A Scalable Model for Resident and Faculty Well-Being: Applying Self-Determination Theory and the Job Demands-Resources Framework in Graduate Medical Education

Description Despite growing attention to burnout in graduate medical education (GME), many institutional efforts remain fragmented and lack theoretical coherence. In response, HCA Healthcare developed a system-wide initiative grounded in Self-Determination Theory (SDT) and the Job Demands-Resources (JD-R) framework to guide leadership development, learning climate improvement, and resident and faculty well-being. What began as a single-program effort evolved into a multi-year, system-wide initiative involving more than 5800 residents across 366 programs at 85 hospitals. In collaboration with workplace psychologists from Claremont Graduate University and Immersyve Health, the initiative integrated theory-informed leadership workshops, validated assessment platforms, and continuous quality-improvement processes to help programs identify workplace demands, strengthen resources, and support basic psychological needs. Preliminary findings suggest that programs led by directors who participated in Resident Experience and Retention Summit (RERS) workshops were associated with higher resident retention and improvements in Workforce Interests and Needs Survey (WINS) metrics related to well-being, program affinity, and perceived leadership support. This paper describes the development, scaling, and early outcomes of this initiative and offers a practical roadmap for other GME systems seeking to translate motivation science into sustainable improvements in resident and faculty well-being.