513 - The Barriers We See – Resident Perceptions Behind a Program’s Satisfaction Evaluation Scores

Monday, May 1, 2023

9:30 AM – 11:30 AM ET

Poster Number: 513
Publication Number: 513.423

Virginia J. Pedigo, Medical University of South Carolina College of Medicine, Charleston, SC, United States; Sarah Olson, MUSC, Charleston, SC, United States; Mason Walgrave MD, Medical University of South Carolina College of Medicine, Charleston, SC, United States; Michael Lugo, Medical University of South Carolina, Charleston, SC, United States; Natasha Ruth, Medical University of South Carolina, Charleston, SC, United States; Daniel Williams, Medical University of South Carolina, Charleston, SC, United States; Whitney Marvin, MUSC Children's Hospital, Charleston, SC, United States

Presenting Author(s)

Mason Walgrave, MD (he/him/his)

Fellow, Pediatric Hospital Medicine
Medical University of South Carolina College of Medicine
Charleston, South Carolina, United States

Co-Author(s)

VP

Virginia J. Pedigo, B.S., M.D.

Medical University of South Carolina College of Medicine
Charleston, South Carolina, United States

Background: Burnout is a leading barrier to physician well-being especially among pediatricians^1,2. To be more successful with interventions focused on burnout mitigation, targeted studies are needed to assess the diversity of program specific causes³. This qualitative study focused on barriers to resident physicians feeling a sense of value in the workplace and helped identify areas for future high-impact intervention.

Objective: To explore pediatric and medicine-pediatrics (M-P) residents’ perceptions behind a programs’ lower scoring domains in a year-end evaluation to better target future burnout interventions.

Design/Methods: Pediatric and M-P residents at a tertiary care academic center participated in focus groups addressing lower scoring domains in the programs’ year-end evaluations compared with national averages. Domains examined include feeling supported, feeling positively challenged at work and having enough time for reflection. Discussion prompts were created and reviewed by the institution’s Wellness Team (WT). Four focus group sessions with 12-15 residents each were moderated by former and current chief residents who did not otherwise evaluate resident performance. Focus groups were recorded and transcribed verbatim with Microsoft Teams with identities removed to ensure anonymity. Using a grounded theory design, the recordings were coded by three investigators. Coding was then discussed with all investigators and abstracted for the common thematic factors driving the lower domain scores. It was then reviewed by the WT.

Results: Common themes isolated included: 1) being intentional and proactive at the faculty level to promote support and reflection at work. This included more structured education, proactive assistance to help residents and a more ideal fit with mentors. 2) Being flexible in wellness efforts to promote a culture of support which improves time for reflection. This included guaranteeing time for lunch or alternate wellness activities. 3) Ensuring adequate distribution of work and promoting efficient workflow improves time for reflection and education. Examples included protected space and time for sign-out, and better work flows for non-medical work. These examples were also felt to boost feelings of support and create positive challenges at work.

Conclusion(s): While well-being initiatives exist at many programs, universal well-being approaches may not work equally for all programs. A focus group approach can outline program specific shortcomings and provide constructive feedback for targeted interventions and improve resident involvement in program improvement.