112 Institution of a National Multi-Faceted Emergency Medicine Wellness Curriculum is Not Associated With Changes in Burnout Scores

Abstract

Study Objectives: The ACGME recognizes that residents are at high risk for burnout and depression and the Common Program Requirements effective 2017 state that programs and sponsoring institutions have the same responsibility to address well-being as they do other aspects of resident competence. In response, the authors developed a multi-faceted wellness curriculum, including bi-monthly didactic presentations, corresponding non-didactic elements, individualized interactive instruction (III) assignments, and additional Internet-based resources. The authors sought to determine if the initiation of a multi-faceted wellness curriculum improved resident burnout as measured by scores on the Maslach Burnout Inventory (MBI). We performed a multi-center educational interventional trial at 10 emergency medicine residencies nationally. In February 2017, we administered the MBI at all 10 participating sites. The MBI is considered the gold standard in the measurement of physician burnout, and consists of 3 scales: emotional exhaustion, depersonalization, and personal accomplishment. A year-long multi-faceted wellness curriculum was then introduced at 5 intervention sites while the other 5 control sites agreed not to introduce new wellness initiatives during the study period. The MBI was re-administered in August 2017 and February 2018 at all sites. Of 523 potential respondents at 10 study sites, 437 residents (83.5%) completed at least 1 MBI assessment with 85 residents (16.3%) completing all 3 measurements. The only significant difference in MBI scores between intervention and control groups at baseline was a slightly higher mean depersonalization score in the intervention sites (13.68 versus 11.87, p=0.02). In August, the only significant difference between groups was a slightly higher mean personal accomplishment score at the control sites (40.26 versus 38.50, p=0.02). At the conclusion of the study, there only significant difference was a slightly higher mean depersonalization score in the intervention group (13.37 versus 11.69, p=0.04). When linear regression analysis was applied, no statistically significant difference remained between the control and intervention MBI scores, controlling for age, sex, ethnicity, education debt level, or depression screen. In addition, average burnout scores did not change significantly over time for either the control or intervention sites (Table 1). In this national study of emergency medicine residents, MBI scores remained stable over time and the introduction of a multi-faceted wellness curriculum was not associated with a change in burnout scores. Further study is needed to determine best practices to lessen resident burnout.Table 1Feb '17Aug '17Feb '18Emotional Exhaustion21.4620.421.25Depersonalization12.7411.4212.38Personal Accomplishment39.1239.5438.95 Open table in a new tab