Mount Sinai St. Luke’s-West-ICAHN School of Medicine
New York, NY
Abstract Authors: Mirna Mohanraj, MD; Nisha Kotecha, MD; Janet Shapiro, MD
Program Director: Mirna Mohanraj, MD
Type of Program: Pulmonary/Critical Care
BACKGROUND
Humanism in healthcare is characterized by a compassionate relationship between physician and patient. It reflects attitudes and behaviors that are sensitive to the values and background of others. Trainee burnout, poor cross-cultural interactions and limited understanding of how patients experience illness are a few factors that impair trainees’ provision of humanistic care. Inattention to wellbeing may lead to job dissatisfaction, emotional exhaustion and psychological impairment. We developed a fellow-devised and fellow-directed curriculum to strengthen practice of patient-centered care and to promote physician well-being.
METHODS
A needs assessment was compiled from previously validated questionnaires on mindfulness, stress and burnout. Nine fellows completed the questionnaire. Each month, a fellow leader – under faculty supervision - becomes a ‘mini-expert’ in a curriculum topic by exploring relevant materials and creating an interactive discussion forum. Session topics range from moral distress to spirituality in medicine to resilience in training. Fellow participants are engaged via various techniques and resources including meditation, literature and narrative medicine. In addition, the program addresses several ACGME-mandated areas of focus: recognition of impairment in self and peers; fatigue mitigation; accountability to patients, society and the profession; sensitivity to a diverse patient population; leadership and communication.
RESULTS
Selected notable results from the needs assessment include: 78% felt emotionally drained after work; 33% stated they have difficulty respecting patient values in decision-making; 45% reported that they talked about work in a negative way; 22% reported they did their job mechanically; 56% felt that work demands interfered with relieving patient suffering; 33% felt they did not tolerate work pressure well. After five sessions, the baseline questionnaire was re-administered with marked improvements in several areas. Only 22% felt emotionally drained after work; zero fellows felt they had difficulty respecting patient values in decision-making, and 12% reported talking about work in a negative way. While the course is in its early stages, qualitative reviews indicate that learned strategies are immediately applicable to self-care and patient care. As supervisors and mentors to junior trainees, fellows model learned strategies in daily interactions. Faculty have been inspired to engage via literature review and faculty development sessions in topics of humanism and well-being.
DISCUSSION
Trainee-devised programs in humanism and wellbeing may be more impactful than those devised at the program- or system-level. This is a unique program where fellows are both leaders and participants. The curriculum can be easily adopted and adapted (with zero financial investment) for medical trainees at any level.
