Radiology Well-Being Program

As a long-term stress reaction characterized by depersonalization, emotional exhaustion, a feeling of decreased personal achievement and a lack of empathy for patients, burnout exacts a distressingly high toll. With almost half of radiologists reporting burnout in the 2019 Medscape Radiology Lifestyle Report, it is abundantly clear we must work together to help combat this; this is our struggle.

The American Collegee乐彩app官方下载旧版 of Radiology cares about your well-being and has developed the ACR Radiology Well-Being Program to help. This program provides you with tools and resources to assess your level of wellness and identify ways to improve your well-being over time.  All ACR members, including residents/fellows and medical students, receive free access to the following:

Did You Know?

AMA members receive a free 2-year subscription to Headspace, a mindfulness and meditation app.

 

Using the Well-Being Index (WBI) and Toolkit

This screening tool allows you to better understand your overall well-being and identify areas of risk compared to your peers across the countrye乐彩app官方下载旧版. This is 100% anonymous—your information will not be shared with anyone, including the ACR.

  1. now or download the mobile app from the or from .
  2. Click on “Register Here” and enter the appropriate invitation code:
    • Radiologists and radiation oncologists: ACRPHYSICIAN
    • Medical physicists: ACRMEDPHYS
    • Residents and fellows: ACRRFS
    • Medical students: ACRMEDSTUDENT
  3. Register and complete the 9-question survey. If you have an existing account, WBI can merge accounts, ensuring you retain any previous scores. After verifying your password, check the box to “Make this my primary organization” in order to see the radiology-specific resources curated by the ACR.
  4. View your results and how your level of well-being compares to others in your demographic group. The comparative groups include more than 7,000 physicians, 1,700 residents and fellows, and 2,000 medical students. The resource categories provided are based on your score.
  5. Track your well-being over time by returning to the WBI and repeating your self-assessment. Resources are available any time, and the survey can be completed monthly.

Have a resource or feedback you would like to share? Contact the Well-Being team at copllstaff@e乐彩app官方下载旧版.

Well-Being Curriculum for Physicians, Residents, and Students

Curriculum Objectives

The ACR is providing radiologists with tools to promote wellness and combat burnout. Physician-directed interventions such as restoring work-life integration, mindfulness, cognitive behavioral therapy, seeking mental health services, improving one’s self confidence and communication skills can be helpful[1]. Organization-directed interventions must include open communication and transparency from leadership, workflow autonomy, mentorship opportunities, adequate PACS and EMR support, promotion of a healthy and collegial work environment, a regular measurement of wellness, creation of a wellness committee, and endorsement of wellness and burnout resources[1]. Two years ago, the Accreditation Council for Graduate Medical Education (ACGME) introduced updated common program requirements for all accredited residencies and fellowships in recognition of the need to further promote resident and faculty member well-being and patient safety[2].

However, both physicians and organizations/institutions may need guidance in assembling the tools to promote wellness; to this end, the Well-Being Toolkit (i.e., the radiology-specific resources within the WBI) and the Well-Being Curriculum (below) have been carefully curated by ACR Well-Being committees under the leadership of Lori Deitte, MD, chair of the ACR Commission on Publications and Lifelong Learning and Claire Bender, MD, FACR, chair of the ACR Commission on Human Resources. The compiled resources are shining examples of our talented community working together toward a common goal: being well together.

1. Chetlen AL, Chan TL, Ballard DH, et al. Addressing burnout in radiologists. Academic Radiology. 2019;26(4):526-533.

2. Accreditation Council for Graduate Medical Education. Common Program Requirements. Available at  . Accessed December 1, 2018.

1. Appreciative Inquiry

  •  — A collection of information and resources from Appreciative Inquiry practitioners all over the world.
  • — An online learning module that allows physicians to earn CME as part of the STEPS Forward program, a practice improvement initiative created by the AMA. This module is part of the Professional Well-Being section of the STEPS Forward program; its objectives are to:
    • Evaluate current strengths, assets and values of the practice, department or organization;
    • Construct a “discovery team” to elicit positive stories and themes from the organization;
    • Incorporate appreciative inquiry into daily work and existing performance improvement initiatives.
  •  — A case study which depicts the journey of a non-profit hospital in an under-served community and its attempts to turn around suffering patient experience. The article shows how the hospital turned to the theories of Appreciative Inquiry and the power of a strengths-based approach to create a framework to support the patient experience initiatives.
  •  — The AI approach can be used for the development and enhancement of the potential of both individuals and organizations. This guide from the Association for Medical Education in Europe describes the core principles of Appreciative Inquiry and their practical application in medical education.
  •  — The Center for Appreciative Practice, established in 2007 by UVA's Schools of Medicine and Nursing, its Medical Center and University Physicians Group, offers an overview of Appreciative Inquiry and its principles. .
  •  — Appreciative Inquiry, a highly participatory approach to developing human and organizational systems, can accelerate positive change and provide the influence necessary to revolutionize medicine and create the positive future we desire.
  •  — Appreciative inquiry is an organizational change process that derives its power from the positive imagination of a community. Academic medicine currently struggles under a deficit model, bound by a seemingly unsolvable lack of time, money, respect, and purpose. Learn how the University of Virginia is improving its graduate medical education programs using Appreciative Inquiry.
  • * — See how the authors implemented a novel application of Appreciative Inquiry and its four phases (Inquire, Imagine, Innovate, and Implement) in its pediatric pulmonology fellowship program evaluation process and demonstrate how it led to meaningful improvements.

2. Team Building

  • * — Although Program Coordinators (PCs) play an integral role in residency training programs, there exist few, if any, interventions aimed at addressing their burnout. See how residency PCs experienced improvements in mental quality of life, resiliency, stress, and sleep scores on attending a wellness program.
  • * — Authors recommend team-building activities for radiology residents focused on five aspects of team-building: personal history sharing, creativity and imagination, common bonds, cooperation, and shared experience.

3. Ensuring Quality Patient Care

  •  — Patient-centered care is a model in which health care providers respect patients’ values and preferences, address their emotional and social needs, and involve them and their families in decision making. This may yield substantial benefits in the form of improved quality and patient safety, reduced costs, higher-value care, improved patient outcomes, and greater patient and provider satisfaction.
  •  — Times are changing as radiology practices and hospital radiology departments are implementing patient-centered strategies intended to improve patient care and, in turn, support an increased level of patient satisfaction. This article outlines a number of actions radiologists have taken in the name of better care, better satisfaction and better reimbursement.
  •  — The SHARE Approach outlines five steps health care professionals can take to ensure that they are effectively implementing shared decisionmaking with patients during clinical encounters, and offers sample conversation starters for meaningful discussions with patients.

4. Feedback

  • * — This study examined the extent to which dimensions of feedback are related to self-development. Those who perceived receiving more positive reinforcement and nonthreatening feedback and who felt empowered were rated higher in performance. Implications for practice and future research taking into account feedback dimensions and national culture are discussed.
  • * — This article argues that the source of feedback's perceptions and reactions to the recipient's performance depend on the relationship between the source and recipient. The dominant role together with the source's self-esteem and self-control affect whether the feedback is constructive or destructive. New directions for feedback research and practice are considered.
  • * — Feedback orientation refers to an individual's overall receptivity to feedback, including comfort with feedback, tendency to seek feedback and process it mindfully, and the likelihood of acting on the feedback to guide behavior change and performance improvement.
  • Fine Art of Feedback Activity Packet — The instrument was developed as a performance-based instrument for evaluating faculty development efforts of clinical preceptors. (Reused per Creative Commons license from Jeff Pettit, Carver Collegee乐彩app官方下载旧版 of Medicine, The University of Iowa.) 
  • * — The authors demonstrate that their third-year clerkship program using peer groups has built supportive learning networks and facilitated reflection, allowing students to develop critical professional skills. Student communication around patient care was also feasible and highly valued.
  • * — This critical research plus enhanced recognition of shame and guilt will allow teachers and institutions to further cultivate the engaged, empathetic, and shame-resilient learners they strive to create.
  • * — A study on constructive and deconstructive criticism. Individuals who received destructive criticism reported greater anger and tension and indicated that they would be more likely to handle future disagreements with the source through resistance or avoidance and less likely to handle disagreements through collaboration or compromise. 
  • * — This article examines the effectiveness of four interventions in countering the negative impact of destructive criticism.
  • Critical Analysis of the Objective Structured Teaching Exercise (OSTE) in Faculty Feedback Skills — The goal of the resource is to provide material for a workshop on feedback, including giving, receiving, and soliciting, that is both informative and participative.  (Reused per Creative Commons license from Stone S MK, Devaney-O’Neil S, Starr S, Ferguson W, Wellman S, Jacobson E, Hatem DS, Quirk M. Development and Implementation of an Objective Structured Teaching Exercise (OSTE) to Evaluate Improvement in Feedback Skills Following a Faculty Development Workshop. Teaching and Learning in Medicine. 2003; 15(1):7-13.)
  •  — How do we build a feedback-rich culture? This article discusses four essential elements.
  •  -— A positive workplace is more successful over time because it increases positive emotions and well-being. Here are four ways that supervisors can create a positive and healthy culture that supports well-being.
  •  — Help create a more candid and feedback rich culture by following these seven steps.
  •  — When leadership WalkRounds are conducted, acted on, and the results are fed back to those involved, the work setting is a better place to deliver and receive care as assessed across a broad range of metrics, including teamwork, safety, leadership, growth opportunities, participation in decision-making, and the emotional exhaustion component of burnout.
  • * — Changing our environment to embrace mentorship, the continual exchange of feedback, and the fostering of self-care could startlingly improve our work environment.
  •  — Could positive feedback and a culture of well-being help combat the epidemic of physician disengagement and unhappiness, often codified as burnout?
  •  — All leaders should be aware of the ratio of positive and negative comments made by their colleagues in leadership team meetings, and endeavor to move the proportion closer to the ideal of 5.6 to 1.

5. Dealing with Errors

  •  — Self-perceived medical errors are common among internal medicine residents and are associated with substantial subsequent personal distress. Personal distress and decreased empathy are also associated with increased odds of future self-perceived errors, suggesting that perceived errors and distress may be related in a reciprocal cycle.
  • * — The perception of having made a mistake creates significant emotional distress for practicing physicians. The severity of this distress may be influenced by factors such as prior beliefs and perfectionism. The extent to which physicians share this distress with colleagues may be influenced by the degree of competitiveness engendered by medical training.
  •  — Physicians will always make mistakes. The decisive factor will be how we handle them. This articles offers suggestions for how to respond to and have a dialogue about medical errors.
  •  *— Evidence exists that errors are common in clinical practice and that physicians often deal with them in dysfunctional ways, yet there is no general acknowledgment of the inevitability of errors or of the need for practitioners to be trained in their management. This article focuses on the affective aspects of physician errors and presents a strategy for coping with them.
  • * — Careful investigation and systems analysis can identify the factors that set the stage for a medical error. The author argues that the process of understanding adverse events leads to improvements in care and reductions in errors and that insensitive and inadequate handling of an incident can result in additional harm to patients and families. He outlines practical strategies to minimize the trauma resulting from adverse events.
  •  — In this analysis of malpractice data, the authors report the proportion of physicians who had malpractice claims in a year, the proportion of claims leading to an indemnity payment, and the size of indemnity payments, and estimate the cumulative risk of ever being sued among physicians in high- and low-risk specialties.
  •  — This article discusses how and why physicians react to an accusation of malpractice and the range of strategies that they can use to diminish the emotional disequilibrium that accompanies this experience. 

6. Conflict Resolution

  •  — The authors developed teaching tools emphasizing team dynamics and employing lessons from diplomacy and improvisational theatre to underscore nonverbal cues that improve communication during conflict. This resource includes instructions for teaching conflict management and conflict resolution styles, small-group negotiations, case-based clinical scenarios, personal reflection, and facilitated debrief.
  •  — A simulation/role-play activity for interprofessional learners to acquire knowledge about crucial conversations and conflict resolution and to demonstrate their skills with interprofessional team members. It was developed for learners on an interprofessional family medicine clerkship as an educational adjunct to be used during protected curricular time.
  •  — This paper describes the nature of conflict in the health care system and identifies the difference between conflict and disagreement. Using a conflict resolution model, strategies for dealing with conflict as it arises are explored and tips are provided on how to effectively manage conflict to a satisfactory resolution for all parties.
  •  — Understanding the nature and source of conflict is a vital aspect of leadership. Causes of conflict include the miscomprehension of communication, emotional issues, personal history, and values. When the difference is understood and the resultant behavior properly addressed, most conflict can be settled in a way that provides needed change in an organization and interrelationships.
  •  — In most relationships, conflict is inevitable and it can cause some discomfort. If handled appropriately, conflict can strengthen relationships and improve our understanding of each other. When handled poorly, conflict can cause broken friendships, ended relationships, and long-simmering feuds.
  •  — This site has been established through the joint efforts of the Office of Human Resource Development and Office of Quality Improvement at UW-Madison as a resource to enhance the skills of faculty, staff, and students as they seek to manage conflicts that occur in the campus community and build a positive campus climate.
  •   — The Conflict Resolution Network has put together a toolkit of 12 skills - you can reach in and take out what fits for any occasion.
  •  — The Interest-Based Relational approach to conflict resolution is based on the idea that your role as a manager is not simply to resolve conflict but to ensure that team members feel respected and understood, and that you appreciate their differences.

7. Mentorship

  • * — Discover the importance of introspection and mentorship to successfully transition from radiology residency to academic faculty. Key points include alignment of goals with those of the institution, formation of a mentorship program, and periodic reassessment of career goals.
  •  — In this article, the authors define mentorship and discuss the challenges faced by junior faculty members in academic radiology, the value of mentorship in helping junior faculty members overcome these challenges, stages of mentorship, strategies to implement mentorship, and threats to successful sustained mentorship in radiology.
  •  — The purpose of this study is to determine the effects of a formal mentorship program (FMP) on the well-being of Otolaryngology-Head and Neck surgery resident (OHNSR) physicians. It is the first study to show that FMP can potentially alleviate high levels of stress and burnout within a surgical residency program and achieve higher levels of personal satisfaction as well as overall quality of life.
  • * — A study which evaluates the impact of organizational leadership on the professional satisfaction and burnout of individual physicians working for a large health care organization. It shows that leadership qualities of physician supervisors appear to impact the well-being and satisfaction of individual physicians working in health care organizations.
  • * — Today, trainees face high levels of burnout, depression, anger, emotional exhaustion, sadness, anxiety, and uncertainty around performance. Career mentoring, a partnership focused on growth and development of the trainee, is rare in today’s postgraduate training environment. However, there is evidence that mentoring is beneficial: those with mentors make more informed career decisions, are more productive, experience less burnout, and have an improved sense of well being than do those without mentors.
  • * — Hypothesizing that physicians who spend more of their time in the aspect of work they found most meaningful would have a lower risk of burnout, the authors suggest that efforts to optimize career fit may promote physician satisfaction and help to reduce attrition among academic faculty physicians.
  •  — In this study of effective mentoring, the Mentoring Across Differences sessions are workshops designed to develop and nurture skills, tools, self-awareness, and mindful practice in mentors and mentees. The workshops encourage participants to gain confidence in navigating differences across a variety of domains.

8. Inclusion and Diversity

  • * — Discover the key steps that practice leaders can take to address the needs of women in radiology.

9. Communication

  •  — A new analysis published in Current Problems in Diagnostic Radiology addressed the many ways radiologists can benefit from direct communication with patients.
  • * — This article uses fictional case vignettes as a vehicle to discuss the complex way organizational and individual factors contribute to physician burnout. It incorporates a review of the current literature on physician burnout focusing on workplace inefficiency and ineffective leadership.
  • * — The authors sought to determine whether an intensive educational program in mindfulness, communication, and self-awareness is associated with improvement in primary care physicians’ well-being, psychological distress, burnout, and capacity for relating to patients.
  •  — Learn how patient-physician communication improves care, decreases the risk of medical error and increases clinicians’ joy at work.
  •  — This study on nurses suggests a decreasing trend in burnout related to communication skills training, and since this is an effective and inexpensive way for reducing burnout, its implementation should be considered by leadership.
  •  — The article touches on the Cleveland Clinic's model of relationship-centered communication called R.E.D.E. Rather than being provider-centered or patient-centered, this model is relationship-centered.
  •  — Developing effective communication skills improves patients' understanding of their illness, increases patients' adherence to treatment and helps oncologists avoid professional burnout.
  •  — This article introduces the Communication Curriculum for Radiology Residents developed by the ACR PFCC Committee, as well as describes the research behind it and how radiology residency program directors can use it.
  •  — This is an online learning module is part of the Professional Well-Being section of the STEPS Forward program and delineates interventions focused on improving communications.

10. Harassment and Bullying

  •  — There's no question that bullying is endemic in medical education. One study revealed that about half of residents and fellows in the U.S. reported being bullied, most often by their attending physicians. Canadian researchers found that 78% of residents surveyed reported being bullied and harassed in their training, often by attendings or program directors.
  •  — Workplace bullies can be hard to detect because they work within the rules of the organization. That means that the solutions lie within the organizational structure.
  •  — We need to ensure that people feel safe and empowered to share their concerns and create a workplace culture where no one feels they are laboring in obscurity.
  •  — While seasoned clinical professionals may tell you that bullying has always been present at patient care facilities, some experts believe it’s on the rise, likely because of health policy changes putting massive financial pressures on the healthcare system.
  •  — In order to develop robust and effective interventions for bullying there is consequently a need for further research on the nature, risk groups antecedents, and consequences of bullying through the use of advanced and sound methodological designs and a well-developed theoretical framework.
  •  — The Workplace Bullying Institute is dedicated to the eradication of workplace bullying and offers help for individuals, research, books, public education, training for professionals-unions-employers, legislative advocacy, and consulting solutions for organizations.
  •  — Workplace culture impacts all aspects of a business, from day-to-day functioning to the organization's bottom line. In his book, From Bully to Bull's Eye, Andrew Faas describes three types of workplace cultures: dictatorial, disjointed, and stable.

11. Humor at Work

  •  — According to research, every chuckle brings with it a host of business benefits. Laughter relieves stress and boredom, boosts engagement and well-being, and spurs not only creativity and collaboration but also analytic precision and productivity.

12. Self-care

  •  — The authors found that radiologists who spent more than 7 hours per day at a computer workstation were more likely to experience higher total pain, most commonly in the neck, lower back, upper back, right shoulder, and right wrist.
  •  — Ergonomic approaches, such as proper reading room structure, lighting, temperature, noise, and equipment setup, can help decrease the frequency and severity of repetitive strain injuries and improve radiologist productivity.
  •  — Medical student and resident leadership share their perspectives on how to increase physician well-being and prevent burnout.
  •  — Pressure in the high-stakes environment of medical training can be overwhelming. This video from Mayo Clinic and the American Foundation for Suicide Prevention explains how everyone can help prevent suicide by being alert for the signs of depression and escaping stress and how to be most helpful.

13. Resilience

  • * — Most radiology residents reported high levels of personal achievement but routine symptoms of emotional exhaustion and depersonalization. Finances may be an underappreciated influence on resident burnout, and subjective feelings of financial scarcity could outweigh the impact of objective indebtedness.
  • * — This article reviews causes, preventive measures, and possible solutions for physician (radiologist) burnout.
  • * — A health and wellness task force presents a review of the prevalence, causes, and impact of burnout among radiology faculty and trainees, and a discussion on strategies for overcoming burnout and promoting overall health and well-being among radiologists.
  •  — This curriculum serves as an introduction for medical trainees and educators to the concept of resilience and teaches skills to help cultivate resilience and promote wellness. 
  •  — In order for faculty to role-model behaviors of wellness, they need to understand what this means and how to incorporate it into their lives.
  •  — It is feasible to implement a low-cost, peer-led wellness curriculum to educate residents and foster an environment during residency training where mindfulness, optimism, gratitude, and social connectedness are the norm.

14. Grand Rounds and Journal Clubs

  • * — Burnout, satisfaction, and other professional challenges for physicians vary by career stage. Efforts to promote career satisfaction, reduce burnout, and facilitate retention need to be expanded beyond early career interventions and may need to be tailored by career stage.
  • * — In this review, the authors highlight recognized stressors in the contemporary radiology workplace and offer practical suggestions for mitigating burnout, improving professional engagement, and promoting wellness. 
  •  — The 2018 Radiology Intersociety Committee reviewed the current state of stress and burnout in our workplaces and identified approaches for fostering engagement, wellness, and job satisfaction. 
  •  — Strategies to reduce burnout include addressing the sources of job dissatisfaction, instilling lifestyle balance, finding reasons to work other than money, improving money management, developing a support group, and seeking help when needed.
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ACR Bulletin: Road to Wellness



In this special issue of the Bulletin, hear personal stories of burnout and resilience.

JACR: Road Map to Foster Wellness

JACR_320

The 2018 radiology Intersociety Committee reviewed workplace burnout and identified approaches for fostering engagement, wellness, and job satisfaction.

Learn More