Residents are more likely to flourish in their training programs and daily lives when peer support is strong and leadership prioritizes residents’ wellbeing, according to results from a multi-institutional survey published in Annals of Internal Medicine.
“The ‘flourishing’ concept as a method to measure resident wellbeing that aims to move the conversation beyond a narrow conversation of burnout to ask the broader question of what graduate medical education programs can do in order to promote holistic flourishing among their trainees,” said Collin Hanson, MD, a palliative care fellow in the Department of Medicine and a co-author of the publication.
In the current study, the investigators conducted a multi-institutional survey which aimed to expand beyond traditional measures of physician well-being, such as mental health, wellness, or burnout, to incorporate a more holistic view and measure of wellbeing, and determine what factors help residents flourish.
“Flourishing offers promise as a holistic conceptualization of wellbeing, as it integrates eudaimonic, hedonic, psychological, social and physical aspects of wellbeing,” the authors wrote.
More than 270 residents enrolled in 14 different residency programs across the U.S. completed the survey, which included measures from the Flourish Index (FI) — happiness and life satisfaction, physical and mental health, meaning and purpose, character and virtue, and close social relationships — and the from the Secure Flourish Index (SFI) — financial and material stability.
Additional measures included medicine as a calling, overall quality of life, satisfaction with work-life balance, resilience, burnout, spirituality and religion, resident program community wellbeing (including program leadership, relationships, practices and mission), demographic and program characteristics, and local incidence of COVID-19.
Of the total number of survey participants, 49 percent were interns (residents in their first year of traineeship) and 47 percent were women.
Final survey results showed that SFI had a positive correlation with quality of life, work-life balance, resilience, viewing medicine as a calling, spirituality and religion, and residency program community wellbeing. In contrast, the results also showed a negative correlation with emotional exhaustion and depersonalization with SFI.
Average SFI scores were also higher among residents who viewed medicine as a calling compared with those who did not, and in residents who had a higher quality of life, higher work-life balance, and who were not experiencing emotional exhaustion or depersonalization.
The findings support the notion that residents flourish when leadership prioritizes residents’ well-being, when peer support among residents is strong and relationships are robust, Hanson said.
“Program-level factors including leadership, mission, and relationships are important targets for cultivating a culture of well-being,” Hanson said. “Graduate medical education should be encouraged to cultivate and structure their training environments such that they promote a strong sense of flourishing among their trainees.”
David Vermette, MD, MBA, MHS, assistant professor of Medicine in the Division of General Medicine and Geriatrics at the Washington University School of Medicine in St. Louis, was lead author of the study.
