P129: The impact of high performance physician training on resident wellness and clinical performance

Abstract

Introduction / Innovation Concept: There are numerous research studies in the medical literature, which demonstrate how the experience of a medical residency can contribute towards burnout. The escalating performance pressures and expectations during residency training have the potential to negatively impact upon physician health and clinical performance. The purpose of this prospective cohort study was to test the effectiveness of the High Performance Physician (HPP) program among General Surgery residents at the University of Manitoba with regard to burnout and clinical performance. Methods: This program was delivered over a 9-week period. All 26 residents were asked to complete the Maslach Burnout Inventory - Human Services Survey (MBI-HSS). Each resident then participated as the team leader for a 15-minute trauma resuscitation simulation. Three attending physicians from Surgery & Emergency Medicine assessed resident performance and ability to manage work-based stressors. Following the simulation, each resident received a debrief interview. Once the HPP curriculum had been completed, residents took part in a second high fidelity simulation session and again completed the MBI-HSS. Curriculum, Tool, or Material: The HPP program offered through the Department of Emergency Medicine (EM), is a performance enhancement based curriculum. It is designed to equip physicians with mental skills to help optimize focus, arousal control, stress management, communication, and teamwork. Further, to utilize these skills to cope and respond more effectively to the inherent performance pressures that may present within one’s area of specialization. Conclusion: The Emotional Exhaustion domain of the MBI-HSS demonstrated a statistically significant decrease. The other domain scores were not statistically significant. Simulation domain scores did not demonstrate a statistically significant difference in performance between the pre- and post-HPP curriculum simulation sessions. A summative content analysis of the interview data demonstrated that residents believed internal barriers to situational awareness were the most significant impact on performance. Further study is required to determine if differences are seen in long-term follow-up.