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Acad Med. 2020 Feb 25. doi: 10.1097/ACM.0000000000003243. [Epub ahead of print]

Designing Well-Being: Using Design Thinking to Engage Residents in Developing Well-Being Interventions.

Author information

1
L.R. Thomas is associate professor, Division of Hospital Medicine, Zuckerberg San Francisco General Hospital and Trauma Center, and Department of Medicine, University of California, San Francisco, San Francisco, California. R. Nguyen is assistant professor, Division of Hospital Medicine, Zuckerberg San Francisco General Hospital and Trauma Center, and Department of Medicine, University of California, San Francisco, and assistant health officer, San Francisco Department of Public Health, San Francisco, California. A. Teherani is professor, Division of General Internal Medicine, and education scientist, Center for Faculty Educators, University of California, San Francisco, School of Medicine, San Francisco, California. C.R. Lucey is professor, Department of Medicine and Office of Medical Education, University of California, San Francisco, San Francisco, California. E. Harleman is professor, Division of Hospital Medicine, Zuckerberg San Francisco General Hospital and Trauma Center, and Department of Medicine, University of California, San Francisco, San Francisco, California.

Abstract

PROBLEM:

Improving well-being in residency requires solutions that focus on organizational factors and the individual needs of residents, yet there are few examples of successful strategies to address this challenge. Design thinking (DT), or human-centered design, is an approach to problem solving that focuses on understanding emotions and human dynamics and may be ideally suited to tackling well-being as a complex problem. The authors taught residents to use DT techniques to identify, analyze, and address organizational well-being challenges.

APPROACH:

Internal medicine residents at the University of California, San Francisco completed an 8-month DT program in 2016-2017. The program consisted of 4 2-hour workshops with small group project work between sessions. In each session, resident teams shared their progress and analyzed emerging themes to solve well-being problems. At the conclusion of the program, they summarized the final design principles and recommendations that emerged from their work and were interviewed about DT as a strategy for developing well-being interventions for residents.

OUTCOMES:

Eighteen residents worked in teams to design solutions to improve: community and connection; space for reflection; peer support; and availability of individualized wellness. The resulting recommendations led to new interventions to improve well-being through near-peer communities. Residents emphasized how DT enhanced their creative thinking and trust in the residency program. They reported that not having enough time to work on projects between sessions and losing momentum during their clinical rotations were their biggest challenges.

NEXT STEPS:

Residents found DT useful for completing needs assessments, piloting interventions, and outlining essential design principles to improve well-being in residency. DT's focus on human values may be particularly suited to developing well-being interventions to enhance institutional community and culture. One outcome-that DT promoted creativity and trust for participants-may have applications in other spheres of medical education.

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