The day opened with some personal reflections from Dr. Rob Orman (@emergencypdx) and moving narrative from Dr. Chris Doty (@PoppasPearls). As a group it was imperative to introduce and talk about the importance and impact of physicians suicide and the difficulties of residency training.
Dr. Matt Melamed gave a sneak peak into the preliminary results of our national resident wellness survey, which measured the current level of burnout among EM residents. Spoiler alert: The numbers don’t look good for our trainees, with almost half of them suffering from very high levels of burnout based on the preliminary data. This was definitely a nidus for conversation.
The group then split up into 4 working groups to tackle different wellness-themed projects:
- Building Blocks
- New Initiatives
- Best Tech
- Lesson Plans
Each of the groups had a at least a dozen talented and inspiring residents who rolled up their sleeves and got to work expanding upon and refining the products created in the months leading up to the Summit. Fresh eyes from the residents new to the Think Tank helped to identify gaps and generate new ideas to promote and support resident wellness on a large scale.
Building Blocks
The Building Blocks group addressed the overwhelming request by residents in the Wellness Think Tank for a formal wellness curriculum. Prior to the RWCS, this group used known educational methods to develop a framework for a longitudinal and comprehensive curriculum for residency programs. In addition to generating a list of actual topic sessions, the Wellness Think Tank members also developed a survey for programs to conduct a targeted needs assessment as well as an evaluation plan to determine effectiveness. During the Summit, the RWCS working group members added several additional topics that they felt were critical to a successful curriculum, which included:
- Workplace wellness
- Dealing with difficult patients and staff
- Developing a support network of non-physicians
- Debriefing
The RWCS team explored making use of small groups, tailoring sessions to special situations (e.g. pregnancy, family illness), creating a wellness library of resources, and combining modules.
Lesson Plans
The Wellness Think Tank members involved in the Lesson Plans project created 3 different lesson plan modules with a focus on practical skills for residents that could be used by training programs either individually or as part of a larger wellness curriculum. The three plans created prior to the RWCS covered:
- Second victim syndrome
- Mindfulness
- Meditation and positive psychology
After a brief overview of the 3 lesson plans, the group got to work standardizing the plans to ensure that they all included hands-on learning and sessions lasting no more than 30 minutes. The working group members all also felt that concluding each lesson plan with a “commitment to act” would be essential to adding an element of personal accountability for residents.
New Initiatives
Prior to the Summit, the New Initiatives members of the Wellness Think Tank collected and shared a wide range of different wellness activities, resources, and ideas that had been started by residency programs across North America. All of these inspiring initiatives then prompted the next natural question, “Well, which of these things does MY program need?” During the RWCS, working group members tackled this question head-on by developing a program needs assessment survey that could be used by programs to identify wellness gaps. The working group felt that by templating a systematic approach to a needs assessment, residents and leadership would then be able to develop tailored new future wellness initiatives unique to their own residents’ needs.
Best Tech
Every day it seems like a new wellness app, gadget, or fun electronic toy hits the market. The Wellness Think Tank members tried them all! In the months leading up to the RWCS, they tracked their steps, sleep, meditation, food habits, exercise routines, and daily mood to figure out the best technology out there for resident wellness. At the Summit, working group residents loved that the reviews and looked for ways to improve the project. Much of the discussion also focused on how to best deliver all of this information to residents across North America.
We finished the RWCS with updates from the consensus groups and a thought provoking closing session by Dr. Felix Ankel (@felixankel) Our hope is that the residents who participated in the RWCS and the Wellness Think Tank will embrace their involvement in this grassroots movement to improve physician wellness. The group agreed that there should be a focus on developing community and open communication amongst physicians discussing the stressors and challenges that are faced as physicians and residents in training.
We are a tribe of fiercely intelligent and hardworking individuals, and we need to take care of each other, just as we take care of our patients. A commitment has been made to shine a light for those who struggle with feelings of hopelessness, helplessness, inadequacy and depression. There is a sense of urgency, our trainees can’t stand idly by waiting for the institutions of medicine to fix this problem. We hope this is an igniting force for a movement empowering the “inmates to take over the asylum.”
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