Defining well-being: A case-study among emergency medicine residents at an academic center: A qualitative study

Background Healthcare-associated burnout is linked to reduced quality of care, decreased patient experience, and higher cost. The National Academy of Medicine has emphasized the importance of supporting clinician well-being across healthcare; however, well-being is poorly defined, especially early in emergency medicine training. Objectives The primary objective of this study was to explore and understand the attitudes, beliefs, and perspectives of emergency medicine (EM) resident physicians surrounding well-being. A secondary objective was to identify priority areas of focus to promote a culture of well-being for EM trainees. Approach We conducted semi-structured focus groups of EM resident physicians at an urban, academic institution with a 4-year training curriculum. Focus group interviews were transcribed and constructivist aggregated themes were identified using content analysis with a constant comparative coding approach. Results Seventeen EM residents participated in semi-structured qualitative focus groups (PGY1 = 6, PGY2 = 6, PGY3 = 2, PGY4 = 3). Six key themes related to well-being emerged spanning clinical and nonclinical areas: (1) a focus on basic needs being met, (2) on-shift operational structure, (3) individual feedback, (4) feeling valued for clinical contributions, (5) a sense of community within the clinical environment, and (6) a sense of personal ownership over time. Conclusions Shifting the focus for medical trainees away from mitigating burnout and toward proactively promoting well-being is important. Understanding the perspectives and key themes in how EM residents define well-being can help support trainees early in their careers. Using qualitative methods, this study identified six key themes that can guide trainees, educational leaders, and academic hospital systems as they work toward building a culture of well-being early in graduate medical education.