Well-being in residency: effects on relationships with patients, interactions with colleagues, performance, and motivation.
OBJECTIVE
Previous studies about resident well-being have focused on negative aspects of well-being. We conducted this study to explore residents' conceptions of well-being and how it affects their work.


METHODS
One investigator conducted semi-structured interviews with residents at two hospitals during February-June 2005. Through random sampling stratified by program and gender, we invited 49 residents from internal medicine, psychiatry, surgery, emergency medicine, anesthesia, obstetrics/gynecology, and pediatrics. Using an editing analysis style, three investigators independently coded transcripts.


RESULTS
26 residents participated in 45-min interviews. Residents acknowledged that well-being affected four elements of their work: relationships with patients, interactions with colleagues, performance, and motivation. Residents described higher quality discussions with patients when their well-being was high and inappropriate exchanges when well-being was low. Residents attributed conflict with colleagues to lower states of well-being. Residents felt they had improved decision-making when their well-being was higher. Residents' motivation in their daily work and career varied with fluctuating well-being. Five residents initially denied that their well-being affects their work, voicing concerns that this would be unprofessional.


CONCLUSIONS
Most residents felt that both high and low levels of well-being affected their work, particularly their work relationships.


CONCLUSIONS
The educational and patient care goals of residency training may be enhanced through interventions that promote resident well-being.
Ratanawongsa
Neda
N
Division of General Internal Medicine, Johns Hopkins Bayview Medical Center, Johns Hopkins University School of Medicine, Baltimore, MD 21224, USA. neda@jhmi.edu
Wright
Scott M
SM
Carrese
Joseph A
JA
D000223:Adaptation, Psychological; D000328:Adult; D001291:Attitude of Health Personnel; D015142:Baltimore; D003657:Decision Making; D005260:Female; D006801:Humans; D007396:Internship and Residency / Q000458:organization & administration*; D007400:Interprofessional Relations; D007588:Job Satisfaction; D008297:Male; D008505:Medical Staff, Hospital / Q000193:education / Q000523:psychology*; D008603:Mental Health; D008960:Models, Psychological; D009042:Motivation; D010549:Personal Satisfaction; D010817:Physician-Patient Relations; D011361:Professional Competence; D036301:Qualitative Research; D011788:Quality of Life / Q000523:psychology; D020377:Self Efficacy; D011795:Surveys and Questionnaires