Assessing Resident Well-Being After the ABSITE: A Bad Time to Ask?

Elaine O Cheung; Yue-Yung Hu; Andrew Jones; Meixi Ma; Cary Jo R Schlick; Judith T Moskowitz; Gaurava Agarwal; Karl Y Bilimoria

doi:10.1097/AS9.0000000000000209

Assessing Resident Well-Being After the ABSITE: A Bad Time to Ask?

Ann Surg Open. 2022 Sep 28;3(4):e209. doi: 10.1097/AS9.0000000000000209. eCollection 2022 Dec.

Authors

Elaine O Cheung¹, Yue-Yung Hu^{2

3}, Andrew Jones⁴, Meixi Ma^{2

5

6}, Cary Jo R Schlick², Judith T Moskowitz¹, Gaurava Agarwal⁷, Karl Y Bilimoria^{2

5}

Affiliations

¹ Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL.
² Surgical Outcomes and Quality Improvement Center (SOQIC), Department of Surgery and Center for Health Services and Outcomes Research, Feinberg School of Medicine, Northwestern University, Chicago, IL.
³ Division of Pediatric Surgery, Ann & Robert H. Lurie Children's Hospital, Feinberg School of Medicine, Northwestern University, Chicago, IL.
⁴ American Board of Surgery, Philadelphia, PA.
⁵ American College of Surgeons, Chicago, IL.
⁶ Department of Surgery, University of Alabama at Birmingham Medical Center, Birmingham, AL.
⁷ Department of Psychiatry, Feinberg School of Medicine, Northwestern University, Chicago, IL.

Abstract

Assess the association of residents' exam performance and transient emotions with their reports of burnout, suicidality, and mistreatment.

Background: An annual survey evaluating surgical resident well-being is administered following the American Board of Surgery In-Training Examination (ABSITE). One concern about administering a survey after the ABSITE is that stress from the exam may influence their responses.

Methods: A survey was administered to all general surgery residents following the 2018 ABSITE assessing positive and negative emotions (scales range from 0 to 12), as well as burnout, suicidality over the past 12 months, and mistreatment (discrimination, sexual harassment verbal/emotional or physical abuse) in the past academic year. Multivariable hierarchical regressions assessed the associations of exam performance and emotions with burnout, suicidality, and mistreatment.

Results: Residents from 262 programs provided complete responses (N = 6987, 93.6% response rate). Residents reported high mean positive emotion (M = 7.54, SD = 2.35) and low mean negative emotion (M = 5.33, SD = 2.43). While residents in the bottom ABSITE score quartile reported lower positive and higher negative emotion than residents in the top 2 and 3 quartiles, respectively (P < 0.005), exam performance was not associated with the reported likelihood of burnout, suicidality, or mistreatment.

Conclusions: Residents' emotions after the ABSITE are largely positive. Although poor exam performance may be associated with lower positive and higher negative emotion, it does not seem to be associated with the likelihood of reporting burnout, suicidality, or mistreatment. After adjusting for exam performance and emotions, mistreatment remained independently associated with burnout and suicidality. These findings support existing evidence demonstrating that burnout and suicidality are stable constructs that are robust to transient stress and/or emotions.

Keywords: burnout; emotion; exam performance; residency; wellbeing.