title: Understanding Resident Performance, Mindfulness, and Communication in Critical Care Rotations.
abstract: OBJECTIVE
  Evidence from the medical literature suggests that surgical trainees can benefit from mindful practices. Surgical educators are challenged with the need to address resident core competencies, some of which may be facilitated by higher levels of mindfulness. This study explores whether mindful residents perform better than their peers as members of the health care team.
  
  
  METHODS
  This study employed a multiphase, multimethod design to assess resident mindfulness, communication, and clinical performance.
  
  
  METHODS
  Academic, tertiary medical center.
  
  
  METHODS
  Residents (N = 51) working in an intensive care unit. In phase I, medical residents completed a self-report survey of mindfulness, communication, emotional affect, and clinical decision-making. In phase II, resident performance was assessed using independent ratings of mindfulness and clinical decision-making by attending physicians and registered nurses.
  
  
  RESULTS
  In phase 1, a significant positive relationship was found between resident performance and mindfulness, positive affect (PA), and communication. In phase 2, attending physicians/registered nurses' perceptions of residents' mindfulness were positively correlated with communication and inversely related to negative affect (NA). The top quartile of residents for performance and mindfulness had the lowest NA. Higher-rated residents underestimated their performance/mindfulness, whereas those in the lowest quartile overestimated these factors.
  
  
  CONCLUSIONS
  This study offers a number of implications for medical resident education. First, mindfulness was perceived to be a significant contributor to self-assessments of competency and performance. Second, both PA and NA were important to mindfulness and performance. Third, communication was associated with resident performance, mindfulness, and PA. These implications suggest that individual characteristics of mindfulness, communication, and affect, all potentially modifiable, influence care quality and safety. To improve low performers, surgical educators could screen and identify residents with inaccurate self-assessments. Residents open to feedback will improve faster and develop awareness toward situations and interactions with patients, colleagues, attending physicians, and staff.
authors.affiliation: Department of Communication, University of Kentucky, Lexington, Kentucky.
authors.forename: Kevin
authors.initials: K
authors.lastname: Real
authors.affiliation: Graduate Program in Communication, University of Kentucky, Lexington, Kentucky.
authors.forename: Katelyn
authors.initials: K
authors.lastname: Fields-Elswick
authors.affiliation: Department of Surgery, UK Healthcare, University of Kentucky, Lexington, Kentucky. Electronic address: andrew.bernard@uky.edu.
authors.forename: Andrew C
authors.initials: AC
authors.lastname: Bernard
mesh_terms: D000046:Academic Medical Centers; D002983:Clinical Competence; D000066491:Clinical Decision-Making; D032882:Comprehension; D003422:Critical Care / Q000458:organization & administration*; D004503:Education, Medical, Graduate / Q000379:methods*; D005260:Female; D013502:General Surgery / Q000193:education*; D006801:Humans; D033183:Interdisciplinary Communication; D007396:Internship and Residency / Q000379:methods*; D007400:Interprofessional Relations; D007629:Kentucky; D008297:Male; D064866:Mindfulness; D013647:Task Performance and Analysis
keywords: Interpersonal and Communication Skills; Medical Knowledge; Patient Care; Practice-Based Learning and Improvement; Professionalism; Systems-Based Practice; clinical decision-making; communication; emotions; medical residents; mindfulness; resident performance