graduate medical education office ( GME ) involved in wellness initiatives and a research nurse with experience in qualitative research . Because two of the investigators are involved in resident evaluation and may have perceived conflict of interest , they were not involved in participant selection , did not have direct contact with participants , and only reviewed blinded results of the surveys and interviews .
SURVEY
A survey assessing wellness techniques and challenges was developed by the authors CS and SS ( members of the Resident Wellness Committee ). Content validity was strengthened through the review and agreement of three authors ( CS , PD , and SS ) on the questions ’ readability , clarity , and comprehensiveness . An email with a link to the REDCap survey was sent to all residents at WVU SoM ( n = 450 ) asking for their examples ( short answers ) of ways in which their wellness has been supported or inhibited by faculty members , their program , co-residents , and nursing and ancillary staff . In addition , the residents were asked about their own techniques to foster wellness and about negative wellness experiences . The respondents could choose to return an anonymous survey or self-identify as willing to participate in a face to face interview .
INTERVIEWS
The survey also asked for volunteers to participate in a face to face interview about their wellness experiences . Because of a paucity of possible enrollees , all potential participants were included . After written informed consent , all interviews were conducted in a private office or via telephone by a trained research nurse ( PD ), audio recorded , and professionally transcribed . The interviews lasted 30-60 minutes each . See Table 1 for interview guide . The interview guide was informed by the role-based survey responses aiming to understand how they fit into Hale ’ s modified framework . All transcripts were checked for accuracy with the audio recordings by investigators . The transcribed interviews were deidentified and uploaded into NVivo 9 for organization . Content analysis was utilized as the methodological orientation underpinning the analysis . Two co-investigators preliminarily
TABLE 1 : Semi-Structured Interview Guide 1 . Can you tell me what factors make your residency easier for you ?
2 . How has it been for your families , significant other , or close friends dealing with you being a resident ?
3 . How do you deal with the demands of residency versus those of your personal relationships ? How do you deal with them when they are in direct conflict ?
4 . Have you ever felt that you needed a break from you medical training ? How did you deal with this ?
5 . Can you tell me about any strategies you currently use to self-manage your own wellness ?
6 . What barriers prevent you from effectively managing your wellness ? 7 . How do you feel the experience of internship ( residency ) has changed you ?
8 . If you could change one thing in your day-to-day clinical or educational environment that you feel would benefit your overall wellbeing , what would that one thing be ?
9 . Have you ever used any of the resources offered ? If so , which ones ? Did you find them helpful ? Why or why not ?
10 . Are you aware of the WVU SoM ' s GME Well-being Program ? What are your thoughts on this program ?
11 . Is there anything else you would like to share with me about your experiences as a resident that I have not asked about ?
* WVU SoM : West Virginia University School of Medicine
reviewed the interviews and constructed a codebook based upon Hale ’ s framework . 7 Memo writing and group discussion were utilized to verify coding and expand themes . An audit trail was maintained throughout . Methodological rigor was enhanced by triangulation back to the survey results as well as investigator triangulation . To strengthen the reliability of results , two researchers coded the transcripts independently before comparing codes and assigning labels within the framework . The analysis team included two researchers , both with qualitative research experience ( PD and CS ). Methods were compared against the consolidated criteria for reporting qualitative research checklist . 10
RESULTS PARTICIPANTS
The response rate was 11 % ( N = 51 ). Although 20 residents indicated they would be open to being interviewed and provided their contact information , seven semi-structured interviews were completed . The participants included four men and three women from seven different program specialties , which included residents in their second through fifth post-graduate years of training ( See Table 2 ).
SURVEY
The write-in results for the email survey were reviewed and categorized in terms of role-specific interventions ; similar and duplicate answers were removed . A summary of these results is presented in Table 3 and Table 4 .
INTERVIEWS
Interview data was analyzed using Hale ’ s adapted framework as the theoretical framework for the qualitative analysis . Representation was found across all the major categories of these themes as follows :
Basic Physiologic Needs
Time is discussed as a basic need for residents and is referenced in many physiologic needs such as sleeping , exercise , and mental health . Many residents described how a lack of time was a primary concern and a most valued resource . Control over time was often discussed in terms of in-
West Virginia Medical Journal • March 2022 • 19