Resident wellness: institutional trends over 10 years since 2003

Figures & data

Table 1 Response rates for surveys: overview

Survey year	Start date (mm/dd/yyyy)	End date (mm/dd/yyyy)	Respondents (n)	Residents (n)	Response rate (%)
2003	12/15/2002	1/31/2003	327	581	56
2005	1/15/2005	2/28/2005	450	625	72
2008	1/15/2008	2/29/2008	445	675	66
2011	1/15/2011	2/28/2011	507	701	72
2013	1/15/2013	2/28/2013	520	752	69

Abbreviations: dd, day; mm, month; yyyy, year.

Table 2 Characteristics of survey respondents

Characteristics	Survey year
	2003	2005	2008	2011	2013
Number of respondents	327	450	445	507	520
Gender
Female (%)	48	49	46	51	50
Male (%)	49	51	54	49	50
Unknown (%)	3	0	0	0	0
Age
26–30 (%)	41	42	38	32	36
31–35 (%)	35	43	45	50	48
36–40 (%)	9	10	11	10	10
40+ (%)	6	4	4	6	5
Unknown (%)	9	0	2	1	1
Race
White (%)	57	77	79	77	75
Others (%)	15	23	18	23	25
Unknown (%)	28	1	2	0	0
Specialty
Primary care (%)	34	30	29	25	25
Others (%)	66	70	71	75	75
Postgraduate training year
1 (%)	26	24	21	14	21
2 (%)	25	25	24	22	20
3 (%)	23	22	22	22	18
4+ (%)	26	28	32	42	41
Unknown (%)	0	1	0	0	0

Figure 1 Trends in key outcome measures and major changes in training environment.

Notes: Sleep: 1, <3 hours; 2, 3–4 hours; 3, 5–6 hours; 4, 7–8 hours; 5, 8+ hours. Dates shown as month/year, eg, 1/2003 indicates January 2003. Some questions were added in later surveys.
Abbreviations: RWP, resident wellness program; PTA, personal time availability.

Table 3 Subgroup analyses of satisfaction by gender or PGY

	2003		2005			2008			2011			2013
	Mean	SD	Mean	SD	p-value*,#	Mean	SD	p-value*,#	Mean	SD	p-value*,#	Mean	SD	p-value*,#
PGY1	3.83	1.08	3.65	1.15	0.504	3.84	1.19	0.203	3.87	1.31	0.487	4.43	0.75	0.001
PGY2	3.65	1.21	3.72	1.20	0.954	3.62	1.19	0.901	3.80	1.11	0.258	4.27	0.75	0.001
PGY3	3.87	1.06	3.89	1.03	0.340	3.77	1.09	0.182	3.98	1.09	0.128	4.19	0.93	0.216
PGY4+	4.02	1.04	3.93	1.14	0.811	3.91	1.04	0.194	4.20	0.97	0.001	4.29	0.88	0.645
p-value*	0.485		0.267			0.057			0.003			0.392
Female	3.72	1.12	3.80	1.14	0.406	3.64	1.10	0.430	3.91	1.12	0.028	4.28	0.84	<0.001
Male	3.96	1.07	3.80	1.14	0.489	3.91	1.13	0.361	4.13	1.04	0.132	4.32	0.84	0.064
p-value*	0.039		0.986			0.023			0.021			0.813

Notes:

* Chi-square test. p-values were computed by Monte Carlo simulations. Bold data indicates <0.05.

# P-value against previous year survey.

Abbreviations: PGY, postgraduate training year; SD, standard deviation.

Table 4 Comparisons of career satisfaction and other key measures between residents with PTA scores above and below the median

Year	Mean	SD	p-valuea against previous year survey	By PTA scores	Lower score		Higher score		Lower vs higher score
					Mean	SD	Mean	SD	p-value
2008	2.70	0.57		Satisfaction	3.53	1.18	4.00	1.08	<0.001b
				Stress	3.21	0.79	2.93	0.82	0.001b
				Sleep	3.27	0.60	3.44	0.61	0.004b
2011	2.88	0.60	<0.001	Satisfaction	3.78	1.17	4.22	0.97	<0.001b
				Stress	3.33	0.84	2.93	0.72	<0.001b
				Sleep	3.27	0.62	3.58	0.56	<0.001b
				Burnout	2.66	0.80	2.08	0.59	<0.001b
2013	2.95	0.60	0.052	Satisfaction	4.15	0.88	4.43	0.78	0.001b
				Stress	3.26	0.87	2.78	0.88	<0.001b
				Sleep	3.30	0.56	3.65	0.56	<0.001b
				Burnout	2.47	0.80	2.01	0.68	<0.001b
				masEEd	24.94	10.23	17.42	9.73	<0.001c
				masDPd	10.10	6.15	7.05	5.42	<0.001c
				masPAd	39.32	6.09	40.75	5.33	0.010c

Notes:

a Two independent sample two sided t-test;

b chi-square test (p-values were computed by Monte Carlo simulations);

c Wilcoxon test;

d Maslach Burnout Inventory summary scores for emotional exhaustion (masEE), depersonalization (masDP), and personal achievement (masPA). A higher PTA score implies that one can find more time to take care of personal needs. Bold data indicates <0.05.

Abbreviations: PTA, personal time availability; SD, standard deviation.

Table 5 Linear model analyses of personal time availability (PTA) scores by sex and post graduate training year (PGY)

Year	Variable	Value	Reference	Estimates	Standard error	p-value
2008	Intercept			2.460	0.063	<0.001
	Sex	Female	Reference
		Male		0.157	0.053	0.003
	PGY	PGY1	Reference
		PGY2		0.141	0.078	0.072
		PGY3		0.150	0.080	0.061
		PGY4+		0.262	0.074	<0.001
2011	Intercept			2.606	0.074	<0.001
	Sex	Female	Reference
		Male		0.279	0.051	<0.001
	PGY	PGY1	Reference
		PGY2		0.070	0.088	0.428
		PGY3		0.146	0.088	0.100
		PGY4+		0.204	0.080	0.011
2013	Intercept			2.749	0.060	<0.001
	Sex	Female	Reference
		Male		0.236	0.051	<0.001
	PGY	PGY1	Reference
		PGY2		−0.014	0.078	0.857
		PGY3		0.037	0.080	0.643
		PGY4+		0.185	0.068	0.006

Note: A higher PTA scores implies that one can find more time to take care of personal needs.

Appendix S1 2013 Survey Instrument.

Abbreviations: ACGME, Accreditation Council of Graduate Medical Education; dd, day; mm, month; OHSU, Oregon Health & Science University; PGY, postgraduate training years; yyyy, year.