The Effects of the COVID-19 Pandemic on Resident Education and Burnout.

Background: The COVID-19 pandemic has impacted the residency experience for physicians across all specialties. There have been studies examining resident perspectives on changes in curriculum and clinical experiences due to the pandemic; however, little research has been conducted on how residents in different specialties interpreted their educational experience and rates of burnout during the pandemic. Methods: We extended surveys to 281 residents across 15 separate residency programs between November 17, 2020, and December 20, 2020. The questions pertained to burnout and the effects of the pandemic on their careers. Differences between general and specialty medicine resident responses were analyzed using descriptive statistics and the Mann-Whitney U test. Results: The final analysis included 105 responses (40% response rate). We received 62 surveys (59%) from general medicine residents and 43 surveys (41%) from specialty medicine residents, with a higher response rate from junior level trainees in both groups. We found no significant differences between general and specialty residents on the level of burnout, impact on clinical experience, or future career due to COVID-19, though there was a significant difference between resident groups on the perceived impact of COVID-19 on learning. Conclusion: Specialty medicine residents reported a negative perception of the pandemic's impact on their learning during residency suggesting a greater impact on training than was perceived by the general medicine residents. Residents from general and specialty medicine programs reported similar levels of burnout and similar perceptions of the pandemic's impact on their clinical experience and future career prospects. Understanding the impacts of the COVID-19 pandemic on resident education and well-being should serve graduate medical education administrators well and prepare them for future interruptions in the traditional learning process.

Nursing opinions on collaborating with residents in new and legacy OB/GYN programs.

Collaboration among physicians and nurses is vital and has shown to lead to better patient care and improve outcomes. Our study surveyed two groups of Labor and Delivery nurses in two regionally similar community hospitals in midwestern United States: one group from a new Obstetrics and Gynecology (OB/GYN) residency program (n = 49) and another from an established (legacy) OB/GYN residency program (n = 49). The survey asked nurses from the hospital with new and legacy residency program about preparedness for working with residents, perceptions of nurse-resident-patient relationships, collaboration and opinions about how resident physicians impact patient safety. Most nurses from the legacy residency program showed positive perceptions of collaboration with the residency and institutional support. In the new OB/GYN residency program, nurses were generally neutral and showed skepticism about collaboration with OB/GYN resident physicians and institutional support. Nurses from both hospitals felt similarly in their comfort escalating issues to administration and in their satisfaction with interprofessional collaboration within Labor and Delivery units. Providing nurses with opportunities to learn about the role of new medical residents in their patient care setting as well as intentional collaboration between nursing and residency program administration might result in more effective collaboration between physician residents and nursing staff.

Assessing Nursing Sentiments on Nurse-Resident Physician Collaboration and Administrative Support in the Labor and Delivery Setting: Development and Validation of a Novel Instrument.

OBJECTIVE: To develop a survey instrument that: 1) investigates the dynamics of collaboration in multidisciplinary care units such as labor and delivery (L&D); and (2) uniquely determines the collaborative relationships between nurses and resident physicians. BACKGROUND: An effective interprofessional collaboration between healthcare providers is considered a critical component in delivering high-quality care to patients and lies at the root of ensuring positive patient outcomes. METHODS: Two samples of responses (n = 98) were collected from L&D nurses working in 2 hospitals: 1 with novel obstetrics and gynecology (OB/GYN) residency program and 1 with legacy OB/GYN residency program. Descriptive statistics and reliability statistics (Cronbach's α and item-total correlations) were calculated for each sample. RESULTS: Reliability analysis revealed strong internal consistency of the survey items in both samples even after completing single-item deletion analysis. CONCLUSIONS: Findings suggest that our 11-item instrument shows promise in effectively assessing nursing sentiments toward collaboration with resident physicians.

A Two-Year Longitudinal, Cross-Sectional Evaluation of Resident Physician Burnout: An Exploration of the Effects of Stress, Satisfaction, Exercise and EMR.

Background: There is a need for better understanding of trajectory of burnout in clinical training and what factors are associated with resident well-being and burnout overtime. This study examined medical resident burnout and physical activity throughout different times of the academic year, across several different medical specialties and postgraduate years (PGY), over two years. Methods: A resident wellness survey was administered throughout five different waves from summer 2018 to winter 2020. A total of 493 survey responses from seven subspecialties completed the survey. We used 474 responses for quantitative statistical analysis and 138 for qualitative thematic analysis. Results: The average response rate was 47%, and ranged between 40% (Wave 3) and 56% (Wave 1). Three analyses were conducted: the first demonstrated significantly higher Satisfaction in Wave 1 as opposed to Wave 2. The second analysis showed significant correlations between Overall, Satisfaction, and Stress scores and exercise-based questions for female, male, and primary care cohorts of residents. The third analysis showed that in 2018, interns and non-interns differed on Stress but did not differ on Satisfaction or Overall scores. Conclusions: Similar levels of satisfaction, stress, and overall well-being were reported at different times in the academic year and from year to year. Exercise was not consistently related to resident well-being outcomes. These findings suggest a need for targeted interventions based on post-graduate year, time in the academic year and well-being drivers.

Resting state signatures of domain and demand-specific working memory performance.

Working memory (WM) is one of the key constructs in understanding higher-level cognition. We examined whether patterns of activity in the resting state of individual subjects are correlated with their off-line working and short-term memory capabilities. Participants completed a resting-state fMRI scan and off-line working and short-term memory (STM) tests with both verbal and visual materials. We calculated fractional amplitude of low frequency fluctuations (fALFF) from the resting state data, and also computed connectivity between seeds placed in frontal and parietal lobes. Correlating fALFF values with behavioral measures showed that the fALFF values in a widespread fronto-parietal network during rest were positively correlated with a combined memory measure. In addition, STM showed a significant correlation with fALFF within the right angular gyrus and left middle occipital gyrus, whereas WM was correlated with fALFF values within the right IPS and left dorsomedial cerebellar cortex. Furthermore, verbal and visuospatial memory capacities were associated with dissociable patterns of low-frequency fluctuations. Seed-based connectivity showed correlations with the verbal WM measure in the left hemisphere, and with the visual WM measure in the right hemisphere. These findings contribute to our understanding of how differences in spontaneous low-frequency fluctuations at rest are correlated with differences in cognitive performance.