“I Cannot Take This Any More!”: Preparing Interns to Identify and Help a Struggling Colleague

Background Few programs train residents in recognizing and responding to distressed colleagues at risk for suicide. Aim To assess interns’ ability to identify a struggling colleague, describe resources, and recognize that physicians can and should help colleagues in trouble. Setting Residency programs at an academic medical center. Participants One hundred forty-five interns. Program Design An OSCE case was designed to give interns practice and feedback on their skills in recognizing a colleague in distress and recommending the appropriate course of action. Embedded in a patient “sign-out” case, standardized health professionals (SHP) portrayed a resident with depressed mood and an underlying drinking problem. The SHP assessed intern skills in assessing symptoms and directing the resident to seek help. Program Evaluation Interns appreciated the opportunity to practice addressing this situation. Debriefing the case led to productive conversations between faculty and residents on available resources. Interns’ skills require further development: while 60% of interns asked about their colleague’s emotional state, only one-third screened for depression and just under half explored suicidal ideation. Only 32% directed the colleague to specific resources for his depression (higher among those that checked his emotional state, 54%, or screened for depression, 80%). Discussion This OSCE case identified varying intern skill levels for identifying and assessing a struggling colleague while also providing experiential learning and supporting a culture of addressing peer wellness.