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Taste of Boston
Taste of Boston

P4: Plenary Session 4

RS13 - A Prospective Trial of Program-Led Wellness Interventions on Trainee Well-Being, Results from Four Years of the Vascular Arm of the SECOND Trial

Thursday, June 11, 2026
11:37 AM - 11:44 AM ET
Location: Hynes CC, Third Level, Ballroom B

    Presenting Author only(s)

  • Christina L. Cui, MD, MS

    Vascular Surgery Resident Physician
    Division of Vascular and Endovascular Surgery, Department of Surgery, Duke University, Durham, NC
    Duham, North Carolina

    • Co-Author(s)

  • Margaret A. Reilly, MD, MS

    Vascular Surgery Resident Physician
    Division of Vascular Surgery, Department of Surgery, Northwestern University, Chicago, IL
    Chicago, Illinois

  • YJ

    Yue Jiang

    PhD
    Department of Statistical Science, Duke University, Durham, NC

    • Submitting Author only(s)

  • TZ

    Tara J. Zielke

    Vascular Surgery Resident Physician
    Division of Vascular Surgery, Department of Surgery, Indiana University, Indianapolis, IN
    Indianapolis, Indiana

    • Co-Author(s)

  • EP

    Eric B. Pillado

    Assistant Professor of Vascular Surgery
    Division of Vascular Surgery, Department of Surgery, Stanford University, Palo Alto, CA

  • RL

    Ruojia Debbie Li

    Assistant Professor of Vascular Surgery
    Division of Vascular Surgery, Department of Surgery, Rush University Medical Center, Chicago, IL

  • JE

    Joshua S. Eng

    PhD
    Surgical Outcomes and Quality Improvement Center, Department of Surgery, Indiana University School of Medicine, Indianapolis, IN
    Indianapolis, Indiana

  • LG

    Leanne E. Grafmuller

    Assistant Professor, Division of vascular and endovascular surgery
    The University of Tennessee Health Science Center, Memphis, TN

  • KD

    Kathryn L. DiLosa

    Assistant Professor, Department of Surgery
    Division of Vascular and Endovascular Surgery, Department of Surgery, Louisiana State University School of Medicine, New Orleans, LA
    New Orleans, Louisiana

  • Guillermo A. Escobar, MD

    Associate Professor of Vascular Surgery
    Division of Vascular Surgery, Department of Surgery, Emory University School of Medicine, Atlanta, GA
    Atlanta, Georgia

  • Palma M. Shaw, MD, MBA

    Professor of Surgery
    Division of Vascular Surgery, Department of Surgery, Upstate Medical University, Syracuse, NY
    Syracuse, New York

  • YH

    Yue-Yung Hu

    Associate Professor of Surgery
    Division of Pediatric Surgery, Ann and Robert H. Lurie Children's Hospital, Department of Surgery, Northwestern University, Chicago, IL
    Chicago, Illinois

  • KB

    Karl Y. Bilimoria

    Chair, Department of Surgery
    Department of Surgery, Indiana University School of Medicine, Indianapolis, IN
    Indianapolis, Indiana

    • Senior Author(s)

  • Malachi G. Sheahan, III, MD

    Department Head and Professor
    Division of Vascular and Endovascular Surgery, Department of Surgery, Louisiana State University School of Medicine, New Orleans, LA
    New Orleans, Louisiana

    • Senior Author Discussant(s)

  • Dawn M. Coleman, MD

    Chief, Division of Vascular and Endovascular Surgery and Professor of Surgery
    Division of Vascular and Endovascular Surgery, Department of Surgery, Duke University, Durham, NC
    Durham, North Carolina

Objectives: Burnout remains pervasive among vascular surgery trainees, and effective program-level interventions are lacking. This study evaluated whether individualized program feedback reduces trainee burnout and whether supplemental implementation resources provide additional benefit. We report results from the vascular surgery arm of the Surgical Education Culture Optimization Through Targeted Interventions Based on National Comparative Data (SECOND) Trial, a program-led, prospective, pragmatic trial designed to improve the learning environment and well-being of U.S. surgical trainees.

Methods: From 2020 to 2024, vascular surgery training programs were included if their affiliated general surgery program was enrolled and followed identical randomization. Trainee well-being and learning environment metrics were collected from a survey administered after the Vascular Surgery In-Training Examination (VSITE). Control programs received annual program-specific trainee well-being reports. Intervention programs received these reports, a Wellness Toolkit of ready-to-implement interventions, and implementation support. The primary outcome was burnout, defined as weekly emotional exhaustion or depersonalization. Multivariable mixed-effects logistic regression assessed the association between intervention exposure and burnout, adjusting for trainee demographics, program characteristics, learning environment factors, and random program intercepts.

Results: 968 total trainee responses (480 intervention and 488 control) from 43 programs (23 intervention, 20 control) across four years (2020, 2021, 2022, and 2024) were analyzed. Overall, 40% of responses (n=390) reported weekly burnout symptoms, with burnout prevalence declining over time. Trainees in intervention programs were more frequently junior residents, attending academic programs in the Midwest, parents, and single. They also more frequently reported adverse learning environment factors and had higher burnout prevalence (Table I). After adjusting for trainee and program characteristics, intervention program assignment was not significantly associated with reduction of burnout (adjusted odds ratio [aOR] 1.16, 95% CI 0.88–1.54). Burnout was significantly associated with work-hour violations (aOR 2.73, 95% CI 2.13–3.50) and perceived program non-responsiveness (aOR 5.15, 95% CI 2.81–9.43). Racially and ethnically underrepresented trainees had lower adjusted odds of reported burnout (aOR 0.70, 95% CI 0.55–0.88). Female trainees (aOR 1.35, 95% CI 1.06–1.73) and trainees in relationships (aOR 1.54, 95% CI 1.13–2.09) had higher adjusted odds of burnout (Table II).

Conclusions: A program-led wellness intervention was not independently associated with reduced burnout among vascular surgery trainees. Female gender and modifiable learning environment characteristics, particularly duty-hour compliance and perceived lack of program responsiveness, were strongly associated with burnout. These findings highlight the need for targeted interventions addressing program culture and accountability to meaningfully improve trainee well-being.