, D. B., Jin, L., Awad, M. M., & Turnbull, I. R. (2016) · Journal of the American College of Surgeons · doi:10.1016/j.jamcollsurg.2016.05.014 · Cited by 476 · see citing works
A Mindfulness Course Decreases Burnout and Improves Well-Being among Healthcare Providers
Goodman, M. J., & Schorling, J. B. (2012) · The International Journal of Psychiatry in Medicine · doi:10.2190/pm.43.2.b · Cited by 453 · see citing works
Stress and Burnout Among Surgeons
Balch, C. M. (2009) · Archives of Surgery · doi:10.1001/archsurg.2008.575 · Cited by 444 · see citing works
Burnout among American surgeons
Campbell, D. A., Sonnad, S. S., Eckhäuser, F. E., Campbell, K. K., & Greenfield, L. J. (2001) · Surgery · doi:10.1067/msy.2001.116676 · Cited by 434 · see citing works
Balch, C. M., Shanafelt, T. D., Sloan, J. A., Satele, D. V., & Freischlag, J. A. (2011) · Annals of Surgery · doi:10.1097/sla.0b013e318230097e · Cited by 342 · see citing works
Kuerer, H. M., Eberlein, T. J., Pollock, R. E., Huschka, M. M., Baile, W. F., Morrow, M., Michelassi, F., Singletary, S. E., Novotny, P. J., Sloan, J. A., et al. (2007) · Annals of Surgical Oncology · doi:10.1245/s10434-007-9579-1 · Cited by 305 · see citing works
Stress and burnout in residents: impact of mindfulness-based resilience training
Rosdahl, J. A., Goldhagen, B. E., Kingsolver, K., & Stinnett, S. S. (2015) · Advances in Medical Education and Practice · doi:10.2147/amep.s88580 · Cited by 208 · see citing works
Utility of a Brief Screening Tool to Identify Physicians in Distress
Dyrbye, L. N., Satele, D., Sloan, J. A., & Shanafelt, T. D. (2012) · Journal of General Internal Medicine · doi:10.1007/s11606-012-2252-9 · Cited by 201 · see citing works
Bohman, B. D., Dyrbye, L. N., Sinsky, C. A., Linzer, M., Olson, K. D., Babbott, S. F., Murphy, M. L., de Vries, P. P., Hamidi, M. S., & Trockel, M. (2017) · NEJM Catalyst · Cited by 180 · see citing works
Helping the Helpers: Mindfulness Training for Burnout in Pediatric Oncology—A Pilot Program
Moody, K., Kramer, D., Santizo, R. O., Magro, L., Wyshogrod, D., Ambrosio, J., Castillo, C., Lieberman, R., & Stein, J. (2013) · Journal of Pediatric Oncology Nursing · doi:10.1177/1043454213504497 · Cited by 154 · see citing works
Ability of the Physician Well-Being Index to Identify Residents in Distress
Dyrbye, L. N., Satele, D., Sloan, J. A., & Shanafelt, T. D. (2014) · Journal of Graduate Medical Education · doi:10.4300/jgme-d-13-00117.1 · Cited by 128 · see citing works
A National Study of Burnout Among American Transplant Surgeons
Bertges-Yost, W., Eshelman, A. K., Raoufi, M., & Abouljoud, M. S. (2005) · Transplantation Proceedings · doi:10.1016/j.transproceed.2005.01.055 · Cited by 127 · see citing works
Shanafelt, T. D., Kaups, K. L., Nelson, H., Satele, D., Sloan, J. A., Oreskovich, M. R., & Dyrbye, L. N. (2013) · Annals of Surgery · doi:10.1097/sla.0b013e3182a58fa4 · Cited by 113 · see citing works
Risk and Resilience Factors Associated with Resident Burnout
Chaukos, D. C., Chad‐Friedman, E., Mehta, D. H., Byerly, L. K., Celik, A., McCoy, T. H., & Denninger, J. W. (2016) · Academic Psychiatry · doi:10.1007/s40596-016-0628-6 · Cited by 105 · see citing works
Jackson, T. N., Pearcy, C., Khorgami, Z., Agrawal, V., Taubman, K. E., & Truitt, M. S. (2017) · World Journal of Surgery · doi:10.1007/s00268-017-4286-y · Cited by 103 · see citing works
McLuckie, A., Matheson, K. M., Landers, A. L., Landine, J., Novick, J., Barrett, T., & Dimitropoulos, G. (2017) · Academic Psychiatry · doi:10.1007/s40596-017-0800-7 · Cited by 85 · see citing works
Determinants of Burnout Among Transplant Surgeons: A National Survey in the United States
Jesse, M. T., Abouljoud, M. S., & Eshelman, A. K. (2015) · American Journal of Transplantation · doi:10.1111/ajt.13056 · Cited by 72 · see citing works
Energy Leadership: Transforming Your Workplace and Your Life from the Core
Schneider, B. D. (2007) · Cited by 13 · see citing works
Flagged first, then by citations
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Sorted by citations
Factors associated with burnout syndrome in surgeons: a systematic review
Galaiya, R., Kinross, J., & Arulampalam, T. (2020) · The Annals of The Royal College of Surgeons of England · doi:10.1308/rcsann.2020.0040 · Cited by 214 · see citing works
“Psychological factors Higher levels of emotional intelligence are associated with less burnout as measured by the Trait Emotional Intelligence Questionnaire,(11,63,64) while average resonating level (self-awareness and emotional intelligence) is associated with lower burnout scores in general surgery residents (n = 48…”
MethodWestern Journal of Emergency Medicine
Saucedo, C., & Do, N. (2022) · Western Journal of Emergency Medicine · doi:10.5811//westjem.2022.1.56133 · Cited by 209 · see citing works
Physician Workforce Disparities and Patient Care: A Narrative Review
Silver, J. K., Bean, A., Slocum, C. S., Poorman, J. A., Tenforde, A. S., Blauwet, C. A., Kirch, R., Parekh, R., Amonoo, H. L., ZAFONTE, R. D., et al. (2019) · Health Equity · doi:10.1089/heq.2019.0040 · Cited by 200 · see citing works
Lebares, C. C., Coaston, T. N., Delucchi, K. L., Guvva, E. V., Shen, W. T., Staffaroni, A. M., Kramer, J. H., Epel, E. S., Hecht, F. M., Ascher, N. L., et al. (2021) · Annals of Surgery · doi:10.1097/sla.0000000000004145 · Cited by 81 · see citing works
Addressing Surgeon Burnout Through a Multi-level Approach: A National Call to Action
Golisch, K. B., Sanders, J. M., Rzhetsky, A., & Tatebe, L. C. (2023) · Current Trauma Reports · doi:10.1007/s40719-022-00249-x · Cited by 78 · see citing works
“Riall (2018) [84] Maintaining the Fire but Avoiding Burnout: Implementation and Evaluation of a Resident Well-Being Program Pre-/post-intervention survey Initiative Institutional”
BackgroundSeo, C., Corrado, M., Fournier, K., Bailey, T., & Haykal, K.-A. (2021) · BMC Medical Education · doi:10.1186/s12909-021-02495-0 · Cited by 65 · see citing works
“Of the 5 resilience curricula that were based on previously developed training models, 2 used the Stress Management and Resilience Training Program [95, 98], and 3 used the Penn Resilience Program [90], Coping with Work and Family Stress Intervention [89], and Energy Leadership Well-Being and Resiliency Program [99],…”
MethodZhang, L. M., Cheung, E. O., Eng, J. S., Ma, M., Etkin, C. D., Agarwal, G., Shanafelt, T. D., Riall, T. S., Nasca, T. J., Bilimoria, K. Y., et al. (2020) · The American Journal of Surgery · doi:10.1016/j.amjsurg.2020.10.026 · Cited by 59 · see citing works
Self-citationParsons, M., Bailitz, J. M., Chung, A. S., Mannix, A., Battaglioli, N., Clinton, M., & Gottlieb, M. A. (2020) · Western Journal of Emergency Medicine · doi:10.5811/westjem.2019.11.42961 · Cited by 55 · see citing works
Pijpker, R., Vaandrager, L., Veen, E. J., & Koelen, M. A. (2019) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph17010055 · Cited by 64 · see citing works
“Study 7 [36]; USA General surgery residents working at the University of Arizona; one group, pre-test/post-test design Reducing burnout complaints; MBI-GS (EX, CY, PE) Staff members at risk of developing burnout; the intervention was part of their formal (on the job) education (n = 49) None Not reported Combined inter…”
BackgroundA Model for a Formal Mentorship Program in Surgical Residency
Bingmer, K. E., Wojnarski, C. M., Brady, J. T., Stein, S. L., Ho, V. P., & Steinhagen, E. F. (2019) · Journal of Surgical Research · doi:10.1016/j.jss.2019.04.068 · Cited by 49 · see citing works
The role of resilience in the work-life interface: A systematic review
Bernuzzi, C., Sommovigo, V., & Setti, I. (2022) · Work · doi:10.3233/wor-205023 · Cited by 55 · see citing works
Song, Y., Swendiman, R. A., Shannon, A. B., Torres-Landa, S., Khan, F. N., Williams, N. N., Dumon, K. R., Brooks, A. D., DeMatteo, R. P., & Aarons, C. B. (2020) · Journal of Surgical Education · doi:10.1016/j.jsurg.2020.04.014 · Cited by 42 · see citing works
Burnout and psychological distress between surgical and non-surgical residents
Serenari, M., Cucchetti, A., Russo, P. M., Fallani, G., Mattarozzi, K., Pinna, A. D., Colonnello, V., Poggioli, G., & Cescon, M. (2019) · Updates in Surgery · doi:10.1007/s13304-019-00653-0 · Cited by 40 · see citing works
Trends in Surgeon Burnout in the US and Canada: Systematic Review and Meta-Regression Analysis
Etheridge, J. C., Evans, D. L., Zhao, L., Ibrahim, N., Wick, E. C., Freischlag, J. A., & Brownstein, M. R. (2022) · Journal of the American College of Surgeons · doi:10.1097/xcs.0000000000000402 · Cited by 37 · see citing works
Kiratipaisarl, W., Surawattanasakul, V., & Sirikul, W. (2024) · BMC Medical Education · doi:10.1186/s12909-024-06195-3 · Cited by 37 · see citing works
“In summary, our findings suggest the influence of interventions characteristics on the observed outcomes, as well as emphasizing the potential benefits of combining mediation with coaching interventions, may lead to improvement in both EE and PA [62, 66, 86].”
BackgroundPrice, E. T., Coverley, C. R., Arrington, A. K., Nfonsam, V. N., Morris, L. F., & Riall, T. S. (2019) · Journal of surgical education · doi:10.1016/j.jsurg.2019.12.003 · Cited by 35 · see citing works
Self-citationMeasuring and Improving Emotional Intelligence in Surgery
Abi‐Jaoude, J., Kennedy-Metz, L. R., DIAS, R. D., Yule, S., & Zenati, M. A. (2021) · Annals of Surgery · doi:10.1097/sla.0000000000005022 · Cited by 33 · see citing works
“8% (n 1⁄4 4/37) utilized an interventional approach aimed at improving EI.(29,34,50,55) Of these interventions, 1(29) assessed EI at multiple time points and 3 studies(34,50,55) assessed EI in a pretest and post-test manner.”
BackgroundMethodInfluentialBurnout and work-life balance in neurosurgery: Current state and opportunities
Neal, M. T., & Lyons, M. (2020) · Surgical Neurology International · doi:10.25259/sni_736_2020 · Cited by 33 · see citing works
“[50] Wellness and resiliency programs targeting residents[32,38] and attending physicians[11,33] have successfully reduced stress and EE.”
BackgroundTeaching Evaluation Algorithm Based on Grey Relational Analysis
Zhang, X., Yang, X., & Yang, J. (2021) · Complexity · doi:10.1155/2021/5596518 · Cited by 29 · see citing works
“For example, this planet system is a black system if the planet known to people is regarded as a system, but the volume, mass, and distance between planets and Earth are completely unknown [9].”
BackgroundEvaluation of leadership curricula in general surgery residency programs
Torres-Landa, S. R., Wairiri, L. W., Cochran, A. L., & Brasel, K. J. (2021) · The American Journal of Surgery · doi:10.1016/j.amjsurg.2021.05.012 · Cited by 28 · see citing works
Precision Marketing Method of E‐Commerce Platform Based on Clustering Algorithm
Zhang, B., Wang, L., & Li, Y. (2021) · Complexity · doi:10.1155/2021/5538677 · Cited by 27 · see citing works
The Correlation of Burnout and Optimism among Medical Residents
Fowler, J. B., Fiani, B., Kiessling, J. W., Khan, Y. R., Li, C., Quadri, S. A., Mahato, D., & Siddiqi, J. (2020) · Cureus · doi:10.7759/cureus.6860 · Cited by 24 · see citing works
Mastering Stress: Mental Skills and Emotional Regulation for Surgical Performance and Life
Anton, N. E., Lebares, C. C., Karipidis, T., & Stefanidis, D. (2021) · Journal of Surgical Research · doi:10.1016/j.jss.2021.01.009 · Cited by 23 · see citing works
“1,2,3,67,68”
Vasquez, T. S., Close, J., & Bylund, C. L. (2021) · Journal of Graduate Medical Education · doi:10.4300/jgme-d-20-01433.1 · Cited by 23 · see citing works
“Several studies included in this review support the importance of organization-directed interventions to better ascertain the more systems-based components of residents’ daily experiences that contribute to higher degrees of burnout.(16,19,20,22,36) Organizational elements including high workloads, long work hours, an…”
BackgroundKobritz, M., Nofi, C. P., Demyan, L., Farno, E., Fornari, A. B., Kalyon, B. D., & Patel, V. M. (2022) · Journal of surgical education · doi:10.1016/j.jsurg.2022.11.002 · Cited by 23 · see citing works
Serrano, O. K., Vock, D. M., Snyder, J. J., Chinnakotla, S., Kandaswamy, R., Pruett, T. L., Matas, A. J., & Finger, E. B. (2019) · American Journal of Transplantation · doi:10.1111/ajt.15301 · Cited by 23 · see citing works
Surgery Resident Wellness Programs
Williams-Karnesky, R. L., Greenbaum, A. A., & Paul, J. S. (2020) · Advances in Surgery · doi:10.1016/j.yasu.2020.05.005 · Cited by 21 · see citing works
Discussing Prognosis with Empathy to Cancer Patients
Lelorain, S. (2021) · Current Oncology Reports · doi:10.1007/s11912-021-01027-9 · Cited by 20 · see citing works
Compassion Fatigue in Surgical Trainees
Seemann, N. M., Karanicolas, P. J., Guttman, M. P., Nathens, A. B., Tien, H. C. N., Ellis, J., Zaretsky, A. E., & Conn, L. G. (2019) · Journal of surgical education · doi:10.1016/j.jsurg.2019.03.012 · Cited by 19 · see citing works
Work Context and Burnout: Confirmation of Moderators from Meta-analysis Evidence
Cortêz, P. A., Zerbini, T., & Veiga, H. M. D. S. (2019) · Revista Psicologia Organizações e Trabalho · doi:10.17652/rpot/2019.4.17499 · Cited by 18 · see citing works
“Although, inefficient ergonomic practices that offer low autonomy and overload workers with constant high demands, elevated complexity tasks, and stressful conditions seem as negative influencers and may foster burnout (Ladstätter et al., 2015; Riall et al., 2018).”
A Facilitated-Group Approach to Wellness in Surgical Residency
Mueller, C. M., Buckle, M. E., & Post, L. I. (2018) · JAMA Surgery · doi:10.1001/jamasurg.2018.3109 · Cited by 18 · see citing works
We Need to Do Better: A Scoping Review of Wellness Programs In Surgery Residency
Anand, A., Jensen, R. M., & Korndorffer, J. R. (2023) · Journal of surgical education · doi:10.1016/j.jsurg.2023.07.009 · Cited by 17 · see citing works
Cevallos, J. R., Gonzales, P. A., Berler, M. H., Greenberg, A. L., & Lebares, C. C. (2023) · Journal of the American College of Surgeons · doi:10.1097/xcs.0000000000000775 · Cited by 16 · see citing works
Swanson, S., & Schweiss, S. K. (2019) · Currents in Pharmacy Teaching and Learning · doi:10.1016/j.cptl.2019.05.004 · Cited by 15 · see citing works
Emotional Regulation in Surgery: Fostering Well-Being, Performance, and Leadership
Greenberg, A. L., Sullins, V. F., Donahue, T. R., Sundaram, V. M., Saldinger, P. F., Divino, C. M., Anton, N. E., Stefanidis, D., Reilly, L. M., Egan, R. J., et al. (2022) · Journal of Surgical Research · doi:10.1016/j.jss.2022.02.032 · Cited by 16 · see citing works
Self-citationHekman, K. E., Wohlauer, M. V., Magee, G. A., Shokrzadeh, C. L., Brown, K. R., Carsten, C. G., Chaer, R. A., Jazaeri, O., Lee, A. M., Singh, N. N., et al. (2019) · Journal of Vascular Surgery · doi:10.1016/j.jvs.2019.02.050 · Cited by 15 · see citing works
To the Point: a prescription for well-being in medical education
Hopkins, L., Morgan, H. K., Buery-Joyner, S. D., Craig, L. B., Everett, E. N., Forstein, D. A., Graziano, S., Hampton, B. S., McKenzie, M. L., Page-Ramsey, S. M., et al. (2019) · American Journal of Obstetrics and Gynecology · doi:10.1016/j.ajog.2019.05.012 · Cited by 15 · see citing works
Ojute, F. M., Gonzales, P. A., Berler, M. H., Puente, N., Johnston, B., Singh, D., Edwards, A., Lin, J. A., & Lebares, C. C. (2024) · Journal of surgical education · doi:10.1016/j.jsurg.2023.12.010 · Cited by 14 · see citing works
Greenberg, A. L., Tenzing, N., Ghadimi, T. R., Tilahun, M., Berler, M. H., & Lebares, C. C. (2022) · Journal of the American College of Surgeons · doi:10.1097/xcs.0000000000000250 · Cited by 14 · see citing works
Lu, F.-I., & Ratnapalan, S. (2023) · Archives of Pathology & Laboratory Medicine · doi:10.5858/arpa.2021-0115-ep · Cited by 14 · see citing works
Hicks, M. D., Braden, L., Walsh, E. M., Greene, B., & Grayson, J. W. (2021) · The Journal of Laryngology & Otology · doi:10.1017/s0022215121003091 · Cited by 13 · see citing works
Leadership skills curriculum development for residents and fellows: A needs-assessment
Friendly, C., Villacreses, C. F., Mukherjee, R. D., Babilon, E., Caraway, J., Dieffenbaugher, S. T., Hink, A. B., Mellinger, J. D., Plumblee, L., Walters, M. L., et al. (2021) · The American Journal of Surgery · doi:10.1016/j.amjsurg.2021.10.007 · Cited by 13 · see citing works
See One, Do One, Improve One’s Wellness
Abahuje, E. A. E., Smith, K. S., Amórtegui, D., Eng, J. S., Philbin, S. E., Verma, R., Dastoor, J. D., Schlick, C. J. R., Ma, M., Mackiewicz, N. I., et al. (2023) · Annals of Surgery · doi:10.1097/sla.0000000000006002 · Cited by 12 · see citing works
Measuring Uncertainty Intolerance in Surgical Residents Using Standardized Assessments
Ying, L., Harrington, A. W., Assi, R., Thiessen, C., Contessa, J., Hubbard, M. O., Yoo, P. S., & Nadzam, G. S. (2019) · Journal of Surgical Research · doi:10.1016/j.jss.2019.07.035 · Cited by 11 · see citing works
Adapting Orthopaedic Surgery Training Programs During the COVID‐19 Pandemic and Future Directions
Zhang, A. S., Myers, M., Kee, C. J., McClary, K. N., Barton, R. S., & Massey, P. A. (2020) · Arthroscopy Sports Medicine and Rehabilitation · doi:10.1016/j.asmr.2020.06.008 · Cited by 9 · see citing works
Residents Need a Dynamic Approach to Leadership Education: A Qualitative Study
Ho, J. W., Cerier, E. J., Diaz, C. M., Hu, Y., Tatebe, L. C., Alam, H. B., Johnson, J. K., & Halverson, A. L. (2024) · Journal of surgical education · doi:10.1016/j.jsurg.2024.03.003 · Cited by 12 · see citing works
Kemp, M. T., Evans, J., Rivard, S. J., Sharma, S. B., Williams, A. M., Coleman, D. M., Dimick, J. B., & Sandhu, G. (2021) · Annals of Surgery · doi:10.1097/sla.0000000000005230 · Cited by 8 · see citing works
“Some programs have included educational sessions on several topics, including the following: emotional intelligence, resilience, team building, communication, work-life integration, goal setting, empathy, strategic diet and exercise, operative posture and ergonomics, stress reduction techniques, and mindfulness.(2,5)…”
BackgroundRickard, M. J. F. X., Kozlowski, D., & Schnitzler, M. (2023) · Journal of surgical education · doi:10.1016/j.jsurg.2023.07.021 · Cited by 8 · see citing works
Mindfulness-Based Training Improves Technical Skills and Emotional Regulation for Surgical Residents
Gurland, B. (2019) · JAMA Network Open · doi:10.1001/jamanetworkopen.2019.4087 · Cited by 8 · see citing works
Depression and suicide: Occupational hazards of practicing medicine
Poorman, E. A. (2019) · Journal of Patient Safety and Risk Management · doi:10.1177/2516043519866993 · Cited by 6 · see citing works
“Stanford General Surgery has created a successful wellness program for residents that emphasizes relationships, structural support, and psychological safety.(25) It is notable that both of these programs are not afraid to speak openly about suicide.”
BackgroundIammeechai, W., Srikulmontri, T., & White, B. A. A. (2026) · Medical Teacher · doi:10.1080/0142159x.2026.2621214 · Cited by 6 · see citing works
“…– 36, Some interventions integrated emotional intelligence with communication and empathy training, aiming to raise learners ’ awareness of their communication styles, enhance emotional understanding, and support effective interaction in interprofessional teams [21,22,25,40,42,46,48,50,56 – 58].”
Anxiety and depression symptoms among medical residents in KSA during the COVID-19 pandemic
Alawad, H. S., Amin, H. S., AlFaris, E., Ahmed, A. M. A., Alosaimi, F. D., & BaHammam, A. S. (2022) · Journal of Taibah University Medical Sciences · doi:10.1016/j.jtumed.2022.01.005 · Cited by 6 · see citing works
Cost‐Effectiveness of Depression Screening for Otolaryngology–Head and Neck Surgery Residents
Kligerman, M. P., Devine, E. E., Bentzley, J. P., & Megwalu, U. C. (2020) · The Laryngoscope · doi:10.1002/lary.28780 · Cited by 5 · see citing works
“This was intended to mirror similar pilot programs that provide mindfulness classes and/or therapy sessions to entire residency cohorts regardless of symptoms.(15,16) In the second, third, and fourth algorithms, depression screening was modeled using the Patient Health Questionnaire-9 (PHQ-9) survey.”
MethodBurnout: Definition, Prevalence, Risk Factors, Prevention, and Interventions Literature Reviews
Bouskill, K., Danz, M., Meredith, L. S., Chen, C., Chang, J., Baxi, S. M., Huynh, D., Al-Ibrahim, H., Motala, A., Larkin, J., et al. (2022) · RAND Corporation eBooks · doi:10.7249/rr-a428-1 · Cited by 5 · see citing works
Berry, P. (2021) · Postgraduate Medical Journal · doi:10.1136/postgradmedj-2021-140463 · Cited by 5 · see citing works
Implementation, Feasibility, and Perception of Facilitated Process Groups in Surgical Residency
Letica‐Kriegel, A. S., Connolly, M. R., Westfal, M. L., Treadway, D. C., Post, L. I., Mullen, J. T., & Qadan, M. (2023) · Journal of surgical education · doi:10.1016/j.jsurg.2023.04.002 · Cited by 5 · see citing works
Evaluating the Feasibility of Stress-Resilience Training in Surgical Residency
Riall, T. S. (2018) · JAMA Surgery · doi:10.1001/jamasurg.2018.2735 · Cited by 4 · see citing works
Self-citationThe Growing Momentum of Leadership Education in General Surgery Training: A Systematic Review
Maqbool, B., Jahangir, A., Hassan, M., Nasim, M. T., Rehman, S. S. U., & Uzair, M. (2026) · Journal of surgical education · doi:10.1016/j.jsurg.2025.103854 · Cited by 3 · see citing works
Domínguez, L. C., Vega, N. V., & Sanabria, Á. (2024) · Revista Colombiana de Cirugía · doi:10.30944/20117582.2569 · Cited by 2 · see citing works
Promoting Well‐Being Among Gastroenterologists – A Call for Systemic Action
Zimmermann, K., Rodríguez–Lago, I., Sidhu, R., Heinrich, H. S., Sousa, P., Dieninytė, E., Duijvestein, M., Hann, A., Gemilyan, M., Knüttel, H., et al. (2025) · United European Gastroenterology Journal · doi:10.1002/ueg2.70149 · Cited by 3 · see citing works
“…Participation in a leadership and resiliency program to improve surgical residents well‐being was associated with a significant decrease in emotional exhaustion [73], while the Women Leaders in Medicine program [72] resulted in significant improvements across all burnout dimensions (Table 2).”
Does following a breast cancer patient for a day enhance medical student empathy?
Barr, L. C., & Daniel, B. (2024) · Medical Teacher · doi:10.1080/0142159x.2024.2311864 · Cited by 2 · see citing works
“…distancing from the patient, such as creating protected time to share experiences with a designated clinical ‘ buddy ’ (McCool et al. 2022), or integrating mindfulness techniques into the working week (Raab 2014), or having a support group to interact and share experiences with (Riall et al. 2018).”
Plastic Surgeon Well-being, Mindfulness, and the Art of Letting Go
Kim, D. H., Chandawarkar, S. K., Krajewski, A. L., DeLuca-Pytell, D., Akiki, R. K., Asanbe, O. A., & Patel, S. A. (2025) · Plastic & Reconstructive Surgery Global Open · doi:10.1097/gox.0000000000006440 · Cited by 2 · see citing works
“20 Once one assumes the role of a new attending surgeon and even later in one’s career, several professional and personal challenges may threaten to disrupt mental well-being.”
Strong, D. M., Amin, S., Caputo, J., Sheehan, A. H., Seyss, C., Mistry, A. D., & Miller, M. L. (2023) · JACCP JOURNAL OF THE AMERICAN COLLEGE OF CLINICAL PHARMACY · doi:10.1002/jac5.1750 · Cited by 2 · see citing works
“A decrease in stress and burnout has been documented in medical residents who participated in resilience and well-being training.(23) Pharmacy residency, physician trainee, and health care student programs are beginning to address the stress and burnout of their trainees with targeted well-being training programs, how…”
BackgroundDo, A., Li, L., Heller, D. R., Ziki, M. D. A., Glaser, D. H., Kumar, S. P., & Huot, S. J. (2020) · BMJ Leader · doi:10.1136/leader-2020-000233 · Cited by 2 · see citing works
Metrics of Resident Achievement for Defining Program Aims
Jewell, C., Kraut, A., Miller, D. T., Ray, K. A., Werley, E. B., & Schnapp, B. (2022) · Western Journal of Emergency Medicine · doi:10.5811/westjem.2021.12.53554 · Cited by 2 · see citing works
Connors, B., Horne, C. M., Vilchez, V., & Asfaw, S. H. (2019) · IntechOpen eBooks · doi:10.5772/intechopen.84349 · Cited by 2 · see citing works
Making the Financial Case for Surgical Resident Well-being: A Scoping Review
Greenberg, A. L., Doherty, D. V., Cevallos, J. R., Tahir, P., & Lebares, C. C. (2022) · Annals of Surgery · doi:10.1097/sla.0000000000005719 · Cited by 3 · see citing works
Letter to the Editor. “Burned out” at work but satisfied with one’s job: anatomy of a false paradox
Laurent, É., Schonfeld, I. S., & Bianchi, R. (2018) · Journal of neurosurgery · doi:10.3171/2018.2.jns18430 · Cited by 2 · see citing works
Relationship Between Well-Being, Psychological Resilience, and Life Satisfaction of Residents
Erfen, T., Acehan, S., Önder, F. C., Gülen, M., Isıkber, C., Kaya, A., & Satar, S. (2022) · Kafkas Journal of Medical Sciences · doi:10.5505/kjms.2022.97820 · Cited by 1 · see citing works
Maximizing Surgical Success by Aligning Interventions to Outcomes: A Systematic Review
Armstrong, B. A., Tung, A., Lo, L., Abssy, S. S., Zulfiqar, M., van Oost, J., Wong, J., Janevski, J., Martyniuk, J., & Trbovich, P. (2025) · Annals of Surgery Open · doi:10.1097/as9.0000000000000558 · Cited by 1 · see citing works
Riall, T. S. (2018) · Surgery · doi:10.1016/j.surg.2018.06.009 · Cited by 1 · see citing works
Self-citationTarrash, M., Nelson, D., Gabbur, N., & Goldberg, G. L. (2022) · BMC Medical Education · doi:10.1186/s12909-022-03897-4 · Cited by 1 · see citing works
Sadeghi, Y., Hatamizadeh, N., Shahshahani, S., & Hosseinzadeh, S. (2023) · Iranian Rehabilitation Journal · doi:10.32598/irj.21.1.417.2 · Cited by 1 · see citing works
Egan, C. E., Lee, Y. J., Stratigis, J. D., Ku, J., Greenberg, J. A., Beninato, T., Zarnegar, R., Fahey, T. J., Agrusa, C. J., & Finnerty, B. M. (2023) · Journal of surgical education · doi:10.1016/j.jsurg.2023.06.014 · Cited by 1 · see citing works
Smith, K., Dandil, Y., Baillie, C., & Tchanturia, K. (2019) · Brain Sciences · doi:10.3390/brainsci9100247 · Cited by 1 · see citing works
“However, well-being programs in hospitals have been shown to positively impacted clinicians stress and well-being levels a year later [19].”
BackgroundTemporal Biases in the Evaluation of Resident Well-Being Programs?
Oliveira, G. D. (2018) · Journal of the American College of Surgeons · doi:10.1016/j.jamcollsurg.2018.04.001
Riall, T. S. (2018) · Journal of the American College of Surgeons · doi:10.1016/j.jamcollsurg.2018.04.002
Self-citationWellbeing Consideration for Residents
Cellini, C., & DeCaporale-Ryan, L. N. (2020) · Success in academic surgery · doi:10.1007/978-3-030-29470-0_16
Vérgez, J. C. (2012) · Gaceta fiscal
Gade, L., & Yeo, H. (2020) · Success in academic surgery · doi:10.1007/978-3-030-29470-0_18
Tarrash, M., Nelson, D., Gabbur, N., & Goldberg, G. L. (2022) · Research Square · doi:10.21203/rs.3.rs-1622282/v1
Síndrome de Burnout entre cirurgiões
de Carvalho, C. J. B., de Oliveira, L. C., Tavares, N. N., Carvalho, L. L., Abreu, B. C. B., Jiquiriçá, L. D. M., ARKADER, B. T. F., Duarte, C. H. J., Wanderley, L. S., & Cazagrande, G. S. (2023) · Revista Eletrônica Acervo Saúde · doi:10.25248/reas.e14461.2023
Unninayar, D., Fung, B. S. C., Best, G., & Raîche, I. (2024) · Journal of Wellness · doi:10.55504/2578-9333.1222
de Miranda, M. L., da Cunha, S., Barbosa, L. V., Balarini, M. D. M., Pinto, S. A. D. S., & Afonso, D. H. (2024) · Revista Brasileira de Educação Médica · doi:10.1590/1981-5271v48.3-2024-0305
Sandhya, D. S., & Annamalai, S. (2025) · Journal of Workplace Behavioral Health · doi:10.1080/15555240.2025.2491389 · Cited by 2 · see citing works
“Interventions such as resilience training programs have been shown to increase satisfaction with WLB (Riall et al., 2018).”
Formal leadership curriculum in United States surgical residency programs: a systematic review
Wahle, C. F., Ryder, M., Berkane, R., Mao, Y. V., de Virgilio, C., & Bazargan‐Hejazi, S. (2025) · Global Surgical Education - Journal of the Association for Surgical Education · doi:10.1007/s44186-025-00394-2
“Alternatively, both Pepe et al. and Riall et al. used professional coaches from the business sector to help develop their programs [22, 28].”
Seo, C., Corrado, M., Fournier, K., Bailey, T., & Haykal, K.-A. (2021) · Figshare · doi:10.6084/m9.figshare.13685005
Seo, C., Corrado, M., Fournier, K., Bailey, T., & Haykal, K.-A. (2021) · Figshare · doi:10.6084/m9.figshare.13685008
Seo, C., Corrado, M., Fournier, K., Bailey, T., & Haykal, K.-A. (2021) · Figshare · doi:10.6084/m9.figshare.13685002
Mentorship in General Surgery Residency: A Qualitative Study
Peng, T. D., Senofsky, S., Desai, K., Wu, J. X., Tillou, A., Wagner, J. P., & Chen, F. C. (2026) · The American Surgeon · doi:10.1177/00031348261443330
Petrie, K. A., Gaschen, P. D., & Petrie, T. A. (2026) · Academia Mental Health and Well-Being · doi:10.20935/mhealthwellb8314
- Authors
- Riall, T. S., Teiman, J., Chang, M., Cole, D., Leighn, T., McClafferty, H., & Nfonsam, V. N.
- Affiliations
- University of Arizona (US)
- Corresponding author
- Riall, Taylor S.
- Venue
- Journal of the American College of Surgeons
- Published
- 2018-04
- Volume
- 226
- Issue
- 4
- Pages
- 369-379
- ISSN
- 1072-7515 (ISSN-L)
- OpenAlex
- W2777949727
- Cited by
- 92
- References
- 27
- Citations by year
- 2026: 4 · 2025: 5 · 2024: 7 · 2023: 10 · 2022: 15 · 2021: 15 · 2020: 13 · 2019: 16 · 2018: 6 · 2012: 1
- FWCI
- 15.52
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Journal of the American College of Surgeons (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Health Professions › General Health Professions › Healthcare professionals’ stress and burnout
- Social Sciences › Psychology › Social Psychology › Stress and Burnout Research
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Innovations in Medical Education
- Keywords
- burnout, perceived stress, emotional intelligence, general surgery residency, program implementation and evaluation, emotional exhaustion, work-life balance, resident satisfaction, leadership skills
- MeSH terms
- Adolescent, Adult, Burnout, Professional, Depression, Female, Humans, Internship and Residency, Leadership, Male, Personal Satisfaction, Quality of Life, Surveys and Questionnaires, Self Concept, General Surgery, Workload, Young Adult, Emotional Intelligence
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