**5. Emotional intelligence, wellness, and cultural transformation**

Physician burnout remains a sobering affair [57, 58]. It may be particularly egregious in medical residency [59]. Family medicine, internal medicine, and

#### *Emotional Intelligence and Leadership Development: Implications for Family Medicine… DOI: http://dx.doi.org/10.5772/intechopen.99463*

emergency medicine residents may be at particularly high risk given they are often on the "front lines" of care [60]. The side effects of burnout may include: unethical and bad-mannered behavior [61], patient-care mistakes [60, 62], and physicians quitting their practice [63, 64].

The benefits of cultivating psychosocial proficiencies in medical learners may include mitigation of contempt, anxiety, and improvement in clinical ability [65]. It may also further reduce grave medical oversights as well as better-quality bonds with contemporaries and patients [66]. Rather than focusing on the diagnosis and treatment of emotional fatigue and depersonalization among residents, there has been a more recent push in the direction of the formation of a scholastic philosophy of wellness [67]. An alternative residency culture has been proposed as a framework [68]. **Figure 6** is a schematic representation of an emotionally intelligent learning community [69].

With physician burnout a grave concern and a scarcity of evidence on successful tactics to diminish it during residency, an intervention to lower burnout through an emphasis on wellness, safety, and interpersonal skills in a family medicine program was proposed. In a mixed-methods case study that utilized results from three quantitative self-reported instruments for well-being, along with content analysis of transcripts from 20 focus groups and 33 resident advising sessions described experiences of family medicine residents in a single site enrolled between July 2007 and June 2012 [69].

In this intervention, no statistically significant quantitative differences in the well-being of residents compared with the family medicine faculty and staff was discovered; however residents in general recognized the nurturing culture of the program. While individuals' commentaries about experiences during residency were unique, analysis revealed six recurrent themes (**Figure 7**). Although wellbeing scores for residents and the community did not change during the intervention, resident feedback over the five years showed they acknowledged purpose of the curriculum changes, recognized the new curricular practices, and respected the importance of physical and emotional wellness.

It should be pointed out that not every learner will embrace the innovations of emotional intelligence, leadership-development, or other form of wellness curriculum and some may even have utter contempt for the methodology. Still, even being able to articulate this disdain creates a culture of safety and helps dissipate the "culture of silence" that is all too often pervasive in academic medicine [70].

#### **Figure 6.**

*Representation of an emotionally intelligent learning community.*

#### **Figure 7.** *Six recurrent themes of an emotionally intelligent learning community.*

What's more, scholastic culture change utilized by a program that focuses on EI may provide ample time and space for residents to reflect on what it means to be a doctor without any modifications to the day-to-day clinical obligations of the residents. Lastly these interventions may help regulate resident's feelings as they move between different stress levels throughout their training [71].

It has been difficult to find interventions that reduce burnout during residency. Limited evidence supports duty hour reductions, a revised grading system, mindfulness training, and self-development groups to prevent burnout in medical students and residents [72]. An electronic reflective writing portfolio has been created as a professional identity development tool, which provides opportunities for residents to explore work-life balance, resiliency, and burnout prevention [73]. There are calls for GME to reform the way medicine is taught and to place more emphasis on the heart and mind of a clinician [74]. Future research should include multisite studies and control sites with less emphasis on well-being as well as studies that follow residents into practice to determine if long-term benefits exist.
