Improving burnout and well-being among medicine residents: Impact of a grassroots intervention compared to a formal program curriculum
Open accessAbstract
BACKGROUND: With growing resident burnout, Accreditation Council for Graduate Medical Education issued new requirements for program interventions to optimize resident well-being. Little evidence exists on how to best teach resiliency to residents. This study assesses the impact of both a grassroots intervention and formal resiliency curriculum on resident burnout and well-being. MATERIALS AND METHODS: From November 2016 to August 2017, residents in a large Internal Medicine Residency Program participated in grassroots wellness interventions from the resident-led Gator Council in Gainesville, FL USA. From August 2017 to June 2018, residents participated in a formal program-driven resiliency curriculum. Wellness interventions included monthly morning reports, bimonthly workshops, and biannual noon conferences. Pre- and postintervention Maslach Burnout Inventory (MBI) and Physician Well-Being Index (PWBI) assessed the effect of both interventions on resident burnout and well-being. Statistical analyses used Student's t -test, Fisher's exact tests, and linear regression model. RESULTS: One hundred and twenty-two residents participated in grassroots interventions. One hundred and seventeen (87 residents, 35 students) participated in formal curriculum. Mean MBI scores for all three sections did not differ between pre -and postgrassroots intervention (emotional exhaustion [EE] P = 0.46; depersonalization [DP] P = 0.43; personal accomplishment [PA] P = 0.73]) or between pre- and postcurriculum (EE P = 0.20; DP P = 0.40; PA P = 0.51). Students scored higher burnout levels compared to residents in EE ( P = 0.001) and PA ( P = 0.02). Pre- versus postcurriculum PWBI scores did not differ among residents ( P = 0.20), while PWBI scores improved among students ( P = 0.01). CONCLUSIONS: This study found no improvement in resident burnout or well-being from a bottom-up and top-down approach. Our results imply the need for an early wellness curriculum to improve student well-being given their higher level of burnout. System-wide efforts are vital to combat physician burnout.
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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 [67]
The Results (Table 1; page unavailable) report emotional-exhaustion measurements before and after the paper’s wellness interventions, so the paper could supply study-level data for a pooled analysis. It does not report the cited subgroup’s Cohen’s d, confidence interval, p-value, or I²; its own pre–post emotional-exhaustion comparisons were not statistically significant. The quoted pooled result is therefore not a finding of this source. (LLM, conf=0.84)
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References 23 · Cited by 11
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- Authors
- Sheer, A. J., Estores, I. M., Nickels, R., Radhakrishnan, N., Goede, D. L., Mramba, L. K., & Lo, M. C.
- Affiliations
- University of Florida (US)
- Malcom Randall VA Medical Center (US)
- University of Florida Health (US)
- University of Kansas Medical Center (US)
- Corresponding author
- Sheer, Amy J.
- ORCID
- Venue
- Journal of Education and Health Promotion
- Published
- 2021-07
- Volume
- 10
- Issue
- 1
- Pages
- 250-250
- ISSN
- 2277-9531 (ISSN-L)
- 2319-6440
- PMC
- PMC8396059
- OpenAlex
- W3187094571
- Cited by
- 11
- References
- 23
- Citations by year
- 2026: 1 · 2025: 5 · 2024: 2 · 2023: 2 · 2022: 1
- FWCI
- 1.40
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- cc-by-nc-sa
- Locations
- Journal of Education and Health Promotion (publishedVersion, cc-by-nc-sa)
- PubMed Central (publishedVersion, cc-by-nc-sa)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- 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
- physician burnout, resident well-being, medical residents, internal medicine residency, emotional exhaustion, depersonalization, personal accomplishment, physician well-being, medical students, wellness curriculum
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