Facilitating resident well-being: a pilot intervention to address stress and teamwork issues on an inpatient service

Residency presents unique challenges for learners with regard to stress management and working with others to deliver quality patient care. To address resident concerns about stress and teamwork on a family medicine inpatient service, a structured 15-minute intervention was implemented weekly, over a 20-month period. The intervention was conducted by the clinical psychologist and inpatient service medical director. Residents rated their respective stress levels at each session, and facilitators engaged them in problem solving if their stress level was rated 7 or higher on a 0--10 scale. Twenty-six residents experienced the intervention on multiple occasions. The amount of resident participation in the intervention varied based on the resident's level of training during the intervention period.

Residents (n=26) completed a brief questionnaire regarding the effectiveness of the intervention at the end of each 4-week block in which they participated. One hundred of a possible 108 questionnaires were completed (92%).

Questionnaire items were rated on a 7-point Likert scale ranging from 1 (not at all effective) to 7 (very effective). Resident-rated helpfulness of the intervention ranged from a mean of 5.28 (SD=1.30, Resolving Communication Difficulties) to 5.76 (SD=1.06, Facilitating Discussion of Stressful Aspects of Work). Most resident-identified stressors were resolved during the scheduled meetings; only five additional meetings were needed during the 20 months of the project to achieve resolution of resident stressors.

The intervention is time- and cost-efficient, addresses at least two of the Accreditation Council on Graduate Medical Education (ACGME) competencies (professionalism and interpersonal and communication skills) as well as Agency for Healthcare Research and Quality teamwork competencies (leadership, communication, situation monitoring, and mutual support) and can easily be adapted by other specialties.