56 Exploring the Wellness Needs of Paediatric Residents: An Appreciative Inquiry Approach

Abstract

BACKGROUND: It has been established that residents face high rates of burnout and depression. This issue was highlighted in the recent Canadian Medical Association National Physician Health Survey, with resident rates of burnout as much as 38% and positive depression screen in 48% of resident respondents (Canadian Medical Association 2018). Evidence is limited regarding the impact of interventions (West et al. 2016). Many current interventions focus on developing resilience on an individual basis and are not always generalizable to the specific context a medical trainee is working in. OBJECTIVE(S): The objective of this study was to assess the wellness needs of local Paediatric Medicine trainees. DESIGN/METHODS: A needs assessment of current trainees was conducted utilizing an appreciative inquiry approach, a qualitative method of organizational development to understand transformational change from a positive light (Hennessy, 2014). Qualitative responses were collected through a REDCap survey, which was distributed electronically. Responses were coded by three members of the project team and overarching themes were identified. Survey questions asked trainees to reflect on a difficult time where they emerged resilient, what exists in the learning environment that promotes resilience, what are the characteristics of an ideal learning environment and what changes need to be done to achieve such an environment. Survey respondents were also asked to select what formal wellness initiatives they would find helpful. RESULT(S): 32 of 86 residents (37%) completed the survey. Paediatric medicine trainees reported feeling supported by individual relationships, but sought additional opportunities to share experiences and grow from structured activities Participants reported wanting a shift in the structure of the learning environment to create scaffolding for optimal resident learning. Participants also shared that they would like an opportunity to meet their basic needs both at work and in their lives, including physical health, mental health, and psychological safety. Finally, participants envisioned a positive shift in the culture of medicine that would help mitigate the demands created by structural barriers in the learning environment. CONCLUSION(S): This project highlights key areas to target in the development of wellness programming and underlines the need for structural and cultural change in medical training and learning environments to support the wellbeing of paediatric medicine trainees in their local environment.