Title

Quality Improvement Initiative To Promote Resident Well-Being And Enhance Skill Confidence; A Peer-To-Peer Approach

Authors

Opoku-Agyemang C1, Anim-Koranteng C1, Soto G. R1, Yong E1, Ayinla R2 1-Internal Medicine department, NYCHHC-Harlem hospital, 2- Department of Pulmonary and Critical Care, NYCHHC-Harlem

Introduction

The first three months of residency can come with immense stress. Being an International medical graduate (IMG) in a new environment and seemingly naive to the American medical practice can be a daunting experience for any new IMG intern. The challenges are endless, and our residency program recognized and acknowledged some of these challenges and helped the new interns address these challenges through our Intern Boot Camp initiative. We aimed to assess the impact of a peer-to-peer intervention on interns’ well-being and level of skill set.

Methods

The Initiative was implemented within a 6-week period with one hour of interaction each week. The intervention was in the form of interactive lectures on oral presentation, and time management, online video learning sections on EMR use, open forum to address mental health concerns. Pre-intervention and post-intervention surveys were distributed to participants, capturing their confidence levels on a scale of 1 to 10 on various metrics, including Documentation, Electronic Medical Record (EMR) Use, Mental Health, Oral Presentation, and Time Management. The survey was done anonymously. The pre-intervention and post-intervention surveys were compared using the mean and standard deviation (SD) for each survey category. The normality of data was tested, and based on the results, either unpaired t-tests or Mann-Whitney U tests were employed to compare the two groups. Statistical significance was set at p < 0.05. The R programming language was used for statistical analysis.

Results

From 25 first-year residents, 21 pre-intervention and 19 post-intervention surveys were collected. The peer-to-peer intervention demonstrated a statistically significant improvement in four out of five surveyed categories. Post-intervention, Documentation mean scores increased from 5.95 (SD = 1.56) to 7.37 (SD = 1.86) with p = 0.002. EMR Use saw an enhancement in mean scores from 5.76 (SD = 1.76) to 7.00 (SD = 1.49), p = 0.018. Mental Health improved from a mean of 6.14 (SD = 1.59) to 7.32 (SD = 1.53), p = 0.023. Oral Presentation scores were also significantly better, increasing from 5.67 (SD = 2.27) to 7.05 (SD = 1.61), p = 0.020. Time Management was the only category not showing a statistically significant change, with mean scores moving from 6.24 (SD = 2.02) to 7.26 (SD = 1.48), p = 0.078. These results suggest that the peer-to-peer intervention was effective in improving physician well-being and skill confidence across most surveyed domains.

Conclusion

The confidence level of interns increased in four out of five parameters of the study, namely documentation, EMR use, mental health, and oral presentation. This implies peer-to-peer mentorship is crucial for the effective transition of IMG residents. The limitations of this study were the absence of some residents during the study due to late arrivals and vacations. Our intention is to expand on this study to make it an annual event for incoming residents.

References

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