Well-being continues to be a pressing issue in surgical training. In the Flexibility in duty-hour Requirements for Surgical Trainees (FIRST) Trial, we found that 22% of U.S. general surgery residents report weekly burnout symptoms, and that various aspects of the learning environment – not duty hours – drive poor well-being.
Currently, programs have no data about their performance on these issues compared to others in the country. More importantly, programs lack readily available strategies to make improvements.
The SECOND Trial will be a prospective, pragmatic cluster-randomized trial examining how we can improve the learning environment and resident well-being. All programs will receive a Program-Specific Report of their residents' well-being metrics. Intervention programs will also receive:
The Program-Specific Report will provide each program (i.e., both control and intervention arms) with
data on its residents' well-being, i.e., burnout, thoughts of attrition, and suicidal ideation,
benchmarked against other programs in the country.
To preserve resident anonymity, Program-Specific Reports will be provided as quartiles (e.g., for burnout, your program ranks in the fourth (worst) quartile of programs in the country), instead of percentage of residents reporting.
Learning Environment Report
The Learning Environment Report will provide intervention programs with their performance
on various metrics about the learning environment, benchmarked against other programs in the country.
These metrics are currently under development.
To preserve resident anonymity, Learning Environment Reports will be provided as quartiles (e.g., for service vs education, your program ranks in the fourth (worst) quartile of programs in the country), instead of percentage of residents reporting.
Once intervention programs have decided what areas to focus on, they may choose from a variety of potential interventions in the Wellness Toolkit. Potential interventions will be developed based on lessons learned during Program Tours and from available literature. Programs have complete autonomy to decide what, if any, interventions to implement.
We will provide Implementation Support to help programs tailor the interventions they've selected within their local environments. Implementation Support may include coaching calls, the establishment of topic-specific learning collaboratives, and in person meetings.