Registration

STEP 1: Consent to Participate in a Clinical Research Study

STUDY TITLE: Sustaining and Training for Resilience, Engagement and Meaning

PRINCIPAL INVESTIGATOR: Dr. John Mahan

CONTACT TELEPHONE NUMBER: 615-722-4462

STUDY SPONSOR: Health Services and Resources Administration

1) INTRODUCTION
We invite you to be in this research study. Using this form as a guide, we will explain the study to you. If you have any questions about the study, please ask. If you do not want to be in this study, all regular and standard medical care will still be available to you here at Nationwide Children’s Hospital. Participation is voluntary. You can leave this study at any time.

2) WHERE WILL THE STUDY BE DONE AND HOW MANY SUBJECTS WILL TAKE PART?
This study will be done at several sites, including Nationwide Children’s Hospital. Overall, 10,000 participants will take part in this study. We hope to enroll 1000 participants here at Nationwide Children’s Hospital.

3) WHAT WILL HAPPEN DURING THE STUDY AND HOW LONG WILL IT LAST?
The purpose of this study is to determine how training sessions impact physician and resident mental health, resilience, engagement and connecting to the meaning of their work. Study participation: Participants will fill out questionnaires every six months for the duration of the study. If participants enroll in the training program, they will attend up to 4 STREAM sessions ranging from 60-90 minutes. They will have access to additional optional asynchronous virtual material.

4) WHAT ARE THE RISKS OF BEING IN THIS STUDY?
The risks for this study are no more than what happens in everyday life. Although we will take every precaution, there is a small chance of loss of confidentiality of your study information. No identifiable information will be recorded. This study involves questions or surveys that may make you feel depressed. You should call the Principal Investigator at 614-722-4462 if you notice any changes in your mood, ideas, or behavior. Immediate help is available if thoughts or feelings of hurting oneself come up. Call one of the numbers below or go to the closest Emergency Room.

Nationwide Children’s Psychiatric Emergency Evaluation Center 614-722-1800
Hopeline/Lifeline – 1-800-784-2433 or 1-800-SUICIDE

Although we will take every precaution, there is a small chance of loss of confidentiality of your study information. There may be other risks of being in this research study that are not known at this time.

5) ARE THERE BENEFITS TO TAKING PART IN THIS STUDY?
1.1 Although there may be no benefit to you from being in this study, we hope to learn something that could help others. If you are faculty, you will be eligible to for up to 6 hours of CME. You will also be eligible for up to 6 hours of MOC part 2 credit. Participants who complete the 6 month follow up surveys will be sent a promotional item of their choosing (t-shirt, hat, water
bottle, travel mug or notebook).

6) WHAT ARE THE COSTS AND REIMBURSEMENTS?
There are no costs to participate.

7) WHAT HAPPENS IF I DO NOT FINISH THIS STUDY?
It is your choice to be in this study. You may decide to stop being in this study at any time. If you stop being in the study, there will be no penalty or loss of benefits to which you are otherwise entitled. If at any time the Principal Investigator believes that this study is not good for you, the study team will contact you about stopping.

8) OTHER IMPORTANT INFORMATION
If you are an employee of Nationwide Children’s Hospital or the Research Institute at Nationwide Children’s Hospital, your job or performance appraisal will not be affected in any way if you decline to participate or withdraw your consent to participate in this study.

The Principal Investigator is being paid by Human Resources and Services Administration for the time and knowledge needed to do this study.

Nationwide Children’s Hospital is a teaching hospital and we are committed to doing research. Doing research will enable us to learn and provide the best care for our patients and families. You may be asked to participate in other research studies in the future. You have the right to decide to participate or decline to participate in any future studies. We will not share your contact information with researchers outside Nationwide Children’s Hospital.

9) HOW WILL MY STUDY INFORMATION BE KEPT PRIVATE?
Efforts will be made to keep your study-related information confidential. However, there may be circumstances when this information must be released. For example, personal information regarding your participation in this study may be disclosed if required by state law. The results from this study may be published but your identity will not be revealed. Some of the information collected as part of this study will be sensitive, such as information relating to your mental health. This information will be encrypted in a way that it will not be able to be linked to you. The results from this study may be published but your identity will not be revealed.

10) WHOM SHOULD I CALL IF I HAVE QUESTIONS OR PROBLEMS?
If you have questions about anything while on this study or you have been injured by the research, you may contact the Principal Investigator at 614-722-4462 Monday – Friday, between 9-5 EST. If you have questions, concerns, or complaints about the research; if you have questions about your rights as a research volunteer; if you cannot reach the Principal Investigator; or if you want to call someone else, call (614) 722-2708, Nationwide Children's Hospital Institutional Review Board, (the committee that reviews all research involving human subjects at Nationwide Children’s Hospital).

Constent to Participate(Required)

I have read and agree to the consent to participate information above

STEP 2: Generate your STREAM ID, and use it to register below.

This work is funded from a HRSA grant and you fill out several surveys so we can report process and well-being outcomes. As part of the program, all information is deidentified.

The STREAM eLMS utilizes a unique id to represent yourself, our users. Please click on this a link to generate a StreamID for you to use in the registration form below.

https://streamid.healthcare/

StreamID(Required)

Email(Required)

Password(Required)

Enter Password Confirm Password

Strength indicator

Password must be at least 8 characters long, Passwords must include lowercase and uppercase characters, numbers, and special characters.

Professional Degree 1(Required)

Professional Degree 2

Professional Degree 3

Institution(Required)

Institution Other(Required)

1. How do you gender-identify at this point in time?(Required)

2. How do you identify (check all that apply)?(Required)

African or Afro-Caribbean or Black

Arab or Middle Eastern

Asian or Pacific Islander

Caucasian or European or White

Latino or Latina or Hispanic

Native American or Alaskan Native

Multi-ethnic

I do not identify as any of the above

Prefer not to answer

3. Are you a:(Required)

Resident

Fellow

Faculty (Physician)

APP

Other

Prefer not to answer

4. If Faculty or APP: What is your primary clinical setting:

5. If a resident or fellow what year of training in current program are you in?

6. What is your primary clinical setting?(Required)

7. Age in years:(Required)

8. Check all that apply:(Required)

I come from a rural residential background

I come from a disadvantaged background

I practice in a rural residential area

I practice in a disadvantaged area

9. Right now, I have so much at work to be thankful for.(Required)

10. At this present time, if I had to list everything that I felt grateful for at work, it would be a very long list.(Required)

11. At the present time, life has been good to me at work.(Required)

12. Currently, I couldn’t have gotten where I am today at work without the help of many people.(Required)

13. Although I think it’s important to feel good about my current work accomplishments, I think that it’s also important to remember how others have contributed to my accomplishments.(Required)

14. Although I’m basically in control of my work at the present time, I can’t help but think about all those who have supported me and helped me along the way.(Required)

15. Right now, I feel deeply appreciative for the things others have done for me at work.(Required)

16. Currently, I think that it’s important to “Stop and smell the roses” as it pertains to my work.(Required)

17. Currently, I believe that it’s important to pause often to “count my blessings” at work.(Required)

18. Right now, I think it’s important to enjoy the simple things that pertain to my work.(Required)

19. I have a chance to use my strengths every day at work(Required)

20. I feel like I am thriving at my job(Required)

21. I feel like I am making a meaningful difference at my job(Required)

22. I am often pleasantly fascinated by things that happen at my job(Required)

23. I always bounce back quickly after difficulties:(Required)

24. I always find a solution when something unforeseen happens:(Required)

25. I can adapt to events in my life that I cannot influence:(Required)

26. My mood reliably recovers after frustrations & setbacks:(Required)

27. Events from this work setting affect my life in an emotionally unhealthy way:(Required)

28. I feel burned out from my work(Required)

29. I feel fatigued when I get up in the morning & have to and to face another day on the job(Required)

30. I feel frustrated by my job(Required)

31. I feel I am working too hard(Required)

32. How likely are you to recommend this as a good place to work to a colleague?(Required)

33. Please explain your reasoning for your answer above.

34. Have you completed an individual or group wellness plan?(Required)

Yes

35. (if yes to above) What are the elements of your plan?

36. I obtain a sense of sense of joy/mutual delight through connection with my colleagues at work(Required)

37. I find that through my present work, I am able to connect to the meaning in medicine.(Required)

38. I am currently engaged in a project to improve my workplace (QI, process improvement, etc)(Required)

Yes

39. Do you currently make a conscientious habit of reflecting on your mental health as a vital sign?(Required)

Yes

40. I have become more callous toward people since I took this job(Required)

41. Engagement: I believe that engaging in improving workplace systems/activities supports my well-being.(Required)

42. Feeling nervous, anxious or on edge(Required)

Not at all	Several days	More than half the days	Nearly every day

43. Not being able to stop or control worrying(Required)

Not at all	Several days	More than half the days	Nearly every day

44. Feeling down, depressed, or hopeless(Required)

Not at all	Several days	More than half the days	Nearly every day

45. Little interest or pleasure in doing things(Required)

Not at all	Several days	More than half the days	Nearly every day

46. In the last month, how often have you felt that you were unable to control the important things in your life?(Required)

47. In the last month, how often have you felt confident about your ability to handle your personal problems?(Required)

48. In the last month, how often have you felt difficulties were piling up so high that you could not overcome them?(Required)