Why It Matters
There's a new confidential website to help medical students and residents deal with challenges such as burnout, work/life balance, medical errors, and ethical issues.
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Physicians Create Online Haven for Medical Students and Residents

By IHI Open School | Friday, March 17, 2017
Online Haven for Medical Students and Residents

During a 50-year career in medicine, Dr. Paul Griner, MD, MACP, held several leadership roles — including President of the American College of Physicians — and mentored dozens of students and residents. Now, he’s bringing that mentoring mindset online. He and his partner, Dr. Donald Bordley, Professor of Medicine at the University of Rochester, created a website to help medical students and residents deal with professional and personal challenges they face during their training years (www.talk4hp.com). The Open School interviewed Paul about how the site was created, the goals of the site, and the long-term vision:

Open School: Could you tell us a bit about the website? What are the goals?

Paul Griner: Our website was created to help medical students and residents deal with challenges such as burnout, personal/professional imbalance, serious mistakes, difficult patients and ethical issues. For the most part, these challenges have not been dealt with effectively by medical schools and teaching hospitals; in large part, because students and residents are reluctant to talk to their teachers about these issues. Our website is one way that these learners can discuss sensitive personal and professional issues in a confidential environment. Our ultimate goal is to expand our program to learners in nursing, pharmacy and other health professions since they experience similar challenges.

OS: What will students and residents find on the website?

PG: Services include annotated references, blogs, forums, and direct contact with senior advisors through chats, email, and scheduled advisory sessions. The 17 senior advisors are respected physicians from academic medical centers throughout the country — physicians with many years’ experience as educators and mentors. Confidentiality is an essential element of contacts between learners and advisors.

OS: Is there a cost for the resources or chat sessions?

PG: These services are provided free of charge thanks to a grant from the Betty and Gordon Moore Foundation. The foundation is giving us funds to study the use and effectiveness of the website.

OS: Taking a step back for a moment, why did you want to do this? Where did you get the idea?

PG: The website was created as a result of two surveys of medical students and residents that we conducted in 2015 and 2016; the first at the University of Rochester Medical Center, the second, a national survey of 1,695 residents at 17 academic medical centers throughout the US. The surveys asked what the most frequent personal and professional issues the learners experienced during their training, how they addressed these issues, and whether a confidential web-based resource might be helpful to them. In both surveys, the response rate was high, 92% for Rochester students and residents and 63% for the national survey. We interpreted the excellent response rates as a high level of interest in the problem. The most frequent issues they anticipated asking for advice about were burnout (78%), lack of personal/professional balance (70%), dealing with a serious mistake (62%), responding to a difficult patient (51%), and handling ethical conflicts including abuse (43%). Only 37% of respondents indicated they would talk to their teachers about these issues, fearing that they would be seen as “weak.” Seventy-seven percent indicated interest in a web-based resource to help them address these issues by talking them out with senior advisors in a confidential setting and learning to cope more effectively with their issues.

OS: How’s it going so far?

PG: The website has been fully up for just about a month. Over that time, there have been about 350 users, 320 of whom are residents. Participation in forums, blogs, and advisory sessions has lagged, which we attribute to the newness of the site. The New England Journal of Medicine Resident 360 program website is a competitor, though they do not offer confidential sessions with advisors as we do. There could be some reluctance or intimidation about seeking advice from a senior advisor. It is also possible that there is concern over whether interactions between resident and advisor can be truly confidential.  More limited use than expected at this point in our development could be the result of greater attention to resident wellness at the participating institutions. Indeed, a significant number of programs whose residents we are offering our services to have begun to introduce in-house programs that have the same goal. We have said, right along, that our ultimate goal is to be put out of business by programs for resident wellness that academic medical centers are introducing themselves.

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