Understanding drivers of influenza-like illness presenteeism within training programs: A survey of trainees and their program directors

Background: Working with influenza-like illness (ILI) is pervasive throughout health care. We assessed knowledge, attitudes, and practices regarding ILI presenteeism of both postgraduate trainees and program leaders. Methods: This survey study was conducted at the Montefiore Medical Center, Albert Einstein College of Medicine, a large academic center in the Bronx, New York. Internal medicine and subspecialty house staff and program directors completed an anonymous electronic survey between April 23 and June 15, 2018. Results: A total of 197 of 400 (49%) house staff and 23 of 39 (59%) program leaders participated; 107 (54%) trainees and 6 (26%) program leaders self-reported ILI presenteeism in the past 12 months. More than 90% of trainees and program leaders reported that ILI presenteeism places others at risk. Only 9% of program leaders accurately estimated trainee ILI presenteeism prevalence. Both cited “not wanting to burden colleagues” as the top reason for ILI presenteeism. Twenty-six (24%) trainees practiced ILI presenteeism on critical care units. The majority reported that they would provide patient care with upper respiratory symptoms without fever. Most trainees incorrectly answered influenza knowledge questions. Conclusions: ILI presenteeism prevalence is high within training programs at our medical center. Program leaders can model best practices, enforce nonpunitive sick-leave policies, and ensure infection prevention competencies are met annually.