Residents Invited to Share Ideas to Improve Patient Interactions in ACGME Competition

Medical trainees across the United States are being challenged to find innovative ways to enhance meaning in their daily work in an initiative called “Back to Bedside.” The initiative, sponsored by the Accreditation Council for Graduate Medical Education (ACGME), will fund up to five trainee-led teams with $10,000 each for up to two years.

The deadline for applications is August 5.

“The initiative started with what we saw as an anti-burnout campaign” for residents and physicians, Dinchen Jardine, M.D., told Psychiatric News in an interview. Jardine is chair of the ACGME Council on Review Committee Residents. Last year, she led a series of focus groups that included resident and fellow members of the council and were guided by the memoir When Breath Becomes Air by Paul Kalanithi, M.D.

Kalanithi was a 36-year-old neurosurgery resident at Stanford University in his sixth year of training when he received a diagnosis of stage IV lung cancer. Kalanithi decided to continue with his training after being diagnosed because his patients gave great meaning to his work and life. One of the questions residents and fellows answered as part of the focus groups was whether they, too, would return to their training programs given the same circumstances, Jardine said.

In resulting discussions, resident and fellow members of the focus groups discussed profound moments of meaningful interactions with patients, according to Jardine. “I asked residents why they were happy they went into medicine, and the reasons ranged from ‘I put a burr hole into someone’s head, and they went from comatose to talking’ to ‘I spent three hours with a patient on Christmas Day talking with them about how much they missed their family because I missed my family too.’ ”

Out of these discussions came the “Back to Bedside” Initiative, with goals for applicant trainee teams centering on creating more opportunities for meaningful patient interactions through direct patient care and thus increasing patients’ satisfaction with their treatment team.

Jardine explained that trainee teams may have to find innovative solutions to overcome some of the barriers that prevent physicians from spending as much time as they would like with their patients, such as completing various types of paperwork that could perhaps be assumed by administrative personnel or others.

In addition, Jardine noted, the ACGME is being flexible about its interpretation of what is “meaningful” to each trainee-led team as this may vary widely from applicant to applicant. In addition to helping programs achieve local goals, the teams will be asked to travel to ACGME headquarters in Chicago for two collaborative meetings with other teams. They will also be invited to attend the 2019 ACGME Annual Education Conference and share ideas and innovations with the wider GME audience.

Ultimately, the initiative is hoped to decrease burnout among physicians.

“We need a healthy workforce to have healthy patients,” former APA President Carol Bernstein, M.D., told Psychiatric News. Bernstein is co-chair of the ACGME Task Force on Physician Well-Being. She is also vice chair for education and director of the residency training program in the Department of Psychiatry at New York University School of Medicine..

The ACGME is encouraging trainee innovators “to improve their learning and clinical environments in a meaningful way” through the “Back to Bedside” initiative, Bernstein said, “because creating meaning and community goes a long way to offset the challenges that contribute to burnout.” ■