A Novel Design-Thinking, Hospital Innovation Core Certificate Curriculum for Radiologists and Trainees: Creation, Implementation, and Multiyear Results.

RATIONALE AND OBJECTIVES: Innovation is a crucial skill for physicians and researchers, yet traditional medical education does not provide instruction or experience to cultivate an innovative mindset. This study evaluates the effectiveness of a novel course implemented in an academic radiology department training program over a 5-year period designed to educate future radiologists on the fundamentals of medical innovation. MATERIALS AND METHODS: A pre- and post-course survey and examination were administered to residents who participated in the innovation course (MESH Core) from 2018 to 2022. Respondents were first evaluated on their subjective comfort level, understanding, and beliefs on innovation-related topics using a 5-point Likert-scale survey. Respondents were also administered a 21-question multiple-choice exam to test their objective knowledge of innovation-related topics. RESULTS: Thirty-eight residents participated in the survey (response rate 95%). Resident understanding, comfort and belief regarding innovation-related topics improved significantly (P < .0001) on all nine Likert-scale questions after the course. After the course, a significant majority of residents either agreed or strongly agreed that technological innovation should be a core competency for the residency curriculum, and that a workshop to prototype their ideas would be beneficial. Performance on the course exam showed significant improvement (48% vs 86%, P < .0001). The overall course experience was rated 5 out of 5 by all participants. CONCLUSION: MESH Core demonstrates long-term success in educating future radiologists on the basic concepts of medical technological innovation. Years later, residents used the knowledge and experience gained from MESH Core to successfully pursue their own inventions and innovative projects. This innovation model may serve as an approach for other institutions to implement training in this domain.

A Prospective Intervention to Reduce Burnout Among Academic Radiologists.

RATIONALE AND OBJECTIVES: Few studies have examined what constitutes effective interventions to reduce burnout among radiologists. We compared self-reported burnout among academic medical center radiologists before and after a series of departmental initiatives intended to increase wellbeing and professional satisfaction. MATERIALS AND METHODS: This Institutional Review Board-approved, prospective study took place 2017-2019 in a tertiary academic medical center. In pre- (2017) and post-intervention (2019) periods, we administered the previously-validated Stanford Physician Wellness Survey to faculty in our 11-division radiology department. Faculty rated their burnout level across 8 domains (professional fulfillment, emotional exhaustion, interpersonal disengagement, sleep difficulties, self-compassion, negative work impact on personal relations, organizational/personal values alignment, perceived quality of supervisory leadership). Between the two surveys, departmental initiatives focusing on culture, team building, work-life balance, and personal well-being were implemented (e.g., electronic medical record training, shorter work hours). Pre- and post-survey results were compared, using Whitney-Mann U test to calculate Z scores. RESULTS: Faculty members rated lower professional fulfillment (Z-3.04, p=0.002), higher emotional exhaustion (Z=2.52, p=0.012), increased sleep-related impairment (Z=2.38, p=0.012), and reduced organizational/personal values alignment (Z=-4.10, p<0.0001) between the two surveys. No significant differences were identified associated with interpersonal disengagement (Z=1.82, p=0.069), self-compassion (Z=1.39, p=0.164), negative impact of work on personal relationship (Z=0.89, p=0.372) and perceived supervisory leadership quality (Z=0.07, p=0.942). CONCLUSION: Despite numerous departmental initiatives intended to improve culture, workplace efficiency, work-life balance, and personal wellness, self-reported burnout was unchanged or worsened over time.Physician and employee wellness embedded into institutional culture maybe more effective than departmental improvement initiatives.

Self-reported Burnout: Comparison of Radiologists to Nonradiologist Peers at a Large Academic Medical Center.

RATIONALE AND OBJECTIVES: Relatively little data exist on factors associated with radiologists' burnout versus other medical specialties. We compared self-reported burnout among academic medical center radiologists versus nonradiologist peers to inform initiatives to increase wellbeing and professional satisfaction. MATERIALS AND METHODS: In 2017, our large urban academic medical center administered the Stanford Physician Wellness Survey to faculty in fifteen clinical departments (fourteen academic, one community-based). Faculty rated burnout via Likert scale (0-no burnout; 1-occasional stress/no burnout; 2-one or more burnout symptoms; 3-persistent burnout symptoms; 4-completely burned out); burnout defined as >=2. Responses in 11 domains (professional fulfillment, emotional exhaustion, interpersonal disengagement, sleep difficulties, self-compassion, negative work impact on personal relations, perceived appreciation, control over schedule, organizational/personal values alignment, electronic health record, perceived quality of supervisory leadership) compared radiologists versus nonradiologists for association with burnout, using Whitney-Mann U test to calculate Z scores. RESULTS: There was no significant difference in overall self-reported burnout between radiologists and nonradiologists, nor in self-rating for emotional exhaustion, interpersonal disengagement, self-compassion, control over schedule, organizational/personal values alignment, or electronic health record experience. Radiologists had significantly lower self-rating for work happiness (Z = -2.669, p = 0.0076), finding work meaningful (Z = -2.77351, p = 0.0055), perceiving physicians as highly valued (Z = -2.5486, p = 0.0108), and believing leadership treated them with respect and dignity (Z = -3.44149, p = 0.0006). CONCLUSION: Compared to nonradiologist colleagues, radiologists were less likely to find work meaningful and more likely to feel unhappy and undervalued in the workplace and by leadership. Initiatives to increase perceived appreciation, leadership relationships, and meaningfulness of work for radiologists may reduce burnout.

Contributors to Gender Differences in Burnout and Professional Fulfillment: A Survey of Physician Faculty.

BACKGROUND: This study was conducted to describe gender differences in physician burnout and professional fulfillment and to explore their potential contributors. METHODS: This was a single-center, cross-sectional survey study of physician faculty at Brigham and Women's Hospital, an academic medical center in Boston. The population included all physician faculty who practiced clinical medicine in 2017 (n = 2,388). The study was conducted using the Stanford Physician Wellness Survey. Burnout and professional fulfillment were the main outcome measures assessed. Other variables assessed included ratings of culture of wellness, personal resilience, and efficiency of practice factors associated with physician experience. RESULTS: The study population consisted of 1,066 faculty, of whom 46.4% were female and 59.8% were younger than 50. Female physicians reported significantly higher rates of burnout (42.4% vs. 34.4%, p = 0.01) and lower rates of professional fulfillment (35.1% vs. 50.4%, p < 0.01) than male physicians. Female physicians reported lower ratings for self-compassion and multiple culture of wellness factors. After adjusting for demographic factors and academic rank, the study team identified multiple culture of wellness factors (perceived appreciation, schedule control, work environment diversity and inclusion) and self-compassion as attenuating the significant relationship between gender and burnout. Only perceived appreciation attenuated the significant relationship between gender and professional fulfillment. CONCLUSION: This study demonstrated higher rates of burnout and lower rates of professional fulfillment among female vs. male physician faculty. Culture of wellness factors and self-compassion may contribute to gender differences in burnout and professional fulfillment and potentially represent modifiable targets for efforts seeking to eliminate gender disparities in physicians' workplace experiences.

Predictors of Self-Reported Burnout Among Radiology Faculty at a Large Academic Medical Center.

OBJECTIVE: Determine predictors of self-reported burnout among academic radiologists. METHODS: In 2017, radiologists at an urban medical center completed the Stanford Wellness Survey, rating burnout via Likert scale (0: no burnout; 1: occasional stress, no burnout; 2: one or more burnout symptoms; 3: persistent burnout symptoms; 4: completely burned out). Univariate analyses assessed age, gender, family situation, clinical versus research focus, and academic rank for association with burnout (Likert scale ≥ 2). Responses in 11 domains querying definitions of burnout (professional fulfillment, emotional exhaustion, interpersonal disengagement), individual factors (sleep-related impairment, self-compassion, negative work impact on personal relationships), institutional factors (perceived appreciation, control over schedule, organizational or personal values alignment, electronic health record experience, supervisor's leadership quality) were evaluated for association with burnout, using χ2 and logistic regression to calculate odds ratios (ORs). RESULTS: In 159 of 204 (77.9%) completed radiologist surveys, 35.2% (56 of 159) reported burnout. Age < 40 years (P = .0068) and clinical focus (P = .0111) were significantly associated with burnout. In univariate analysis, all domains except electronic health record were statistically significant: emotional exhaustion (OR = 1.93, P < .0001); professional fulfillment (OR = 0.78, P < .0001); self-compassion (OR = 1.36, P < .0001); perceived appreciation (OR = 0.78, P < .0001); sleep-related impairment (OR = 1.20, P < .0001); supervisor's leadership quality (OR = 0.91, P < .0001); interpersonal disengagement (OR = 1.31, P < .0001); organizational or personal values alignment (OR = 0.87, P = .0004); negative work impact on personal relationships (OR = 1.10, P = .0070); control over schedule (OR = 0.80, P = .0054); electronic health record experience (OR=1.03, P = .5392). DISCUSSION: Nearly all questions significantly predicted self-reported burnout, observed in over one-third of academic radiologists. Younger age and clinical focus were associated with burnout. Initiatives targeting individual factors (eg, sleep impairment, self-compassion) and institutional factors (eg, physician appreciation, leadership-faculty interactions) may reduce burnout.