Resident and attending physician perception of maladaptive response to stress in residents

Abstract

Background

Residency stress has been shown to interfere with resident well-being and patient safety. We developed a survey research study designed to explore factors that may affect perception of a maladaptive response to stress.

Methods

A 16-item survey with 12 Likert-type perception items was designed to determine how often respondents agreed or disagreed with statements regarding the resident on the trigger tape. A total of 438 respondents from multiple institutions completed surveys.

Results

Attending physicians were more likely than residents to agree that the resident on the trigger tape was impaired, p<0.0001; needed to seek professional counseling, p=0.0003; should be removed from the service, p=0.002; was not receiving adequate support from the attending physician, p=0.007; and was a risk to patient safety, p=0.02. Attending physicians were also less likely to agree that the resident was a good role model, p=0.001, and that the resident should be able to resolve these issues herself/himself, p<0.0001.

Conclusion

Our data suggest that resident physicians may not be able to adequately detect maladaptive responses to stress and that attending physicians may be more adept at recognizing this problem. More innovative faculty and resident development workshops should be created to teach and encourage physicians to better observe and detect residents who are displaying maladaptive responses to stress.

• stress
• stress management
• residents
• graduate medical education

Acknowledgements

The authors wish to thank Joel M. Bartfield, MD, FACEP, Designated Institutional Official and Associate Dean, Graduate Medical Education, Albany Medical Center, Albany, New York for using our workshop materials and collecting survey data from chief residents of diverse residency programs.

Conflict of interest and funding

Partial funding for research assistants was provided by Christiana Care Health System, Newark, Delaware, through a resident research grant.

Ethical approval

This research study was reviewed and granted exempt status by the IRBs of Christiana Care Health System, Newark, Delaware, and Thomas Jefferson University, Philadelphia, Pennsylvania.