Giving Literal Thanks: An ACGME-Sponsored Initiative to Bring Residents Back to the Bedside

Author:

Diacovo Natalie1ORCID,Gundewar Anisha2,Wallace Alexandra3,Scott-Vernaglia Shannon E.4,Dzara Kristina5,Healy Michael G.6,Frey-Vogel Ariel S.7

Affiliation:

1. Natalie Diacovo, MD, is Pediatrician, Cambridge Health Alliance Somerville Pediatrics, Somerville, Massachusetts, USA, and Instructor in Pediatrics, Harvard Medical School, Boston, Massachusetts, USA

2. Anisha Gundewar, MD, is PGY-4 Fellow, Department of Pediatric Gastroenterology, MassGeneral Hospital for Children and Yawkey Center for Outpatient Care, Boston, Massachusetts, USA

3. Alexandra Wallace, MD, is Pediatrician, Pediatric Health Care, Newton Wellesley, Newton, Massachusetts, USA

4. Shannon E. Scott-Vernaglia, MD, is Pediatrician and Associate Chief for Clinical Faculty Development, Department of Pediatrics, MassGeneral for Children and Harvard Medical School, Boston, Massachusetts, USA

5. Kristina Dzara, PhD, MMSc, is Assistant Dean of Scholarly Teaching and Learning and Associate Professor of Family and Community Medicine, Saint Louis University School of Medicine, St. Louis, Missouri, USA

6. Michael G. Healy, EdD, is Health Professions Education Researcher, Massachusetts General Hospital, and Instructor in Surgery, Harvard Medical School, Boston, Massachusetts, USA; and

7. Ariel S. Frey-Vogel, MD, MAT, is Assistant Professor, Department of Pediatrics, MassGeneral for Children and Harvard Medical School, Boston, Massachusetts, USA

Abstract

Background Resident burnout is at an all-time high. In response, the Accreditation Council for Graduate Medical Education (ACGME) developed the Back to Bedside grant for resident-led burnout interventions that increase the time residents spend with patients. Objective We designed a resident-patient reading intervention, Giving Literal Thanks (GLT), intended to increase meaningful time residents spend with patients and thereby decrease burnout. Methods All 65 pediatric residents rotating through our academic hospital’s inpatient units from Fall 2019 through Fall 2021 were invited to read and gift books to their patients. We studied our intervention’s relationship to resident burnout using a convergent mixed-methods design, including anonymous, unlinked pre-, peri-, and post-intervention surveys and focus groups. Qualitative and quantitative data were analyzed separately, then integrated to describe burnout pre- and post-intervention. Results Forty-one of 65 residents (63.1%) completed pre-intervention surveys, and 8 of 65 (12.3%) completed post-intervention surveys. Twenty-seven resident-patient reading interactions were recorded, and 2 focus groups were held (1 pre- and 1 post-intervention). Five themes were identified: (1) limited opportunities exist to spend time at the bedside; (2) spending time at the bedside is valuable; (3) other responsibilities may preclude time at the bedside; (4) GLT could promote positive outcomes; and (5) GLT might not be the right tool to reduce burnout. Further quantitative data analysis was prevented by low survey response rates. While GLT was positively received and feasible, we were unable to show an improvement in burnout. Conclusions GLT was well-regarded but may not improve resident burnout.

Publisher

Journal of Graduate Medical Education

Subject

General Medicine,Education

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