Applying Design-based Research Principles to a Multi-Pronged Neurology Residency Wellness Intervention
Ramita Karra1, Katherine Fu2, Adrienne Keener3
1University of California at Los Angeles, Dept of Neurology, 2University of California, Los Angeles, 3UCLA Neurology
Objective:

We aimed to characterize factors contributing to neurology resident burnout and implemented design-based research (DBR) principles to determine the effectiveness of a multi-pronged wellness intervention.

Background:

Burnout stems from chronic workplace stress and is characterized by emotional exhaustion, depersonalization, and a sense of low personal accomplishment. 

Design/Methods:

We conducted a nonrandomized pre- and post-intervention study at a single neurology residency program from June 2023 to June 2024, including postgraduate years 2-4. DBR is an iterative methodology to improve practices through the design and testing of interventions in real-world settings, appropriate for the development of this pilot program. The multi-pronged wellness intervention included longitudinal didactics, bimonthly resident social events, and weekly emails highlighting spaced repetition of pertinent topics, among other elements. Longitudinal didactics consisted of five 1-hour blocks on topics such as institutional mental health resources, finding meaning in medicine, and resident self-led projects. The Physician Well Being Index (PWBI) was the primary outcome and has been previously validated to identify residents with low mental quality of life at a threshold score of >=5 (range, 0-7). Due to a small sample size, Fisher’s exact test was used to assess the primary outcome.

Results:

22/37 (59%) and 21/37 (57%) residents completed the pre- and post-intervention surveys, respectively. In the preintervention survey, 9/22 residents (41%) had a PWBI score >=5 (mean 3.5), as compared to 1/21 residents (5%, mean 2.4) in the postintervention survey (p=0.01). Areas of improvement centered upon reducing workplace interruptions and increasing resident vigor.

Conclusions:

Overall, the impact of these pilot wellness interventions as assessed by the PWBI was statistically significant towards an improvement in burnout. Goals for this year included improving awareness of resources and building personal resilience, reflecting DBR principles of iterative improvement. Future studies may evaluate wellness interventions within precision well-being frameworks at both the individual and program levels.

10.1212/WNL.0000000000211621
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