Abstract
Introduction: Past studies demonstrate that stress and anxiety affect emergency medicine physicians, but the causal factors identified are usually from sources outside the work shift. We attempt to show the relationship between intrinsic factors of a work shift and anxiety perceived by residents, while also examining differing gender responses. Methods: In 2018, a cross-sectional survey of emergency medicine residents in the United States was distributed anonymously through the Emergency Medicine Residents Association. The survey consisted of demographic questions, novel questions identifying intrinsic factors, and the Generalized Anxiety Disorder 7-item (GAD-7) scale. Spearman correlation, independent t-test, and multivariate analysis of variance were performed. Results: Data from 573 residents found several stressful factors: working with a nurse perceived to be inefficient, working with no inpatient beds available, and working with a colleague perceived to be inefficient. The majority of respondents reported some general anxiety on the GAD-7 assessment. There was no difference on anxiety level as a function of year of residency (p > .05). There was a significant gender difference on anxiety level, t(571) = -4.8689, p < .05, where male residents reported lower anxiety levels (mean=5.15) as compared to female residents (mean=7.02). Lastly, post-hoc analyses revealed that male and female respondents reported differing levels of stress in response to several intrinsic stress factors. Conclusion: We identified several intrinsic factors during a shift that contribute to resident anxiety and analyzed differing gender responses to these factors; this may provide a framework for residency programs to minimize stressors in the future.
Highlights
Past studies demonstrate that stress and anxiety affect emergency medicine physicians, but the causal factors identified are usually from sources outside the work shift
Research has demonstrated that emergency medicine (EM) physicians are at higher risk for post-traumatic stress disorder (PTSD) as compared to other specialties due to exposure to violence, trauma, and death beginning in residency [1,2,3,4]
The current study investigated factors occurring during EM work shifts and their relationship to stress by identifying specific stressful events during a work shift and evaluating the overall level of anxiety among EM residents
Summary
Past studies demonstrate that stress and anxiety affect emergency medicine physicians, but the causal factors identified are usually from sources outside the work shift. We attempt to show the relationship between intrinsic factors of a work shift and anxiety perceived by residents, while examining differing gender responses. Wellness among emergency medicine (EM) physicians has been a popular topic recently, with a plethora of research discussing attending physician wellness. EM physicians have increased risk for chronic stress, possibly due to increased encounters with workplace violence, emotional exhaustion, and exposure to traumatic injuries and child/adolescent mortality. Research has demonstrated that EM physicians are at higher risk for post-traumatic stress disorder (PTSD) as compared to other specialties due to exposure to violence, trauma, and death beginning in residency [1,2,3,4]. Despite extensive research regarding attending physician wellness, research regarding wellness of resident emergency physicians has only recently begun to be explored, and there is no standardized approach to improve wellness in resident education [10, 11]
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