Measuring resilience, performance anxiety and burnout in emergency medicine residents

Background: Medical providers' ability to perform in acute care situations is dependent on a functional mix of background knowledge, procedural skills, and the mental ability to navigate complex matrices of diagnostic challenges. Medical training traditionally measures background knowledge and procedural skills, while the mental skills needed to implement these tools have been sparsely studied. The goal of this single center study is to assess aspects of mental performance including resilience, performance anxiety and burnout in emergency medicine (EM) residents. Methods: We conducted a single-site survey study of EM residents to assess resilience, performance anxiety, and burnout. We used three previously validated scores: Connor Davidson Resilience Scale (CDRISC10), Revised Competitive State Anxiety Inventory-2 (CSAI-2), and the two-question Maslach Burnout Inventory (2QMBI). Higher CDRISC10 scores are associated with greater resilience. The CASI-2 quantifies cognitive anxiety, somatic anxiety, and self-confidence with a higher composite score indicating greater anxiety. A higher 2QMBI score is associated with greater burnout. Invitations to the survey were sent via RedCap. Results: Response rate was 36%. Mean CDRISC10 score was 28 ± 5, CSAI-2 was 32± 9, and 2QMBI was 5.7 ± 3. There was a negative correlation between CDRISC10 and CSAI-2 (r= -0.65, p<0.001), and between CDRISC10 and 2QMBI (r= -0.538, p<0.001). Conclusion: The study demonstrated a negative correlation between resilience and performance anxiety, and a negative correlation between resilience and burnout in a cohort of emergency medicine residents. This study adds to the existing literature that supports integrating resilience training into medical residency training to both improve resilience and reduce performance anxiety and burnout in residents.