obstetrics, gynecology, faculty, residency, burnout, well-being
Background: Between 22% and 60% of practicing physicians are reported to have experienced burnout. OB/GYN resident burnout has been reported at 90%. Duty-hour limitations were implemented for patient safety and have been associated with some increase in overall resident quality of life, but also potential sacrifices in resident education and patient care. Contributors to burnout and drivers of engagement include workload and job demands, control and flexibility, and poor work-life integration.
Purpose: To evaluate the impact associated with implementing limited weekend rounding, redistribution of postpartum rounding on weekdays, and introduction of quarterly wellness mornings on overall resident and faculty well-being.
Methods: Effective July 2, 2017, two workload protocols were changed. Weekend rounding protocols continue to have residents round on all antepartum and gynecology patients at the end of each 24-hour shift, but now faculty complete all postpartum rounding. Weekday postpartum rounding was redistributed, decreasing the number of patients per junior resident from > 10 patients to a maximum of 6–7 patients per resident. Quarterly wellness mornings began in September 2017, using protected education time for faculty and resident physicians. A brief 3-item well-being check-in card (WBCIC) was developed and used to obtain participants’ quarterly ratings regarding the adequacy of time for wellness, level of meaning in their work, and comments. Debriefings during resident-required curriculum time provided perspective on impact of reduced rounding protocols.
Results: Mean WBCIC scores revealed time spent on personal well-being at baseline and 7 months postimplementation was 1.6 and 2.1 for residents, respectively, and 2.4 and 2.4 for faculty (Scale: 1 = pitiful to 4 = excellent). The item “Work I do is meaningful to me” scored 4.9 and 4.1 for residents pre- and postintervention and 5.5 and 6.3 for faculty (Scale: 1 = strongly disagree to 7 = strongly agree).
Conclusion: After changes in rounding, residents’ personal well-being improved but meaning in work declined. In contrast, faculty’s personal well-being remained constant and meaning in work increased. Additional well-being interventions focused on residents’ meaning in work will be explored.
Copperman E, Light N, Kelly CJ, Simpson D. Evaluating well-being in OB/GYN residents and faculty. J Patient Cent Res Rev. 2018;5:322.