• J. Am. Coll. Surg. · Sep 2023

    Multicenter Study

    Operationalizing the Culture of Burnout and Wellbeing: Multicenter Study of Value Congruence and Flourishing in General Surgery Residency.

    • Jenny R Cevallos, Paul Adam Gonzales, Michael H Berler, Anya L Greenberg, Carter C Lebares, and General Surgery Research Collaborative on Resident Well-being.
    • From the UCSF Center of Mindfulness in Surgery, Department of Surgery, University of California, San Francisco, San Francisco, CA.
    • J. Am. Coll. Surg. 2023 Sep 1; 237 (3): 397407397-407.

    BackgroundValue congruence (VC) is the degree of alignment between worker and workplace values and is strongly associated with reduced job strain and retention. Within general surgery residency, the impact of VC and how to operationalize it to improve workplace well-being remain unclear.Study DesignThis 2-part mixed-methods study comprised 2 surveys of US general surgery residents and qualitative interviews with program directors. In Part 1, January 2021, mixed-level surgical residents from 16 ACGME-accredited general surgery residency programs participated in survey #1. This survey was used to identify shared or conflicting perspectives on VC concerning well-being initiatives and resources. In April 2021, interviews from 8 institutions were conducted with 9 program directors or their proxies. In Part 2, May to June 2022, a similar cohort of surgical residents participated in survey #2. Unadjusted logistic and linear regression models were used in this survey to assess the association between VC and individual-level global well-being (ie flourishing), respectively.ResultsIn survey #1 (N = 300, 34% response rate), lack of VC was an emergent theme with subthemes of inaccessibility, inconsiderateness, inauthenticity, and insufficiency regarding well-being resources. Program directors expressed variable awareness of and alignment with these perceptions. In survey #2 (N = 251, 31% response rate), higher VC was significantly associated with flourishing (odds ratio 1.91, 95% CI 1.44 to 2.52, p < 0.001).ConclusionsExploring the perceived lack of VC within general surgery residency reveals an important cultural variable for optimizing well-being and suggests open dialogue as a first step toward positive change. Future work to identify where and how institutional actions diminish perceived VC is warranted.Copyright © 2023 by the American College of Surgeons. Published by Wolters Kluwer Health, Inc. All rights reserved.

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