McCallus, R. L., Smith, J. G., Xoxakos, P., Hedrick, K. N., Shuffler, M. L., Hirsh, E. L., Britt, T. W., Klinefelter, Z., Jackson, W. H., Mueller, C. B., & Pirrallo, R. G
Purpose/Objectives
The COVID-19 pandemic has inflicted countless challenges and novel stressors on healthcare workers. One of the hardest hit populations is emergency medicine clinicians, as they have been on the frontlines of this crisis from the very start. Emergency medicine leadership at a large healthcare system in the southeastern United States collaborated with university research partners to design and implement a rapid-cycle well-being survey to emergency medicine clinicians to monitor and track changes and trends throughout the COVID-19 pandemic from March 2020 through present day. Research presented here aims to address the question of whether a rapid-cycle survey design implemented through a scientist-practitioner framework can assess emergency medicine residents’ experiences related to burnout and well-being throughout the COVID-19 pandemic and provide a comprehensive summary of challenges and coping mechanisms.
Background
Emergency medicine clinicians confront a variety of workplace stressors, separate and unique even from other medical specialties. Variable and difficult schedules, severely acute patients, and a wide and unpredictable range of patient profiles and symptoms contribute to a high-stakes and high-stress work environment. These environmental and occupational factors contribute to emotional exhaustion, stress, and burnout among emergency medicine clinicians (Chung et al., 2020). Previous research has cited the need to assess individual, team-based, and organizational factors related to emergency medicine clinicians’ well-being as part of essential initiatives to ensure the health and career longevity among these groups (Dasan et al., 2014). Residents face a variety of challenges at this early stage of their career and have experienced numerous unique stressors and hurdles because of the COVID-19 pandemic (Pek et al., 2020). Considering the unprecedented circumstances surrounding the COVID-19 pandemic, the present research seeks to advance this knowledge by providing insight into emergency medicine residents’ experiences related to burnout, well-being, coping mechanisms, and career implications.
Methods
The results informing the present research come from an innovative, rapid-cycle survey implemented in March 2020 and continuing through the present. This survey was distributed to over 700 emergency medicine clinicians, including physicians, advanced practice clinicians, residents, and nurses. The first six iterations of the survey were administered on a weekly basis, after which point a monthly survey schedule was adopted to avoid survey fatigue while preserving the updated and immediate nature of feedback elicited from the survey. Quantitative and qualitative analyses inform a mixed methods design to provide a multifaceted and holistic picture of emergency medicine residents? experiences related to burnout and well-being throughout the COVID-19 pandemic.
Findings
Data collection is ongoing, and analyses are underway to provide a comprehensive picture of emergency medicine residents’ experiences related to occupational health and well-being throughout the COVID-19 pandemic. Quantitative and qualitative data will inform a multi-faceted longitudinal overview of residents’ scores on well-being, burnout, and sleep measures, as well as qualitative summaries of key coping mechanisms and challenges reported throughout phases of the pandemic. Analyses are updated monthly and reported to emergency medicine departmental leadership and will be aggregated for presentation at the time of the conference to provide the most updated description of results, which will include 24 rounds of quantitative and qualitative survey data collection by November 2021.
Discussion
The present research offers an innovative investigation into emergency medicine residents’ experiences through the entirety of the COVID-19 pandemic, including their experiences at work and outside of work related to well-being and burnout. Dynamic survey design and rapid distribution and analysis cycles allow for immediate feedback and organizational recommendations, providing a continuous and detailed storyline of challenges and coping mechanisms that emergency medicine residents have reported throughout this global crisis. Results presented here include unique contextual factors such as occupational anxiety related to future work, impacts on residency education because of the pandemic, social isolation stemming from restrictions and quarantine policies and difficulty with detachment outside of work in response to widespread health threats. This data has informed practical organizational decision-making in emergency department leadership and is intended to inform future research within emergency medicine.
Conclusions
Emergency medicine residents reported unique occupational challenges including perceptions of educational challenges, uncertainty about the future of their work and industry, health-related concerns and anxiety related to the COVID-19 virus, and social well-being challenges stemming from isolation. The research presented here will inform future analyses of emergency medicine clinicians’ experiences at and outside of work related to burnout and well-being, accounting for the unique circumstances and features of residency and emergency medicine during the COVID-19 pandemic.