“One size does not fit all” – lessons learned from a multiple-methods study of a resident wellness curriculum across sites and specialties

Abstract Background There is growing recognition that wellness interventions should occur in context and acknowledge complex contributors to wellbeing, including individual needs, institutional and cultural barriers to wellbeing, as well as systems issues which propagate distress. The authors conduc...

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Autores principales:	Deanna Chaukos, Jonathan P. Zebrowski, Nicole M. Benson, Alper Celik, Emma Chad-Friedman, Aviva Teitelbaum, Carol Bernstein, Rebecca Cook, Afia Genfi, John W. Denninger
Formato:	article
Lenguaje:	EN
Publicado:	BMC 2021
Materias:	Resident wellness Learning environment Resident Wellbeing Resident wellbeing Special aspects of education LC8-6691 Medicine R
Acceso en línea:	https://doaj.org/article/a2495ea7b7624e41ace16a0b56d36b49
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spelling	oai:doaj.org-article:a2495ea7b7624e41ace16a0b56d36b492021-11-14T12:43:18Z“One size does not fit all” – lessons learned from a multiple-methods study of a resident wellness curriculum across sites and specialties10.1186/s12909-021-02995-z1472-6920https://doaj.org/article/a2495ea7b7624e41ace16a0b56d36b492021-11-01T00:00:00Zhttps://doi.org/10.1186/s12909-021-02995-zhttps://doaj.org/toc/1472-6920Abstract Background There is growing recognition that wellness interventions should occur in context and acknowledge complex contributors to wellbeing, including individual needs, institutional and cultural barriers to wellbeing, as well as systems issues which propagate distress. The authors conducted a multiple-methods study exploring contributors to wellbeing for junior residents in diverse medical environments who participated in a brief resilience and stress-reduction curriculum, the Stress Management and Resiliency Training Program for Residents (SMART-R). Methods Using a waitlist-controlled design, the curriculum was implemented for post-graduate year (PGY)-1 or PGY-2 residents in seven residency programs across three sites. Every three months, residents completed surveys, including the Perceived Stress Scale-10, General Self-Efficacy Questionnaire, a mindfulness scale (CAMSR), and a depression screen (PHQ-2). Residents also answered free-text reflection questions about psychological wellbeing and health behaviors. Results The SMART-R intervention was not significantly associated with decreased perceived stress. Linear regression modeling showed that depression was positively correlated with reported stress levels, while male sex and self-efficacy were negatively correlated with stress. Qualitative analysis elucidated differences in these groups: Residents with lower self-efficacy, those with a positive depression screen, and/or female residents were more likely to describe experiencing lack of control over work. Residents with higher self-efficacy described more positive health behaviors. Residents with a positive depression screen were more self-critical, and more likely to describe negative personal life events. Conclusions This curriculum did not significantly modify junior residents’ stress. Certain subpopulations experienced greater stress than others (female residents, those with lower self-efficacy, and those with a positive depression screen). Qualitative findings from this study highlight universal stressful experiences early in residency, as well as important differences in experience of the learning environment among subgroups. Tailored wellness interventions that aim to support diverse resident sub-groups may be higher yield than a “one size fits all” approach. Trial registration NCT02621801 , Registration date: December 4, 2015 – Retrospectively registered.Deanna ChaukosJonathan P. ZebrowskiNicole M. BensonAlper CelikEmma Chad-FriedmanAviva TeitelbaumCarol BernsteinRebecca CookAfia GenfiJohn W. DenningerBMCarticleResident wellnessLearning environmentResidentWellbeingResident wellbeingSpecial aspects of educationLC8-6691MedicineRENBMC Medical Education, Vol 21, Iss 1, Pp 1-7 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Resident wellness Learning environment Resident Wellbeing Resident wellbeing Special aspects of education LC8-6691 Medicine R
spellingShingle	Resident wellness Learning environment Resident Wellbeing Resident wellbeing Special aspects of education LC8-6691 Medicine R Deanna Chaukos Jonathan P. Zebrowski Nicole M. Benson Alper Celik Emma Chad-Friedman Aviva Teitelbaum Carol Bernstein Rebecca Cook Afia Genfi John W. Denninger “One size does not fit all” – lessons learned from a multiple-methods study of a resident wellness curriculum across sites and specialties
description	Abstract Background There is growing recognition that wellness interventions should occur in context and acknowledge complex contributors to wellbeing, including individual needs, institutional and cultural barriers to wellbeing, as well as systems issues which propagate distress. The authors conducted a multiple-methods study exploring contributors to wellbeing for junior residents in diverse medical environments who participated in a brief resilience and stress-reduction curriculum, the Stress Management and Resiliency Training Program for Residents (SMART-R). Methods Using a waitlist-controlled design, the curriculum was implemented for post-graduate year (PGY)-1 or PGY-2 residents in seven residency programs across three sites. Every three months, residents completed surveys, including the Perceived Stress Scale-10, General Self-Efficacy Questionnaire, a mindfulness scale (CAMSR), and a depression screen (PHQ-2). Residents also answered free-text reflection questions about psychological wellbeing and health behaviors. Results The SMART-R intervention was not significantly associated with decreased perceived stress. Linear regression modeling showed that depression was positively correlated with reported stress levels, while male sex and self-efficacy were negatively correlated with stress. Qualitative analysis elucidated differences in these groups: Residents with lower self-efficacy, those with a positive depression screen, and/or female residents were more likely to describe experiencing lack of control over work. Residents with higher self-efficacy described more positive health behaviors. Residents with a positive depression screen were more self-critical, and more likely to describe negative personal life events. Conclusions This curriculum did not significantly modify junior residents’ stress. Certain subpopulations experienced greater stress than others (female residents, those with lower self-efficacy, and those with a positive depression screen). Qualitative findings from this study highlight universal stressful experiences early in residency, as well as important differences in experience of the learning environment among subgroups. Tailored wellness interventions that aim to support diverse resident sub-groups may be higher yield than a “one size fits all” approach. Trial registration NCT02621801 , Registration date: December 4, 2015 – Retrospectively registered.
format	article
author	Deanna Chaukos Jonathan P. Zebrowski Nicole M. Benson Alper Celik Emma Chad-Friedman Aviva Teitelbaum Carol Bernstein Rebecca Cook Afia Genfi John W. Denninger
author_facet	Deanna Chaukos Jonathan P. Zebrowski Nicole M. Benson Alper Celik Emma Chad-Friedman Aviva Teitelbaum Carol Bernstein Rebecca Cook Afia Genfi John W. Denninger
author_sort	Deanna Chaukos
title	“One size does not fit all” – lessons learned from a multiple-methods study of a resident wellness curriculum across sites and specialties
title_short	“One size does not fit all” – lessons learned from a multiple-methods study of a resident wellness curriculum across sites and specialties
title_full	“One size does not fit all” – lessons learned from a multiple-methods study of a resident wellness curriculum across sites and specialties
title_fullStr	“One size does not fit all” – lessons learned from a multiple-methods study of a resident wellness curriculum across sites and specialties
title_full_unstemmed	“One size does not fit all” – lessons learned from a multiple-methods study of a resident wellness curriculum across sites and specialties
title_sort	“one size does not fit all” – lessons learned from a multiple-methods study of a resident wellness curriculum across sites and specialties
publisher	BMC
publishDate	2021
url	https://doaj.org/article/a2495ea7b7624e41ace16a0b56d36b49
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“One size does not fit all” – lessons learned from a multiple-methods study of a resident wellness curriculum across sites and specialties

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