Supporting resident well-being on and outside the ICU during the COVID-19 pandemic: the use and value of institutional interventions and individual strategies

Interventions to Support Resident and Fellow Well-Being During the COVID-19 Pandemic: A Scoping Review

Background The COVID-19 pandemic led to rapid and wide-scale changes in graduate medical education and impacted the well-being of frontline physicians, including residents and fellows. While institutions and programs implemented initiatives to support the unique needs of trainees during the pandemic, there remains a gap in the literature in examining the approaches used, the domains of well-being addressed, and the effectiveness of these efforts. Objective To review the literature on interventions designed to promote resident and fellow well-being during the COVID-19 pandemic. Methods The authors conducted a scoping review of the literature published between January 1, 2020, and November 30, 2023, in PubMed, Scopus, Embase, PsycINFO, CINAHL, and ERIC to identify interventions to promote the well-being of trainees during the COVID-19 pandemic. Results Eighteen articles met inclusion criteria, mainly studies conducted in the United States (14 of 18, 77.8%). Most interventions targeted psychological well-being (16 of 18, 88.9%), with only a few studies that included interventions in the physical or social domains. Interventions entailed redeployment, schedule modifications, communication strategies, and expanded mental health support. Most interventions were limited to a few weeks' duration in the first surge phase of the pandemic. Only 11 studies (61%) reported outcome measures, and only 2 (11%) used instruments with validity evidence. Most studies did not report sufficient data to evaluate study quality. Conclusions While longer-term outcome data were often lacking, studies described a range of interventions to support resident well-being. Future research should focus on the effectiveness of well-being interventions and include cohorts from more diverse clinical settings.

Transformations in postgraduate medical education following the COVID-19 pandemic: lessons learned from advances and challenges

The COVID-19 pandemic has profoundly reshaped postgraduate medical education, driving immediate and significant adaptations in teaching methodologies and educational frameworks. This review examines the multifaceted transformations within medical education environments, particularly in response to the pandemic. Through a structured narrative review of recent literature, we identify key lessons learned and the subsequent shifts in educational practices. Our analysis underscores the critical importance of flexibility in educational delivery, the integration of technology, and the emphasis on mental health and resilience among medical trainees. We also explore the challenges and successes associated with maintaining equality and diversity in a rapidly evolving educational landscape. The findings highlight the necessity for continuous professional development and robust support systems to navigate future challenges effectively. Recommendations are provided for educational institutions to enhance adaptability, foster inclusive learning environments, and prepare for unforeseen global health emergencies. This study aims to contribute to the ongoing discourse on optimizing postgraduate medical education to better prepare health professionals for a dynamic and uncertain future.

Let's Talk About it: The Utility of Formalized Support for Medical Residents

Medical residents are significantly impacted by burnout and depression. Recent events have only further increased the pressure and demands on the healthcare sector, intensifying the burden facing residents and posing a threat to residents' well-being. As a result, significant efforts are being made to provide formalized support and well-being programs. Yet, emergent evidence indicates that residents do not sufficiently utilize this form of support. Considering the organizational investment and focus on formalized support programs, we conducted a mixed-method study to investigate residents' utilization of formalized well-being support, and potential reasons for non-use. Our study was conducted during a period of increased work burden and stress for medical residents, where formalized support was specifically offered and targeted to medical staff. Our findings confirm earlier results of low support utilization and point to the importance of informal support mechanisms, in particular peer support. We conclude by discussing the role of managers and educational programs in facilitating a positive cultural shift to promote and support residents in seeking support.

COVID-19 pandemic in the intensive care unit: Psychological implications and interventions, a systematic review

BACKGROUND

The coronavirus disease 2019 (COVID-19) pandemic produced changes in intensive care units (ICUs) in patient care and health organizations. The pandemic event increased patients’ risk of developing psychological symptoms during and after hospitalisation. These consequences also affected those family members who could not access the hospital. In addition, the initial lack of knowledge about the virus and its management, the climate of fear and uncertainty, the increased workload and the risk of becoming infected and being contagious, had a strong impact on healthcare staff and organizations. This highlighted the importance of interventions aimed at providing psychological support to ICUs, involving patients, their relatives, and the staff; this might involve the reorganisation of the daily routine and rearrangement of ICU staff duties.

AIM

To conduct a systematic review of psychological issues in ICUs during the COVID-19 pandemic involving patients, their relatives, and ICU staff.

METHODS

We investigated the PubMed and the ClinicalTrials.gov databases and found 65 eligible articles, upon which we commented.

RESULTS

Our results point to increased perceived stress and psychological distress in staff, patients and their relatives and increased worry for being infected with severe acute respiratory syndrome coronavirus-2 in patients and relatives. Furthermore, promising results were obtained for some psychological programmes aiming at improving psychological measures in all ICU categories.

CONCLUSION

As the pandemic limited direct inter-individual interactions, the role of interventions using digital tools and virtual reality is becoming increasingly important. All considered, our results indicate an essential role for psychologists in ICUs.