For more than two years, the COVID-19 pandemic fundamentally changed how every person on the globe works, plays, and interacts with each other. As what many hoped would be a few weeks of fear and uncertainty stretched into months and months, no one felt this stress more than health care professionals on the frontlines. Dr. Saadia Akhtar and her colleagues explored the specific causes of this stress and shared their research in the Poster Hall at the 2022 ACGME Annual Educational Conference, held virtually March 30-April 1, 2022.
Poster: Factors Associated with Psychological Distress and Burnout in Trainees at an Urban Tertiary Care Hospital during the COVID-19 Surge
Primary Author: Saadia Akhtar, MD
Co-Authors: Robert Pietrzak, PhD, MPH; Michelle Tong, MS; Jordan Feingold, MD, MSCR, MAPP; Steven Southwick, MD; Adriana Feder, MD; Lauren Peccoralo, MD, MPH; Jonathan Ripp, MD, MPH; Michael Leitman, MD
ACGME: Tell us about your academic and professional role.
Dr. Akhtar: I am the associate dean for trainee well-being and resilience at the Icahn School of Medicine at Mount Sinai in New York City. I am a member of the Office of Graduate Medical Education and the Office of Well-being and Resilience with a focus on advancing the well-being of our residents and fellows. I am a professor of emergency medicine and medical education. As an emergency physician working clinically at the frontlines during the COVID-19 pandemic, this research is very meaningful to me.
ACGME: Can you briefly describe your project for us
Akhtar: This poster highlights longitudinal findings that serve as a follow-up to our cross-sectional study published last year in Academic Medicine by Carly Kaplan et al. In short, we administered a web-based survey to learners at the Mount Sinai Hospital in New York City at two different time points: the first during the initial 2020 COVID-19 pandemic surge from April to May 2020 and the second seven months later. The survey asked about symptoms related to post-traumatic stress disorder, major depressive disorder, generalized anxiety disorder, and burnout. It also asked about occupational and personal exposures to COVID-19, coping strategies, and other psychosocial characteristics.
ACGME: What inspired you to do this project?
Akhtar: While prior research has examined COVID-related distress and burnout during the pandemic in some GME specialties, none have evaluated these symptoms across many frontline specialties. In addition, the Mount Sinai Health System in New York City trains one of the largest cohorts of GME learners and was at the epicenter of the US COVID-19 pandemic in Spring 2020. We wanted to explore the psychosocial impact of COVID-19 on learners at a high-acuity site and identify areas that may benefit from additional support or intervention.
ACGME: What did you discover?
Akhtar: Between these two time points, we found a significant increase in psychological distress from 16.3 percent to 27.2 percent and an increase in burnout, though not statistically significant, from 32.6 percent to 39.3 percent. For psychological distress at the second time point, we found that greater COVID-19-related stressors were positively associated with this outcome, while greater team camaraderie, emotional support from loved ones, and dispositional curiosity were negatively associated. For burnout at the second time point, greater work-related concerns (such as prioritizing the health of one COVID-19 patient over another) were positively associated with this outcome, while greater perceived instrumental support was negatively associated.
ACGME: What was the main takeaway?
Akhtar: Overall, our findings suggest that interventions targeting, (1) cohesive and supportive team dynamics and (2) increased time away from work to spend with loved ones or to form new, meaningful relationships, may help mitigate risk for psychological distress and burnout in learners during both “standard” medical education and times of crisis.
ACGME: Who could benefit from this?
Akhtar: Program directors may benefit from understanding key factors that drive resident/fellow burnout in times of crisis, which could then inform proactive interventions. For example, the GME Wellness Days initiative at the Icahn School of Medicine at Mount Sinai is one component of giving residents and fellows space to spend time away from work to attend to well-being needs.
ACGME: Any additional follow-up plans?
Akhtar: We plan to assess the long-term psychological effects of the crisis on learners.