Cultivating emotional intelligence in general surgery residents through a patient-centered experience.

BACKGROUND: Emotional intelligence (EI) can decrease physician burnout. EI and burnout were assessed in surgical residents through participation in Patient-Centric Resident Conferences (PCRCs), which incorporated patients in resident education. We hypothesized PCRCs would improve EI and reduce burnout. METHODS: This was a single institution study of General Surgery residents from 2018 to 2019. Residents participated in standard didactic conferences and PCRCs. The Trait Emotional Intelligence Questionnaire-Short Form (TEIQue-SF) survey and an ACGME burnout survey were administered at three time points. RESULTS: Higher EI scores correlated with lower burnout scores over three survey distributions (R2 0.35, 0.39, and 0.68, respectively). EI and burnout scores did not change significantly over time. EI and burnout were not associated with conference attendance, meaning in work, or satisfaction with teaching. CONCLUSIONS: General Surgery resident EI and burnout scores were inversely correlated. Previously, PCRCs were shown to be associated with increased resident meaning in work. The current study demonstrates PCRCs did not have a significant impact on measures of resident EI or burnout. Further research is needed for EI and burnout in surgery.

Peer-to-Peer Trauma-Informed Training for Surgical Residents Facilitated by Psychiatry Residents.

OBJECTIVE: This article describes the implementation of trauma-informed care (TIC) didactic training, using a novel, interdisciplinary peer-to-peer teaching model to improve confidence surrounding trauma-informed practices in a surgical residency program. METHODS: Eight psychiatry residents and two medical students with a background in psychological trauma and TIC and an interest in medical education were recruited to participate in three 2-hour "train the trainer" sessions led by a national expert in TIC. Eight psychiatry residents and two medical students subsequently developed and delivered the initial TIC training to 29 surgical interns. Training included the neurobiology of psychological trauma, principles of trauma-informed care, and developing trauma-informed curricula. RESULTS: Surgical interns reported significantly improved understanding of the physiology of trauma, knowledge of TIC approaches, and confidence and comfort with TIC and practices. Among surgical interns, understanding of the physiology of the fear response increased from 3.36 to 3.85 (p = 0.03). Knowledge of the neurobiology of trauma improved between pre- and post-training surveys (2.71 to 3.64, p = 0.006). Surgery interns also expressed an improved understanding of the connection between fear, trauma, and aggression (3.08 to 4.23, p = 0.002) from pre- to post-training surveys. Post-training knowledge of trauma-informed approaches increased from 2.57 to 4.71 (p < 0.001) and confidence in delivering TIC on the wards increased from 2.79 to 4.64 (p < 0.001). CONCLUSION: This TIC curriculum delivered via a peer-to-peer training model presents an effective way to improve comfort and confidence surrounding TIC practices and approaches in a surgical residency training program.

Trauma-informed care: recognizing and resisting re-traumatization in health care.

Trauma is often viewed as an individual or interpersonal issue. This paper expands the definition of trauma to include the impact collective and structural elements on health and well-being. The need for a trauma-informed response is demonstrated, with instruction as to how to implement this type of care in order to resist re-traumatization. Three examples from healthcare settings across the nation are provided, to demonstrate the ways in which organizations are bringing forward this patient-centered, trauma-informed approach to care.

Revitalizing the Patient-Surgeon Relationship: Surgical Curriculum Including the Patient Perspective.

OBJECTIVE: General Surgery residents have increasing obligations that limit time with patients. This affects the patient-physician relationship, decreases meaning in work and increases burnout. Patient-Centric Resident Conferences (PCRC)1 incorporate patients in resident didactics to promote meaning in work and improve resident confidence in counseling and consenting patients for surgery. DESIGN: Prospective cohort study of General Surgery residents who participated in standard didactic conferences (control) and modified conferences (PCRC) between 2017 and 2019. Control conferences covered a relevant surgical topic. PCRC had shortened didactics and discussions with patients who had undergone the relevant index operation. Pre- and postconference surveys measured teaching effectiveness, confidence in counseling and consenting, and resident perception of how well the conference supported their decision to pursue surgery. Survey data was compared using chi-squared tests. Qualitative data analysis used ground theory methodology. SETTING: This study was performed by the Department of Surgery at Oregon Health and Science University in Portland, Oregon. PARTICIPANTS: All active General Surgery residents were asked to participate in conferences. RESULTS: Eighty-one residents completed 136 surveys over 5 control conferences and 207 surveys over 7 PCRC. Residents reported increased confidence in counseling and consenting for surgery following control conferences (p < 0.0001) and PCRC (p < 0.0001). Residents' perception of effectiveness of teaching pathophysiology (p = 0.008) and operative steps (p = 0.013) was greater in control conferences whereas effectiveness of teaching surgical complications was greater in PCRC (p = 0.006). Resident responses indicated greater support for a surgical career following PCRC compared to control conferences (p = 0.013). Themes like "patient perspective," "impact on surgeon," and "psychological effects of surgery" were common in PCRC and rare in control conferences. CONCLUSIONS: PCRC were associated with stronger motivations for a surgical career and included patient-centered themes, which can enhance meaning in work. These conferences complement but do not replace standard didactics.