Abstract
Objective
To evaluate the effect of resident physicians' distress on their personal safety.
Participants and Methods
We conducted a prospective, longitudinal cohort study of internal medicine residents
at Mayo Clinic in Rochester, Minnesota. Participants completed surveys quarterly from
July 1, 2007, through July 31, 2011, during their training period. Frequency of self-reported
blood and body fluid (BBF) exposures and motor vehicle incidents was recorded. Associations
of validated measures of quality of life, burnout, symptoms of depression, fatigue,
and sleepiness with a subsequently reported BBF exposure or motor vehicle incident
were determined using generalized estimating equations for repeated measures.
Results
Data were provided by 340 of 384 eligible residents (88.5%). Of the 301 participants
providing BBF exposure data, 23 (7.6%) reported having at least 1 BBF exposure during
the study period. Motor vehicle incidents were reported by 168 of 300 respondents
(56.0%), including 34 (11.3%) reporting a motor vehicle crash and 130 (43.3%) reporting
a near-miss motor vehicle crash. Other than the low personal accomplishment domain
of burnout, distress and fatigue at one time point exhibited no statistically significant
associations with BBF exposure in the subsequent 3 months. However, diminished quality
of life, burnout, positive screening for depression, fatigue, and sleepiness were
each associated with statistically significantly increased odds of reporting a motor
vehicle incident in the subsequent 3 months.
Conclusion
Exposures to BBF are relatively uncommon among internal medicine residents in current
training environments. Motor vehicle incidents, however, remain common. Our results
confirm the importance of fatigue and sleepiness to resident safety concerns. In addition,
higher levels of distress may be contributory factors to motor vehicle crashes and
other related incidents. Interventions designed to address both fatigue and distress
may be needed to optimally promote patient and resident safety.
Abbreviations and Acronyms:
BBF (blood and body fluid), MVC (motor vehicle crash), QOL (quality of life)To read this article in full you will need to make a payment
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Article Info
Footnotes
See editorial comment, page 1135
Grant Support: This work was supported by the Mayo Clinic Department of Medicine Program on Physician Well-being .
Role of the Sponsor: The funding source played no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; and preparation of the manuscript.
Identification
Copyright
© 2012 Mayo Foundation for Medical Education and Research. Published by Elsevier Inc. All rights reserved.
