Study population: The curriculum was piloted with residents in the departments of radiology and emergency medicine from April 2017 to October 2017 with approval from our Institutional Review Board.
Our study group consisted of 12 (35%) females and 21 (62%) males who ranged in age from 25-34 years (n=28; 82%) to 35-44 years (n=6; 18%).
More than half (n=20; 59%) indicated they were White/Caucasian,
three (9%) Black/African American,
and five (15%) Asian/Pacific Islander.
Other ethnic groups were represented,
including,
but not limited to,
Hispanic/Latino.
(Table 1)
The curriculum: The curriculum,
comprised of two one-hour sessions,
included interactive didactics and discussion.
It was administered during the regularly scheduled protected resident educational conference time for each department.
Attending physicians and department leadership,
including program directors and department chairs,
were present during the initial sessions to promote burnout discussion normalization.
The interactive didactic portion consisted of an explanation of the Window of Tolerance and how stress affects this window,
training on how to recognize the symptoms of one’s stress response activation (Fig. 1),
and the teaching of the Relaxation Response,
combined with some DBT skills to manage stress response activation (Fig. 2),
with the goal of promoting affect regulation and,
ultimately,
resilience.
Participants anonymously took the abbreviated Maslach Burnout Inventory (aMBI) during the first session via an audience response system with average scores displayed in real time to the audience in an attempt to normalize burnout symptoms experienced by the participants and to encourage discussion.
The discussion portion consisted of participants,
including attending physicians and department leadership,
sharing their experiences with burnout.
The follow up sessions also allowed participants to share their experiences in trying the different stress response deactivation skills over the previous month that were learned during the first session.
Data acquisition: Pre- and post-curriculum surveys and a one-month follow-up survey were administered to assess the effectiveness of the curriculum.
The aMBI was incorporated into the pre-curriculum survey to collect and evaluate baseline burnout data among the 34 residents (17 Radiology,
17 Emergency Medicine) in total who participated.
Response options for the aMBI questions used a Likert scale.
The three subscales of burnout were evaluated and scored separately (emotional exhaustion,
depersonalization,
and personal accomplishment).
As per convention,
burnout was defined as scoring high in emotional exhaustion and depersonalization,
while scoring low in personal accomplishment.
Response options for questions assessing the quality of the curriculum used both a Likert scale and free response.
Data analysis: All three aMBI subscale scores were reported using univariate analysis.
A multinomial logistic regression model was used to evaluate changes in responses to questions related to session quality from pre- to post-curriculum to follow-up.