Table 1
The main components and objectives of the well-being building triad pilot program
|
Components |
Description |
Objectives |
|---|---|---|
|
Peer groups |
– Offered quarterly in person, voluntary, structured/semi-structured time of 90 minutes – Resident-facilitated and attended to promote confidentiality and security – Integrates aspects of peer-support, debriefing, Balint and Doctoring to Heal groups, as well as experiential relaxation exercises – Promotes safe sharing of experiences and processing of emotions related to the ups and downs of residency |
1. Build awareness and knowledge about the importance of enhancing wellness and mitigating burnout, while also employing principles of adult-learning, granting authority to learn at their own pace and for their own needs. 2. Combat stigma and stress to foster trainees’ comfort in sharing and destigmatizing their experiences with chronic stress and burnout, while empowering them to explore new ways to approach concerns and challenges. 3. Build a community of support and strength by demonstrating that physicians are not alone in their experiences and forming a unified voice calling for change. 4. Advocate for cultural change by encouraging dialogue between the medical infrastructure and medical professionals to maintain a bidirectional, healthy, and lifelong learning process aimed at caring for both the public and its healers. 5. Promote sustainability in medicine by supporting the modern physician to participate in a more effective and tolerable manner when addressing the needs of a rapidly changing healthcare landscape |
|
Electronic resilience curriculum |
– https://respite.machealth.ca – Publicly available, online, voluntary, and can be accessed by trainees during optional teaching times on their own schedules – Founded on two core learning dimensions: Know Yourself and Integrate New Lifestyles, which respectively teach about burnout, and offer strategies to enhance resilience or combat stress and struggles in medicine – Utilizes a case-based approach, skill-building exercises and quizzes to promote reflection and solidify learning | |
|
Wellness newsletter |
– Distributed quarterly via group listserve – Designed for residents, but both faculty and residents contribute and receive – Utilizes positive psychology, as well as personal stories and experiences to address stigma and isolation |
Table 2
Structure and process of the peer groups
|
Pre-group |
– All psychiatry residents invited via email to participate in upcoming peer group one month prior to the event. – An email reminder is sent out, again to all residents one week prior to the event. |
|
In-group |
1) Resident arrival – Residents obtain refreshments and settle in, socializing with their peers. 2) Welcome and check in (5 mins) – Resident facilitators and participants introduce themselves and check in with how they are presently feeling. 3) Orientation (5 mins) – Rationale and purpose for the group is reviewed, along with other more formal supports and resources available should these be needed. – Ground rules are reviewed: a. Maintain confidentiality b. Be non-judgmental c. Allow equal air time d. Become engaged e. Be respectful 4) Group discussion and debrief (50 mins) – Residents engage in round-table open group discussion about a previously selected theme. – Residents developed strategies to address stress and burnout in medicine through sharing of their own experiences, supporting and validating one another, and learning from one another’s wisdom, skills and resources to help mitigate challenges and maintain one’s wellness. – Topics include: a. Difficult or adverse events b. Feedback and failure c. Work-life balance d. Seeking help 5) Experiential session (15–20 mins) – Designed to promote grounding and relaxation post-discussion. – Experiences include: a. Body scans b. Mindfulness meditations c. Loving kindness meditations d. Progressive muscle relaxation 6) Closing and check out (5–10 mins) – All residents comment on how they are now feeling after the group and what they will be taking away from the session. – Reminders provided regarding post-group survey to elicit feedback and the date for the next session. |
|
Post-group |
– Immediately following the group residents who attended the session are provided with evaluations. Paper evaluations were initially used, which were later switched to an electronic survey for ease and convenience. – Residents currently receive an email thanking them for their attendance and with the post-group evaluation survey immediately post the event, and then a week later as a reminder. |
Table 3
Preliminary results of the well-being building triad pilot program
|
Measures |
Findings (average rates) |
|---|---|
|
Resident participation cohort |
31% of total psychiatry residents |
|
Resident attendance return rate |
23%; attendance amongst the peer group grew by 57% |
|
Gender of participants |
83% females |
|
Pre-attendance | |
|
Currently experiencing burnout |
48% |
|
Currently coping with burnout (somewhat well—not well) |
75% |
|
External factors influencing well-being |
83% |
|
Familiarity with supports/resources (somewhat—not at all) |
66% |
|
Post-attendance | |
|
Would attend a future peer-support group |
100% |
|
Felt that the peer groups should be facilitated and attended by residents only |
100% |
|
Felt experiential sessions to be effective |
100% |
|
Strongly agree/agree that they learned new tools and practices to cope with stress and combat burnout |
100% |
|
Strongly agree/agree with feeling more comfortable talking about stress and burnout and/or asking for help when needed |
80% |
|
Strongly agree/agree with feeling more knowledgeable about resources or supports available and how to access these |
80% |
|
Strongly agree/agree with feeling respected and supported by peers |
100% |
|
Highly interested in further promoting resident wellness |
83% |
|
Average stress reduction in attendees |
50% (5.5/10 to 2.75/10) |
|
Cited accepted strategies to cope with burnout |
– Informal supports/activities: 100% (discussing with family/peers/staff, physical activity, social activities, mindfulness and spiritual practices, and taking vacation) – Formal supports: 0% (resident wellness programs and other formal medical or psychological treatment) |
|
Cited benefits of the program |
Relaxing environment/exercises; sharing experiences with others; feeling less alone; understanding of self-compassion and practical tools to increase it; discussing tips to staying well and seeking support |